scholarly journals Improving Risk Assessments by Sanitary Inspection for Small Drinking-Water Supplies—Qualitative Evidence

Resources ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 71 ◽  
Author(s):  
Katherine Pond ◽  
Richard King ◽  
Jo Herschan ◽  
Rosalind Malcolm ◽  
Rory Moses McKeown ◽  
...  
Keyword(s):  
Drinking Water ◽  
Assessment Tool ◽  
World Health Organisation ◽  
Ease Of Use ◽  
World Health ◽  
Remedial Action ◽  
Water Supplies ◽  
Qualitative Evidence ◽  
Operations And Maintenance

Small drinking-water supplies face particular challenges in terms of their management. Being vulnerable to contamination but often not monitored regularly nor well-maintained, small drinking-water supplies may pose consequences for health of users. Sanitary inspection (SI) is a risk assessment tool to identify and manage observable conditions of the water supply technology or circumstances in the catchment area that may favour certain hazardous events and introduce hazards which may become a risk to health. This qualitative research aimed to identify the strengths and weaknesses of the SI tool as published by the World Health Organisation to inform a review and update of the forms and to improve their robustness. The study identified a number of benefits of the approach, such as its simplicity and ease of use. Challenges were also identified, such as potential for inconsistencies in perception of risk between inspectors, in interpreting questions, and lack of follow-up action. The authors recommend a revision of the existing SI forms to address the identified challenges and development of complementary advice on possible remedial action to address identified risk factors and on basic operations and maintenance.

scholarly journals Detection of trace arsenic in drinking water: challenges and opportunities for microfluidics

2021 ◽  
Author(s):  
Nevetha Yogarajah ◽  
Scott S. H. Tsai
Keyword(s):  
Drinking Water ◽  
World Health Organisation ◽  
Arsenic Contamination ◽  
Ease Of Use ◽  
World Health ◽  
Arsenic Detection ◽  
Routine Monitoring ◽  
Challenges And Opportunities ◽  
Sensitivity And Selectivity ◽  
Economic Constraints

Arsenic contamination of drinking water is a major global problem, with contamination in Bangladesh deemed most serious. Although the current World Health Organisation (WHO) maximum contamination limit (MCL) for arsenic in drinking water is 10 μg L−1, due to practical and economic constraints, the standard limit in Bangladesh and many other developing nations is 50 μg L−1. We propose that an ideal arsenic sensor, designed for routine monitoring, will have five essential qualities: sensitivity and selectivity for arsenic; speed and reliability; portability and robustness; reduced health and environmental risks; and affordability and ease of use for local technicians. It is our opinion that many of these characteristics can be accentuated by microfluidic systems. We describe candidate colorimetric, electrochemical, biological, electrophoretic, surface-sensing, and spectroscopic methods for arsenic detection; and comment on their potential for portable microfluidic adaptation. We also describe existing developments in the literature towards the ultimate creation of microfluidic total analysis systems (μTASs) for arsenic detection. The fundamental purpose of this review is to highlight the need for better portable arsenic contamination detection, and describe how microfluidic technology may be developed to address this need.

scholarly journals Detection of trace arsenic in drinking water: challenges and opportunities for microfluidics

2021 ◽  
Author(s):  
Nevetha Yogarajah ◽  
Scott S. H. Tsai
Keyword(s):  
Drinking Water ◽  
World Health Organisation ◽  
Arsenic Contamination ◽  
Ease Of Use ◽  
World Health ◽  
Arsenic Detection ◽  
Routine Monitoring ◽  
Challenges And Opportunities ◽  
Sensitivity And Selectivity ◽  
Economic Constraints

Arsenic contamination of drinking water is a major global problem, with contamination in Bangladesh deemed most serious. Although the current World Health Organisation (WHO) maximum contamination limit (MCL) for arsenic in drinking water is 10 μg L−1, due to practical and economic constraints, the standard limit in Bangladesh and many other developing nations is 50 μg L−1. We propose that an ideal arsenic sensor, designed for routine monitoring, will have five essential qualities: sensitivity and selectivity for arsenic; speed and reliability; portability and robustness; reduced health and environmental risks; and affordability and ease of use for local technicians. It is our opinion that many of these characteristics can be accentuated by microfluidic systems. We describe candidate colorimetric, electrochemical, biological, electrophoretic, surface-sensing, and spectroscopic methods for arsenic detection; and comment on their potential for portable microfluidic adaptation. We also describe existing developments in the literature towards the ultimate creation of microfluidic total analysis systems (μTASs) for arsenic detection. The fundamental purpose of this review is to highlight the need for better portable arsenic contamination detection, and describe how microfluidic technology may be developed to address this need.

scholarly journals A Novel Mobile Health Tool for Home-Based Identification of Neonatal Illness in Uganda: Formative Usability Study

10.2196/14540 ◽  
2019 ◽  
Vol 7 (8) ◽  
pp. e14540 ◽  
Author(s):  
Madison Vanosdoll ◽  
Natalie Ng ◽  
Anthony Ho ◽  
Allison Wallingford ◽  
Shicheng Xu ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Health Workers ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Ease Of Use ◽  
World Health ◽  
Severe Illness ◽  
Home Setting ◽  
Danger Signs ◽  
Neonatal Assessment

Background While early identification of neonatal illness can impact neonatal mortality rates and reduce the burden of treatment, identifying subtle clinical signs and symptoms of possible severe illness is especially challenging in neonates. The World Health Organization and the United Nations Children’s Fund developed the Integrated Management of Neonatal Childhood Illness guidelines, an evidence-based tool highlighting seven danger signs to assess neonatal health. Currently, many mothers in low-resource settings rely on home visits from community health workers (CHWs) to determine if their baby is sick. However, CHWs visit infrequently, and illness is often detected too late to impact survival. Thus, delays in illness identification pose a significant barrier to providing expedient and effective care. Neonatal Monitoring (NeMo), a novel neonatal assessment tool, seeks to increase the frequency of neonatal screening by task-shifting identification of neonatal danger signs from CHWs to mothers. Objective This study aimed to explore the usability and acceptability of the NeMo system among target users and volunteer CHWs by assessing ease of use and learnability. Methods Simulated device use and semistructured interviews were conducted with 32 women in the Iganga-Mayuge districts in eastern Uganda to evaluate the usability of the NeMo system, which involves a smartphone app paired with a low cost, wearable band to aid in identification of neonatal illness. Two versions of the app were evaluated using a mixed methods approach, and version II of the app contained modifications based on observations of the first cohort’s use of the system. During the posed scenario simulations, participants were offered limited guidance from the study team in order to probe the intuitiveness of the NeMo system. The ability to complete a set of tasks with the system was tested and recorded for each participant and closed- and open-ended questions were used to elicit user feedback. Additionally, focus groups with 12 CHWs were conducted to lend additional context and insight to the usability and feasibility assessment. Results A total of 13/22 subjects (59%) using app version I and 9/10 subjects (90%) using app version II were able to use the phone and app with no difficulty, despite varying levels of smartphone experience. Following modifications to the app’s audio instructions in version II, participants’ ability to accurately answer qualitative questions concerning neonatal danger signs improved by at least 200% for each qualitative danger sign. All participants agreed they would trust and use the NeMo system to assess the health of their babies. Furthermore, CHWs emphasized the importance of community sensitization towards the system to encourage its adoption and regular use, as well as the decision to seek care based on its recommendations. Conclusions The NeMo system is an intuitive platform for neonatal assessment in a home setting and was found to be acceptable to women in rural Uganda.

Imaging in low-grade glioma: a guide for neurologists

2017 ◽  
Vol 18 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Jennifer Larsen ◽  
Nigel Hoggard ◽  
Fiona M McKevitt
Keyword(s):  
Surgical Planning ◽  
World Health Organisation ◽  
Low Grade Glioma ◽  
World Health ◽  
Low Grade ◽  
The Central Nervous System ◽  
Contemporary Management

The management of low-grade glioma (LGG) is shifting as evidence has emergedthat refutes the previously commonplace imaging-based ‘watch and wait’ approach, in favour of early aggressive surgical resection. This coupled with the recent 2016 update to the World Health Organisation Classification of Tumours of the Central Nervous System is changing LGG imaging and management. Recently in Practical Neurology the contemporary management of low-grade glioma and the changes to this grading system were discussed in detail. 1 In this complementary article, we discuss the role of imaging in the diagnosis, surgical planning and post-treatment follow-up of LGG. We describe the principles of imaging these tumours and use several cases to highlight some difficult scenarios.

scholarly journals Groundwater Quality Analysis of Domestic Water Sources from Hand Dug Wells In Gwallameji, Bauchi State

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Olufunmilayo I Ndububa ◽  
Abubakar U Ardo
Keyword(s):  
Drinking Water ◽  
Water Samples ◽  
Health Workers ◽  
Water Sources ◽  
World Health ◽  
Quality Analysis ◽  
Domestic Water ◽  
Water Supplies ◽  
Environmental Interventions ◽  
Dug Wells

Lack of access to safe and adequate domestic water supplies contributes to poverty levels through the economic costs of poor health and the high proportion of household expenditure on safe water supplies. Gwallameji, a community on the outskirts of Bauchi town has no access to municipal water supply from Bauchi town, groundwater water, mainly hand dug wells are used as domestic water sources. The quality of water available from these hand dug wells  in the community were determined by the physical, chemical and biological parameters of the water samples collected from domestic water points in the community. The results from the water samples were compared with World Health Organization (WHO) Standards for Drinking Water. High levels of Nitrate and Chromium above recommended levels from the standard were found in all water samples. Concentrations of Calcium highest value of 213mg/l and Magnesium a highest value of 22.02 mg/l at levels higher than recommended levels for drinking water were also obtained in all samples. It was recommended that restrictions on farming activities with use of fertilizers and location of latrines around domestic water sources should be enforced. Hand dug wells should be at a distance of at least 30m from soak away pits and pit latrines. Well lining and cover should be provided for all hand dug wells to reduce contamination of water from these sources. Increased and continued environmental interventions through public health education by community based health workers, awareness and sensitization campaigns should be carried out for improved household and community sanitation in the area.

Ultrasonographic determination of thyroid volume in infants and children from Aegean region of Turkey and comparison with national and international references

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Edis Çolak ◽  
Behzat Özkan ◽  
Sinan Genç ◽  
Burak Polat
Keyword(s):  
Standard Deviation Score ◽  
Body Height ◽  
Thyroid Volume ◽  
World Health Organisation ◽  
World Health ◽  
Turkish Children ◽  
Aegean Region ◽  
Normal Ranges

Abstract Objectives Accurate diagnosis and follow-up of pediatric patients with thyroid disorders, depends on the availability of appropriate data for normal thyroid volume (TV). The aim of this study was to determine the TV by ultrasonography (US) in subjects from the newborn period up to 18 years of age from the Aegean region of Turkey. Methods We measured the thyroid volumes in 513 children using US and compared them with the children’s age, gender, standard deviation score (SDS) of body height (BH-SDS), body weight (BW-SDS), body mass index (BMI-SDS), and body surface area (BSA-SDS). The 3rd, 50th, and 97th percentiles of the age-dependent distribution of the TV were calculated and compared with national and international references. Results The BH, BW, BMI, and BSA of all the participants were within the normal ranges for Turkish children. The TV was significantly positively correlated with age, gender, BH-SDS, BW-SDS, BMI-SDS, and BSA-SDS in all subjects (r=0.748, r=0.267, r=0.730, r=0.735, r=0.664 and r=0.735, respectively; p<0.0001 for all). The most important predictors for TV were age and BW-SDS, followed by BSA-SDS and BH-SDS. In multivariate regression, age and BW-SDS were the only significant independent predictors for TV. Our results were nearly similar to the corresponding data reported by the World Health Organisation in 2004. Conclusions The present study provides updated values for TV that can serve as a potential tool in differentiating the normal from the abnormal size of the thyroid gland in children aged 0–18 years from the Aegean region of Turkey.

scholarly journals Telehealth-based diagnostic testing in general practice during the COVID-19 pandemic: an observational study

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0123
Author(s):  
Rae-Anne Hardie ◽  
Gorkem Sezgin ◽  
Chisato Imai ◽  
Emma Gault ◽  
Precious McGuire ◽  
...  
Keyword(s):  
General Practice ◽  
Observational Study ◽  
Diagnostic Testing ◽  
World Health Organisation ◽  
Estimating Equation ◽  
World Health ◽  
Test Collection ◽  
Face To Face ◽  
Health Technologies

BackgroundSince the World Health Organisation declared COVID-19 a pandemic on 11 March 2020, health technologies have been rapidly scaled up to ensure access to care. A significant innovation has been telehealth in general practice. Now widespread, it remains unknown how this shift to virtual care has impacted on quality-of-care indicators such as pathology testing and diagnosis.AimTo undertake a comparison of telehealth and face-to-face general practice consultations to: identify if there were differences in the proportion of pathology test referrals from 2019-2020; and quantify any change in pathology test collection and follow-up patterns.Design and SettingRetrospective observational study of routinely collected electronic patient data from 807 general practices across New South Wales and Victoria, Australia.MethodMultivariate generalised estimating equation models were used to estimate the proportion of pathology test referrals for: overall, face-to-face, and telehealth consultations. Pathology test follow-up was described through median (and interquartile range (IQR)) time.ResultsPathology test referrals declined during periods of high COVID-19 cases, falling from 10.8% in February 2020 to a low 4.5% during the first peak in April. Overall, pathology test referrals were lower for telehealth than face-to-face. Median time between referral and test collection was 3 days (IQR 1–14) for telehealth and 1 day (IQR 0–7) for face-to-face.ConclusionFor telehealth to become part of routine care, it is crucial that gaps in functionality, including difficulty in test referral processes, be addressed. Quality improvements supporting care practices will ensure clinicians’ workflows are supported and patients receive diagnostic testing.

scholarly journals Comparative Studies of Water and Sediment Qualities of Some Dams in Kwara State

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
N Abdus-Salam
Keyword(s):  
Heavy Metals ◽  
Drinking Water ◽  
Oxygen Demand ◽  
Anthropogenic Pollution ◽  
World Health Organisation ◽  
World Health ◽  
Total Hardness ◽  
Who Guidelines ◽  
Water And Sediment

Potable water is becoming progressively scarce due to anthropogenic pollution and it has necessitated monitoring of water quality of rivers and dams as a subject of ongoing concern and research. This study was conducted to assess the quality of water collected from four different dams (Agba, Igbaja, Oloru and Omu-Aran) in Kwara State, Nigeria using standard procedures. Water and sediment samples were collected from three different spatial locations on the dams. The average values of most physicochemical parameters like pH, temperature, Dissolved Oxygen (DO), Biochemical Oxygen Demand (BOD), Total Dissolved Solid (TDS), Total Hardness (TH), Alkalinity, some nutrients such as chloride (Cl-), sulphate (SO42-), phosphate (PO43-), nitrate (NO3-) and some heavy metals such as Cu, Zn have values that were within World Health Organisation (WHO) guidelines for drinking water for each of the dams while Cd and Fe concentrations were observed to be much higher than WHO guidelines for drinking water. This could be as a result of anthropogenic input. The dams’ sediments analyzed for heavy metals showed that Mn, Zn and Cd were high in the dams, which can be easily washed into the water body through leaching, thereby causing detrimental effect to the consumers.

scholarly journals A STUDY OF AGREEMENT BETWEEN WHO-UPPSALA MONITORING CENTRE CRITERIA, NARANJO ALGORITHM, AND LIVERPOOL ALGORITHM FOR CAUSALITY ASSESSMENT OF ADVERSE DRUG REACTIONS

2021 ◽  
pp. 20-22
Author(s):  
MESSALINE SUNITHA ◽  
SHOBHA PARVATHY
Keyword(s):  
Assessment Tool ◽  
Causality Assessment ◽  
World Health Organisation ◽  
Assessment Tools ◽  
World Health ◽  
Uppsala Monitoring Centre ◽  
Kappa Statistics ◽  
Monitoring Centre ◽  
Naranjo Algorithm ◽  
Uppsala Monitoring

Objective: A standard causality assessment tool of an adverse drug reaction (ADR) is essential to compute the risk-benefit assessment of the medication taken by the patient and categorize its relationship likelihood. It should be reproducible and should not differ with the background and experience of the evaluator. Though there are a large number of causality assessment tools, none is unanimously accepted worldwide. So, this study was done to assess the agreement between three frequently used methods of causality assessment, the World Health Organisation-Uppsala Monitoring Centre (WHO-UMC) system, the Naranjo’s algorithm, and the Liverpool algorithm. Methods: 172 ADR forms from the pharmacovigilance unit were randomly selected for the study. Causality assessment was done using three different methods, the WHO-UMC system, Naranjo’s algorithm, and the Liver pool algorithm. Cohen’s Kappa statistics was applied to look for agreement between the causality assessment methods. Results: The agreement between the WHO-UMC criteria and Naranjo’s algorithm was the highest (136), with a Kappa value of 0.511, suggesting a moderate level of agreement. A maximum number of disagreements were noted between the WHO-UMC system and the Liverpool algorithm method (110). Conclusion: A moderate agreement exists between the WHO-UMC system and the Naranjo algorithm. There is poor agreement between the Liverpool algorithm and the other two scales. Therefore, it is recommended that both the WHO-UMC system and the Naranjo algorithm be used for causality assessment of ADRs.

scholarly journals Measuring retention in care for HIV-positive pregnant women in Prevention of Mother-to-Child Transmission of HIV (PMTCT) option B+ programmes: the Mozambique experience

2019 ◽  
Author(s):  
Laurence Ahoua ◽  
Thierry Tiendrebeogo ◽  
Shino Arikawa ◽  
Maria Laheurta ◽  
Dario Aly ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Retention In Care ◽  
World Health Organisation ◽  
Retention Rates ◽  
World Health ◽  
Hiv Positive ◽  
Appointment Adherence ◽  
Art Initiation ◽  
Sensitivity Specificity

Abstract Background: Failure of retention of HIV-positive pregnant women on ART leads to increased mortality for the mother and her child. This study evaluated different retention measures intended to measure women’s engagement along the continuum of care for PMTCT option B+ services in Mozambique. Methods: We compared ‘point’ retention (patient’s presence in care at 12-months post-ART initiation or any time thereafter) to the following definitions: alive and in care at 12 months post-ART initiation (Ministry of Health); attendance at a health facility up to 15 months post-ART initiation (World Health Organisation); alive and in treatment at 1, 2, 3, 6, 9, and 12 months post-ART initiation (Inter-Agency Task Team); and alive and in care at 12 months post-ART initiation with ≥75% appointment adherence during follow-up (i.e. ‘appointment adherence’ retention) or with ≥75% appointment done on-time during follow-up (i.e. ‘on-time adherence’ retention). Kaplan-Meier survival curves were produced to assess variability in retention rates. We used ‘on-time adherence’ retention as our reference to estimate sensitivity, specificity, and proportion of misclassified patients. Results: Considering the ‘point’ retention definition, 16,840 HIV-positive pregnant women enrolled in option B+ PMTCT services were identified as ‘retained in care’ 12 months post-ART initiation. Of these, 60.3% (95% CI 59.6–61.1), 84.8% (95% CI 84.2–85.3), and 16.4% (95% CI 15.8–17.0) were classified as ‘retained in care’ using MOH, WHO, and IATT definitions, respectively, and 1.2% (95% CI 1.0–1.4) were classified as ‘retained in care’ using the ‘ ≥75% on-time adherence’ definition. All definitions provided specificity rates of ≥98%. The sensitivity rates were 3.0% with 78% of patients misclassified according to the WHO definition and 4.3% with 54% of patients misclassified according to the MOH definition. The ‘point’ retention definition misclassified 97.6% of patients. Using IATT and ‘appointment adherence’ retention definitions, sensitivity rates (9.0% and 11.7%, respectively) were also low; however, the proportion of misclassified patients was smaller (15.9% and 18.3%, respectively). Conclusion: More stringent definitions indicated lower retention rates for PMTCT programmes. Policy makers and programme managers should include attendance at follow-up visits when measuring retention in care to better guide planning, scaling up, and monitoring of interventions.

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