Demographic and socio-economic risk factors associated with self-reported TB

BACKGROUND: The infectiousness of Mycobacterium tuberculosis is known to be shaped by the human environment, with research showing positive associations with poverty, homelessness and overcrowding, among other factors. In this study, the focus is primarily on environmental health risks for TB, particularly on those associated with sociodemographic and household living conditions in South Africa.METHODS: Data for this study were collected between 2014 and 2019 from a number of sites implementing community-oriented primary care (COPC) in the Gauteng Province of the country. Community health workers (CHWs) used AitaHealthtm, a custom-built mobile information management application, to obtain data on the TB status and environmental conditions of households. Statistical models were used to determine associations between various demographic, socio-economic and environmental risk factors, and TB.RESULTS: Approximately 12,503 TB cases were reported among 7,769 households. Substance use and male-headed households were found to have significant associations in households with at least one individual with TB. Overcrowding, as well as lack of access to piped water and adequate sanitation were also found to be positively associated with a ‘TB-household.´CONCLUSION: Improvements in housing and services, particularly the provision of piped water and reticulated flush toilets, are needed to control and prevent TB in South Africa.

Embodied Burning, E-Waste Epidemiology, and Toxic Postcolonial Corporality

This chapter introduces the ways in which e-pyropolitics are embodied by exploring the illness narratives and bodily distress experiences of several copper burners. The author draws on ethnographic narratives to explore how Agbogbloshie workers narrate, understand, and refer to their own bodily distress to make sense of the toxic exposures and environmental health risks they face. In addition to exploring how toxic embodiment and experience break down or reconfigure demarcations of body and environment, the author highlights the ways in which toxicity and corporality become the site of laudable environmental health risk mitigation efforts that ironically fail to transform or reduce toxic corporality in an enduring postcolonial context. In this way, the author explores how a solutions-based intervention in Agbogbloshie overlooks the complexity and diversity of eco-corporeal relations in a tech metal extraction zone where bodies, toxins, and economies intersect.

ANALYSIS OF MANAGERIAL COMPONENTS IN MOSQUITO VECTORS (AEDES AEGYPTI) CONTROL IN THE BUFFER AREA OF THE CLASS 1 SURABAYA PORT HEALTH OFFICE

ABSTRACTThe Aedes aegypti index in the buffer area of the Class 1 Surabaya Port Health Office was in accordance with the Standard Operating Procedures (SOP) as stated in the Regulation of the Indonesian Ministry of Health Number 431 of 2007 (431/MENKES/SK/IV/2007) on Technical Guidelines for Control of Environmental Health Risks in Ports/Airports/Cross-Border in the Context of Health Quarantine. The Port Health Office has responsibilities to control environmental risks, one of which was the Aedes aegypti mosquitos in the borders. This study was descriptive observational and aimed to analyze the managerial components in Aedes aegypti mosquito control in the buffer area ofthe Class 1 Surabaya Port Health Office in Surabaya. The research variables (factors that determine control activities) were manpower, money, methods, materials, markets, machines, and information. The research subjects were two officers at Class 1 Surabaya Port Health Office and five cadres who monitored larva. Data were analyzed descriptively. The results explained that manpower, money, materials, market, technology, and information were all in accordance with the SOP of the Surabaya Port Health Office. However, the larva survey method did not comply with the SOP as officers still used the visual method. It was concluded that managerial components in Aedes aegypti control by Class 1 Surabaya Port Health Office followed the SOP except in their larva survey method. The researchers recommended carrying out a larva survey method by taking 1 larva from each container (single larva) at a time. Keywords: Aedes aegypti, control vector, managerial components.

Lead Pollution, Demographics, and Environmental Health Risks: The Case of Philadelphia, USA

Lead (Pb) soil contamination in urban environments represents a considerable health risk for exposed populations, which often include environmental justice communities. In Philadelphia, Pennsylvania (PA), Pb pollution is a major concern primarily due to extensive historical Pb-smelting/processing activity and legacy use of Pb-based paints and leaded gasoline. The U.S. Environmental Protection Agency (USEPA) organized and/or compiled community-driven soil sampling campaigns to investigate Pb content in surface soils across Philadelphia. Using these data (n = 1277), combined with our own dataset (n = 1388), we explored the spatial distribution of Pb content in soils across the city using ArcGIS. While assessing Zone Improvement Plan (ZIP)-code level data, we found strong correlations between factors, such as the percentage of children with elevated blood lead levels (% EBLL) and % minority population as well as between % EBLL and % children in poverty. We developed a “Lead Index” that took demographics, median measured Pb-in-soil content, and % EBLLs into account to identify ZIP codes in need of further assessment. Our results will be used to help lower the Pb-exposure risk for vulnerable children living in disproportionately burdened communities.

Perceived Risk in the Population Living near the Turin Incinerator: Comparison between before and at Three Years of Operation

When the Turin incinerator went into operation in 2013, it was accompanied by surveillance of health effects that included a human biomonitoring survey of 394 residents. They responded to items investigating their awareness of environmental and health issues and perception of environmental health risks. In this study, we compared the questionnaire responses before plant startup and at 3 years of operation. To accomplish this, we investigated changes in perceived risk and evaluated the efficacy of communication strategies. A total of 344 participants equally distributed in an exposed and an unexposed group responded to the follow-up questionnaire. Survey items investigated the perception of a relationship between illness and exposure to environmental pollution, feeling at risk of developing an illness, and concern about natural and anthropogenic hazards. The proportion of ‘certain’ and ‘very probable’ responses was compared to the total using the difference-in-differences method. Analyses showed an overall decrease in the differences between the two groups, which suggests that the communication actions undertaken for the exposed group were effective. Future communication plans should also include initiatives targeting the unexposed group.

The Health-trash Nexus in Challenging Environments: A Spatial Mixed Methods Analysis of Accra, Ghana

Background: Increasing urbanization in Ghana has led to a waste management crisis with multiple public health consequences. The contextualized mapping of what is dumped, where and why might provide vital on-the-ground support to address the problem itself, as well as the spillover disease impacts. One of the biggest challenges, however, are the required spatial and temporal granular data. Methods: In this paper, we employ a spatial mixed methods approach to investigate the issue of waste management through the lens of health and disparity in Teshie, a suburb of Accra, Ghana. Environmental health risks digitized and mapped from these data sources included trash, plant overgrowth, drains and stagnant water. Results: There was an overlaying relationship between trash and open drains. Open drains encouraged the indiscriminate disposal of trash and also served as a cheaper alternative to paying for waste pick up. Poverty played an intricate role in influencing a trash disposal complex at the sub-neighborhood scale.Conclusion: The trash situation in Teshie is a complex one with varied levels of risks for infectious diseases.

Private emptiers' perspectives on the regulation of faecal sludge emptying services in Sub-Saharan Africa

Using a two-round Delphi study, 15 faecal sludge emptiers from 11 cities in Sub-Saharan Africa have expressed views on the regulation of faecal sludge emptying services. Their responses identify the regulatory mechanisms in place where they operate, their opinions of these mechanisms, and prioritisation of those considered most useful to enable safe emptying services for all urban residents. All respondents (100%) support regulation, with 80% finding the regulation they encounter useful. However, all also state that regulatory mechanisms should extend beyond only rules and sanctions, to incorporate support, incentives and pro-poor mechanisms. This study is the first to provide a first-hand account of Sub-Saharan African private emptiers' willingness to accept clear regulation. In that regard, regulation should be flexible and adapted to the context in order to facilitate fair competition, safe and satisfactory service for customers and workers alike, and to alleviate the public and environmental health risks.