A Systematic Review of Zoonotic Enteric Parasites Carried by Flies, Cockroaches, and Dung Beetles

Filth flies, cockroaches, and dung beetles have been close neighbors with humans and animals throughout our joint histories. However, these insects can also serve as vectors for many zoonotic enteric parasites (ZEPs). Zoonoses by ZEPs remain a paramount public health threat due to our close contact with animals, combined with poor water, sanitation, and hygiene access, services, and behaviors in many global regions. Our objective in this systematic review was to determine which ZEPs have been documented in these vectors, to identify risk factors associated with their transmission, and to provide effectual One Health recommendations for curbing their spread. Using PRISMA guidelines, a total of 85 articles published from 1926 to 2021 were reviewed and included in this study. Qualitative analysis revealed that the most common parasites associated with these insects included, but were not limited to: Ascaris spp., Trichuris spp., Entamoeba spp., and Cryptosporidium spp. Additionally, prominent risk factors discovered in the review, such as poor household and community WASH services, unsafe food handling, and exposure to domestic animals and wildlife, significantly increase parasitic transmission and zoonoses. The risk of insect vector transmission in our shared environments makes it critically important to implement a One Health approach in reducing ZEP transmission.

Sustainable Water and Sanitation in Sierra Leone: Impact evaluation of the ‘Improved WASH Services in WAU and WAR Districts’ project

Between October 2016 and March 2019, the Freetown WASH Consortium, led by Oxfam with Against Hunger, Concern Worldwide and Save the Children as members, carried out the 'Improved WASH Services in Western Area Urban (WAU) and Western Area Rural (WAR) Districts' project. Broadly, the project aimed to improve the availability, accessibility, affordability and sustainability of integrated water, sanitation and hygiene (WASH) services, in alignment with the Government of Sierra Leone's national agenda on Ebola recovery and increased preparedness against possible future outbreaks. This Effectiveness Review evaluates the success of this project to increase the sustainability of water and sanitation systems and services. Using a quasi-experimental, mixed method evaluation design, impact is assessed among individuals, households and communities in intervention and comparison areas. Community-level factors contributing to better individual- and household-level outcomes are explored. Find out more by reading the full report now.

The impact of a demand-side sanitation and hygiene promotion intervention on sustained behavior change and health in Amhara, Ethiopia: A cluster-randomized trial

Behaviors related to water, sanitation, and hygiene (WASH) are key drivers of infectious disease transmission, and experiences of WASH are potential influencers of mental well-being. Important knowledge gaps exist related to the content and delivery of effective WASH programs and their associated health impacts, particularly within the contexts of government programs implemented at scale. We developed and tested a demand-side intervention called Andilaye, which aimed to change behaviors related to sanitation, personal hygiene, and household environmental sanitation. This theory-informed intervention was delivered through the existing Ethiopian Health Extension Programme (HEP). It was a multilevel intervention with a catalyzing event at the community level and behavior change activities at group and household levels. We randomly selected and assigned 50 kebeles (sub-districts) from three woredas (districts), half to receive the Andilaye intervention, and half the standard of care sanitation and hygiene programming (i.e., community-led total sanitation and hygiene [CLTSH]). We collected data on WASH access, behavioral outcomes, and mental well-being. A total of 1,589 households were enrolled into the study at baseline; 1,472 households (94%) participated in an endline assessment two years after baseline, and approximately 14 months after the initiation of a multi-level intervention. The intervention did not improve construction of latrines (prevalence ratio [PR]: 0.99; 95% CI: 0.82, 1.21) or handwashing stations with water (PR: 0.96; 95% CI: 0.72, 1.26), or the removal of animal feces from the compound (PR: 1.10; 95% CI: 0.95, 1.28). Nor did it impact anxiety (PR: 0.90; 95% CI: 0.72, 1.11), depression (PR: 0.83; 95% CI: 0.64, 1.07), emotional distress (PR: 0.86; 95% CI: 0.67, 1.09) or well-being (PR: 0.90; 95% CI: 0.74, 1.10) scores. We report limited impact of the intervention, as delivered, on changes in behavior and mental well-being. The effectiveness of the intervention was limited by poor intervention fidelity. While sanitation and hygiene improvements have been documented in Ethiopia, behavioral slippage, or regression to unimproved practices, in communities previously declared open defecation free is widespread. Evidence from this trial may help address knowledge gaps related to challenges associated with scalable alternatives to CLTSH and inform sanitation and hygiene programming and policy in Ethiopia and beyond. Trial registration: This trial was registered with clinicaltrials.gov (NCT03075436) on March 9, 2017.

Galvanising and fostering sub-national government leadership for area-wide sanitation programming

Government leadership at both the national and sub-national levels is an essential step towards ensuring safely managed sanitation services for all. Though the importance of sub-national government leadership for water, sanitation and hygiene is widely acknowledged, to date much of the focus has been on the delivery of water services. This article sets out to start to address this imbalance by focusing on practical ways to galvanise and foster sub-national government leadership for sanitation programming. By focusing on the experiences across three sub-national areas in East Africa where positive changes in the prioritisation of sanitation by local governments have been witnessed, we (a group of researchers, local government representatives and development partner staff) cross-examine and identify lessons learnt. The results presented in this paper and subsequent discussion provide practical recommendations for those wishing to trigger a change in political will at the local level and create the foundation to strengthen sanitation governance and the wider system needed to ensure service delivery for all.

Post-conflict development, reviewing the water sector in Somalia

Somali post-conflict development faces many challenges that affect the sustainability of the water sector. This paper reviews and analyses the post-conflict development activities in the water sector through local communications and reviewing published materials and databases from international players in Somalia, funding agencies and financial tracking service. The paper has shown that there has been great attention and support given to the country during its post-conflict development. However, most of these initiatives and projects have focused on emerging issues such as tackling food security and water, sanitation and hygiene services. The paper also shows that the continuous funding of emerging issues in Somalia has reduced its long-term sustainability of the water sector and limited its national and long-term benefits but has increased corruption due to increase the gap between actors and local people. Therefore, new transparent cooperative initiatives are needed based on transparent involvement and coordination among donors, local authorities and implementers to improve and develop the water sector and the livelihood in Somalia through a solid water governance system.

Evaluating the Impact of (WASH) Program on Education in the New Juaben North Municipal of Ghana: Evidence from SDA College Demonstration Basic Schools

The study assessed the causes of inefficiencies in the WASH programme at the Demonstration Basic Schools in the New Juaben North Municipal Assembly; examined the effects of the inefficiencies on the learners at the schools, and suggested appropriate strategies to improve the WASH programme. The researcher employed a qualitative approach to achieve these objectives. The population included headteachers, teachers and learners for the study. The study used purposive sampling technique to select 8 participants. This comprised three head teachers, two teachers and three learners from the school. The findings of the study showed that challenges that confront the WASH programme at the schools were inadequate water supply, poor sanitation and hygiene systems, lack of adequate handwashing points, unclean and not properly maintained toilets, lack of quality toilet facilities, lack of menstrual hygiene management (MHM), inadequate sanitary materials, and unhygienic toilet conditions. It is recommended that the government and authorities should improve the WASH system in the school. Moreover, adequate WASH facilities should be provided considering the various guidelines for WASH to ensure that facilities are adequate, sufficient, accessible, and safe for use by learners. Also, the Ghana Education Service should infuse sanitation education into the new or existing curriculum.