Persuasion factors influencing the decision to use sustainable household water treatment

Solar water disinfection (SODIS) is a sustainable water treatment method. With the help of the sun and plastic bottles, water is treated and illnesses prevented. This paper aims to identify the factors influencing SODIS uptake, that is, why someone may become a SODIS user. This uptake decision can be influenced by persuasion. From behaviour theory, variables are recognised which have been proven to influence intention and behaviour and simultaneously can be influenced by persuasion. A total of (n = 878) structured interviews were conducted in a field study in Zimbabwe. Linear and binary logistic regressions showed that several of the initially proposed persuasion variables have significant influence. Persuasion factors have a stronger influence on the uptake of SODIS use and on intention to use SODIS in the future than on the amount of SODIS water consumed. Ideas are presented for using the effective variables in future SODIS campaigns and campaigns in other fields.     

山东省2016-2017年人群烟草使用及其影响因素调查

目的:了解山东省人群烟草使用现状以及主要影响因素。方法:运用多阶段分层整群抽样方法,在山东省36个区（县）216个村（居委会）抽取调查对象,使用非条件logistic回归模型进行多因素分析。结果:有效调查6 271人,经过复杂加权计算后,≥15岁人群现在吸烟率为23.93%,其中男性为45.58%,女性为1.18%;不...     

Prematurity and associated factors in Santa Catarina State, Brazil, in 2005: an analysis based on data from the Information System on Live Births

The aim of this study was to evaluate the prevalence of preterm birth in the State of Santa Catarina, Brazil, and identify associated factors. Data were obtained from the SINASC database (Information System on Live Births). The chi-squared test and Wald linear trend test between the dependent variable (prematurity) and the covariates were applied. Logistic regression was performed to evaluate the association between factors. In 2005, the preterm birth rate was 6.1% (95% CI: 5.9-6.2). Odds of prematurity were higher among mothers under 20 and over 40 years old, those with fewer prenatal consultations, and those undergoing cesarean sections. Prevalence of prematurity in Santa Catarina appears to be increasing. This scenario suggests the need to encourage prenatal care and discourage cesarean deliveries in order to decrease the prematurity rate. More studies using the existing databases could help identify their shortcomings and improve the quality of the data.     

Microbiological performance of common water treatment devices for household use in India

Diarrhoea and other diseases associated with unsafe drinking water are a leading cause of mortality and morbidity worldwide and in India. Household-based water treatment has been shown to be an effective means of reducing this disease burden. Numerous such devices are manufactured and sold all over the world. We tested the microbiological performance of a leading brand of each of three common types of water treatment devices designed for household use in India: a ceramic candle gravity filter, an iodine resin gravity filter and an iodine resin faucet mounted filter. The ceramic candle filter and the iodine resin faucet filter reduced bacteria by more than 4 logs. However, the reduction of the MS2 phage (surrogate for viruses) and 3 micron microspheres (surrogate for protozoan cysts) in these devices was lower than log 3.4 and log 2.6, respectively. There were also high levels of residual iodide (and in some cases, iodine) in treated water from the iodine-based devices. While household water treatment could play an important role in India, standards are necessary so that consumers can ensure that the devices they purchase and use in the home are effective and safe.     

Intimate partner violence against women in western Ethiopia: prevalence, patterns, and associated factors

Background

Workplace health programs have demonstrated improvements in a number of risk factors for chronic disease. However, there has been little investigation of participant characteristics that may be associated with change in risk factors during such programs. The aim of this paper is to identify participant characteristics associated with improved waist circumference (WC) following participation in a four-month, pedometer-based, physical activity, workplace health program.

Methods

762 adults employed in primarily sedentary occupations and voluntarily enrolled in a four-month workplace program aimed at increasing physical activity were recruited from ten Australian worksites in 2008. Seventy-nine percent returned at the end of the health program. Data included demographic, behavioural, anthropometric and biomedical measurements. WC change (before versus after) was assessed by multivariable linear and logistic regression analyses. Seven groupings of potential associated variables from baseline were sequentially added to build progressively larger regression models.

Results

Greater improvement in WC during the program was associated with having completed tertiary education, consuming two or less standard alcoholic beverages in one occasion in the twelve months prior to baseline, undertaking less baseline weekend sitting time and lower baseline total cholesterol. A greater WC at baseline was strongly associated with a greater improvement in WC. A sub-analysis in participants with a 'high-risk' baseline WC revealed that younger age, enrolling for reasons other than appearance, undertaking less weekend sitting time at baseline, eating two or more pieces of fruit per day at baseline, higher baseline physical functioning and lower baseline body mass index were associated with greater odds of moving to 'low risk' WC at the end of the program.

Conclusions

While employees with 'high-risk' WC at baseline experienced the greatest improvements in WC, the other variables associated with greater WC improvement were generally indicators of better baseline health. These results indicate that employees who started with better health, potentially due to lifestyle or recent behavioural changes, were more likely to respond positively to the program. Future health program initiators should think innovatively to encourage all enrolees along the health spectrum to achieve a successful outcome.     

Community and household socioeconomic factors associated with pesticide-using,small farm household members' health: a multi-level,longitudinal analysis

Background  

Longitudinal studies using multi-level models to examine health inequalities in lower and middle income countries (LMICs) are rare. We explored socio-economic gradients in health among small farm members participating in a pesticide-related health and agriculture program in highland Ecuador.     

Clean water,sanitation and diarrhoea in Indonesia: Effects of household and community factors

Diarrhoea is an important health issue in low- and middle-income countries, including Indonesia. We applied a multilevel regression analysis on the Indonesian Demographic and Health Survey to examine the effects of drinking water and sanitation facilities at the household and community level on diarrhoea prevalence among children under five (n?=?33,339). The role of the circumstances was explored by studying interactions between the water and sanitation variables and other risk factors. Diarrhoea prevalence was reported by 4820 (14.4%) children, who on average were younger, poorer and were living in a poorer environment. At the household level, piped water was significantly associated with diarrhoea prevalence (OR?=?0.797, 95% CI: 0.692–0.918), improved sanitation had no direct effect (OR?=?0.992, 95% CI: 0.899–1.096) and water treatment was not related to diarrhoea incidence (OR?=?1.106, 95% CI: 0.994–1.232). At the community level, improved water coverage had no direct effect (OR?=?1.002, 95% CI: 0.950–1.057) but improved sanitation coverage was associated with lower diarrhoea prevalence (OR?=?0.917, 95% CI: 0.843–0.998). Our interaction analysis showed that the protective effects of better sanitation at the community level were increased by better drinking water at the community level. This illustrates the importance of improving both drinking water and sanitation simultaneously.     

Immunization status of children in Nepal and associated factors, 2016

BackgroundNepal has made substantial improvements in childhood immunization uptake. However, vaccination levels are still below the country-specific Sustainable Development Goal target of 94.8% coverage by 2025 for children aged 12–23 months who received all immunizations recommended in the national immunization schedule by their first birthday. A better understanding of the predictors of full immunization can inform successful programmatic interventions to improve coverage while also guiding resource allocation to ensure all children are fully vaccinated. This study estimates childhood immunization coverage in Nepal and characterizes the association between immunization status and various sociodemographic predictors.MethodsData from the 2016 Nepal Demographic and Health Survey were used to examine the immunization status of children aged 12–23 months. Immunization status was categorized as fully immunized (receiving all recommended doses), under-immunized (receiving at least one, but not all, recommended doses), and un-immunized (not receiving any doses of any vaccine). Associations between full and under-immunization and potential sociodemographic predictors were assessed using logistic regression.ResultsAmong 976 children, 78.2% were fully immunized, 21% were under-immunized, and 0.8% were un-immunized. Retention of an immunization card was significantly associated with full immunization status. Mothers who had completed a formal education above secondary school and mothers who were working at time of interview had increased odds of full immunization. Birthing in an institutional setting was also associated with higher odds of full immunization.ConclusionsOverall, immunization coverage in Nepal is relatively high, although it varies by dose and sociodemographic factors. Almost 25% of Nepalese children were not fully immunized, leaving them at increased risk for vaccine-preventable disease related morbidity and mortality. Nepal must continue focused efforts to reach every child and minimize the equity gap; programs may focus on advocating for the use of immunization cards, education and empowerment for girls, and delivery in institutional settings.     

Determinants of exclusive consumption of fluoride-free water: a cross-sectional household study in rural Ethiopia

Aim

The occurrence of high fluoride concentrations in the ground- and surface water all over the world leads to the risk of developing dental and skeletal fluorosis. In Ethiopia, 8 million people depend on water sources with excessive fluoride. In four project areas in the Ethiopian Rift Valley, fluoride removal household filters based on bone char media have been implemented. This study examines possible predictors of consuming filtered water derived from various behavior change theories.

Subject and methods

In a complete cross-sectional survey, 160 filter users were interviewed through structured face-to-face interviews. A logistic regression was carried out to reveal factors predicting consumption of filtered water.

Results

The results show that the consumption of fluoride-free water is mainly related to people’s pride in offering filtered water to guests (status norm) and the feeling of being able to produce enough water with the filter (perceived behavioral control). Moreover, the study showed that the more filter users like the taste of filtered water and the more expensive they perceive the filter media, the more likely users will exclusively consume filtered water (attitudinal beliefs). Furthermore, perceiving the act of filling as a matter of habit (perceived habit) enhances filtered water consumption.

Conclusion

Based on the results, possible intervention strategies to change the influential psychological factors and, hence, increase the consumption of treated water can be designed.     

Household factors associated with older Australian's purchasing a varied diet: Results from household expenditure data

Objective: To examine the household factors associated with older Australian's (aged 55 years and over) purchasing a varied diet. Design and methods: National cross‐sectional survey. Setting: All states and territories of Australia. Subjects: A total of 1898 households headed by adults aged 55 years and over. Main outcome measures: Food diversity was measured using the Dietary Variety Score (DVS). The DVS is the total number of food items purchased within a two‐week period, from a possible 110 individual food expenditure items. Data analysis: Negative binomial regression was used to examine the association between the respondent's individual and household characteristics with the DVS, after controlling for all factors in the model. Results: Among the demographic factors, living arrangements, age and education are found to be associated with dietary diversity. Lone males, lone females, and households headed by people with no secondary school education, or aged over 75 years were most likely to experience lower levels of dietary diversity. Conclusions: The finding that both poor education and low income in old age are associated with dietary diversity suggests the need for early life‐course interventions to improve nutritional outcomes. Nutrition education programs that also focus on those with poor education and low income, as well as lone person households and those aged over 75 years, may improve nutritional wellbeing, and thereby reduce public health costs.     

Risk factors for active trachoma in children and trichiasis in adults: a household survey in Amhara Regional State, Ethiopia

Identification of risk factors is essential for planning and implementing effective trachoma control programmes. We aimed to investigate risk factors for active trachoma and trichiasis in Amhara Regional State, Ethiopia. A survey was undertaken and eligible participants (children aged 1-9 years and adults aged 15 years and above) examined for trachoma. Risk factors were assessed through interviews and observations. Using ordinal logistic regression, associations between signs of active trachoma in children and potential risk factors were explored. Associations between trichiasis in adults and potential risk factors were investigated using conventional logistic regression. A total of 5427 children from 2845 households and 9098 adults from 4039 households were included in the analysis. Ocular discharge [odds ratio (OR)=5.9; 95% CI 4.8-7.2], nasal discharge (OR=1.6; 95% CI 1.3-1.9), thatch roof in household (OR=1.3; 95% CI 1.0-1.5), no electricity in household (OR=2.4; 95% CI 1.3-4.3) and increasing altitude (Ptrend<0.001) were independently associated with severity of active trachoma. Trichiasis was associated with increasing age (ORper 5 year increase=1.5; 95% CI 1.4-1.7), female gender (OR=4.5; 95% CI 3.5-5.8), increasing prevalence of active trachoma in children (Ptrend=0.003) and increasing altitude (Ptrend=0.015).     

Adherence to antihypertensive treatment and associated factors among patients on follow up at University of Gondar Hospital, Northwest Ethiopia

ABSTRACT: BACKGROUND: Hypertension is an overwhelming global challenge with high morbidity and mortality rates. In Ethiopia 6% and Addis Ababa, 30% of the population has been estimated to have hypertension. Poor adherence is associated with bad outcome of the disease and wastage of healthcare resources. In Ethiopia, particularly in the study area little is known about treatment adherence and associated factors. Therefore this study aimed to assess adherence to antihypertensive therapy and associated factors among HTN patients on follow up at University of Gondar Referral Hospital. METHOD: Institution based cross sectional study was conducted. Systematic sampling technique was used to select 384 participants. A structured standard questionnaire was used after some modifications. Morisky Medication Adherence Scale was used for labeling patients as adherent or non-adherent. Data were entered and analyzed using SPSS version 16. RESULTS: Only 64.6% of the study subjects were found to be adherent to their treatment. Sex (AOR=0.48, 95%CI = 0.28, 0.82), knowledge about HTN and its treatment (AOR=6.21, 95%CI=3.22, 11.97), distance from the hospital (AOR = 2.02, 95% CI =1.19-3.43) and co morbidity (AOR=2.5, 95%CI=1.01, 6.21) variables were found significantly associated with treatment adherence. Conclusion and Recommendations: Only 64.6% of the study subjects were found to be adherent to their treatment. Factors such as sex, distance from the hospital, number of co morbidities, Knowledge about HTN and its treatment were associated with adherence behavior of patients. Early diagnosis and management of co morbidities, adherence counseling and patient education about the disease and its treatment are important to improve adherence status of patients.     

Periods of child growth up to age 8 years in Ethiopia,India, Peru and Vietnam: Key distal household and community factors

Recent research has demonstrated some growth recovery among children stunted in infancy. Less is known about key age ranges for such growth recovery, and what factors are correlates with this growth. This study characterized child growth up to age 1 year, and from ages 1 to 5 and 5 to 8 years controlling for initial height-for-age z-score (HAZ), and identified key distal household and community factors associated with these growth measures using longitudinal data on 7266 children in the Young Lives (YL) study in Ethiopia, India, Peru and Vietnam. HAZ at about age 1 year and age in months predicted much of the variation in HAZ at age 5 years, but 40–71% was not predicted. Similarly, HAZ at age 5 years and age in months did not predict 26–47% of variation in HAZ at 8 years. Multiple regression analysis suggests that parental schooling, consumption, and mothers' height are key correlates of HAZ at about age 1 and also are associated with unpredicted change in HAZ from ages 1 to 5 and 5 to 8 years, given initial HAZ. These results underline the importance of a child's starting point in infancy in determining his or her growth, point to key distal household and community factors that may determine early growth in early life and subsequent growth recovery and growth failure, and indicate that these factors vary some by country, urban/rural designation, and child sex.     

Prevalence of childhood diarrhea and associated risk factors in Dire Dawa,eastern Ethiopia

Aim

Childhood diarrhea caused by enteric bacteria remains an important public health problem in the developing countries. Therefore, this study aimed to determine the prevalence of childhood diarrhea, etiological agents, antibiotic susceptibility patterns and associated risk factors in Eastern Ethiopia.

Subjects and methods

A total of 196 children under the age of 5 years with diarrhea were chosen for the study. Stool specimens were collected for the isolation of bacterial agents and their antibiotic susceptibility pattern using standard methods. Analysis of data was done using SPSS version 16.

Results

The overall prevalence of enteric bacteria observed in this study was 21.9%. The bacterial isolates identified were Escherichia coli (12.8%), Shigella species (5.6%) and Salmonella species (3.6%). Children using an unprotected spring/well source for their water supply were more likely to be infected with diarrhea-causing bacteria (AOR = 4.74, 95% CI: 1.48,15.13). None of the bacterial isolates showed resistance to ceftriaxone, while resistance to amoxicillin was observed for Shigella (100%), Salmonella (85.7%) and E. coli (56%) isolates. Resistance to ampicillin was found to be 90.9%, 71.4% and 52% for Shigella, Salmonella and E. coli isolates. All Shigella isolates were found to be multidrug resistant.

Conclusion

Interventions aimed to improve safe drinking water access should be strengthened/considered in the study area.

     

Correcting and estimating HIV mortality in Thailand based on 2005 verbal autopsy data focusing on demographic factors, 1996-2009

Background

It is known that death registry (DR) underestimates HIV deaths. The objectives of this study were to examine under-reporting/misclassification and to estimate HIV mortality in Thailand during 1996-2009 from a model based on 2005 verbal autopsy (VA) data.

Methods

Logistic regression was used to predict HIV deaths from the VA dataset with and without demographic covariates. This full model was then used to predict individual HIV deaths from the DR dataset of provinces in which VA was conducted. The proportions in the remaining provinces were predicted from spatial interpolation based on coefficients of the VA provinces.

Results

Area under Receiver Operating Characteristic curve of the full model was 0.969 compared to 0.879 of the simple cross-referencing model when demographic covariates were not included. DR-reported HIV deaths accounted for only one-third of all VA-estimated HIV deaths. The most misclassified HIV deaths were those registered as tuberculosis and mental and nervous system. Under-reporting was most common among females and people aged 20-39 years, and effect of province was highest in the upper north and upper south regions.

Conclusions

For approximately two-thirds of all HIV deaths estimated by the full model, the causes were reported under other categories, not HIV. Demographic variables are essential for accurately correcting causes of death from death registries.

     

合肥市2005-2011年儿童血铅水平及影响因素分析

了解2005-2011年合肥市儿童血铅水平、分布特征及变化情况,为制定环境铅污染控制措施、保护儿童健康提供科学依据.方法 采用分层整群随机抽样方法,在合肥市城区采集0~6岁儿童末梢血7 788例,采用原子吸收光谱法检测儿童血铅值,同时对儿童家长进行问卷调查.结果 合肥市儿童血铅平均值为48.53 μg/L,血铅水平≥100μg/L的占2.8%.血铅均值及高血铅率均呈逐年下降趋势.男童的血铅水平均值(51.03 μg/L)高于女童(44.72 μg/L),差异有统计学意义(P<0.01).多元回归分析显示,母亲职业、饭前是否洗手、喂养方式、经常食用膨化食品因素会影响儿童的血铅水平.结论 合肥市儿童血铅水平呈下降趋势,但仍有一定的危害;控制环境铅污染、降低儿童血铅水平是一项长期任务.     

Beyond efficacy in water containers: Temephos and household entomological indices in six studies between 2005 and 2013 in Managua,Nicaragua

Background

A cluster-randomized controlled trial of community mobilisation for dengue prevention in Mexico and Nicaragua reported, as a secondary finding, a higher risk of dengue virus infection in households where inspectors found temephos in water containers. Data from control sites in the preceding pilot study and the Nicaragua trial arm provided six time points (2005, 2006, 2007 and 2011, 2012, 2013) to examine potentially protective effects of temephos on entomological indices under every day conditions of the national vector control programme.

Methods

Three household entomological indicators for Aedes aegypti breeding were Household Index, Households with pupae, and Pupae per Person. The primary exposure indicator at the six time points was temephos identified physically during the entomological inspection. A stricter criterion for exposure at four time points included households reporting temephos application during the last 30 days and temephos found on inspection. Using generalized linear mixed modelling with cluster as a random effect and temephos as a potential fixed effect, at each time point we examined possible determinants of lower entomological indicators.

Results

Between 2005 and 2013, temephos exposure was not significantly associated with a reduction in any of the three entomological indices, whether or not the exposure indicator included timing of temephos application. In six of 18 multivariate models at the six time points, temephos exposure was associated with higher entomological indices; in these models, we could exclude any protective effect of temephos with 95% confidence.

Conclusion

Our failure to demonstrate a significant protective association between temephos and entomological indices might be explained by several factors. These include ecological adaptability of the vector, resistance of Aedes to the pesticide, operational deficiencies of vector control programme, or a decrease in preventive actions by households resulting from a false sense of protection fostered by the centralized government programme using chemical agents. Whatever the explanation, the implication is that temephos affords less protection under routine field conditions than expected from its efficacy under experimental conditions.

Trial registration

ISRCTN 27581154.