Effect of water supply and sanitation on the prevalence and intensity of Ascaris lumbricoides among pre-school-age children in Ajebandele and Ifewara,Osun State,Nigeria

The relationship between Ascaris lumbricoides infection and provisions for safe water supply and excreta disposal was investigated in Ajebandele and Ifewara, 2 peri-urban communities near Ile-Ife, Osun State, Nigeria, from September 1998 to December 1999. Although there were more facilities for safe water supply (pipe-borne and shallow wells) and sanitation (flush toilets and pit latrines) in Ajebandele than in Ifewara, they were not evenly distributed and only a few families, mainly in Ajebandele, were well provided for. Our results indicated that the prevalence of A. lumbricoides was significantly higher in Ifewara (21.2%) than in Ajebandele (13.1%), and within villages was much lower in houses with tap water and flush toilets. However, the mean intensity of infection was unexpectedly higher in Ajebandele (166.5 +/- 692.0) than in Ifewara (153.1 +/- 485.8) suggesting that the present level of investment in Ajebandele is probably not sufficient to reduce morbidity. These findings confirm suggestions that there is a threshold level of investment below which interventions on water supply and sanitation may not significantly improve human health. Sustainable ascariasis control in the study communities will require significant improvements to existing water supplies and sanitation facilities and any future interventions should incorporate a programme of health education to ensure that the facilities provided are properly used and hygienically maintained.     

安徽省农村卫生厕所质量及粪便无害化效果的研究

目的　了解安徽省农村卫生厕所质量及粪便无害化效果。方法　选择安微省WES项目县作为调查县 ,按改厕覆盖率不同选择调查点 ,对调查点的改厕户进行卫生厕所质量和粪便无害化调查。结果　安徽省农村卫生厕所建造质量合格率达 97.7% ,基本无蝇蛆达 94 .0 % ,基本无臭达 94 .2 % ,便纸进行无害化处理率为 84 .0 8% ,便纸篓使用率只有 6 8.6 4 % ,便器清洁只占 70 .4 3% ,无害化合格率为 84 .4 % ,改厕户对卫生厕所满意度为 95 .0 %。结论　安徽省农村建造的卫生厕所质量较高 ,粪便的无害化处理基本得到国家“粪便无害化卫生标准”。     

Piped water supply and intestinal parasitism in Zimbabwean schoolchildren

The prevalence of intestinal parasitism in primary schoolchildren in three areas, communal (peasant farm) lands, commercial farms and urban townships, was assessed by examination of concentrated and stained stool specimens to determine the effect of water supply on intestinal parasitism. Piped water in communal lands was associated with decreased frequency of schistosomiasis and hymenolepiasis, but not with decreased frequency of protozoa. Schistosomiasis was very common in commercial farm labour communities, particularly on farms adjoining the local river, despite the availability of stored borehole water supplied through communal taps. The prevalence of intestinal parasitism in children from urban areas with municipal water supplied to taps in each household was similar to that of children in communal areas who obtained water from surface streams. The frequency of Giardia lamblia infection was higher in urban than in rural schoolchildren, and within communal areas was higher in children with access to protected borehole water. The provision of piped water was, therefore, not found to be associated with reduced prevalence of intestinal parasitism, though additional factors such as frequency of contact with infected water, the provision of ancillary improvements and the actual usage of available water supplies would need to be more closely assessed.     

农村生态卫生厕所综合效益分析研究

目的 对农村生态卫生厕所的综合效益开展研究。方法 通过对恭城等10个地区三种类型厕所的调查，对其综合效益进行比较分析。结果 三格化粪池卫生厕所、三联式沼气池卫生厕所和粪尿分集式生态卫生厕所能达到粪便无害化卫生标准，都具有一定的综合效益。结论 三者都可在农村地区应用，但由于后两者有较高的生态效益和综合效益，更适宜在各种不同地区推广应用。     

Sanitation and hygiene in urban and rural households in East Africa

Latrine possession, disposal of children's faeces and waste-water in 1015 households in 33 sites in Kenya, Tanzania and Uganda were studied in 1997. Assistants conducted interviews and observed the state and use of latrines, disposal of children's faeces, wastewater, and household socio-demographic characteristics. Latrine possession was 92.4% in Uganda, 95% in Kenya and 99.5% in Tanzania. In unpiped sites, 73.5% of Ugandan, 90.5% of Tanzanian and 95% of Kenyan households had latrines. Over 30% of latrines in rural Uganda were contaminated with faeces, compared with 10% in Tanzania. More latrines in urban Kenya and Uganda had contaminated surroundings than in the rural areas. The mean number of people using a toilet in the urban areas (10) was significantly higher than in rural areas (7), (F = 45.5; P < 0.001). Toilets in Kenya and Uganda were more likely to be fouled than in Tanzania. Households where the head was an educated professional or business person, or the toilet had a door, lid or concrete wall or floor or waste water was disposed of in the latrine, were less likely to have fouled toilets. Most households disposed of the faeces safely with a few placing them in the garden or elsewhere. The study emphasises the need to promote appropriate sanitation and hygiene.     

Health and social benefits from improving community hygiene and sanitation: an Indian experience

India is a country where Atomic Age and near Stone Age people co-exist. On one hand India has achieved development in many areas, but on the other hand there is still the practice of open defecation and manual cleaning of human excreta from bucket privies by scavengers. National sanitation coverage is only about 34% meaning that 66% of the population practises open defecation. Such unhygienic conditions lead to infections and high mortality and morbidity in the community. Low sanitation coverage could be due to lack of affordable sanitation technology and awareness or motivation. Although the sewerage system was introduced in India long ago, high operational and maintenance costs have prohibited it from being implemented in most towns and cities. Similarly, the cost of a septic tank is beyond most people, and disposal of undigested sludge from septic tanks remains a problem. In contrast, the pour-flush two-pit toilet (known as Sulabh Shauchalaya) is a low cost, socially acceptable and appropriate technology that does not require scavengers to clean the pits. Sulabh has converted and constructed over 1.2 million such toilets throughout India, making 240 towns scavenger-free. Liberated scavengers are thereby available to take up vocational training in various market-oriented trades enabling self-employment. The on-site/ decentralised systems of waste management has improved community health and hygiene, particularly in socially deprived groups, and reduced the financial burden of local government.     

Slum inhabitants’ perceptions and decision-making processes related to an innovative sanitation service: evaluating the Blue Diversion Toilet in Kampala (Uganda)

The inadequate provision of sanitation in informal urban settlements, also known as slums, continues to be an important issue. New technologies and services are being designed to solve this problem. However, the history of failed sanitation programmes and projects highlights a lack of understanding of how slum inhabitants decide on investing in such products and services. In this paper, we gather perspectives from potential clients and investigate how slum inhabitants (1) perceive the current situation and whether they desire improvements of sanitation, (2) how they evaluate a new toilet that is still in development, and how (3) social processes and (4) constraints affect decisions. Data were collected through interviewing 1538 people within a general household survey. People using shared and public latrines desire an improvement of their sanitation facilities. The lack of water for washing is perceived by residents as a the biggest problem when accessing current latrines. The new toilet was mostly evaluated positively: people like it, expect large health benefits from it and it complies with cultural norms. However, people also expect some problems with the functioning of the toilet and expect opposition to pay for the service, due to the high costs and a lack of space to set up new toilets.     

Can the case-control method be used to assess the impact of water supply and sanitation on diarrhoea? A study in the Philippines.

This study had 2 objectives: 1) to determine whether a case-control approach is an effective measure for assessing the effect of improved sanitation on bacterial diarrhea, and 2) to assess the effects of environmental sanitation on diarrheal disease in Cebu. The study took place during the warm, rainy months (July-September) of 1985. The study population consisted of 281 children under 2 who were treated at 1 of 16 clinics for diarrhea due to Escherichia coli, salmonella, shigella, and Vibrio cholerae. The controls were 384 children under 2 who were brought to the clinics for respiratory ailments and did not have diarrhea. Environmental sanitation was classed as "good" if the bacterial count in the water supply was low (i.e., water was obtained from the municipal water supply or bore holes) and if excreta disposal was adequate (i.e., there were flush toilets, sealed latrines, or pit latrines). Water quantity was measured by the number of times the child was bathed. The effects of the exposure variables on the study children were determined by logistic regression analyses adjusted for confounding variables, which included sex, educational level of the household, breast feeding, attendance at well-baby clinics, number of children under 5 in the household, and frequency of bathing the child. The results of the study showed that improved sanitation reduced the episodes of bacterial diarrhea by 40%, and that case-control studies with sample sizes of about of about 500 cases and 500 controls are adequate to detect disease reductions of 33% or more.     

2004～2005年济南市中央补助地方农村改厕项目实施情况调查

[目的]了解2004～2005年中央补助地方农村改厕项目状况,发现存在的问题,为今后项目的实施提供科学依据。[方法]2007年5月,对实施项目工作的济南市槐荫区和未实施项目的商河县,采取问卷调查和现场调查的方法,项目区与非项目区分别随机抽取了61户农厕和61位村民作对照调查。[结果]项目区61户全部建厕,户厕建筑均符合《农村户厕卫生标准》要求,其中59户为高压节水式,2户为水冲式 56户建在庭院内 贮粪池全部做到定期清掏和无害化处理 村民满意度为100.00%。非项目区61户中,2户为水冲式,粪便直接用于沼气池,其余59户为无盖浅坑型旱厕,粪便未进行无害化处理即用作肥料。村民卫生知识得分4分以上者,项目区（61人）为83.61%,非项目区（61人）为29.51%（P〈0.01） 村民卫生行为得分4分以上者,项目区为95.08%,非项目区为70.49%（P〈0.01）。[结论]中央补助地方农村改厕项目加快了农村改厕工作步伐,村民逐渐养成了良好的卫生习惯,卫生知识知晓率也明显提高。     

Low-cost water supplies and their contribution to health

The importance of low cost water supplies and sanitation facilities is heightened in drought conditions such as occurred in Zimbabwe during 1991-92. A summary of water and toilet systems is given. Zimbabwe must recognize that it is a dry country and adopt water and sanitation services appropriate to the climate. Since 1980, 10,000 water sources have been protected. The Blair Latrine has been installed in 300,000 locations and uses little or no flush system, is odorless, free of insects, and doubles as a bathroom. The target is to install 1.4 million Blair toilets, 576 piped water supplies, and 36,000 primary water supplies between 1985-2005. When piped water supplies are used in conjunction with the Blair toilet, a tank replaces the soil-lined pit. A Harare based company is currently manufacturing a 1-liter flush toilet instead of a 10-liter one. The Vonder Rig is another technological improvement being tested by the Blair Research Institute, which is effective in drilling through soils and rocky areas in the Epworth area which has a high water table. However, Epworth water supplies were installed in just a few homes; wells currently in use are placed too close to pit latrines and are dry due to the drought. Save the Children Fund (SCF) has been involved with rural water programs, but finds hauling water to rural areas too expensive. People must move into the city with friends and relatives. A SCF engineer has upgraded and dug 1000 wells in the past year, and finds that the Vonder Rig is suitable only where the water is near the surface and soil conditions are right. The SCF has improved existing wells by reinforcing the well lining and headworks and adding a long-lasting windlass plus an apron and cover for prevention of contamination. The SCF develops ways of obtaining water through rural participation. Africare, a US nongovernmental organization, prefers digging boreholes and has completed 800 at a cost of $10 million. However, boreholes dry out, suffer mechanical failures, and must be maintained. For communal wells, the pumps are associated with lower bacteria counts of E. coli. The Bush Pump has been found to be most successful, but cost prevents wide-scale use. Since 1991, upgrading wells has become a strategy, based on trial data. UNICEF has rated Zimbabwe highly concerning the number of people with access to safe water; hopefully, when normal rainfall returns, safe water supplies will also.     

Public toilets down the drain? Why privies are a public health concern

Whether you call it the loo, john, privy, lavatory or toilet, this facility is essential wherever humans gather or live: toilet provision has even been called the barometer of civilization. The modern development of public toilets dates from the late 19th century when sewer systems and water supplies provided hygienic means of dealing with waste, facilitated by public health legislation that also permitted local authorities to provide toilets in town centres. Yet the statutes in the United Kingdom, where the flushing toilet as we know it was invented, never went so far as to require provision of these facilities outside the home. Pressure on resources during the last 20 years has led to many public toilets being closed, for example, 40% of those in London, or to entry charges that reduce accessibility. At the same time an increasingly mobile population has made public toilets even more necessary. Recent public inquiries into public toilet provision in the UK have revealed the impact of the paucity of facilities on the elderly, women, families with young children, ill health that increases the need for toilet use, visitors and poor or homeless members of the community. There has been little attention in public health on the provision of public toilets. With street urination on the increase and less free access to toilets, it is time for public health to recognize a great need and to campaign to turn the tide on public toilet closures, with imaginative planning strategy and associated opportunities to encourage hand washing and other hygiene health promotion.     

Defecation practices of young children in a Peruvian shanty town.

Little is known about feces disposal practices, their determinants and feasibility for change, despite their importance in the control of diarrheal diseases. We report here the results of formative research for the development of an intervention to promote sanitary disposal of feces of young children. The study was conducted in a densely populated shanty town area of Lima, where water and sanitation systems are scarce. In-depth interviews were undertaken with mothers, husbands and community leaders. Group discussions were held with mothers in order to validate findings from the interviews, investigate particular topics further and explore reactions to possible intervention strategies. The principal defecation sites for young children were diapers, potties, the ground in or near the home, the hill, latrines and flush toilets. The main determinants found were the age of the child, the effort required by the method, perceptions of dirtiness and the availability of resources. Almost all children under one year of age use diapers but the high resource cost of diaper washing is a strong motivation for mothers to move their children on as early as possible. Potties were considered the most socially acceptable and 'hygienic' defecation method for children between one and three years of age. Nevertheless, defecation directly onto the ground is common at this age. Potty training is deemed to be quite difficult and the long term achievements are determined by the initial training success. In most cases, the training process is authoritative and inconsistent. The use of latrines and flush toilets is not considered appropriate for children until they are three to four years old. Based on these initial findings, a micro-trial was conducted to assess the feasibility and acceptability of promoting greater use of potties and associated practices. The results of the trial were very encouraging and provided valuable information for the design of a community-wide intervention. Our findings help explain why the emphasis given in most sanitation projects, where efforts have been concentrated on the promotion of latrines, has failed to induce their utilization by small children. Sanitation projects should incorporate interventions that will promote hygienic defecation and stool clearance practices for infants and small children.     

广东省农村学校厕所及卫生设施现状分析

目的了解广东省农村学校厕所卫生与垃圾污水处理状况,为推进农村学校基础卫生设施的改善工作提供依据。方法抽取广东省富裕县、相对宽裕县和贫困县各2个,每县抽取10所农村中小学校,共抽取60所农村学校,对厕所及卫生设施进行现场调查,并抽取1 845名在校学生进行肠道寄生虫感染情况检测。结果 72.4%的学校使用卫生厕所;男生厕所蹲位合格率为30.5%,女生厕所蹲位合格率为10.2%;69.5%的学校厕所没有专人管理;28.1%的厕所粪便未经任何处理随意排放。45.0%的学校污水直接排入河道沟渠或随意排放;6.7%的学校垃圾随意堆放或焚烧。74.2%的学生反映厕所清洁状况差;81.4%的学生反映厕所有苍蝇;49.1%的女生反映上厕所要排队。13.5%的学生感染肠道寄生虫,在富裕地区有3.7%学生感染肝吸虫。结论广东省部分农村学校厕所管理与垃圾污水的处理均存在卫生安全隐患。亟待完善农村学校基础卫生设施的配置,加强卫生监督和管理工作。     

农村改厕对蝇类种群密度影响及卫生效果评价

目的了解济南地区农村改厕对蝇类种群密度的影响，评价农村改厕的卫生效果。方法卫生效果评价以蝇类种群密度为指标，采用捕蝇笼诱捕法。结果农村改厕申家庄、明理和七里堡3村，平均蝇密度为3．6只·笼^-1·8h^-1；未改厕的西铺、清水坡和西张3个对照村，平均蝇密度为65．93只·笼^-1·8h^-1，改厕农村蝇类种群密度与未改厕农村相比，平均下降了94．54％（t’=4．18，t’0.01=3．01，P〈0．01）。结论农村改厕使农户用上了节水型高压水冲式卫生户厕，能够使蝇类种群密度大幅度下降，农民的生活环境质量得到明显改善和提高，卫生效果良好。     

农村生态卫生厕所卫生效果评价

目的 评价农村粪尿分集式生态卫生厕所的卫生效果。方法 监测广西农村45户农户粪尿分集式生态卫生厕所的使用维护情况及卫生效果,按GB7959—87《粪便无害化卫生标准》进行卫生学评价。结果 新型农村粪尿分集生态卫生厕所基本无臭味的农户比例为91．1％,基本无蝇蛆的农户占88．9％,无昆虫的比例为73．3％,生态卫生厕所使用3个月后,粪便无害化合格率可以达到75％以上。结论 粪尿分集式生态卫生厕所适合广西农村的粪便无害化处理。     

农村改厕与卫生防病效果分析

目的：探讨粪便无害化处理对控制肠道传染病和寄生虫病的效果。方法：对卫生厕所普及率、粪便无害化处理率与常见乙类肠道传染病及发病率及蠕虫卵的感染率进行统计分析。结果：随着卫生厕所普及率及粪便无害化处理率的逐年提高，3种肠道传染病（痢疾，伤寒，肝炎），蠕虫卵感染率从1991年的175．14／10万,76.88%逐年下降，到2000年三种肠道传染病发病率下降到57．78／10万，下降了67．01％，蠕虫卵感染率下降至22．16％，下降了71．17％，结论：粪便无害化处理具有明显的卫生防疫效果，在农村应大力普及粪便无害化处理厕所。     

农村环境卫生改良对控制腹泻病的效果评价和经济效益分析

河南省长葛农村经饮水改良和粪便无害化处理后使腹泻病得到控制。试验村1983年腹泻发病率为48%,1986年建起简易集中式供水系统后发病率降至28.2%;改水后再加上修建双瓮漏斗型厕所,使腹泻发病率降至11.08%,较1983年下降76.92势。单纯改水使4岁以下儿童发病减少3/4;改水和改厕可使各年龄组发病率降低54%~79%,对降低6~10月腹泻发病高峰效果显著,但病原分布无明显差异。该两项措施人均投资46.31元,一年内由疾病减少、节省挑水劳力和积肥可获23.53元效益,效益与费用比值(BCR)为0.51。预计总投资可在2年内自身偿还,第三年及以后的BCR为4.42。     

云南省建水县农村环境卫生现状调查结果

目的了解云南省建水县农村户厕和粪便处理,垃圾、污水治理情况,为制定农村爱国卫生相关规划和策略措施提供科学依据。方法根据随机的原则,选取5个乡镇20个村,每村5户为调查点,采用统一调查表入户调查。结果建水县农民以初中文化为主,主要经济来源为种植业,村内道路以部分硬化为主,集中式供水覆盖率为66．1％;卫生厕所普及率为69．5％,厕室大多有臭味和蝇蛆,粪便以直接施肥为主。垃圾主要是生活垃圾,随意堆放占60．0％,所有堆放点都有臭味和苍蝇,主要采用焚烧和填埋方式处理。生活污水明沟排放为主。79．0％的人家房屋周围有病媒生物孳生地,大多数家庭有鼠迹、蟑螂和苍蝇。土壤监测蛔虫卵阳性率15．0％。结论建水县农村垃圾、污水、粪便无害化处理率低,环境卫生状况亟需进一步改善。     

Developing an effective policy for home hygiene: a risk-based approach

Evaluation of the infection potential in the home suggests that improved hygiene practice could significantly reduce the impact of infectious diseases. Fundamental to developing infection prevention policy for the home is the need to recognise that people live in an environment where all human activities occur, including food and water hygiene, hand hygiene, and hygiene related to care of vulnerable groups. In all these situations, reducing infection risks is based on the same underlying microbiological principles. In developing countries, disposal of human and animal excreta and other waste is often also the responsibility of the family and community. Adopting a holistic approach provides the opportunity for a rational approach to home hygiene based on risk assessment. The International Scientific Forum on Home Hygiene (IFH) believes that to deliver hygiene policy with real health benefits, a risk-based approach must be developed and promoted for the home. A risk-based approach starts from the principle that pathogens are introduced continually into homes on people, food and water, pets, insects and air. Inadequate disposal of human and animal excreta serves to increase this risk. Additionally, sites where stagnant water accumulates, such as sinks, toilets and cleaning cloths can support microbial growth and become a source of infection. By assessing the frequency occurrence of pathogens and potential pathogens on hands, hand and food contact surfaces, laundry, reservoir and reservoir/disseminator sites, together with the potential for transfer in the home, the exposure risk can be assessed.     

洞口县农村饮用水与环境卫生现状调查

目的掌握洞口县农村饮用水、改厕和粪便处理现状,了解农村垃圾污水治理情况。方法按照统一的农村饮用水调查表和环境卫生调查表进行调查问卷,按照人口比例分层方法确定采样点,随机抽样检测。结果该县农村饮用地面水的占2.88%、地下水的占97.12%;集中式供水的占11.81%,分散式供水占88.19%,集中式供水水质合格率为6.84%,分散式供水水质合格率66.67%（不包括消毒剂指标）。卫生厕所占总户厕的6.67%。生活垃圾、生产垃圾分别占垃圾总量的59.83%和40.17%;生活性污水排到河流占76.30%,生产性污水排到河流占54.55%。结论该县农村饮用水供水方式和饮用水质亟待改善,卫生厕所普及率低,垃圾及污水的收集和处理不规范,环境卫生状况不容乐观。