scholarly journals Reducing the burden of rural water supply through greywater reuse: a case study from northern Malawi

2017 ◽  
Vol 17 (4) ◽  
pp. 1088-1096 ◽  
Author(s):  
Evan Newcomer ◽  
Courtney Boyd ◽  
Laban Nyirenda ◽  
Emmanuel Opong ◽  
Shannon Marquez ◽  
...  
Keyword(s):  
Rural Areas ◽  
Geographic Location ◽  
Sub Saharan Africa ◽  
World Health ◽  
E Coli ◽  
Colony Forming Units ◽  
Sub Saharan ◽  
Health Organization ◽  
Greywater Reuse

Greywater reuse has potential for non-potable applications that conserve freshwater resources in water-stressed areas especially in sub-Saharan Africa. The feasibility of reusing greywater for domestic activities in a rural area of Malawi, Africa, was evaluated from microbiological and public acceptance perspectives. Median Escherichia coli concentrations for eight domestic greywater sources (handwashing, laundry, runoff from a tap apron, bathing, cleaning a home/kitchen, cleaning a water collection container, washing plates and soaking vegetables) ranged from 100 to >20,000 colony forming units (cfu)/100 ml. Twenty-four of 47 greywater samples tested (51%) met the World Health Organization guideline for unrestricted use of greywater for irrigation. Pertinently, 80% (4/5) and 60% (3/5) of greywater samples from handwashing stations and bathing had E. coli less than the WHO guideline. Users reported greatest acceptance of reusing greywater for growing food and washing clothes, especially when the greywater source was bathing. Acceptance was closely tied to a household's economic standing, geographic location, and first-hand knowledge of reusing greywater. Greywater reuse practices in rural areas, especially targeting bathing water as suitable from bacteriological and user perception criteria, can help mitigate the impacts of water stress in sub-Saharan Africa.

Quantifying Pregnant Women’s Knowledge of Educational Components of Antenatal Care in Lesotho

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Tabeta Seeiso ◽  
Mamutle M. Todd-Maja
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Rural Areas ◽  
Geographic Location ◽  
Sub Saharan Africa ◽  
World Health ◽  
Cross Sectional ◽  
Danger Signs ◽  
In Pregnancy

Antenatal care (ANC) literacy is particularly important for pregnant women who need to make appropriate decisions for care during their pregnancy and childbirth. The link between inadequate health literacy on the educational components of ANC and maternal mortality in sub-Saharan Africa (SSA) is undisputable. Yet, little is known about the ANC literacy of pregnant women in SSA, with most studies inadequately assessing the four critical components of ANC literacy recommended by the World Health Organization, namely danger signs in pregnancy; true signs of labour; nutrition; and preparedness for childbirth. Lesotho, a country with one of the highest maternal mortality rates in SSA, is also underexplored in this research area. This cross-sectional study explored the levels of ANC literacy and the associated factors in 451 purposively sampled women in two districts in Lesotho using a structured questionnaire, making recourse to statistical principles. Overall, 16.4 per cent of the participants had grossly inadequate ANC literacy, while 79.8 per cent had marginal levels of such knowledge. The geographic location and level of education were the most significant predictors of ANC literacy, with the latter variable further subjected to post hoc margins test with the Bonferroni correction. The participants had the lowest scores on knowledge of danger signs in pregnancy and true signs of labour. Adequate ANC literacy is critical to reducing maternal mortality in Lesotho. Improving access to ANC education, particularly in rural areas, is recommended. This study also provides important recommendations critical to informing the national midwifery curriculum.

scholarly journals The Relationship Between the Global Burden of Influenza From 2017 to 2019 and COVID-19: Descriptive Epidemiological Assessment (Preprint)

2020 ◽  
Author(s):  
Stefan David Baral ◽  
Katherine Blair Rucinski ◽  
Jean Olivier Twahirwa Rwema ◽  
Amrita Rao ◽  
Neia Prata Menezes ◽  
...  
Keyword(s):  
Respiratory Infections ◽  
Temporal Trends ◽  
Sub Saharan Africa ◽  
World Health ◽  
Respiratory Pathogens ◽  
Modes Of Transmission ◽  
The World ◽  
Influenza Activity ◽  
Sub Saharan ◽  
Health Organization

BACKGROUND SARS-CoV-2 and influenza are lipid-enveloped viruses with differential morbidity and mortality but shared modes of transmission. OBJECTIVE With a descriptive epidemiological framing, we assessed whether recent historical patterns of regional influenza burden are reflected in the observed heterogeneity in COVID-19 cases across regions of the world. METHODS Weekly surveillance data reported by the World Health Organization from January 2017 to December 2019 for influenza and from January 1, 2020 through October 31, 2020, for COVID-19 were used to assess seasonal and temporal trends for influenza and COVID-19 cases across the seven World Bank regions. RESULTS In regions with more pronounced influenza seasonality, COVID-19 epidemics have largely followed trends similar to those seen for influenza from 2017 to 2019. COVID-19 epidemics in countries across Europe, Central Asia, and North America have been marked by a first peak during the spring, followed by significant reductions in COVID-19 cases in the summer months and a second wave in the fall. In Latin America and the Caribbean, COVID-19 epidemics in several countries peaked in the summer, corresponding to months with the highest influenza activity in the region. Countries from regions with less pronounced influenza activity, including South Asia and sub-Saharan Africa, showed more heterogeneity in COVID-19 epidemics seen to date. However, similarities in COVID-19 and influenza trends were evident within select countries irrespective of region. CONCLUSIONS Ecological consistency in COVID-19 trends seen to date with influenza trends suggests the potential for shared individual, structural, and environmental determinants of transmission. Using a descriptive epidemiological framework to assess shared regional trends for rapidly emerging respiratory pathogens with better studied respiratory infections may provide further insights into the differential impacts of nonpharmacologic interventions and intersections with environmental conditions. Ultimately, forecasting trends and informing interventions for novel respiratory pathogens like COVID-19 should leverage epidemiologic patterns in the relative burden of past respiratory pathogens as prior information.

scholarly journals Prevalence and antibiotic resistance of bacterial pathogens isolated from childhood diarrhoea in four provinces of Kenya

2012 ◽  
Vol 6 (07) ◽  
pp. 572-578 ◽  
Author(s):  
Willie Kipkemboi Sang ◽  
Valerie Oundo ◽  
David Schnabel
Keyword(s):  
Antimicrobial Resistance ◽  
Rural Areas ◽  
Hospital Admissions ◽  
Sub Saharan Africa ◽  
Vibrio Cholera ◽  
Antimicrobial Drug Resistance ◽  
E Coli ◽  
Shigella Isolate ◽  
Stool Samples ◽  
Sub Saharan

Introduction: Diarrhoea is one of the main causes of morbidity and mortality among children in sub-Saharan Africa, and one of the main causes of hospital admissions in rural areas of Kenya. In Kenya, antimicrobial resistance surveillance has been conducted only at the institutional levels, with limited sharing of information and analysis of data. As a result, the actual scale of regional or national antimicrobial drug resistance is not well defined. Methodology: Stool samples were collected between 1 October 2007 and 30 September 2008 from a total of 651 outpatients with diarrhoea who were under five years of age in four provinces of Kenya.  Conventional, biochemical methods, multiplex PCR and antimicrobial susceptibility were conducted to identify the bacterial causes and virulence factors in the isolates, respectively.  Results: Of the 651 patients screened, we identified the causes of 115 cases (17.7%) as follows: Pathogenic E. coli (11.2%) [enteroaggregative (8.9%), enterotoxigenic (1.2%), enteroinvasive (0.6%), shigatoxigenic (0.5%)], Salmonella (3.5%), Shigella (2%) and Vibrio cholera O1 (0.7%). The highest levels of resistance among the E. coli isolates were observed in ampicillin and trimethoprim/sulphamethoxazole each at 95% followed by tetracycline at 81%. Shigella isolate levels of resistance ranged from 80% to 100% for ampicillin, tetracycline and trimethoprim/sulphamethoxazole. Conclusion: The highest prevalence of antimicrobial resistance was to ampicillin followed by trimethoprim/sulphamethoxazole and tetracycline. Though still at low levels, the major concern from our findings is the emerging resistance of enteric pathogens that was observed to quinolones (ciprofloxacin, nalidixic acid, norfloxacin) and gentamycin.

Pregnancy intention and gestational age at first antenatal care visit in Lesotho

2021 ◽  
Vol 15 (1) ◽  
pp. 1-11
Author(s):  
Paul Mkandawire ◽  
Joseph Kangmennaang ◽  
Chad Walker ◽  
Roger Antabe ◽  
Kilian Atuoye ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Gestational Age ◽  
Secondary Data ◽  
Universal Coverage ◽  
Sub Saharan Africa ◽  
World Health ◽  
Antenatal Visit ◽  
Life Saving ◽  
Sub Saharan ◽  
Health Organization

Background/aims With coverage of antenatal care in sub-Saharan Africa approaching a universal level, attention is now turning to maximising the life-saving potential of antenatal care. This study assessed the gestational age at which pregnant mothers make their first antenatal visit in the context of high antenatal coverage in Lesotho. Methods For the purposes of this study, secondary data from the Demographic and Health Survey of 2014 was analysed. These data were collected in 2014, via an interviewer administered questionnaire. Survival analysis was applied to the data, using Stata SE 15 to compute time ratios that estimate time to first antenatal visit in Lesotho. Results Despite near universal coverage, only 24% of mothers start antenatal care before 12 weeks of gestation, as recommended by the World Health Organization. In addition, mothers with unwanted pregnancies are most likely to delay antenatal care until later in gestation, followed by mothers with mistimed pregnancies. Education, but not wealth, correlates with the start of antenatal care. Conclusions Having achieved near universal coverage, emphasising a prompt start and adherence to recommended visits could optimise the life-saving potential of antenatal care in Lesotho.

scholarly journals Proposing a Paradigm Shift in Rural Electrification Investments in Sub-Saharan Africa through Agriculture

2020 ◽  
Vol 12 (8) ◽  
pp. 3096 ◽  
Author(s):  
George Kyriakarakos ◽  
Athanasios T. Balafoutis ◽  
Dionysis Bochtis
Keyword(s):  
Rural Areas ◽  
Business Models ◽  
Sub Saharan Africa ◽  
Rural Electrification ◽  
Agricultural Cooperatives ◽  
New Approach ◽  
Sub Saharan ◽  
The Cost ◽  
Cross Subsidization

Almost one billion people in the world still do not have access to electricity. Most of them live in rural areas of the developing world. Access to electricity in the rural areas of Sub-Saharan Africa is only 28%, roughly 600 million people. The financing of rural electrification is challenging and, in order to accomplish higher private sector investments, new innovative business models have to be developed. In this paper, a new approach in the financing of microgrid electrification activities is proposed and investigated. In this approach, agriculture related businesses take the lead in the electrification activities of the surrounding communities. It is shown that the high cost of rural electrification can be met through the increased value of locally produced products, and cross-subsidization can take place in order to decrease the cost of household electrification. The approach is implemented in a case study in Rwanda, through which the possibility of local agricultural cooperatives leading electrification activities is demonstrated.

scholarly journals A Systematic Review of the Incremental Costs of Implementing a New Vaccine in the Expanded Program of Immunization in Sub-Saharan Africa

2019 ◽  
Vol 4 (2) ◽  
pp. 238146831989454
Author(s):  
Joe Brew ◽  
Christophe Sauboin
Keyword(s):  
Systematic Review ◽  
Data Collection ◽  
Interquartile Range ◽  
Sub Saharan Africa ◽  
World Health ◽  
African Countries ◽  
Vaccine Type ◽  
Sub Saharan ◽  
Health Organization ◽  
The Cost

Background. The World Health Organization is planning a pilot introduction of a new malaria vaccine in three sub-Saharan African countries. To inform considerations about including a new vaccine in the vaccination program of those and other countries, estimates from the scientific literature of the incremental costs of doing so are important. Methods. A systematic review of scientific studies reporting the costs of recent vaccine programs in sub-Saharan countries was performed. The focus was to obtain from each study an estimate of the cost per dose of vaccine administered excluding the acquisition cost of the vaccine and wastage. Studies published between 2000 and 2018 and indexed on PubMed could be included and results were standardized to 2015 US dollars (US$). Results. After successive screening of 2119 titles, and 941 abstracts, 58 studies with 80 data points (combinations of country, vaccine type, and vaccination approach–routine v. campaign) were retained. Most studies used the so-called ingredients approach as costing method combining field data collection with documented unit prices per cost item. The categorization of cost items and the extent of detailed reporting varied widely. Across the studies, the mean and median cost per dose administered was US$1.68 and US$0.88 with an interquartile range of US$0.54 to US$2.31. Routine vaccination was more costly than campaigns, with mean cost per dose of US$1.99 and US$0.88, respectively. Conclusion. Across the studies, there was huge variation in the cost per dose delivered, between and within countries, even in studies using consistent data collection tools and analysis methods, and including many health facilities. For planning purposes, the interquartile range of US$0.54 to US$2.31 may be a sufficiently precise estimate.

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