The Sustainable Development Goal for Urban Sanitation: Africa's Statistical Tragedy Continues?

An Assessment of Personal Hygiene Practices Among Young Adults: A Cross-Sectional, Descriptive Study

Background Personal Hygiene behavior and practices play a major role in health promotion and disease prevention. Socio-demographic, behavioral, and psychological factors sway a person's overall adaptation of good practices. Disease burden leading to loss of productivity and its influence on the economy cannot be overstated. As medical professionals come in contact with a large number of people, they carry the potential to be super-spreaders in disease outbreaks. Thus, it is of utmost importance that medics and paramedics maintain hygiene to the highest standards. Method This cross-sectional study comprised 323 young adult participants from Muslim Town, Faisalabad. A structured questionnaire containing close-ended questions was used for data collection regarding personal hygiene behavior and practices. Dependency between various qualitative categorical variables and hygiene practices was analyzed using Chi-squared tests. Results It was found that although the majority of the participants followed good hygiene for most of the practices; laziness, lack of relevant education, improper time management, and unreliable water supply posed a significant barrier to good practices. Females had demonstrably better practices compared to males. Urbanity did not have a significant correlation with the results.  Conclusion We conclude that a rigorous program of awareness and education regarding this subject is the need of the hour to facilitate an improvement in predictive and preventive health care and reduce morbidity and mortality. Steps should be taken to ease the barriers that are obstructing optimal hygienic practices.

Demographic dynamics of waterborne disease and perceived associated WASH factors in Bushenyi and Sheema districts of South-Western Uganda

Water remains a significant player in spreading pathogens, including those associated with neglected tropical diseases. The implications of socio-demographic delineations of water quality, sanitation, and hygiene ("WASH") interventions are on the downswing. This study assessed waterborne diseases and perceived associated WASH factors in the Bushenyi and Sheema districts of South-Western Uganda. This study examines the linear relationship between WASH and identifies the association of specific demographic factors as well as their contributions/correlations to waterborne disease in the study area. A structured qualitative and quantitative data collection approach was adopted in face-to-face questionnaire-guided interviews of 200 respondents on eight surface water usage. Most participants, 65.5%, were females and had a higher score of knowledge of WASH (71%), 68% score on the improper practice of WASH, and 64% score on unsafe water quality. Low score for basic economic status was (57%), report of common diarrhoea was (47%), and a low incidence of waterborne disease outbreaks (27%). The principal component analysis (PCA) depicts the knowledge and practice of WASH to have a strong positive correlation (r = 0.84, p < 0.001; r = 0.82, p < 0.001); also economic status positively correlated with grade of water source, knowledge, and practice of WASH (correlation coefficient = 0.72; 0.99; 0.76 and p-values = 0.001; < 0.001; < 0.001 respectively). Occupation (p = 0.0001, OR = 6.798) was significantly associated with knowledge and practice of WASH, while age (r = -0.21, p < 0.001) was negatively associated with knowledge and practice of WASH. The basic economic status explains why "low economic population groups" in the remote villages may not effectively implement WASH, and diarrhoea was common among the population. Diarrhoea associated with unsafe water quality and improper practice of WASH is common among the study population, and there is a low incidence of waterborne disease outbreaks. Therefore, government, stakeholders, and non-governmental organisations should work together to promote proper practice of WASH conditions to limit the occurrence of diarrhoea and prevent potential waterborne disease outbreaks.

Environmental determinants of access to shared sanitation in informal settlements: a cross-sectional study in Abidjan and Nairobi

BACKGROUND

Universal access to basic sanitation remains a global challenge, particularly in low- and middle-income countries. Efforts are underway to improve access to sanitation in informal settlements, often through shared facilities. However, access to these facilities and their potential health gains-notably, the prevention of diarrheal diseases-may be hampered by contextual aspects related to the physical environment. This study explored associations between the built environment and perceived safety to access toilets, and associations between the latter and diarrheal infections.

METHODS

A cross-sectional study was carried out between July 2021 and February 2022, including 1714 households in two informal settlements in Abidjan (Côte d'Ivoire) and two in Nairobi (Kenya). We employed adjusted odds ratios (aORs) obtained from multiple logistic regressions (MLRs) to test whether the location of the most frequently used toilet was associated with a perceived lack of safety to use the facility at any time, and whether this perceived insecurity was associated with a higher risk of diarrhea. The MLRs included several exposure and control variables, being stratified by city and age groups. We employed bivariate logistic regressions to test whether the perceived insecurity was associated with settlement morphology indicators derived from the built environment.

RESULTS

Using a toilet outside the premises was associated with a perceived insecurity both in Abidjan [aOR = 3.14, 95% confidence interval (CI): 1.13-8.70] and in Nairobi (aOR = 57.97, 95% CI: 35.93-93.53). Perceived insecurity to access toilets was associated with diarrheal infections in the general population (aOR = 1.90, 95% CI: 1.29-2.79 in Abidjan, aOR = 1.69, 95% CI: 1.22-2.34 in Nairobi), but not in children below the age of 5 years. Several settlement morphology features were associated with perceived insecurity, namely, buildings' compactness, the proportion of occupied land, and angular deviation between neighboring structures.

CONCLUSIONS

Toilet location was a critical determinant of perceived security, and hence, must be adequately addressed when building new facilities. The sole availability of facilities may be insufficient to prevent diarrheal infections. People must also be safe to use them. Further attention should be directed toward how the built environment affects safety.

Population-land urbanization and comprehensive development evaluation of the Beijing-Tianjin-Hebei urban agglomeration

As the main form of the new urbanization strategy, urban agglomeration promotes inter-regional economic development, population flow, and industrial cooperation. It is not only an important platform for the country to participate in international competition, but also an important carrier to explore the multiple influencing factors of urbanization. Based on the Beijing-Tianjin-Hebei urban agglomeration, the temporal and spatial characteristics of its evolution from 1990 to 2020 are analyzed by using the models of urban evolution and industrial transfer. The results show that at the level of urban land use evolution intensity, Beijing > Tianjin > Hebei, and the evolution of urban land use showed an obvious pattern of concentration of resources in central cities (districts) and weak development in sub-central cities (counties). The overall level of urban sprawl showed a downward trend, and only 0.50% of districts and counties were in the stage of high sprawl. Before 2010, the urban sprawl of Beijing, Tangshan, and southern Hebei province remained at a high level, and after 2010, the urban sprawl of central Hebei province remained at a high level. In terms of comprehensive development, the index of cities decreased, including Beijing, Tianjin, and Tangshan, while the index of cities increased including Shijiazhuang, Handan, Xingtai, and Baoding. There is a trend of agglomeration and diffusion of regional industries in geographical space. Middle- and high-end manufacturing industry and service industry gather in the first city, and middle- and low-end processing industry, labor-intensive industry, and agriculture move to surrounding cities. The research results can provide policy suggestions for the coordinated development of regional integration in developing countries.

Out of sight, out of mind: Understanding the sanitation crisis in global South cities

Global monitoring efforts do not provide a clear picture of the challenge of managing human waste at the city scale. Where cities do not provide universal access to publicly managed sanitation systems, households and communities find their own solutions resulting in a patchwork of approaches to removing human waste from places where people live. In dense urban environments, the absence of a coordinated approach can create serious public health problems. In the absence of comparable city-level data, we analyze primary and secondary data from 15 cities and 15 informal settlements in sub-Saharan Africa, South Asia, and Latin America. Across these regions, our study finds that 62 percent of human waste is not safely managed. We also find that, while many cities have a proportion of households connected to sewers, none of the 15 cities safely manage human waste at scale. In the absence of sewers, on-site fecal sludge management systems place enormous responsibility on households and private providers, and unaffordable sanitation options result in risky sanitation practices.

Self-Assessment of Hygiene Practices towards Predictive and Preventive Medicine Intervention: A Case Study of University Students in Ghana

INTRODUCTION

Personal hygiene is essential to the current paradigm shift towards predictive, preventive, and personalized medicine, which enables the prediction and prevention of infectious disease outbreaks.

OBJECTIVE

The aim of this paper was to evaluate the personal hygiene practices among university students aiming at providing a basis for preventive and predictive medical interventions and to make future efforts improve target interventions for young people.

METHODS

The study was conducted using a cross-sectional study. Validated instruments that related personal hygiene practices were used to obtain quantitative data from 412 tertiary students from seven universities in Accra, Ghana. The resulting data were analyzed with IBM-SPSS, version 23.

RESULTS

There were more female respondents (54.4%) in the study than male respondents (45.6%). Respondents between the age group of 19-24 years constituted majority (59.7%) of the respondents in the study. Respondents from urban areas exhibited good hygiene practice compared to those from urban residences. There was a significant association between residence and hygiene practice (χ 2=17.8, P≤0.001). We also observed that those respondents within the upper class in society had a poor hygiene practice, compared to the Lower Class and Middle Class respondents. Lack of education (63.1%) was observed as the main barrier to personal hygiene among the respondents. Future of the society depends on the health of its youth.

CONCLUSION

A significant number of students are not actively practicing good hygiene. There is a need for deployment of preventive medicine interventions targeted at young people. It calls for improvement in methods of hygiene education for young people in tertiary institutions and the inclusion of hygiene in school curricula.