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Gaffan N, Kpozehouen A, Degbey C, Ahanhanzo YG, Paraïso MN. Understanding Households' Willingness to Pay for Improved Sanitation Services in Benin: A Study Protocol. ENVIRONMENTAL HEALTH INSIGHTS 2024; 18:11786302241228954. [PMID: 38323117 PMCID: PMC10846040 DOI: 10.1177/11786302241228954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/11/2024] [Indexed: 02/08/2024]
Abstract
Nowadays, in Benin, latrine construction by households highly depends on their financial contributions. However, empirical evidence shows that many households are unwilling to invest in adequate sanitation services. The study aims to determine the household's willingness to pay for improved sanitation services and the associated factors. The study population will include households lacking unimproved sanitation facilities. The household heads will be eligible for survey participation. We will perform a contingent valuation to determine households' willingness to pay for a Ventilated Improved Pit (VIP) latrine. Following a description of the surveyed population, we will assess willingness to pay using the 'doubleb' command in Stata. Subsequently, we will conduct multivariate logistic regression to determine the factors associated with willingness to pay. The expected results will be: a description of the basic characteristics of households without improved sanitation services, an estimation of household willingness to pay for VIP latrines using the contingent valuation, and factors associated with household willingness to pay for VIP latrines. This study will contribute to the literature on household demand for improved sanitation services in Benin.
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Affiliation(s)
- Nicolas Gaffan
- Department of Epidemiology and Biostatistics, Regional Institute of Public Health, University of Abomey-Calavi, Ouidah, Benin
| | - Alphonse Kpozehouen
- Department of Epidemiology and Biostatistics, Regional Institute of Public Health, University of Abomey-Calavi, Ouidah, Benin
| | - Cyriaque Degbey
- Department of Environmental Health, Regional Institute of Public Health, University of Abomey-Calavi, Ouidah, Benin
| | - Yolaine Glele Ahanhanzo
- Department of Epidemiology and Biostatistics, Regional Institute of Public Health, University of Abomey-Calavi, Ouidah, Benin
| | - Moussiliou Noël Paraïso
- Department of Health Promotion, Regional Institute of Public Health, University of Abomey-Calavi, Ouidah, Benin
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Nasim N, El-Zein A, Thomas J. A review of rural and peri-urban sanitation infrastructure in South-East Asia and the Western Pacific: Highlighting regional inequalities and limited data. Int J Hyg Environ Health 2022; 244:113992. [PMID: 35752101 DOI: 10.1016/j.ijheh.2022.113992] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/22/2022] [Accepted: 06/03/2022] [Indexed: 12/16/2022]
Abstract
Rural and peri-urban communities in developing countries rely on sanitation systems which are often unsafely managed. One of the major barriers to assess safely managed sanitation is a lack of data about the existing sanitation infrastructure and levels of containment safety. The aim was to review rural and peri-urban on-site sanitation studies in order to understand different infrastructure types, associated management practices and any impacts on human health. The scope was limited to South-East Asia and Western Pacific regions in order to better identify regional inequalities. Among the 155 reviewed articles, 73 studies (47%) linked sanitation infrastructure to poor human health. Nearly all articles reported latrine ownership (n = 149, 96%) while sanitation infrastructure types were covered less frequently (n = 104, 67%). In particular, there was a lack of published literature describing back-end characteristics (dimension and materials) (n = 12, 8%) and/or management practices (n = 4, 3%). This stems from a limited application of research methodologies that characterise sanitation infrastructure and faecal sludge management (containment, emptying and on-site treatment). Inequality between regions was prevalent with three quarters of the studies on latrine back-end infrastructure from Bangladesh and India in South-East Asia. A strategic research approach is needed to address the current knowledge gaps regarding sanitation infrastructure and safe faecal sludge management.
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Affiliation(s)
- Nabeela Nasim
- School of Civil Engineering, The University of Sydney, Australia.
| | - Abbas El-Zein
- School of Civil Engineering, The University of Sydney, Australia.
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Wu S, Zhang Y, He BJ. Public Willingness to Pay for and Participate in Sanitation Infrastructure Improvement in Western China's Rural Areas. Front Public Health 2022; 9:788922. [PMID: 35071170 PMCID: PMC8774769 DOI: 10.3389/fpubh.2021.788922] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 11/25/2021] [Indexed: 12/03/2022] Open
Abstract
The suitability and feasibility of public-private partnership (PPP) patterns in a rural context have not been well-documented and understood. To address this research gap and practical plight, this study aims to analyze the rural resident's willingness to pay for and participate in the improvement of rural sanitation facilities, and further explore the drivers and barriers affecting their decisions. This study was performed in rural areas of three western provinces, including Shaanxi, Ningxia, and Inner Mongolia, of western China's rural areas by conducting a survey on 1,248 rural residents. In Inner Mongolia, the proportion of respondents who were willing to pay was highest, while the proportion of respondents who may provide labor was lowest among the three provinces. Respondents from Ningxia had the least willing to pay, and respondents from Shaanxi had the highest willingness to participate. Overall, respondents' rural (living) duration time, personal interest in local government notice, and the latest time when the sanitation facilities were improved could significantly affect their willingness. In Inner Mongolia, occupation and water availability could significantly influence respondents' willingness, and both gender and health conditions had significant impacts. In Ningxia, respondents' personal interest in local government notice had a notable impact on willingness, and low-income respondents showed a more notable willingness to pay and participate. In Shaanxi, occupation and water availability could significantly influence respondents' willingness. Respondents' personal interest in local government notice had a notable impact on their willingness. This study is of significant importance to understand rural resident's participation in sanitation infrastructure improvement to support relevant PPP projects, and is important to solve poverty-caused dilemmas.
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Affiliation(s)
- Simei Wu
- School of Management, Xi'an University of Architecture and Technology, Xi'an, China.,Centre for Climate-Resilient and Low-Carbon Cities, School of Architecture and Urban Planning, Chongqing University, Chongqing, China.,Key Laboratory of New Technology for Construction of Cities in Mountain Area, Ministry of Education, Chongqing University, Chongqing, China
| | - Yang Zhang
- School of Management, Xi'an University of Architecture and Technology, Xi'an, China
| | - Bao-Jie He
- Centre for Climate-Resilient and Low-Carbon Cities, School of Architecture and Urban Planning, Chongqing University, Chongqing, China.,Key Laboratory of New Technology for Construction of Cities in Mountain Area, Ministry of Education, Chongqing University, Chongqing, China
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4
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Nguyen PT, Rahman MS, Le PM, Nguyen HV, Vu KD, Nguyen HL, Dao ATM, Khuong LQ, Hoang MV, Gilmour S. Trends in, projections of, and inequalities in reproductive, maternal, newborn and child health service coverage in Vietnam 2000-2030: A Bayesian analysis at national and sub-national levels. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 15:100230. [PMID: 34528011 PMCID: PMC8342952 DOI: 10.1016/j.lanwpc.2021.100230] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/25/2021] [Accepted: 07/06/2021] [Indexed: 12/14/2022]
Abstract
Background To assess the reproductive, maternal, newborn and child health (RMNCH) service coverage in Vietnam with trends in 2000−2014, projections and probability of achieving targets in 2030 at national and sub-national levels; and to analyze the socioeconomic, regional and urban-rural inequalities in RMNCH service indicators. Methods We used national population-based datasets of 44,624 households in Vietnam from 2000 to 2014. We applied Bayesian regression models to estimate the trends in and projections of RMNCH indicators and the probabilities of achieving the 2030 targets. Using the relative index, slope index, and concentration index of inequality, we examined the patterns and trends in RMNCH coverage inequality. Findings We projected that 9 out of 17 health service indicators (53%) would likely achieve the 2030 targets at the national level, including at least one and four ANC visits, BCG immunization, access to improved water and adequate sanitation, institutional delivery, skilled birth attendance, care-seeking for pneumonia, and ARI treatment. We observed very low coverages and zero chance of achieving the 2030 targets at national and sub-national levels in early initiation and exclusive breastfeeding, family planning needs satisfied, and oral rehydration therapy. The most deprived households living in rural areas and the Northwest, Northeast, North Central, Central Highlands, and Mekong River Delta regions would not reach the 80% immunization coverage of DPT3, Polio3, Measles and full immunization. We found socioeconomic, regional, and urban-rural inequalities in all RMNCH indicators in 2014 and no change in inequalities over 15 years in the lowest-coverage indicators. Interpretation Vietnam has made substantial progress toward UHC. By improving the government's health system reform efforts, re-allocating resources focusing on people in the most impoverished rural regions, and restructuring and enhancing current health programs, Vietnam can achieve the UHC targets and other health-related SDGs. Funding The authors did not receive any funds for conducting this study.
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Affiliation(s)
- Phuong T Nguyen
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.,Division of Cancer Statistics Integration, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Md Shafiur Rahman
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Phuong Mai Le
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Huy Van Nguyen
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.,Innovation Health and Transformation Centre, Federation University, Australia.,Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Massachusetts, USA
| | - Kien Duy Vu
- OnCare Medical Technology Company Limited, Hanoi, Vietnam
| | - Hoa L Nguyen
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Massachusetts, USA
| | - An Thi Minh Dao
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Massachusetts, USA.,School of Public Health, The University of Queensland, Queensland, Australia.,Institution for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | | | | | - Stuart Gilmour
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
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Delaire C, Peletz R, Haji S, Kones J, Samuel E, Easthope-Frazer A, Charreyron E, Wang T, Feng A, Mustafiz R, Faria IJ, Antwi-Agyei P, Donkor E, Adjei K, Monney I, Kisiangani J, MacLeod C, Mwangi B, Khush R. How Much Will Safe Sanitation for all Cost? Evidence from Five Cities. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:767-777. [PMID: 33356187 DOI: 10.1021/acs.est.0c06348] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Global sustainable development goals call for universal access to safely managed sanitation by 2030. Here, we demonstrate methods to estimate the financial requirements for meeting this commitment in urban settings of low-income countries. Our methods considered two financial requirements: (i) the subsidies needed to bridge the gap between the willingness-to-pay of low-income households and actual market prices of toilets and emptying services and (ii) the amounts needed to expand the municipal waste management infrastructure for unserved populations. We applied our methods in five cities- Kisumu, Malindi, Nakuru in Kenya; Kumasi in Ghana; and Rangpur in Bangladesh and compared three to five sanitation approaches in each city. We collected detailed cost data on the sanitation infrastructure, products, and services from 76 key informants across the five cities, and we surveyed a total of 2381 low-income households to estimate willingness-to-pay. We found that the total financial requirements for achieving universal sanitation in the next 10 years and their breakdown between household subsidies and municipal infrastructure varied greatly between sanitation approaches. Across our study cities, sewerage was the costliest approach (total financial requirements of 16-24 USD/person/year), followed by container-based sanitation (10-17 USD/person/year), onsite sanitation (2-14 USD/person/year), and mini-sewers connecting several toilets to communal septic tanks (3-5 USD/person/year). Further applications of our methods can guide sanitation planning in other cities.
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Affiliation(s)
| | - Rachel Peletz
- The Aquaya Institute, P.O. Box 1603, San Anselmo, California 94979, United States
| | - Salim Haji
- The Aquaya Institute, P.O. Box 1603, San Anselmo, California 94979, United States
| | - Joan Kones
- The Aquaya Institute, P.O. Box 21862-00505, Nairobi, Kenya
| | - Edinah Samuel
- The Aquaya Institute, P.O. Box 21862-00505, Nairobi, Kenya
| | | | | | | | - Andy Feng
- Oliver Wyman, New York, New York 10036, United States
| | - Razin Mustafiz
- D2 Technologies Limited, House 7, Road 5, Block F, Banani, Dhaka 1213, Bangladesh
| | - Ismat Jabeen Faria
- D2 Technologies Limited, House 7, Road 5, Block F, Banani, Dhaka 1213, Bangladesh
| | - Prince Antwi-Agyei
- University of Energy and Natural Resources, Sunyani, Ghana
- NHance Development Partners Limited, P.O. Box 214ST 46 Stadium, Kumasi, Ghana
| | - Emmanuel Donkor
- NHance Development Partners Limited, P.O. Box 214ST 46 Stadium, Kumasi, Ghana
| | - Kwaku Adjei
- NHance Development Partners Limited, P.O. Box 214ST 46 Stadium, Kumasi, Ghana
| | - Isaac Monney
- NHance Development Partners Limited, P.O. Box 214ST 46 Stadium, Kumasi, Ghana
| | | | - Clara MacLeod
- The Aquaya Institute, P.O. Box 21862-00505, Nairobi, Kenya
| | - Brian Mwangi
- The Aquaya Institute, P.O. Box 21862-00505, Nairobi, Kenya
| | - Ranjiv Khush
- The Aquaya Institute, P.O. Box 1603, San Anselmo, California 94979, United States
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Assessing the Impact and Equity of an Integrated Rural Sanitation Approach: A Longitudinal Evaluation in 11 Sub-Saharan Africa and Asian Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051808. [PMID: 32164375 PMCID: PMC7084698 DOI: 10.3390/ijerph17051808] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/02/2020] [Accepted: 03/07/2020] [Indexed: 01/03/2023]
Abstract
Few rural sanitation programs have documented large increases in sanitation coverage or have assessed if interventions equitably increase sanitation coverage for vulnerable groups. We characterize the impact of the Sustainable Sanitation and Hygiene for All (SSH4A) approach on key program WASH (water, sanitation, and hygiene) indicators, and also assess if these increases in WASH coverage are equitably reaching vulnerable groups. The SSH4A approach was administered in 12 program areas in 11 countries, including Bhutan, Ethiopia, Ghana, Indonesia, Kenya, Mozambique, Nepal, South Sudan, Tanzania, Uganda, and Zambia. Repeated cross-sectional household surveys were administered over four rounds at annual follow-up rounds from 2014 to 2018. Surveys were conducted in an average of 21,411 households at each round of data collection. Overall, sanitation coverage increased by 53 percentage points between baseline and the final round of data collection (95% CI: 52%, 54%). We estimate that 4.8 million people gained access to basic sanitation in these areas during the project period. Most countries also demonstrated movement up the sanitation ladder, in addition to increases in handwashing stations and safe disposal of child feces. When assessing equity—if sanitation coverage levels were similar comparing vulnerable and non-vulnerable groups—we observed that increases in coverage over time were generally comparable between vulnerable groups and non-vulnerable groups. However, the increase in sanitation coverage was slightly higher for higher wealth households compared to lower wealth households. Results from this study revealed a successful model of rural sanitation service delivery. However, further work should be done to explore the specific mechanisms that led to success of the intervention.
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7
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Tidwell JB, Terris-Prestholt F, Quaife M, Aunger R. Understanding demand for higher quality sanitation in peri-urban Lusaka, Zambia through stated and revealed preference analysis. Soc Sci Med 2019; 232:139-147. [PMID: 31085398 DOI: 10.1016/j.socscimed.2019.04.046] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 04/27/2019] [Accepted: 04/30/2019] [Indexed: 11/18/2022]
Abstract
Poor peri-urban sanitation is a significant public health problem, likely to become more important as the world rapidly urbanizes. However, little is known about the role of consumer demand in increasing peri-urban sanitation quality, especially for tenants using shared sanitation as only their rental choices can be observed in the market. We analyzed data on existing housing markets collected between 9 Jun and 6 Jul 2017 using the Hedonic Pricing Method (HPM) to capture the percentage of rent attributable to sanitation quality (n = 933). We also conducted discrete choice experiments (DCEs) to obtain willingness to pay (WTP) estimates for specific sanitation components (n = 1087), and explored the implications by estimating the proportion of plots for which improved sanitation quality would generate a higher return on investment for landlords than building a place for an additional tenant to live. The HPM attributed 18% of rental prices to sanitation (∼US$8.10 per month), but parameters for several components were poorly specified due to collinearity and low overall prevalence of some products. DCEs revealed that tenants were willing to pay $2.20 more rent per month for flushing toilets on plots with running water and $3.39 more per month for solid toilet doors, though they were willing to pay little for simple hole covers and had negative WTP for adding locks to doors (-$1.04). Solid doors and flushing toilets had higher rent increase to cost ratios than other ways landlords commonly invested in their plots, especially as the number of tenant households on a plot increased. DCEs yielded estimates generally consistent with and better specified than HPM and may be useful to estimate demand in other settings. Interventions leveraging landlords' profit motives could lead to significant improvements in peri-urban sanitation quality, reduced diarrheal disease transmission, and increased well-being without subsidies or infrastructure investments by government or NGOs.
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Affiliation(s)
- James B Tidwell
- London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, United Kingdom.
| | - Fern Terris-Prestholt
- London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, United Kingdom
| | - Matthew Quaife
- London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, United Kingdom
| | - Robert Aunger
- London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, United Kingdom
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8
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Cook D, Eiríksdóttir K, Davíðsdóttir B, Kristófersson DM. The contingent valuation study of Heiðmörk, Iceland - Willingness to pay for its preservation. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2018; 209:126-138. [PMID: 29288935 DOI: 10.1016/j.jenvman.2017.12.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/08/2017] [Accepted: 12/19/2017] [Indexed: 06/07/2023]
Abstract
The decision-making and policy formation context in Iceland has been largely devoid of total economic valuations in cost-benefit assessments. Using an internet survey and applying the double bounded dichotomous choice methodology, this contingent valuation study sets out an estimate of the total economic value pertaining to Heiðmörk, a popular recreational area of urban open space located on the fringes of Reykjavík, Garðabær and Kópavogur. In so doing, this case study advances the practice of using non-market valuation techniques in the country. The welfare estimates provide evidence that Icelanders consider Heiðmörk to possess considerable total economic value, with taxpayers willing to pay a mean lump-sum tax in the range 17,039 to 24,790 ISK per payment to secure its preservation, equating to an estimated total economic value of between 5.87 and 35.47 billion ISK. In the light of possible competitive land management demands among Heiðmörk's three owners and many recreational users in the future, the establishment of these values and their potential use in cost-benefit assessments informs the debate concerning whether the area should be preserved or further developed to satisfy economic objectives. Additionally, a body of experimental evidence is formed suggesting that the increased duration of a fixed payment vehicle is associated with much higher total economic valuations compared to a one-year payment period.
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Affiliation(s)
- David Cook
- Faculty of Economics and Faculty of Environment and Life Sciences, University of Iceland, Gimli, Sæmundargötu 2, 101, Reykjavík, Iceland.
| | - Kristín Eiríksdóttir
- Faculty of Economics, University of Iceland, Gimli, Sæmundargötu 2, 101, Reykjavík, Iceland.
| | - Brynhildur Davíðsdóttir
- Faculty of Economics and Faculty of Environment and Life Sciences, University of Iceland, Gimli, Sæmundargötu 2, 101, Reykjavík, Iceland.
| | - Daði Már Kristófersson
- School of Social Sciences, University of Iceland, Gimli, Sæmundargötu 2, 101, Reykjavík, Iceland.
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Mosler HJ, Sonego IL. Improved latrine cleanliness through behaviour change and changes in quality of latrine construction: a longitudinal intervention study in rural Burundi. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2017; 27:355-367. [PMID: 28877590 DOI: 10.1080/09603123.2017.1373274] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 07/30/2017] [Indexed: 06/07/2023]
Abstract
Latrine cleanliness increased in the intervention group compared to the control group (increase from 21 to 31 % of latrines classified as clean in intervention [N = 198] and decrease from 37 to 27 % in control [N = 91]). Improved habitual latrine cleaning lead to latrines being 3.5 times more likely to improve in observed latrine cleanliness (χ2 = 16.36, p < .001) and so did improvements in quality of latrine construction, eg households that had installed a lid were 7.39 times more likely to have a cleaner latrine (χ2 = 4.46, p < .05). Changes in psychosocial factors, namely forgetting, personal norm, satisfaction with cleanliness, explained much of the change in habitual latrine cleaning (adj. r2 = .46). Behaviour change interventions targeting psychosocial factors and quality of latrine construction seem promising to ensure clean and hygienic latrines.
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Affiliation(s)
- Hans-Joachim Mosler
- a Environmental Social Sciences, ESS , Swiss Federal Institute of Aquatic Science and Technology, Eawag , Duebendorf , Switzerland
| | - Ina Lucia Sonego
- a Environmental Social Sciences, ESS , Swiss Federal Institute of Aquatic Science and Technology, Eawag , Duebendorf , Switzerland
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10
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Trung NV, Nhung HN, Carrique-Mas JJ, Mai HH, Tuyen HT, Campbell J, Nhung NT, Van Minh P, Wagenaar JA, Mai NTN, Hieu TQ, Schultsz C, Hoa NT. Colonization of Enteroaggregative Escherichia coli and Shiga toxin-producing Escherichia coli in chickens and humans in southern Vietnam. BMC Microbiol 2016; 16:208. [PMID: 27612880 PMCID: PMC5017054 DOI: 10.1186/s12866-016-0827-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 08/31/2016] [Indexed: 11/23/2022] Open
Abstract
Background Enteroaggregative (EAEC) and Shiga-toxin producing Escherichia coli (STEC) are a major cause of diarrhea worldwide. E. coli carrying both virulence factors characteristic for EAEC and STEC and producing extended-spectrum beta-lactamase caused severe and protracted disease during an outbreak of E. coli O104:H4 in Europe in 2011. We assessed the opportunities for E. coli carrying the aggR and stx genes to emerge in ‘backyard’ farms in south-east Asia. Results Faecal samples collected from 204 chicken farms; 204 farmers and 306 age- and gender-matched individuals not exposed to poultry farming were plated on MacConkey agar plates with and without antimicrobials being supplemented. Sweep samples obtained from MacConkey agar plates without supplemented antimicrobials were screened by multiplex PCR for the detection of the stx1, stx2 and aggR genes. One chicken farm sample each (0.5 %) contained the stx1 and the aggR gene. Eleven (2.4 %) human faecal samples contained the stx1 gene, 2 samples (0.4 %) contained stx2 gene, and 31 (6.8 %) contained the aggR gene. From 46 PCR-positive samples, 205 E. coli isolates were tested for the presence of stx1, stx2, aggR, wzxO104 and fliCH4 genes. None of the isolates simultaneously contained the four genetic markers associated with E. coli O104:H4 epidemic strain (aggR, stx2, wzxO104 and fliCH4). Of 34 EAEC, 64.7 % were resistant to 3rd-generation cephalosporins. Conclusion These results indicate that in southern Vietnam, the human population is a more likely reservoir of aggR and stx gene carrying E. coli than the chicken population. However, conditions for transmission of isolates and/or genes between human and animal reservoirs resulting in the emergence of highly virulent E. coli strains are still favorable, given the nature of‘backyard’ farms in Vietnam. Electronic supplementary material The online version of this article (doi:10.1186/s12866-016-0827-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nguyen Vinh Trung
- Department of Medical Microbiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. .,Department of Global Health-Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands. .,Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam.
| | - Hoang Ngoc Nhung
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam
| | - Juan J Carrique-Mas
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Ho Huynh Mai
- Sub-Department of Animal Health, My Tho, Tien Giang, Vietnam
| | - Ha Thanh Tuyen
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam
| | - James Campbell
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Nguyen Thi Nhung
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam
| | - Pham Van Minh
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam
| | - Jaap A Wagenaar
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,Central Veterinary Institute of Wageningen UR, Lelystad, The Netherlands
| | | | - Thai Quoc Hieu
- Sub-Department of Animal Health, My Tho, Tien Giang, Vietnam
| | - Constance Schultsz
- Department of Medical Microbiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Global Health-Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.,Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam
| | - Ngo Thi Hoa
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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11
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Nguyen VT, Carrique-Mas JJ, Ngo TH, Ho HM, Ha TT, Campbell JI, Nguyen TN, Hoang NN, Pham VM, Wagenaar JA, Hardon A, Thai QH, Schultsz C. Prevalence and risk factors for carriage of antimicrobial-resistant Escherichia coli on household and small-scale chicken farms in the Mekong Delta of Vietnam. J Antimicrob Chemother 2015; 70:2144-52. [PMID: 25755000 PMCID: PMC4472326 DOI: 10.1093/jac/dkv053] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 01/27/2015] [Accepted: 02/06/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To describe the prevalence of antimicrobial resistance among commensal Escherichia coli isolates on household and small-scale chicken farms, common in southern Vietnam, and to investigate the association of antimicrobial resistance with farming practices and antimicrobial usage. METHODS We collected data on farming and antimicrobial usage from 208 chicken farms. E. coli was isolated from boot swab samples using MacConkey agar (MA) and MA with ceftazidime, nalidixic acid or gentamicin. Isolates were tested for their susceptibility to 11 antimicrobials and for ESBL production. Risk factor analyses were carried out, using logistic regression, at both the bacterial population and farm levels. RESULTS E. coli resistant to gentamicin, ciprofloxacin and third-generation cephalosporins was detected on 201 (96.6%), 191 (91.8%) and 77 (37.0%) of the farms, respectively. Of the 895 E. coli isolates, resistance to gentamicin, ciprofloxacin and third-generation cephalosporins was detected in 178 (19.9%), 291 (32.5%) and 29 (3.2%) of the isolates, respectively. Ciprofloxacin resistance was significantly associated with quinolone usage (OR = 2.26) and tetracycline usage (OR = 1.70). ESBL-producing E. coli were associated with farms containing fish ponds (OR = 4.82). CONCLUSIONS Household and small farms showed frequent antimicrobial usage associated with a high prevalence of resistance to the most commonly used antimicrobials. Given the weak biocontainment, the high prevalence of resistant E. coli could represent a risk to the environment and to humans.
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Affiliation(s)
- Vinh Trung Nguyen
- Department of Medical Microbiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Department of Global Health-Amsterdam Institute for Global Health and Development, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam
| | - Juan J Carrique-Mas
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Thi Hoa Ngo
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Huynh Mai Ho
- Sub-Department of Animal Health, My Tho, Tien Giang, Vietnam
| | - Thanh Tuyen Ha
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam
| | - James I Campbell
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Thi Nhung Nguyen
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam
| | - Ngoc Nhung Hoang
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam
| | - Van Minh Pham
- Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam
| | - Jaap A Wagenaar
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands Central Veterinary Institute of Wageningen UR, Lelystad, The Netherlands
| | - Anita Hardon
- Center for Social Science and Global Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Quoc Hieu Thai
- Sub-Department of Animal Health, My Tho, Tien Giang, Vietnam
| | - Constance Schultsz
- Department of Medical Microbiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Department of Global Health-Amsterdam Institute for Global Health and Development, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam
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Identifying the impediments and enablers of ecohealth for a case study on health and environmental sanitation in Hà Nam, Vietnam. Infect Dis Poverty 2014; 3:36. [PMID: 25313336 PMCID: PMC4194379 DOI: 10.1186/2049-9957-3-36] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 09/12/2014] [Indexed: 11/04/2022] Open
Abstract
Background To date, research has shown an increasing use of the term “ecohealth” in literature, but few researchers have explicitly described how it has been used. We investigated a project on health and environmental sanitation (the conceptual framework of which included the pillars of ecohealth) to identify the impediments and enablers of ecohealth and investigate how it can move from concept to practice. Methods A case study approach was used. The interview questions were centred on the nature of interactions and the sharing of information between stakeholders. Results The analysis identified nine impediments and 15 enablers of ecohealth. Three themes relating to impediments, in particular—integration is not clear, don’t understand, and limited participation—related more directly to the challenges in applying the ecohealth pillars of transdisciplinarity and participation. The themes relating to enablers—awareness and understanding, capacity development, and interactions—facilitated usage of the research results. By extracting information on the environmental, social, economic, and health aspects of environmental sanitation, we found that the issue spanned multiple scales and sectors. Conclusion The challenge of how to integrate these aspects should be considered at the design stage and throughout the research process. We recommend that ecohealth research teams include a self-investigation of their processes in order to facilitate a comparison of moving from concept to practice, which may offer insights into how to evaluate the process. Electronic supplementary material The online version of this article (doi:10.1186/2049-9957-3-36) contains supplementary material, which is available to authorized users.
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Bardosh K, Inthavong P, Xayaheuang S, Okello AL. Controlling parasites, understanding practices: the biosocial complexity of a One Health intervention for neglected zoonotic helminths in northern Lao PDR. Soc Sci Med 2014; 120:215-23. [PMID: 25261615 DOI: 10.1016/j.socscimed.2014.09.030] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 09/15/2014] [Accepted: 09/16/2014] [Indexed: 11/25/2022]
Abstract
A parasitological survey in northern Lao PDR showed a remote ethnic minority village to be hyper-endemic for Taenia solium, a Neglected Tropical Disease (NTD) that impacts human and pig health. An intervention combining human Mass Drug Administration (MDA) with porcine vaccination and antihelmintic treatment was then implemented, targeting both T. solium and other soil-transmitted helminths. To understand the biosocial complexity of this integrated One Health intervention, we conducted a rapid ethnographic study exploring the transmission dynamics of T. solium and locally acceptable long-term control options. Informed by two years of project work in the village, this included six focus group discussions, 35 semi-structured interviews, a latrine survey, a school-based education meeting, participant observation and many unstructured interviews conducted over two weeks in October 2013. We found that risk behaviours were mediated by various social determinants including limited market access, interrelationships between alcohol, ancestral sacrifices and the consumption of raw pork, seasonal variations and poor latrine coverage. Only sixteen percent of households had latrines, attributed to the unacceptability of dry latrines, lack of water access, poor building techniques and poverty. Whilst women could explain T. solium transmission, most men and children could not, revealing that distributed posters/leaflets relied too heavily on text and ambiguous images. Compliance with MDA was high due to trust between project staff and village leaders. However understandings of pharmacology, minor side effects, human migration and children's fear of worms may lead to resistance in future programmes. Our research highlights the complexities of controlling T. solium and other soil-transmitted helminths in a remote ethnic minority village and the need to integrate biomedical and participatory approaches. Although we showcase the heuristic value of using rapid ethnography to inform intervention strategies as part of a One Health/NTD agenda, we also identify several possible paradoxes and conundrums in embedding locally-grounded biosocial analysis into NTD programmes. These need to be acknowledged and negotiated by multidisciplinary teams.
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Affiliation(s)
- Kevin Bardosh
- School of Social and Political Science, The University of Edinburgh, 58 George Square, Edinburgh, United Kingdom; Division of Pathway Medicine and Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom.
| | - Phouth Inthavong
- National Animal Health Laboratory, Ministry of Agriculture and Forestry, Department of Livestock and Fisheries, Luang Prabang Road, Ban Huanmouang, Vientiane Capital, Lao Democratic People's Republic
| | - Sivilai Xayaheuang
- CSIRO Animal, Food and Health Sciences, Australian Animal Health Laboratory (AAHL) Regional Programme, 5 Portarlington Road, East Geelong, Victoria, Australia
| | - Anna L Okello
- National Animal Health Laboratory, Ministry of Agriculture and Forestry, Department of Livestock and Fisheries, Luang Prabang Road, Ban Huanmouang, Vientiane Capital, Lao Democratic People's Republic; CSIRO Animal, Food and Health Sciences, Australian Animal Health Laboratory (AAHL) Regional Programme, 5 Portarlington Road, East Geelong, Victoria, Australia
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