Great video! by Water For People, sure there are a lot of little details not mentioned, but you can not do better for a 5 minute video.
Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
Access to improved sanitation plays an important role in child health through its impact on diarrheal mortality and malnutrition. Inequities in sanitation coverage translate into health inequities across socio-economic groups. This paper presents the differential impact on child mortality and diarrheal incidence of expanding sanitation coverage across wealth quintiles in Nepal.
We modeled three scale up coverage scenarios at the national level and at each of the 5 wealth quintiles for improved sanitation in Nepal in the Lives Saved Tool (LiST): equal for all quintiles, realistically pro-poor and ambitiously pro-poor.
The results show that equal improvement in sanitation coverage can save a total of 226 lives (10.7% of expected diarrhea deaths), while a realistically pro-poor program can save 451 child lives (20.5%) and the ambitiously pro-poor program can save 542 lives (24.6%).
Pro-poor policies for expanding sanitation coverage have the ability to reduce population level health inequalities which can translate into reduced child diarrheal mortality. more….
Reema Kumari(1), JV Singh(2)
1 Associate Professor,2 Prof. and Head Department of Community Medicine & Public Health, King Georges Medical University, Lucknow
njmsonline.org – National Journal of Medical and Allied Sciences [NJMS]
Introduction Diarrhoeal diseases are leading causes of mortality and morbidity in developing countries. Inspite of many programmes and facilities provided by the government towards prevention of diarrhoeal diseases, it continues to be a threat.
Objective: To study the sanitation and hygiene practices followed by patients of diarrhoea admitted at Infectious Disease Hospital (IDH).
Methodology: A descriptive cross sectional hospital based study conducted on 300 patients admitted at Infectious Diseases Hospital, King George’s Medical University, Lucknow. Patients were interviewed using a predesigned schedule after taking informed consent. Information regarding general characteristics including source of drinking water, sanitation practices, toilet facility available and mode of refuse disposable were taken. Data was analysed using SPSS 17.0 statistical software. Results: Majority (50.67%) of patients’ uses Municipal water supply/tap water as main source of drinking water and 30% patients uses India mark II hand pump. Around two-third of diarrhoeal patient practices hand washing with soap and water after household activities. Majority (63.33%) do not practices safe methods of storing drinking water, 87.33% uses sanitary latrines while 12.6% still uses open field for defecation. Almost half of the patients uses dustbin for refuse disposal. Use of sanitary latrines and India mark II drinking water was positively associated with higher socioeconomic status. Conclusion: In spite of the improved facilities of water and sanitation provided by the government, there exists a lacuna between its availability and their proper utilisation. This leads on to the burden of diarrhoeal patients on the health sector. Proper awareness regarding safe drinking water and sanitation practices and proper refuse disposal can reduce the diarrhoeal load. view pdf…
WASHLink from time to time likes to briefly note newly publish papers in hopes of giving them a wider audience – let us know if you know of paper that could use this very small piece of publicity…
- new paper: non-clinical interventions for preventable & treatable childhood diseases – what do we know? (washlink.wordpress.com)
- Spurt in diarrhoea cases, Chennai Corpn. lax (thehindu.com)
Web cast interview with Epidemiologist Irene Shui,
Excerpts from the story:
“A study in the Journal of the American Medical Association examines the safety and effectiveness of another rotavirus vaccine now being used.”
“Other vaccines have since taken its place. But a manufacturer’s study of one of them, the RotaTeq vaccine, suggested it, too, might cause intestinal blockage after the first dose. Epidemiologist Irene Shui, at the Harvard School Of Public Health, decided to investigate. ”
““Because the rotavirus vaccine is given to almost every child in the United States, it’s crucial to monitor the vaccine’s safety,” said Shui.”
“Shui and other researchers examined the records of almost 800,000 babies who received this vaccine, including 300,000 first doses. They were looking for incidents of intussusception, the medical term for this kind of blockage. ”
“We did not find an elevated risk of intussusception following any dose of the vaccine, and especially following the first dose,” she said.”
worthy of reprinting: Here is the beginning of a great article by Francisca Oluyole in the Daily Triumph
Impact of sanitation on survival
By Francisca Oluyole
UNICEF reports recently indicated that diarrhea prevalence rate in Nigeria is 18.8 per cent.
The rate, according to the report, is “one of the worst in sub-Saharan Africa”.
For many experts, the situation is “just not good enough” for a leading producer of crude oil, especially as children remain the worst victims of such a preventable disease.
Associated mostly with vomiting, purging and dehydration, diarrhea has been identified by the Nigerian health authorities as the second largest direct cause of child morbidity and mortality in Nigeria.
According to statistics from UNICEF, diarrhea accounts for more than 16 per cent of child deaths. That is a total of 150,000 deaths amongst children under five, annually.
Experts trace the disease to a lack of access to basic sanitation facilities and poor hygiene practices.
They say it is closely connected with malnourishment, as undernourished children usually have a compromised immune system and are also at a higher risk of developing pneumonia.
Recent reports from the World Health Organisation (WHO) have confirmed that Nigerian children will continue to be victims of diarrhea as the country is said to be one of the seven high-population countries with
total sanitation coverage of less than 50 per cent.
In effect, less than half of the population has access to improved sanitation and the access is as low as 10 per cent in some states with the situation worse in the rural areas.
The situation, according to the reports, has worsened in the last two decades, with environmental sanitation problems resulting in an escalating negative impact on public and environmental health.
Experts say poor environmental sanitation in Nigeria is characterised by the presence of heaps of refuse in cities, indiscriminate disposal of solid and other wastes, blocked drains, overgrown weeds, among others.
The state of food sanitation in homes, markets and abattoirs is equally appalling and unwholesome as food meant for human consumption is exposed to dust, flies, bacteria and other micro-organisms, they say.
The experts say that such probably accounts for the increasing cases of food-borne diseases such as cholera, food poisoning and typhoid fever.
According to Mr Jones Abari, an Abuja-based community health expert, the lack of safe and private toilets and hand-washing facilities in schools has ensured a quicker development of sanitation-related diseases on children. ….
to read full article by Francisca Oluyole in Daily Triumph go to http://www.triumphnewspapers.com/impact1522010.html R/AUWAL 1 1431 A.H. published MONDAY FEBRUARY 15 2010.
While this is being covered everywhere , I thought it is worth mentioning. It seems important that in this report WHO is stressing Zink tablets in conjunction the oral rehydration solution (ORS) The tables and charts provide excellent statistic for fundraisers and agencies wanting to bring help and awareness. For those in the field there are important points to note but ones in the field may ask “tell us something we don’t know”
Recognition of the reality that “WASH/WATSAN” address seems to be following the same slow path of Global Warming (and other critical realities) , taking its time to come to be mainstream and get the energy it deserves. Hopefully the material presented within shall be an effective red flag to wave to get recognition and resources.
the publication Diarrhoea: why children are still dying and what can be done is available in pdf format for viewing
from the press release:
Past success and present needs
Campaigns targeting childhood diarrhoea in the 1970s and 1980s achieved success by scaling up the use of oral rehydration solution (ORS) to prevent dehydration and by educating caregivers. In spite of the promising results of these campaigns, in recent years the international community has shifted its focus to other global emergencies. There is now an urgent need to focus once more on preventing and treating diarrhoea.
Treatment with ORS and zinc tablets
WHO and UNICEF recommend treating diarrhoea with low-osmolarity ORS and zinc tablets, which decrease the severity and duration of the attack. These treatments are simple, inexpensive and life-saving.
Access to clean water and good hygiene practices are extremely effective in preventing childhood diarrhoea. Hand washing with soap has been shown to reduce the incidence of diarrhoeal disease by over 40 per cent, making it one of the most cost-effective interventions for reducing child deaths from this neglected killer.
from the publication:
For a number of years, there was one zinc product that met quality standards for international procurement by UNICEF. Zinc is now procured by UNICEF, governments and
other agencies and is manufactured locally in a handful of countries. However, meeting policy and regulatory requirements for importing a new product continues to present challenges for zinc introduction in many countries. Moreover, changing child health treatment recommendations nationally can also be difficult.
Compounding the problem is the fact that initial start-up funds for these new treatments can be significant, and beyond the scope of regular health budgets. In addition, many countries are hesitant to buy zinc because they have little experience with it as part of diarrhoea management programmes: They are unsure of the demand and are reluctant to devote funds to one-time start-up activities, such as developing training materials. ….
The challenges of scaling up zinc and increasing usage rates of ORS are steep, but not prohibitive. A renewed call to action is needed to ensure that increasing coverage
of diarrhoea treatment interventions becomes an international
pulications Sources: Global Zinc Task Force, 2009; UNICEF Supply Division, 2009.
Excerpt From Napo press release:
SOUTH SAN FRANCISCO, Calif.–(BUSINESS WIRE)–Napo Pharmaceuticals, Inc. (Napo) recently hosted an educational panel to address the impact of the lack of access to clean water and enteric disease on global health, the environment, and human rights. Robert F. Kennedy, Jr., Napo’s Environmental Advisor, discussed the negative consequences of non-sustainable development on indigenous peoples and the environment.
Other speakers included E. Benjamin Skinner, who has written about the connection between the war on diarrhea and modern-day slavery in his book, A Crime So Monstrous; and James Workman, whose book, Heart of Dryness, details the current and future struggles surrounding the scarcity of clean water, as told through the experiences and traditional wisdom of bushmen in southern Africa’s Kalahari region. Dr. Pradip Bardhan of the International Centre for Diarrhoeal Disease Research in Bangladesh (ICDDR,B), a state-of-the-art cholera hospital, shared his experiences with enteric disease, not only at the ICDDR,B, but also with respect to cholera crises around the world, such as the recent outbreak in Zimbabwe.
“This event was an important gathering of world experts to address the various factors affecting the health of global populations,” said Napo CEO Lisa Conte. “The development of crofelemer, Napo’s investigational drug for secretory pediatric infectious diarrhea, is part of an effort by many partners to address the devastating dehydration in pediatric populations, regardless of their geography of social or economic status.”
The panel event followed a recent discussion among international experts on Napo’s global advisory board about the development of crofelemer for use in pediatric population. In addition, on Oct. 2, Ms. Conte addressed the MIT Legatum Center’s second annual Progress Through Innovation conference, which highlights the development and empowerment of people in developing regions of the world. Ms. Conte’s remarks focused on Napo’s global business plan to bring its first-in-class anti-diarrheal agent, crofelemer, to all populations in all countries through a sustainable business model by working with local partners. She also commented on the human-rights impacts and environmental repercussions of unmet global health needs, and the common traits shared by innovators and entrepreneurs around the globe.
Crofelemer for Pediatric Populations (CRO-PED)
Napo is organizing a program to accelerate the development of crofelemer for pediatric infectious diarrheal diseases, targeting regulatory approval in 2011-2012 (pending additional funding). The company has established a global advisory board to ensure that the development of a pediatric product incorporates World Health Organization (WHO) Essential Medicines guidelines for oral rehydration solution (ORS), zinc, etc., and to generate a formulation that is practical and safe for resource-constrained regions with limited health personnel. Napo has formed alliances with Direct Relief International and others to make crofelemer accessible to every childhood population in need. Napo is also in the planning stages for clinical development of crofelemer for severe cholera in pediatric populations at the ICDDR,B.
Napo’s proprietary patented gastrointestinal compound, crofelemer, is a first-in-class anti-secretory agent extracted from Croton lechleri, a medicinal plant sustainably harvested in several South American countries. Crofelemer is in various stages of clinical development for four distinct programs, including a late-stage Phase 3 program. The FDA has granted fast-track status to crofelemer development for IBS and HIV-related indications (CRO-IBS and CRO-HIV):
- CRO-HIV for HIV-related diarrhea, Phase 3 (under Special Protocol Assessment)
- CRO-IBS for diarrhea irritable bowel syndrome (D-IBS), Phase 2
- CRO-ID for acute infectious diarrhea (including cholera), Phase 2
- CRO-PED for pediatric diarrhea, Phase 1
Napo’s licensee, Salix Pharmaceuticals, Inc. has exclusive rights to crofelemer for all indications in North America, Europe (excluding Iceland, Liechtenstein, Norway, and Switzerland), and Japan, and, for certain other indications including irritable bowel syndrome, worldwide. Salix estimates that the HIV-associated diarrhea market opportunity alone may be $300 million. The ADVENT trial of crofelemer as a treatment for chronic diarrhea in patients on antiretroviral therapies for HIV or AIDS is being conducted under fast-track status and Special Protocol Assessment agreement with the FDA.
Crofelemer has also been licensed to Glenmark Pharmaceuticals, Ltd. in India and 140 emerging countries for indications related to HIV (CRO-HIV), use in acute adult infectious diarrhea (CRO-ID), and use in pediatric diarrhea (CRO-PED). Glenmark and Salix have entered into a commercial supply agreement for crofelemer active pharmaceutical ingredient (API). AsiaPharm Group, Ltd. has rights to crofelemer in China (including Hong Kong and Macau).
see Journal of Pediatric Gastroenterology and Nutrition: for more information on Infectious Diarrhea in Children
see google journal search results for studies with Crofelemer