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Humanity faces a wide range of freshwater challenges and threats, from the failure to provide safe water and sanitation to all, to ecological disruptions and degradation, increasing violence over water resources, accelerating climate change, and failing institutions and infrastructure. In recent years, crises around minerals, energy, food, and water have stimulated new debates over definitions and concepts of sustainability—including whether the world is reaching a point where natural resource limits will constrain growing populations and economic expansion. Understanding the concept of "peak water" and the strategies that might be available to avoid these constraints is key to moving toward a more efficient and sustainable water future. [ABSTRACT FROM AUTHOR]

There has been a collapse in the number of public toilets in UK cities. Austerity cuts, a lack of legal requirements, and a failure to prioritise sanitation has led to significant health and equality impacts. Research on public toilets in the Global North focuses on their historical production, contemporary design, or on the experience of particular social groups, with less work bringing governance and social experience together. We argue for a focus on the “ungoverning” of sanitation, on how residents “learn” sanitation in the city, and on the need for radical transformation in sanitation approaches and delivery. Drawing on research in London, we set out the challenges for public toilet provision and make a case for a sanitation revolution in British cities. We focus on the experience of delivery drivers and residents with health concerns in order to illustrate the inequalities in provision and their consequences. [ABSTRACT FROM AUTHOR]

The ongoing Israeli military assault on Gaza has caused a devastating collapse of healthcare infrastructure, resulting in an unprecedented surge in infectious diseases. The destruction of sanitation systems, restrictions on medical supplies, and displacement of civilians have created an environment conducive to the rapid spread of waterborne, vector‐borne, and antibiotic‐resistant infections. This paper draws from the insights of local Palestinian healthcare workers and recent medical missions conducted by FAJR Scientific, the Palestine American Medical Association, and Doctors Without Borders, examining infection control efforts under extreme constraints. The missions encountered major challenges, such as the absence of sterile equipment, inadequate access to clean water, and disrupted healthcare services. These conditions have exacerbated the spread of diseases such as hepatitis, meningitis, and polio, with severe impacts on Gaza's pediatric population. Efforts to implement infection control measures, such as telemedicine consultations, wound care protocols, and antibiotic stewardship, were heavily impeded by the ongoing blockade. The paper underscores the critical importance of lifting the siege to allow humanitarian access and to address the root causes of the infectious disease crisis in Gaza. It also highlights the resilience of Palestinian healthcare workers who continue to provide care under these dire circumstances. The recommendations outlined aim to support future medical teams working in conflict zones by providing practical strategies for infection prevention and control amidst such sustained violence. These efforts are contingent on international intervention and an end to the systematic blockade that has weaponized healthcare access. [ABSTRACT FROM AUTHOR]

Aim: In 2021, infection control guidelines, including those specific to feeding environments, were introduced by the International Olympic and Paralympic Committees to reduce virus transmission at the Tokyo 2020 Summer and Beijing 2022 Winter games. This observational cross‐sectional study aimed to investigate caterers' compliance to these guidelines which included measures for personal hygiene, sanitisation, and physical distancing at these events. Methods: Expert sport dietitians attending Tokyo (n = 15) and Beijing (n = 7) games were surveyed to rate 11 COVID‐19 countermeasures as fully (100%), partially or non‐compliant at nine dining locations across both events. Descriptive analysis of each countermeasure based on observed compliance and location was conducted and reported as a proportion of the total responses. To better understand participant perspectives of the factors influencing compliance, open responses were systematically coded into themes and sub‐themes by researchers through content analysis. Themes generated from participant comments were categorised based on their relevance to specific countermeasures and locations to identify commonalities and disparities in participant experiences, perceptions, and observations. Results: All main dining halls at both events were observed as 100% compliant to countermeasures on more occasions compared with Tokyo's venues and satellite villages. However, Beijing's three main dining halls, showed a greater compliance compared with Tokyo's main dining hall, likely due to overcrowding in Tokyo. Comments suggested that smaller dining spaces, with overcrowding, may have contributed to reduced compliance to physical distancing measures. Food safety concerns were raised about gastrointestinal distress in Beijing due to food cross‐contamination. Conclusion: Findings suggest that the food service environment may influence caterers' abilities to comply with foodservice safety and infection control guidelines. In the post‐pandemic era, enhanced quality control and standardised risk mitigation strategies are needed to improve athletes' health at international sporting events. [ABSTRACT FROM AUTHOR]

Urban sprawl and the shortage of proper sanitary infrastructures significantly jeopardize public health and urban sustainability. The problem is further aggravated as a result of the rapid urbanization and urban sprawl. This study investigated the relationship between urban sprawl and sanitation risk conditions in a rapidly growing city in India. This was accomplished by investigating changes in urban sprawl areas between the periods 2000–2020 using multispectral satellite images and Shanon's entropy model and studying the pattern of spatial variations in basic sanitation services derived from the 100 household‐based surveyed WASH (water availability, sanitation, and hygiene) data collected in 2018 before COVID‐19 from 45 sprawl regions. Spatial statistical techniques, namely, the inverse distance weighted (IDW) interpolation and the multicriteria decision technique, were employed for neighborhood analysis and assessing sanitation risks inside the sprawl region. Results showed that Raipur exhibited urban sprawl and around 93.68% of the sprawl area was classified between high (6.47%)‐ and medium (80.52%)‐risk zones. [ABSTRACT FROM AUTHOR]

The present work aims to investigate the effect of pipe roughness on the construction cost of sewer networks in steep terrains. To achieve this objective, a sensitivity analysis was performed, wherein a sewer network was designed with different pipe roughnesses and varying terrain slopes to simulate four distinct steep terrains. In addition, this study considers the effect of new pipes with very high roughnesses that have appeared on the market in recent years, evaluating their influence on sewer network design and construction cost in steep terrains. The sewer networks were designed using an existing methodology for an optimal design that includes drop manholes if required to meet all the hydraulic constraints. The effect of pipe roughness was tested in two sewer networks from distinct sectors of Bogotá, Colombia. Practical Applications: This study has relevance when considering its ability to lead to the expansion of the sewer service, particularly in hilly regions. The use of higher roughness pipes as a result of this finding has a direct impact on reducing the need for drop manholes, leading to a significant reduction in associated costs. This reduction in costs is of paramount importance in the viability and execution of sewer projects in communities facing significant financial constraints. By minimizing costs, this approach not only optimizes project efficiency but also facilitates access to basic sanitation services in geographic areas previously considered difficult to address. Consequently, this research not only improves sewer systems but also contributes to community development. [ABSTRACT FROM AUTHOR]

Expanding sanitary sewer networks is vital for meeting the Sustainable Development Goals (SDGs) for urban areas. Uncertain future design conditions threaten this infrastructure expansion; notably, climate change has been described as the biggest threat to achieving the SDGs. However, the literature on how climate change can affect sanitation is sparse, especially in low- and middle-income countries, where infrastructure is most needed. We created a simple hydraulic model that quantitatively examines how the uncertainty-induced threats related to urbanization, stormwater inflow, and climate change might affect designed sanitary sewers. Our sanitary sewer model allows a designer or operator to estimate how urban development (e.g., population growth, water consumption, and expansion of impervious areas), stormwater infow, or changing rainfall patterns (e.g., climate change scenarios) would affect the performance of a sanitary sewer network. We identified that the fraction of stormwater inflow entering the sanitary sewers is the most significant threat to urban sewers. Applying the model to three case studies in Brazil revealed that the fraction of stormwater inflow in sanitary sewers is at least 1.8 times more influential than the other considered uncertainties. Stormwater inflow collected in the sanitary system leaves the network vulnerable to extreme rainfall events, consequently leaving the design guidelines vulnerable to climate change, which may compromise their ability to achieve the SDGs. Our model quantitatively demonstrates the essential role that minimizing inflow must play in ensuring climate resilient sanitation and in maximizing the utilization of sanitary sewers. Practical Applications: Safely managing human waste is critical to the health and well-being of humans, especially in cities. Investments in resilient sanitation infrastructure can generate a significant return on investment in health-related benefits. However, if not accounted for, climate change effects can compromise the ability to provide safe sanitation. While 3.5 billion people still need sanitation infrastructure today, methods of expanding sewer systems amid climate change are unclear. In this paper, we provided a simple model that gives a designer or operator insights into the implications of how various sources of uncertainty (urbanization, stormwater inflow, and climate change) can affect the performance of sanitary sewers. Applying the proposed model to three regional capital cities in Brazil, we demonstrated that the biggest threat to urban sewers, even compared to urbanization and climate change, is the fraction of stormwater entering a sanitary sewer. When building or expanding sanitary sewers, inaccurate estimates of how much stormwater will enter the sanitary system can lead to sewage overflow, which might result in health, environmental, and economic hazards. Minimizing the fraction of stormwater that enters the sanitary system would increase the resilience of the sewer network against extreme rainfall events that would increase due to climate change. [ABSTRACT FROM AUTHOR]

Hydatid cyst contamination in food presents a persistent and pervasive threat to public health. Hence, several studies have been published on hydatid cysts in raw meat products. The current study aimed to meta-analyze the prevalence of hydatid cysts in meat. The search was performed in international databases, including PubMed, Web of Science, Scopus, and Google Scholar, from January 1, 2000, to February 10, 2024. A meta-analysis of prevalence was conducted using the metaprop command in the subgroups of countries, animals, and WHO regions. Meta-regression of the prevalence of hydatid cysts in meat over time and sanitation services ranking was conducted using a random effects model (restricted maximum–-likelihood). Fifty-seven published references with 130 data reports were included in the study. The lowest and highest prevalence of hydatid cysts in raw meat was observed in Sudan at 0.01%, 95%CI (0.01–0.02) and Italy at 69.86%, 95%CI (68.14–71.55), respectively. The highest prevalence of hydatid cysts was observed in Sheep (12.32%), Cattle (11.85%), and Buffalo (10.65%). The lowest and highest prevalence of hydatid cysts was South-East Asian Reg (2.77%) and European Region (33.21%), respectively. Meta-regression showed that the prevalence of hydatid cysts has significantly decreased over time (p-value = 0.021) and insignificantly decreased with sanitation services ranking (p-value = 0.679). Therefore, in order to maintain the existing conditions and even reduce the burden of hydatidosis, public health education, promotion of hygienic practices, and investment need to be carried out continuously. [ABSTRACT FROM AUTHOR]

Background: Menstrual hygiene management is a critical aspect of adolescent health. However, access to adequate menstrual hygiene products and sanitation facilities is severely restricted during times of war. There is a dearth of information about the menstrual hygiene needs of adolescent girls during humanitarian crises. This study investigated the menstrual hygiene management needs of the internally displaced adolescent girls in the war-torn region of Tigray, Ethiopia. Methods: A qualitative study was conducted in three centers for internally displaced people in Mekelle, Tigray Region. Four focus-group discussions and six in-depth interviews were conducted using the local language among 39 adolescent girls aged 13–19 years. The collected data were recorded, transcribed, translated, and analyzed using the ATLAS.ti-7.5.18 software through a qualitative thematic analysis approach. Results: Six primary themes were identified: 1) shortage of menstrual pads; 2) poor accommodation of latrine facilities; 3) silence around menstruation; 4) exchange of menstrual pads for life-saving commodities, 5) lack of privacy; 6) menstruation is a "curse" for adolescent girls living in displaced people's camps. The study highlights the significant challenges faced by internally displaced adolescent girls in managing their menstrual hygiene while living in camps for internally displaced people. Lack of access to adequate menstrual hygiene management supplies often leads them to use rags or worn-out clothing instead of menstrual pads. Conclusion: Access to adequate menstrual hygiene products and sanitation facilities is severely limited among displaced adolescent girls in Tigray. The findings emphasize the urgent need to address menstrual hygiene issues during emergencies. Supplying essential items such as sanitary pads, soap, water, sanitation infrastructure, and improved information on menstrual hygiene management should be prioritized. [ABSTRACT FROM AUTHOR]

Food safety is a public health concern worldwide due to an increased morbidity and mortality risk associated with the outbreak of food-borne diseases. This study aimed to assess knowledge, attitude, and food safety practices (KAP) among university students in northern Tanzania. This is interesting because it allows data to be collected for creating awareness on safety, sanitation, and quality of food available within and outside the university environments.We conducted a cross-sectional study among 407 university students in Kilimanjaro region and all authors participated equally. Participants completed an online, self-administered questionnaire. Data was analyzed using SPSS version 25 and summarized using descriptive statistics. The Chi-squared test compared the proportion of KAP by participant characteristics and the multiple logistic regression model used to determine the associated factors. Participants had a mean age (standard deviation) of 23.2 (2.6) years, 51.4% were males, and 83% were < 25 years. The overall proportion of good knowledge, attitude, and food safety practices were 82.6, 78.4, and 31.9%, respectively. Higher odds of knowledge and attitude on food safety were students from KCMUCo (OR = 2.36; 95% CI 1.33–4.17) and (OR = 4.80; 95% CI 2.67–8.63). Also higher odds of food safety practice were students with good knowledge (OR = 1.80; 95% CI 1.03–3.13).Good food safety knowledge but not attitudes was associated with good food safety practices. This shows the need to introduce practical food safety within college environments to help students improve food hygiene and safety practices. [ABSTRACT FROM AUTHOR]

Introduction: Safe drinking water, sanitation, and hygiene (WASH) are crucial to human health. Reducing inequalities and ensuring universal access to WASH are essential to achieving the agenda of sustainable development. We aimed to measure access to WASH among ethnic minority populations in Bangladesh and understand the situation and factors affecting WASH practices among them. Additionally, we reviewed policy related to WASH to highlight the inequality faced by ethnic minority populations. Methodology: We utilized data from the multiple indicator cluster survey-2019. We used the chi-square test for bivariate analysis and multilevel mixed-effect logistic regression analyses to identify the effect of ethnicity on WASH in Bangladesh after controlling selected covariates. Furthermore, we systematically reviewed Bangladesh’s WASH-related policies and programs. Findings: While 98.5% of Bengalis had access to basic drinking water services, the percentage is 60.6% for the ethnic minority population. For improved sanitation facilities not shared with others, the difference between Bengali and ethnic populations was 22.3% (64.6% vs. 42.3%). On the other hand, 75% of the Bengali population had a handwashing facility with water and soap, and 50% of the ethnic population had them. Ethnicity appeared to be a statistically significant predictor of every component of WASH. Compared to Bengali, the ethnic population had 87%, 45%, 31%, and 45% less access to water (aOR = 0.13, p ≤ 0.001), sanitation (aOR = 0.55, p ≤ 0.001), and handwashing (aOR = 0.69, p ≤ 0.05), and WASH facilities aOR = 0.55, p ≤ 0.001), respectively. Among the policies of Bangladesh, only one identified action for WASH rights of ethnic minorities. Conclusion: The government should identify the issues of WASH among ethnic minorities and represent them adequately in policies to achieve the aim of ‘leaving none behind’ of sustainable development goals. [ABSTRACT FROM AUTHOR]

Exposure to chlorine dioxide by staff working in a gnotobiotic mouse facility at an Australian research institute was measured to determine whether current controls were sufficient to ensure their exposure remains below the current Australian workplace exposure standard. A combination of workplace surveys, interviews with workers, and personal sampling was undertaken to understand the workplace, identify higher-risk tasks, and measure the concentration of chlorine dioxide in the air where the workers conduct routine tasks involving the use of a chlorine dioxide-based disinfectant. Personal sampling utilized the validated Occupational Safety and Health Administration (OSHA) method ID-202, with minor alterations. The tasks identified as being associated with higher airborne exposure to chlorine dioxide were the use of an atomizer to fill isolator ports with aerosolized disinfectant and the use of a disinfectant dunk tank to submerge and surface decontaminate objects. The current work practices in the gnotobiotic facility were found to be compliant with the current 8-hr time-weighted average (TWA) limit of 0.1 ppm (0.28 mg/m3) but were not compliant with the 15-min short-term exposure limit (STEL) of 0.3 ppm (0.83 mg/m3). Improvements in exposure controls, such as implementing the use of a fume cupboard (hood) or other local ventilation when activating the disinfectant solution and improving the utilization of respiratory protective equipment, are therefore required to meet the STEL, but it is recommended that such improvements are also aimed at meeting the proposed Peak limitation of 0.1 ppm that is expected to soon be adopted by Safe Work Australia, replacing the current TWA-8hr and STEL exposure standards. [ABSTRACT FROM AUTHOR]

This article explores how early Victorian social reformers deployed lists as sanitation devices to organize messy social and material realities into representative categories. Dickens's own notable reliance on lists has been interpreted as dovetailing with a reformist politics of realist representation. But through a reading of Oliver Twist I argue that Dickens transforms lists from a neutral technology of organization to a more anarchic form in which parts multiply without respect to a larger whole. Dickens's lists mingle various and often mutually incompatible categorical systems and flashily attend to grammatical parts over the regulating whole of the sentence. [ABSTRACT FROM AUTHOR]

The availability of safe water, sanitation, and hygiene (WASH) facilities in schools is essential for a healthy learning environment and achieving sustainable development goals (SDGs) 4 and 6. Despite its importance, comprehensive studies on drinking water quality, sanitation, and hygiene in schools are scarce. This study explicitly assessed the WASH services and gaps in 43 educational institutions, located in Tongi, Bangladesh, through field and laboratory investigations. Thirteen physicochemical and bacteriological parameters were analyzed, and water quality was classified using an Integrated Water Quality Index (IWQI). Hygiene and sanitation were evaluated through observations and data from school administrators on water sources, toilets, handwashing facilities, and solid waste management. Results showed that WASH services exceeded the national average, but all schools had dangerously high Escherichia coli levels (mean: 43.95 CFU/100 mL) in drinking water, posing health risks. Additionally, 89.72% of samples showed elevated manganese levels, 35% had high iron, and 41.86% had increased conductivity. About 35% of water was unsuitable for drinking based on IWQI. Schools lacked the capacity to monitor WASH quality, especially drinking water. A strategic framework for safe WASH facilities is recommended. The findings can lead the policymakers to prioritize the improvements in WASH facilities for attaining SDG 6. [ABSTRACT FROM AUTHOR]

Objective: To examine the effects of the transitional tele-rehabilitation programme on quality of life of adult burn survivors. Design: A prospective, single centre, randomised controlled trial and reported according to the Consolidated Standards of Reporting Trials (CONSORT) guidelines. Participants: Adult burn survivors aged ≥18 years with burn size ≥10% total body surface area irrespective of the depth was considered eligible to participate. Intervention: The intervention was in two phases: pre-discharge and active follow-up phase (which occurred via WeChat). In both phases, comprehensive assessment and intervention guided by the Omaha System and evidenced-based protocols guided the care delivery over an 8-week period. Main measures: The outcome of interest was quality of life. Two outcome measures were used to assess the outcome of interest: Burn Specific Health Scale-Brief (BSHS-B) and the EQ-5D-5L tools. The outcome was assessed at three time points: T0 (baseline), T1 (immediate post-intervention) and T2 (4 weeks from T1). Results: In total, 60 adult burn survivors were randomly allocated to undergo the new programme. The transitional tele-rehabilitation programme elicited statistically significant improvement in simple abilities, affect, interpersonal relationship (T2) and overall quality life (T1 and T2) measured on the BSHS-B. Conclusion: Ongoing rehabilitative care is essential to support the recovery process of burn survivors considering that some quality-of-life subscales may improve faster than others. The study findings highlight the potential of employing a social media platform to improve post-burn quality of life outcomes. Trial registration: ClinicalTrials.govNCT04517721. Registered on 20 August 2020 [ABSTRACT FROM AUTHOR]

Assessing the potential relationship between ownership and performance of water utilities is relevant for water regulators. Incorporating technological heterogeneity among groups of water utilities could solve any incomparability issues and lead to more appropriate policy implications. This can be done with the use of the metafrontier framework which assumes that utilities operate under different technologies. The study applies this framework to compare the efficiency of private water utilities (PWU) and concessionary water utilities (CWU) in Chile using Bayesian Stochastic Frontier Analysis (SFA) techniques. The results indicated that PWU performed better than CWU. Nevertheless, both types of water utilities presented considerable cost inefficiency. PWU and CWU should considerably reduce costs by 34% and 48% using the industry technology as a whole, respectively. The methodological approach proposed in this study could be used to compare the performance of other groups of water utilities to support the decision making of water regulators. [ABSTRACT FROM AUTHOR]

Decentralized water systems (DWS) distribute water in remote African areas. Throughout an intervention in Maniema, Congo, the influence of a DWS performing chlorination in the community's water quality was measured. Additionally, a socio-economic and WASH practices survey was conducted in the communities. Free residual chlorine (FRC) and microbiological contamination were measured; at the borehole, treatment site, distribution points, and households's water containers. In Big Five, water was collected from unimproved sources before DWS construction. Despite that, only 16,6% of households used efficient water treatment methods, resulting in 73% of water stored unsafe for consumption. After construction, household water quality drastically improved, regardless of FRC fluctuations; 93% of samples were classified as low health risk (safe). The renovation guaranteed continuous supply through electro-chlorinators in RVA, where chlorination was intermittent. Water from DWS with adequate chlorine levels prevented microbiological contamination in households for 12 hours. Although economically attractive, the system's sustainability will require future evaluation. [ABSTRACT FROM AUTHOR]

Knowledge gaps remain as to how public expenditures (PE) contribute to key SDG outcomes, including eradicating poverty and hunger and improving food and nutrition security in sustainable manners (SDGs 1 and 2). This study partly fills this knowledge gap using the Statistics on Public Expenditures for Economic Development (SPEED data) and various country-level panel data. We find that greater PEs for agriculture and, to a lesser extent, health sectors consistently reduce poverty and improve access to basic water and sanitation services, reduce child stunting and overweight, undernourishment, and food prices. These relationships are somewhat stronger for countries classified as low- or lower-middle-income in 2000. Greater PEs for education and social protection, which have been generally higher than PEs for agriculture and health in terms of allocations, have had more mixed effects on these outcomes. [ABSTRACT FROM AUTHOR]

Globally, billions of people do not have access to safely managed drinking water and sanitation services. Interventions to improve drinking water, sanitation and hygiene could reduce the incidence of diarrhoea in low- and middle-income countries. This study aimed to investigate the association between these services and the incidence of diarrhoea. Worldwide, ecological observational study, utilising cross-sectional data. Data from the Global Burden of Disease Study 2019 and World Bank were used in this study. Diarrhoeal disease episodes were defined as three or more loose bowel movements within 24 h. Estimated Annual Percentage Change was used to quantify trends in disease incidence over a specific time interval. Quasi-Poisson Generalised Linear Model was introduced to analyse the influence of basic drinking water and sanitation services on the incidence of diarrhoea. Subgroup analyses were carried out to determine potential variations in the incidence of diarrhoeal diseases according to sex, age and sociodemographic index (SDI) region. Between 2000 and 2019, the incidence rate of global diarrhoea remained consistent, with regional variations linked to SDIs. A 1% increase in access to basic drinking water was associated with a 0.41% (95% confidence interval [CI], 0.33%–0.50%) increase in the age-standardised incidence rate of diarrhoea; meanwhile, a 1% increase in sanitation service usage was associated with a 0.47% (95% CI, 0.40%–0.54%) reduction in the age-standardised incidence rate of diarrhoea. The correlation differed across SDI regions. The use of safely managed drinking water was associated with a reduction in diarrhoeal disease rates, but the effect was non-significant in High SDI regions. Higher diarrhoeal disease incidence was seen in younger and older populations. Individuals in the age groups 55–59 years and 10–14 years showed the greatest association of water service usage with diarrhoea, while an increase in sanitation service usage was related to decreased diarrhoea rates in most age groups, excluding children aged 5–14 years. Emphasising initiatives to enhance water quality, elevate the standards of drinking water safety management, and strengthening related infrastructure development in global health policies and development plans could have a positive impact on overall global health. Such comprehensive interventions have the potential to not only prevent waterborne diseases but also elevate the general health status of societies worldwide. [ABSTRACT FROM AUTHOR]

Wastewater affordability is a pressing concern in the US as the cost of collecting and treating wastewater continues to rise rapidly, and reports have revealed that millions of residents are experiencing a lack of equitable access to affordable wastewater management. The USEPA has established an affordability metric based on 2.5% of median household income (MHI) and affordability is typically interpreted as the monthly utility bill. However, this approach is not applicable to the 25% of US households that are not connected to networked sewer. This study developed the first statewide methodology for mapping wastewater affordability for users of both networked and onsite wastewater treatment systems (OWTS) based on USEPA guidelines. The methodology used local data from the Alabama Department of Environmental Management (ADEM), utilities, and the US Census Bureau. This article presents a novel methodology for quantifying water and wastewater affordability challenges for large geographical areas while maintaining the accuracy of small-spatial scale analysis. This study also incorporated income inequalities by using census tract-level household income data to estimate the number of households in Alabama with unaffordable wastewater access. This study revealed that wastewater access affordability challenges are more widespread than indicated by traditional MHI-based analysis and are likely affecting approximately 445,000 households in Alabama (23.7%). This study also showed that expansions in the available funding and types of eligible applicants for grant programs that subsidize OWTS capital costs could reduce OWTS affordability challenges eightfold. We propose using this methodology to quantify affordability challenges alongside a suite of approaches to address wastewater affordability in the US at the utility and household levels to preserve the human right to affordable sanitation. Practical Applications: Wastewater affordability is a key aspect of providing sustainable wastewater collection and treatment for US residents. The ongoing discussions about wastewater access affordability are often centered around customers of sewer utilities and neglect to consider the affordability challenges of residents with OWTS (commonly known as septic tank systems). This study develops a methodology for analyzing statewide wastewater access affordability for both residents with sewer bills and users of OWTS based on annual household incomes at the census tract level. This study reveals that wastewater affordability challenges affect both users of centralized sewer networks and OWTS including approximately 445,000 households in Alabama (23.7%). [ABSTRACT FROM AUTHOR]

Background: The famous Tang Dynasty monk Yi Jing travelled to ancient India in 671 AD, visited more than 30 regions and returned to China in 695 AD. He wrote Nanhai Jigui Neifa Zhuan, which he completed in 691 AD. It describes the basic rules, namely 'Inner Dharma' (Neifa,内法) that Buddhist sites and monks should follow in their daily lives. Additionally, the author provided an overview of ancient Indian Buddhist medicine, covering aetiology, diagnosis, medication, acupuncture, health preservation and other aspects, which exhibited distinct characteristics. Methods: This article first delves into the original text of Nanhai Jigui Neifa Zhuan by reading it thoroughly and extracts core chapters related to hygiene, medicine and health care. Later, the extracted information is meticulously classified and organised. Lastly, through a systematic literature review, keywords search, data screening and comparative analysis, an in-depth and comprehensive exploration and analysis of Nanhai Jigui Neifa Zhuan is conducted within the domains of hygiene, medicine and health care. Results: Nanhai Jigui Neifa Zhuan emphasizes the importance of personal hygiene for ancient Indian monks and introduces the basic theories of ancient Indian medicine. It compares ancient Indian and Chinese medicinal materials, highlighting their respective roles in treating different diseases. Furthermore, it briefly discusses the storage and processing of ancient Indian medicinal materials, poisoning and toxicology, and ancient Indian health preservation ideologies. Conclusion: A comprehensive and in-depth study of traditional ancient Indian medicine, including Buddhist medicine and Ayurveda, and its application in the religious environment and communities of the Tang Dynasty (618–907 AD) aids in understanding the treatment methods and health practices of ancient Indian medicine. Additionally, it facilitates a deeper understanding of the similarities, differences and exchange between Chinese and Indian medicine, thereby opening up new horizons for future research. [ABSTRACT FROM AUTHOR]

Water security and climate change are important priorities for communities and regions worldwide. The intersections between water and climate change extend across many environmental and human activities. This Primer is intended as an introduction, grounded in examples, for students and others considering the interactions between climate, water, and society. In this Primer, we summarize key intersections between water and climate across four sectors: environment; drinking water, sanitation, and hygiene; food and agriculture; and energy. We begin with an overview of the fundamental water dynamics within each of these four sectors, and then discuss how climate change is impacting water and society within and across these sectors. Emphasizing the relationships and interconnectedness between water and climate change can encourage systems thinking, which can show how activities in one sector may influence activities or outcomes in other sectors. We argue that to achieve a resilient and sustainable water future under climate change, proposed solutions must consider the water–climate nexus to ensure the interconnected roles of water across sectors are not overlooked. Toward that end, we offer an initial set of guiding questions that can be used to inform the development of more holistic climate solutions.This article is categorized under: Science of Water > Water and Environmental Change Engineering Water > Water, Health, and Sanitation Human Water > Value of Water [ABSTRACT FROM AUTHOR]

The ongoing conflict in Gaza has led to severe destruction of the health system and eventually its collapse. Moreover, multiple attacks on health workers were reported which led to obstacles in service delivery. The conflict has led to further humanitarian crises including shortage of food, water sanitation, and hygiene, and outbreaks of infectious diseases. About 2 million of Gaza's population are internally displaced with the majority in Rafah. Rafah's population has increased by 500% in less than four months. This has led to acute food severity in Gaza for the whole of the population. Moreover, the cut of UNRWA aid is expected to further expand the humanitarian crisis as over 2 million of the population depends on the aid. [ABSTRACT FROM AUTHOR]

Background: Lifestyle modifications (LM) are crucial in managing comorbid Tuberculosis (TB) and Diabetes Mellitus (DM) patients, significantly impacting treatment outcomes and overall health. In view of this, a study was conducted to clarify sociocultural features associated with LM among TB–diabetes comorbid patients. Methods: A cross-sectional descriptive study among randomly selected 180 adult TB–diabetes-comorbid-patients was conducted using a semi-structured interview schedule. Mann–Whitney-U-test was used to examine differences in means between patterns of distress (PDs) and perceived causes (PCs) regarding TB and Diabetes for two identified LM strategies among comorbid patients. Stepwise logistic regression was used to study factors associated with these LM strategies. Results: TB–diabetes-comorbid-patients reporting physical symptoms as PDs preferred to follow the LM-1 strategy for TB and LM-2 for Diabetes. In contrast, patients reporting health-illness-injury-related causes follow LM-2 for TB and LM-1 for Diabetes. Further patients reporting hypertension for Diabetes (AOR = 2.916, 95% CI 0.9262–9.1788) and concerns-about-the-course-of-TB-illness (AOR = 3.746, 95% CI 1.4683–9.5593) as PDs were 3–4 times more likely to follow LM-1. While those reporting prior illnesses (AOR = 4.255, 95% CI 1.3941–12.9837) and sanitation (AOR = 5.242, 95% CI 1.2028–22.8446) as PCs for TB were 4–5 times follow LM-2. Patients who perceived consumption of alcohol as PCs of Diabetes were 10 times more likely to stop addictions (AOR = 9.680, 95% CI 2.5555–36.6639) and follow the LM-2 strategy. Conclusion: Given significant associations of sociocultural features with LM strategies, consideration of sociocultural features vis-à-vis these strategies is indispensable for managing TBDM comorbidity, emphasizing the need for developing comprehensive, patient-centred self-management interventions to enhance adherence and improve health outcomes. [ABSTRACT FROM AUTHOR]

Background: Poor menstrual hygiene practices are one of the major public health problems in Nepal. Due to persistent taboos and socio-cultural constraints, adolescent girls are often unaware of scientific facts, knowledge, and practices related to menstrual hygiene. This paper aims to assess the effects of health education intervention on menstrual hygiene knowledge and practices among adolescent girls in Pokhara Metropolitan, Nepal. Materials and methods: A true experimental study was conducted in two government basic schools in Pokhara Metropolitan, Nepal. The study population was adolescent girls who had attended the menarche. Firstly, a pretest with the help of a self-administered questionnaire was done to find out the socio-demographic information, knowledge and practices of menstrual hygiene. Next, health education sessions were conducted among the intervention group. Finally, after one month of intervention, a post-test was conducted among the intervention and non-intervention group. Data analysis was done through descriptive and inferential statistics. Results: The findings showed significant improvement in the knowledge and practice level of adolescent girls on menstrual hygiene after health education intervention. Participants in the intervention group showed a significant increase in knowledge scores from 10.0% to 67.0%, while the non-intervention group remained unchanged at 7.5%. Good menstrual hygiene practices scores in the intervention group increased significantly from 22.5% to 67.0%, whereas the non-intervention group saw a slight rise from 20.0% to 22.5%. Regarding observed practice scores in menstrual hygiene, significant improvement was observed in the intervention group (45.0% to 100.0%) in contrast to the non-intervention group (25.0% to 27.5%). Conclusions: This study highlights the crucial role of school health education interventions in promoting menstrual hygiene among adolescent girls. It emphasizes the importance of comprehensive educational programs tailored to early teenage girls, addressing timing, content, and delivery methods alongside ensuring the availability of Water, Sanitation and Hygiene (WASH) facilities. [ABSTRACT FROM AUTHOR]

Background: Indian subcontinent being an important region in the fight to eliminate cholera needs better cholera surveillance. Current methods miss most infections, skewing disease burden estimates. Triangulating serosurvey data, clinical cases, and risk factors could reveal India's true cholera risk. Methods: We synthesized data from a nationally representative serosurvey, outbreak reports and risk factors like water, sanitation and the Multidimensional Poverty Index, to create a composite vulnerability index for assessing state-wise cholera risk in India. We tested 7,882 stored sera samples collected during 2017–18 from individuals aged 9–45 years, for vibriocidal antibodies to Vibrio cholerae O1 using a cut-off titre ≥320 defining as elevated titre. We also extracted data from the 2015–19 Integrated Disease Surveillance Programme and published cholera reports. Results: Overall, 11.7% (CI: 10.4–13.3%) of the sampled population had an elevated titre of cholera vibriocidal antibodies (≥320). The Southern region experienced the highest incidence (16.8%, CI: 12.1–22.8), followed by the West (13.2%, CI: 10.0–17.3) and North (10.7%, CI: 9.3–12.3). Proportion of samples with an elevated vibriocidal titre (≥320) was significantly higher among individuals aged 18–45 years (13.0% CI: 11.2–15.1) compared to children 9–17 years (8.6%, CI 7.3–10.0, p<0.05); we found no differences between sex or urbanicity. Between 2015–2019, the Integrated Disease Surveillance Program (IDSP) reported 29,400 cases of cholera across the country. Using the composite vulnerability index, we found Karnataka, Madhya Pradesh, and West Bengal were the most vulnerable states in India in terms of risk of cholera. Conclusion: The present study showed that cholera infection is present in all five regions across India. The states with high cholera vulnerability could be prioritized for targeted prevention interventions. Author summary: Cholera remains a significant public health threat in areas with inadequate water, sanitation, and hygiene (WASH). The World Health Organization's Global Task Force on Cholera Control (GTFCC) launched "Ending Cholera: A Global Roadmap to 2030" to reduce cholera deaths and eliminate the disease in 20 countries by 2030 through targeted interventions, including improved WASH practices and disease surveillance. cholera surveillance, especially in developing countries seldom poses difficulty in terms of the need for laboratory infrastructure, and other resource constraints. Thereby, in this study, we utilized a viable approach with serosurvey data from 2017, cholera outbreak data, WASH indicators, and the Multidimensional Poverty Index (MPI) to create a composite vulnerability index for cholera risk in India. Overall, 11.7% of the sampled population had detectable levels of cholera antibodies reflecting previous infection. The Southern region of India experienced the highest incidence, followed by the West and North. the study showed that cholera infection is present in all five regions across India. Further, the vulnerability index which we built could be utilized in other settings so that effective tailored interventions could be applied in identified priority areas. [ABSTRACT FROM AUTHOR]

This article analyzes the politics of scale in global development by focusing on a sanitation program in western Kenya. It follows the daily work of a nongovernmental organization that seeks to provide access to chlorine dispensers to millions of people for the purpose of disinfecting water. By engaging with literatures on development and infrastructure, this article proposes reach as an analytic that jointly attends to the aspirations, labors, and uncertain outcomes embedded in scale work. An ethnography of reach emphasizes the temporality of off‐grid infrastructures to capture the ambivalent relationships between aspirations and results and between standardization and adaptation, as well as the unstable nature of care. This proves useful to theorizing expansion as potentially generative of, rather than only inimical to, the good life—thereby troubling the vision of scale making as replication often used to understand development projects and their consequences. [ABSTRACT FROM AUTHOR]

This article assesses the impact of the Municipal Basic Sanitation Plan (PMSB) and the Municipal Basic Sanitation Policy (PolMSB) on the efficiency of basic sanitation service providers in the municipalities of Santa Catarina. In the first stage, the Data Envelopment Analysis (DEA) method is used to obtain sanitation companies’ efficiency scores for the period from 2012 to 2020. In the second stage, the Tobit model is combined with the Differences in Differences (DiD) method to verify the effect of environmental variables, including PMSB and PolMSB, on the efficiency of signed contracts. The results show that regulation did not promote efficiency concerning maximizing the sector’s production – within the observed period – which showed a decline over the years. Another finding is that sanitation companies operated by municipal public authorities, with the exception of local authorities, demonstrate greater efficiency than private operators. Proof of economies of scale and scope in water and sewage services is also relevant. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess secondary high school students' knowledge, attitudes, habits, and other aspects related to managing menstrual hygiene. A quantitative descriptive correlational research design was employed for the 294 respondents aged 16-18The main method used to gather data was a modified structured survey questionnaire. SPSS v.26 was used to determine inferential statistics and descriptive statistics aided by MS Excel. The findings revealed that the extent of knowledge had a mean a of 4.31 (SD= 0.61), corresponding to excellent knowledge. While attitude resulted in a mean of 3.89 (SD= 0.63), a positive attitude and hygienic practices resulted in a mean of 4.23 (SD= 0.61), corresponding to very efficient practices. However, a few of them still need better and moderate knowledge and attitude, although there is no poor practice among them. With a given p-value of .031 for knowledge, .042 for attitudes, and .038 for practices. Significant differences in factors affecting menstrual hygiene management in terms of individuals with a p-value of .023, contextual with .044, sociobehavioral with .024, and finally, school infrastructure with .014 < 0.05 which has a significant difference when grouped according to demographic profiles of female students. The unfavorable conditions in which women had to manage their menstrual cycles while attending school underscored the urgent need for urgent infrastructure improvements related to water, sanitation, and hygiene. Furthermore, targeted educational interventions should be implemented to address the moderate levels of knowledge and attitudes observed and to ensure that all students have the necessary resources and information to properly manage their menstrual hygiene. [ABSTRACT FROM AUTHOR]

Objectives: In non‐industrialized and low‐income populations, adipose stores can serve as a valuable buffer against harsh conditions such as seasonal food scarcity. However, these reserves may incur costs due to adipocytes' production of pro‐inflammatory cytokines; inflammation is associated with increased risk for cardiometabolic diseases later in life. Life history theory posits that, especially in populations with high juvenile mortality, higher adiposity may nonetheless be advantageous if its benefits in early life outweigh its later costs. Relatively little is known about adolescents' C‐reactive protein concentration (CRP; an inflammation biomarker) in such environments. We investigated CRP and its associations with several hypothesized predictors in adolescents in an economically diverse peri‐urban Andean community. Methods: We measured CRP in dried blood spots and collected data on anthropometrics, illnesses, socioeconomic status (SES), and menarcheal status in 59 female and 40 male adolescents ("Alteños", 11.0–14.9 years old) with normal vital signs in El Alto, Bolivia (~4150 m amsl). We used Cole's LMS method to standardize all anthropometrics for sex and age, and principal components analysis to construct a "fat‐factor" variable loading on these standardized z‐scores. We used multiple linear regression to assess the influence of fat‐factor and other likely predictors on CRP rank. Results: Compared to a national Bolivian growth reference, Alteños were, on average, shorter and leaner; only 6% were classified as overweight and none were obese. Pre‐menarche females were on average leaner than post‐menarche females. The best‐fitting model explained 24% of the variance in CRP rank. Significant predictors were fat‐factor, SES, current illness for males and pre‐menarche females, and z‐height for females. Conclusions: Our results are consistent with a tradeoff between investments in growth versus immune functioning, as might be expected in an environment with limited resources and high pathogen exposure (e.g., soil‐transmitted helminths, poor sanitation). Thinner Alteños appear to maintain a minimum CRP concentration independent of fat‐factor, while fatter (or less‐thin) Alteños' CRP rises with fat‐factor. Female Alteños appear to be trading off investment in immune response for investment in growth and maturation. Alteños' high rate of stunting and absence of obesity suggests chronic, presumably multifactorial, stress. Adipose stores likely buffer against some of these stressors and, in an environment such as this—in which many lack sufficient nutritious foods, potable water, adequate sewage, and health care—may confer a net lifetime benefit. [ABSTRACT FROM AUTHOR]

The article discusses the environmental injustices faced by the Kukama Indigenous women in the Loreto department of the Peruvian Amazon due to extractive activities like oil exploration and mining. The Kukama women led a successful legal battle to recognize the Marañón River as a holder of rights, marking a historic ruling in Peru. Their struggle highlights the importance of Indigenous women's knowledge and resistance in the global movement for environmental justice and the Rights of Nature. The article emphasizes the Kukama women's unique worldview and their integral role in challenging environmental injustices beyond regulatory frameworks. [Extracted from the article]

Tagalag, an urban barangay in Valenzuela, has been providing fish supplies to its city since the 1980s. The barangay was established after a massive flood, and in 2016, it was declared a city eco-tourism zone. The Sustainable Development Goals (SDGs) prioritize economic growth, social inclusion, and sustainable development, encompassing objectives pertaining to the tourism sector. The application of the Sustainable Development Goals (SDGs) to the tourism sector has been undertaken by the World Tourism Organization (UNWTO), with the aim of advocating for the implementation of sustainable, equitable, and environmentally friendly practices within the tourism industry. Sustainable tourism encompasses the comprehensive evaluation of its societal, ecological, and economic consequences while simultaneously addressing the requirements of both tourists and local communities, safeguarding natural resources, and mitigating adverse environmental effects. Under the SDG #6 Clean Water and Sanitation this goal is making sure about the Tagalag fishing village has an availability of clean water and good sanitation by all and how this can be sustained in the Tagalag community which the researchers do some recommended plan for the community Tagalag Fishing Village is dedicated to sustainable fishing practices and marine life habitat restoration, implementing scientifically based management programs and regulatory agencies. The village prioritizes water resource conservation and surface runoff reduction but could benefit from enhancing infrastructure and promoting sustainable development. The village's economic growth is exemplary, with policies promoting economic growth, job opportunities, entrepreneurial endeavors, and indigenous culture preservation. However, there is room for improvement in sanitation and clean water. [ABSTRACT FROM AUTHOR]

Aims The aim of this work was to evaluate the efficacy of an organosilicon-based, commercially available antimicrobial formulation in the My-shield® product line against bacterial surface contamination. Methods and results The antimicrobial product was tested in vitro for its long-term persistence on surfaces and effectiveness against Staphylococcus aureus biofilms in comparison to 70% ethanol and 0.1% or 0.6% sodium hypochlorite. Field testing was also conducted over 6 weeks at a university athletic facility. In vitro studies demonstrated the log reductions achieved by the test product, 70% ethanol, and 0.1% sodium hypochlorite were 3.6, 3.1, and 3.2, respectively. The test product persisted on surfaces after washing and scrubbing, and pre-treatment with this product prevented S. aureus surface colonization for up to 30 days. In comparison, pre-treatment with 70% ethanol or 0.6% sodium hypochlorite was not protective against S. aureus biofilm formation after seven days. The field test demonstrated that weekly applications of the test product were more effective at reducing surface bacterial load than daily applications of a control product. Conclusions The test product conferred greater long-term protection against bacterial growth and biofilm formation by S. aureus than ethanol and sodium hypochlorite. Even with less frequent applications, the test product maintained a high level of antimicrobial activity. [ABSTRACT FROM AUTHOR]

Urban freshwater ecosystems have many critical functions, such as providing water to all living things and supporting biodiversity. Factors such as water pollution, increased water consumption, habitat loss, climate change, and drought threaten the health of urban freshwater ecosystems. Looking for solutions to these challenges, this article aims to recycle water and return it to its life cycle using a climate-sensitive water collection strategy. The model focuses on the biomimetic method as a basic strategy. In this regard, the concept of water-harvesting has been examined in detail by conducting a deep literature review, including architecture and engineering disciplines. With all these data obtained, a synthesis/integration study was carried out by developing a model proposal based on adaptive building façade elements to solve the water problems experienced in cities. The model proposal, which is directly related to the titles of "Clean Water and Sanitation (SDG 6)" and "Sustainable Cities and Communities (SDG 11)", which are among the Sustainable Development Goals (SDGs), aims to provide different perspectives on the disciplines with its superficial and functional features. In this context, it is anticipated that the article will become an indispensable resource for other researchers working on the subject. [ABSTRACT FROM AUTHOR]

Carceral recycling—a system of camp-based waste labor—was instrumental to the Judeocide. Tracing the connections between resource fetishism and ideas about cleanliness, this article shows that waste utilization lay at the heart of a destructive matrix that exploited camp and prison labor in the service of racial purification and imperial expansion. The Nazi regime imagined itself as resource poor and spaceless and accordingly mined junk and people rather than land in a desperate attempt to close the energy cycle and squeeze annihilative capacity out of forced labor and waste products. As an extreme form of securitization infrastructure, the landscape of prisons and camps manifested the Nazi paranoia about the existential threat that Jews and biosocial others supposedly posed in distinct locations of forced labor and murder. An extraction machine, the camp complex served a crucial economic function in an empire that did not distinguish between junk and jewels. Grounding this story in the history of carcerality, imperial extraction, and discard studies, this article draws attention to the dynamic relationship among ideas about cleanliness, security, and order that firmly ground the Nazi system of plunder and murder in the trajectory of Western imperialism and its enlightened rationality. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to identify and characterise the determinants influencing the occurrence of diarrheal diseases in children aged 6–24 months undergoing complementary feeding within a low‐income urban community in Kenya. Methods: This study followed a cross‐sectional design and recruited caregivers of children aged 6–24 months from 302 households. The dependent variable was the 2‐week diarrhoea prevalence among children, with independent variables including sociodemographic characteristics, child immunisation and feeding status, and water and sanitation facilities. Data analysis was performed using SPSS. Descriptive statistics and logistic regression analyses were used to assess associations between independent variables and the occurrence of diarrheal diseases. Results: The majority of caregivers were female (n = 282, 93.4%), aged 25–34 years (n = 156, 51.7%), had attained secondary school education (n = 154, 51%), were unemployed (n = 162, 53.6%), and earned Ksh 10,000 (USD 100) or less. 296 (98%) indexed children were fully vaccinated against rotavirus. Most households used improved drinking water sources (n = 272, 90.1%). Most caregivers did not regularly wash their hands with soap and water (n = 225, 74.5%). The 2‐week diarrhoea prevalence among children was 34.1% (103/302), with 69.9% (72/103) of these cases seeking care at a healthcare facility. Logistic regression analysis revealed that children of caregivers earning Ksh 20,000 and below (aOR = 2.9[1.3–6.5], p = 0.01), and those from households using unimproved sanitation facilities (aOR = 1.9 [CI 1–3.4], p = 0.042), had significantly higher odds of having diarrhoea. Conclusion: The study found a high prevalence of diarrhoea in Kenyan children aged 6–24 months, with caregiver income and household sanitation facilities significantly impacting the occurrence of the disease. The study suggests integrated approaches, including education, income generation, hygiene, and improved nutrition, to address the burden of diarrheal disease. [ABSTRACT FROM AUTHOR]

Valuing water is receiving increasing attention within the global water policy agenda as a new water management paradigm. However, it is not yet clear how it can be operationalized in local water management contexts. We apply the Value Landscapes Approach as a conceptual framework to show how water-related preferences are informed by underlying assigned/water values and governance-related values and how these values may explain three different visions for water management among professional respondents in a Northern Kenyan case study. Through making shared and conflicting values explicit, these insights may serve as a foundation for addressing water conflicts in practice. [ABSTRACT FROM AUTHOR]

Helpful online reviews can benefits customers with less stress from information overload and valuable cues for decision-making, and thus many scholars have discussed what the determinants of review helpfulness. However, limited studies explore how specific review content impacts review helpfulness especially in the hotel industry. Using a latent Dirichlet allocation method, we identified review content type regarding hotel attributes with five topics (room experience, location convenience, personalization & uniqueness, event management & staff attitude, and cleanliness & smell) by extracting dimensions from 166, 546 reviews on Ctrip.com. Then we explored the direct and moderating effects of review content type on review helpfulness. Our findings indicated that customers give the most weight to event management & staff attitude in hotel reviews, followed by personalization & uniqueness, cleanliness & smell, and location convenience/room experience. Moreover, the effects of some characteristics of reviews (e.g., review extremity, review photo) and reviewers (e.g., reviewer expertise, reviewer reputation) on review helpfulness vary in different types of review content. These findings could provide foundation on exploring the influence of specific review content on review helpfulness, as well as offer valuable guidelines for hotels to allocate resources effectively. [ABSTRACT FROM AUTHOR]

Pit latrines are the most common household sanitation system in East African cities. Urbanisation reduces the space available for new latrines to be constructed when pits fill and they increasingly require emptying. But formal services that empty and transport sludge to safe disposal or treatment are often unaffordable to low-income households. Cross-subsidies have been suggested to fund services for low-income households but there are no academic studies assessing this funding mechanism. This study analyses empirical financial and operational data shared by a formal service provider in Kigali, Rwanda who is establishing a cross-subsidy model between corporate and high-income households, and low-income households in informal settlements. A semi-mechanical method is used to serve households which cannot be accessed from the road by an exhauster truck. We find that mechanical emptying is gross profitable when exhauster trucks are fully used, particularly large volume and corporate customers. Transferring sludge between vehicles for efficient transport reduces average cost. Cross-subsidies are found to be a viable funding method and a ten-fold increase in mechanical emptying by the service provider would generate 466,876 Int$ (2022 international dollars) gross profit to fund a cross-subsidy for all low-income households in Kigali which require semi-mechanical emptying. This study highlights the opportunities that city authorities have to organise funding to cross-subsidise emptying for low-income households. In addition, by using data from operational records rather than self-reported estimates the reliability of cost estimates is in improved. Further research is required to understand customer group size, demand and emptying frequencies to determine the structure of a citywide cross-subsidy. [ABSTRACT FROM AUTHOR]

Background: Inadequate menstrual hygiene management can result in physical, social, psychological, and educational challenges for schoolgirls. To address these issues, researchers have conducted intervention studies, but the impact on school attendance has varied. This review has systematically collected and evaluated evidence about the effects of menstrual hygiene interventions on schoolgirls. Method: A systematic search of the literature was done and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA statement). Both peer-reviewed journals and gray literature were searched using PubMed and Google Scholar. The search included individual, or cluster randomized controlled trials, and quasi-experimental studies, and covered the period from the date of indexing until January 3, 2023. Result: A review of sixteen trial studies showed that menstrual hygiene interventions have a positive effect on schoolgirls' school attendance, performance, and dropout rates, as well as on their menstrual knowledge, attitudes, practices, and emotional well-being. There was a low to medium risk of bias in most of the studies. Additionally, the literature overlooked the impact of interventions that involve parental and male engagement, interventions correcting community misperceptions about menstruation, and the impact of infrastructure improvements on water, sanitation, and hygiene. Conclusion: Interventions aimed at improving menstrual hygiene management can enhance schoolgirls' educational outcomes, and can improve their menstrual knowledge, attitudes, and practices by helping them manage their periods more effectively. Most interventions have focused on the provision of menstrual products and menstrual education but have neglected improvements in the physical environment at home and school and the social norms surrounding menstruation. Trial studies should take a holistic approach that considers the total socio-cultural environment in which menstrual hygiene management takes place, thus enabling stakeholders and policymakers to develop sustainable, long-term solutions to these problems. [ABSTRACT FROM AUTHOR]

In recent years, international media and the scientific community have expressed concerns regarding rising kidney health-related risks among Nepalese labour migrants in Gulf countries and Malaysia. Previous studies have highlighted poor lifestyles and work conditions among Nepalese migrants, which could potentially impact their kidney health. This qualitative study aims to explore the lifestyles and work environment of returnee Nepalese migrants who were diagnosed with kidney health problems. In-depth interviews were carried out with twelve returnee migrants, all males, with half having worked abroad for at least a decade. Our analysis yielded seven themes: (a) living and lifestyles; (b) work environment; (c) exposure to pollutants; (d) Chronic Kidney Disease (CKD) experience; (e) use of painkillers and healthcare; (f) medical expenses for CKD patients; and (g) pre-departure training. This study indicates that Nepalese migrants face numerous challenges, including limited access to clean water and sanitation facilities, poor diets, exposure to occupational hazards, and overuse of pain medication, all of which may contribute to an increased risk of kidney disease. An enhanced pre-departure and on-arrival orientation programme focusing on kidney health-related topics, including the necessary advocacy at the country of destination to provide access to basic services, may encourage migrants to adopt healthy lifestyles and safe working environments, as well as help sensitise migrants to their kidney health risks. [ABSTRACT FROM AUTHOR]

Freshwater pollution is a major concern in Ghana, directly impacting human health. However, the underlying drivers of exposure and risks are not comprehensively understood, emphasizing the severity and impact of these diseases. This study assessed the interaction between water and human health, specifically focusing on the risk factors for waterborne diseases and the drivers of water pollution among residents near the Tano River Basin, Ghana. A sample size of 400 households was selected from five communities within the basin based on their proximity to the Tano River. In addition, the study combined both spatial and non-spatial data sources to map potential flood zones for the basin. The study found that inadequate sanitation, poor hygiene practices, and contamination from illegal mining were the primary causative factors of waterborne diseases. Additionally, floods and improper waste management significantly contributed to disease outbreaks. The flood susceptibility analysis indicated that areas highly susceptible to flooding cover 21.2% of the basin, predominantly in the southern part. The results highlight the urgent need for comprehensive interventions to address the drivers of waterborne diseases. This study will contribute to the local authorities in developing plans to prevent waterborne diseases and mitigate their economic and public health impacts. [ABSTRACT FROM AUTHOR]

Every year, contaminated water is responsible for over one million deaths globally. Microbiology leads other fields in the development of solutions to water contamination to reduce these deaths while advancing the achievement of SDG 6, which aims to ensure universal access to water and sanitation. This article explores hydrogel polymers as a solution to water contamination through microbial control. Using a systematic approach, this study collects, reviews, analyzes, and synthesizes the findings of studies on the structure, properties, and mechanisms used by hydrogel polymers in pathogen control in water systems, emphasizing recent advances in microbiology that have improved the antimicrobial properties of hydrogel polymers, enhanced their synthetic properties, and improved their overall ability to control the spread of pathogens in water. Other additional notable findings, including the applications of hydrogel polymers in water systems, the environmental implications of using the method to decontaminate and purify water for various purposes, and the regulatory standards needed to reinforce the viability and effectiveness of the adaptation of hydrogel polymers for the control of harmful or unwanted microorganisms in water systems, inform the presented inferences on the future of hydrogel technologies and new opportunities for the expansion of their commercial use. [ABSTRACT FROM AUTHOR]