Share research - Neglected Tropical Diseases

Factors perceived to facilitate or hinder handwashing among primary students: a qualitative assessment of the Mikono Safi intervention schools in NW Tanzania

shareadmin — Mon, 02 Dec 2019 21:16:47 +0000

This paper was published in BMJ Open by Okello et al. (2019). The study used qualitative methods to assess the effects of a multi-modal school-based water, sanitation and hygiene (WASH) intervention on handwashing behaviour among primary students in North Western (NW) Tanzania. Barriers and facilitators to handwashing were explored in the students who participated in the Mikono Safi Trial (Kiswahili for ‘Clean Hands). The intervention increased students' reported capability and motivation to wash their hands with soap at key times, particularly after visiting the toilet. Improvements in students’ handwashing knowledge and skills were reported by both teachers and students, and motivation for handwashing was enhanced by emotional drivers such as disgust, fear and nurture. Newly established handwashing stations improved the physical opportunity to wash hands, although the availability of water and the provision of soap was not always consistent (e.g. due to internal organisational shortcomings or during the dry season). Students and teachers were actively engaged in intervention implementation which created a school community that valued and supported improved hand hygiene.

Download (751.96 KB) Mikono Safi Marni Brennan Tanzania

Estimating the Health Risk Associated with the Use of Ecological Sanitation Toilets in Malawi

shareadmin — Mon, 18 Dec 2017 13:05:34 +0000

Use of Ecological Sanitation (EcoSan) sludge is becoming popular due to increasing price of organic fertilizers in Malawi; however, there is little evidence on the associated risks. Quantitative microbiological risk assessment (QMRA) was done to determine health risks associated with use of EcoSan. Pathogens considered included Escherichia coli (E. coli), Salmonella, and soil transmitted helminths (STHs). Exponential and Beta Poisson models were used to estimate the risk from helminthic and bacterial pathogens, respectively. Main exposure pathways were through poor storage of sludge, contamination of foods during drying, walking barefoot on the ground contaminated with sludge, pit emptying without protection, and application of sludge in the fields. Estimated annual risk for Ascaris lumbricoides, Taenia, and hookworms was approximately over 5.6 × 10−1 for both Fossa Alternas (FAs) and Urine Diverting Dry Toilet (UDDTs). Risk from E. coli and Salmonella was 8.9 × 10−2 and above. The risks were higher than WHO acceptable risk for use of faecal sludge in crops of 10−4 infections per year. Promoters and users of EcoSan latrines need to consider advocating for strict guidelines to reduce the risk.

Download (3.36 MB) Malawi

Mikono Safi - Formative Research Brief

shareadmin — Wed, 13 Sep 2017 10:12:58 +0000

This briefing note provides an overview of the formative research conducted as part of Mikono Safi project in Tanzania. The findings from the formative work, conducted in three schools in the Kagera region, offer recommendations that will inform the main cluster randomised controlled trial.

Download (1.36 MB) Mikono Safi Tanzania

Mikono Safi

shareadmin — Mon, 17 Oct 2016 13:10:36 +0000

Mikono Safi, which means clean hands in Kiswahili, is a study taking place among school-aged children in the Kagera Region, North-West Tanzania. The aim of the study is to assess the effectiveness of a behaviour change intervention that promotes hand washing with soap, in reducing both the prevalence and infection intensity of Soil-Transmitted Helminths (STH) (Ascaris lumbricoides and Triuchuris trichiura).

The cluster randomised controlled intervention trial is being conducted in fourteen schools in the region. The trial is led by the Mwanza Intervention Trials Unit (MITU), a collaborative research unit of the Tanzanian National Institute for Medical Research (NIMR) and the London School of Hygiene and Tropical Medicine (LSHTM).

In the region, the mean prevalence of STH among school children is approximately 25%. If the intervention is effective in reducing infections, it could be rolled out to other schools in North-West Tanzania.

Behaviour Change Neglected Tropical Diseases Tanzania Mwanza Intervention Trials Unit Design Saidi.Kapiga@lshtm.ac.uk 2015 to 2018

The Impact of Water, Sanitation and Hygiene on Key Health and Social Outcomes: Review of Evidence

shareadmin — Thu, 15 Sep 2016 14:46:59 +0000

This evidence paper developed by SHARE and UNICEF looks at 10 areas identified collaboratively on which WASH can plausibly have a strong impact: diarrhoea, nutrition, complementary food hygiene, female psychosocial stress, violence, maternal and newborn health, menstrual hygiene management, school attendance, oral vaccine performance, and neglected tropical diseases. The paper highlights a number of points where evidence-based consensus has been established, or is emerging in these areas. While the paper has been tailored to support the development of the new UNICEF’s Strategy for WASH 2016-2030, it has broader relevance to the WASH sector as a whole.

Download (12.91 MB) Joanna Esteves Mills

Ascaris Eggs on Hands

shareadmin — Wed, 06 Jul 2016 14:03:25 +0000

The role that hands play in the transmission of STH (especially Ascaris and Trichuris infections), is under-researched and therefore not well understood. SHARE is funding two studies to shed further light on this transmission pathway:

Assessing the Quantity of Ascaris Eggs on Hands - this study will add to the limited body of research on the role of contaminated hands in STH transmission by developing a method to assess the number of Ascaris eggs on hands and determine the egg recovery rate of the method. It is hoped that if the method is successful it will allow users to quantify the range of hand contamination with Ascaris eggs found in high, medium and low transmission settings and measure the risk factors for high hand contamination with helminth eggs. It could also potentially be employed to assess the effectiveness of complementing sanitation interventions with hand hygiene promotion to better prevent ascariasis infection.
Transmission of Helminth Eggs Through Hands in a High-Risk Community - in addition to field testing the above method amongst a group of farmers in rural Vietnam, this study will also identify key risk factors associated with the presence and concentration of eggs found on hands.

Neglected Tropical Diseases Other Countries

SuSanA Secretariat (CCBY 2.0, http://creativecommons.org/licenses/by/2.0, via Wikimedia Commons)

London School of Hygiene & Tropical Medicine Completed aurelie.jeandron@lshtm.ac.uk 2013 to 2014 Partners: University of Copenhagen, and Hanoi University of Civil Engineering.

Mikono Safi: Hand Hygiene Intervention to Optimise Helminthic Infections Control

shareadmin — Fri, 10 Jun 2016 15:46:23 +0000

This briefing note outlines SHARE phase II research to be undertaken by MITU which will assess the effectiveness of a behaviour intervention (including promotion of HWWS) among school-aged children in the Kagera Region of Tanzania in reducing the prevalence and intensity of Ascaris lumbricoides and Trichuris trichiura infections. It summarises the two stages of the project and its intended relevance and uptake.

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Ascaris lumbricoides Infection Following School-Based Deworming in Western Kenya: Assessing the Role of Pupils' School and Home Water, Sanitation, and Hygiene Exposure

shareadmin — Mon, 14 Mar 2016 15:55:58 +0000

This paper summarises the findings of a study seeking to characterise how pupils' school and home WASH exposures were associated with Ascaris lumbricoides, a STH infection, after annual school-based deworming and facilitate an understanding of which individual and combinations of WASH technologies and behaviours are most likely to reduce exposure to infective eggs and prevent re-infection post-MDA. It found that few WASH behaviours and technologies were independently associated with Ascaris lumbricoides infection. However, by considering relevant interdependencies between variables, important associations were revealed. For example, the association between handwashing and Ascaris lumbricoides depended largely upon the pupils’ access to an improved water source.

Download (759.85 KB) Kenya External link

Integration of Water, Sanitation and Hygiene for the Control of Neglected Tropical Diseases: A Review of Progress and the Way Forward

shareadmin — Fri, 11 Mar 2016 16:57:59 +0000

This paper reviews progress made in recent years towards integrating WASH for NTD control, explores mechanisms supporting advances - such as the SHARE convened London WASH and NTDs Roundtable, and the development of actionable joint workplans - and identifies priorities and next steps for accelerating integration. It reveals promising advances in collaboration between the two sectors in the areas of: capacity building, data collection/mapping/monitoring, policy, programming and research. Priority next steps identified include: building capacity for WASH programming among NTD control teams, coordination at the country level, and strengthening the epidemiological evidence and operational learning for joint interventions.

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Associations between School & Household Level Water, Sanitation and Hygiene Conditions & Soil-Transmitted Helminth Infection among Kenyan School Children

shareadmin — Mon, 12 Oct 2015 14:25:39 +0000

Access to and use of sanitation facilities and proper hygiene can reduce STH infection in school-age children, but rigorous data on the relative importance of WASH in transmission in these two settings are scarce. This journal paper, supported by SHARE funding, addresses this gap. It explores the association during the baseline of a large-scale mass drug administration programme in Kenya, and the results suggest mixed impacts of household and school WASH on prevalence and intensity of infection.

Download (1.83 MB) Kenya External link