Search Results (86)

Background/Objectives: Childhood stunting remains a critical public health issue in low- and middle-income countries. Despite Malaysia’s economic growth, there is limited large-scale evidence on the determinants of stunting among children from infancy to primary school age. This cross-sectional study, part of South East Asian Nutrition Surveys II (SEANUTS II), aimed to determine sociodemographic and environmental risk factors for stunting among 2989 children aged 0.5–12 years. Methods: Children were recruited from four regions in Peninsular Malaysia (Central, East Coast, 2022–2030Northern, Southern). Standing height or recumbent length was measured, and stunting was classified based on WHO criteria (height-for-age Z-score below −2 standard deviations). Parents reported information on socioeconomic status, sanitation facilities, and hygiene practices. Multivariate binary logistic regression was used to determine the determinants of stunting. Results: Stunting prevalence was 8.9%, with infants (aOR = 2.92, 95%CI:1.14–7.52) and young children (aOR = 2.92, 95%CI:1.80–4.76) having higher odds than school-aged children. Key biological predictors included low birth weight (aOR = 2.41; 95%CI:1.40–4.13) and maternal height <150 cm (aOR = 2.24; 95%CI:1.36–3.70). Chinese (aOR = 0.56; 95%CI:0.35–0.88) and Indian children (aOR = 0.16; 95%CI:0.05–0.52) had a lower risk of stunting compared to Malays. Conclusions: This study highlights the ongoing challenge of childhood stunting in Malaysia, with age, birth weight, ethnicity, and maternal height identified as key determinants. These findings call for early identification of at-risk households and targeted support, especially through education and financial aid to foster healthy child growth. Full article

Safe and adequate water supply, sanitation, and hygiene (WASH) in schools are prerequisites within the right to basic education. WASH facilities across schools in developing nations, particularly in Africa, are unsatisfactory and expose children to risks of disease and infection. This study aims to gather insights into the WASH status of secondary schools in Ibadan, Nigeria, to develop a sustainable water management framework for schools. A concurrent mixed-method design (questionnaires and interviews) was adopted to benchmark water management in schools and inform the design of a framework. Results reveal a wealth of issues and concerns that include infrastructure challenges accessing reliable and safe water supplies, rundown and unhygienic toilet/urinal facilities, and dilapidated sinks/taps, plus resource challenges, such as an absence of tissue paper and soap. These issues are exposing schoolchildren to unnecessary health risks, further supported by reported illnesses and reduced school attendance. Based on these findings, and guided by the UN SDG#6 targets, a water improvement framework has been created and validated by school officials. The framework identifies both short-term and long-term guidance/actions to improve water management in schools across Sub-Saharan Africa. These form crucial steps toward better WASH, building healthier communities and enhancing educational environments and outcomes for schoolchildren. Full article

Zoonotic diseases are a persistent public health concern, especially in low- and middle-income countries like Brazil. This cross-sectional study evaluated the knowledge and perceptions of 132 high school students (70 public and 62 private) in Goiânia, Brazil, regarding zoonoses, using a structured questionnaire. Statistical analyses (Chi-square and Fisher’s exact tests) revealed significant differences (p < 0.05) between public and private school students in knowledge levels, pet care practices, and the awareness of zoonotic risks. While pet ownership was common in both groups, only 53% of private and 21% of public school students correctly defined “zoonosis.” Rabies, taeniasis, leptospirosis, tuberculosis, cysticercosis, cutaneous larva migrans, and leishmaniasis were the most frequently cited diseases, with private school students demonstrating greater recognition across all categories. However, most participants lacked detailed knowledge about transmission routes and prevention. Misconceptions—such as zoonoses affecting only low-income populations—were also identified. Preventive actions like sanitation, public education, and vaccination were commonly suggested but not consistently linked to zoonoses. These findings highlight critical educational gaps and emphasize the need to incorporate One Health principles into school curricula to improve youth understanding and support public health strategies for zoonosis prevention. Full article

The indoor microbiome is a dynamic ecosystem including pathogens that can impact human health. In this regard, the school environment represents the main living space of humans for many years, and an unhealthy environment can significantly condition students’ health. School rooms can suffer from insufficient ventilation and the use of building materials that may favor pathogen contamination, mostly sanitized by conventional chemical-based methods, which can impact pollution, have temporary effects, and induce the selection of antimicrobial resistance (AMR) in persistent microbes. In the search for sustainable and effective methods to improve the healthiness of the classroom environment, a pre–post case–control study was performed in an Italian high school. Over a year, different interventions were sequentially placed and evaluated for their impact on bioburden and air quality, including the introduction of plants, a mechanical ventilation system, and probiotic-based sanitation (PBS) in substitution for chemical sanitation. Through continuous microbial monitoring of the enrolled school rooms, via culture-dependent and -independent methods, a remarkable bioburden level was detected at baseline (around 12,000 and 20,000 CFU/m², before and after classes, respectively), composed mostly of Staphylococcus spp. and fungi. Some decrease in fungal contamination was observed following the introduction of plants. Still, the most significant decrease in pathogens and associated AMR was detected following the introduction of ventilation and PBS, which decreased pathogen level by >80% (p < 0.001) and AMR by up to 3 Log₁₀ (p < 0.001) compared to controls. Collected data support the use of combined strategies to improve indoor microbial quality and confirm that PBS can effectively control bioburden and AMR spread not only in sanitary environments. Full article

This study assessed the status of water, sanitation, and hygiene (WASH) services at (49) selected primary schools in uMfolozi Local Municipality, which is situated in the province of Kwa-Zulu Natal in South Africa. Data were collected using an observational checklist tool and by conducting a walk-through survey to inspect the conditions of sanitary facilities, observe the hand-washing practices of the school learners, and analyse the accessibility to safe drinking water in school premises. The data were analysed with the Statistical Package for Social Science Version 29. This study revealed that there is easy access to safe drinking water in all but one school. The dependability of the water supply seemed to be one of the most urgent problems in every school, even though all of them have some kind of drinking water infrastructure on their grounds. Municipal water (n = 25, 36%) and rainwater (n = 25, 36%) were the most common type of water used in schools compared to borehole (n = 15, 22%) and tanker truck water (n = 4, 6%). Schools must have a reserved water supply because of the inconsistent supply of municipal water, and because rainwater is a seasonal harvest while borehole water may be affected by factors like load-shedding. The UNICEF-described ratio of one tap or disperser per fifty learners suggests that the water taps in the schoolyard were insufficient in some schools (n = 25, 36%). Rainwater is collected through a gutter system in the school building roofs and stored in 5000–10,000 Jojo tanks. Borehole water is pumped into Jojo tanks at an elevated position where it is stored, and learners receive the water through taps connected to the borehole tanks. During an emergency when there is no water supply from other sources, tanker trucks are hired to fill tanks that are also used to store rainwater. The borehole and rainwater quality appeared to be clear, but water treatment had not been performed, and the microbial quality was unknown. This shows that the Sustainable Development Goal (SGD) 6, clean water and sanitation, is still far from being met. According to national norms and standards for domestic water and sanitation services, people who do not use water treatment or purification techniques fall in the ‘no service’ category and contribute to the water backlog. Pit latrines (n = 46, 94%) and flush toilet (n = 3, 6%) were found to be the only convenient toilet systems used. The number of toilets is not sufficient according to the guidelines. There are (n = 46, 94%) of the schools in the study area using pit latrine due to insufficient or no water supply. In 89.8% of primary schools, sanitation facilities are in working condition in terms of repair and hygiene, while 10.2% are not usable in terms of hygiene, and these are mostly boy’s toilets. All schools (n = 46, 94%) that have flush toilets is because they received sponsorship from non-government stakeholders that funded them in achieving piped water systems that permit the functionality of flush toilets. For the purposes of this study, hygiene was evaluate based on the items found in toilets and handwashing practices. The hygiene aspects of toilets included tissues, cleanness, and toilet seat. For handwashing practices we looked the number of washing basins, the colour of water, and having soaps to use. In the schools that did provide handwashing facilities, some of the toilets were broken, there was no water, or there was no drainage system in place to allow them to function. However, according to the school act, the handwash basins should be inside the facilities. A total of (n = 7, 14%) of handwash basins were inside the toilets. Only (n = 2, 4%) of schools had handwashing facilities which were Jojo tanks with taps near toilets, which were outside of the toilet, with no soap provided. Additionally, (n = 40, 82%) of learners used drinking points for handwashing, which can possibly transmit microbes among them. The findings revealed that, in general, (n = 32, 64%) of school toilets were clean, while, in general, the girls’ toilets were cleaner than the boys’ toilets. In all the schools, the cleaning services were from the people who were involved in school nutrition. In conclusion, there were water sources available for access to water inside schools; however, the situation can be improved by increasing the number of water source points. Pit latrines were the main used toilets, which were in a majority of the schools, and did not have the necessary terms for hygiene such as handwashing basin, tissues, and others. The lack of the main aspect, i.e., access to water and sanitation items, results in an impact on hygiene to learners as they will fail to practice proper hygiene. However, improvement can still be made by keeping the boys’ toilets clean while increasing the number of handwashing basins inside the toilets, so that they do not use taps outside the toilets. Schools should work towards meeting the required number of handwashing basins to increase access to handwashing facilities. Full article

Background/Objectives: This study aimed to determine the malnutrition status, prevalence of intestinal parasites and anaemia, and the hygiene and sanitation conditions of children participating in the nutritional recovery programme at Las Salinas school of the ONG Bel Avenir in Toliara (Madagascar). The ultimate goal of the ONG Bel Avenir is to apply synergistic strategies to effectively combat malnutrition. Methods: A total of 49 schoolchildren aged 6 to 17 years enrolled in the nutritional recovery programme were studied. Data collection included sociodemographic information, hygiene and sanitation practices, and haematological and anthropometric measurements. Results: All participants were found to have anaemia. Regarding intestinal parasites, Giardia intestinalis was detected in 93.9% of cases, and Trichuris trichiura was identified in 28.6% of cases. Nutritional assessments revealed that 100% of the participants experienced thinness or acute malnutrition, while 32.6% exhibited stunting or impaired growth. Conclusions: The findings underscore the critical relationship between nutritional status and factors such as parasitology, haematology, and hygiene. Tools like the Nutrimetry assessment enable more specific diagnostics, guiding targeted interventions to address malnutrition. This study highlights the urgent need for policies and collaborative actions to improve the health conditions of the children in Madagascar. Full article

Sustainable Development Goal 6 aims to ensure the availability and sustainable management of water and sanitation for all. This study aimed to describe the implementation, effect and process evaluation of an educational session focused on promoting hand hygiene among school children within a school-based health education program. Seven schools from Romania participated in a longitudinal study. Children were categorized in two groups: Intervention (participating in a session in which they learnt about the importance of hand hygiene and the technique of handwashing, as part of a comprehensive educational program) and Control (standard education). Data were gathered through confidential questionnaires at baseline (October–November 2019, 880 participants) and follow-up (December 2020–February 2021, 484 participants); 350 children participated in both assessments. Many children consistently practiced handwashing in several situations at both evaluations. At follow-up, both groups had improved several hand hygiene practices; students from the Intervention group showed a higher handwashing frequency after using the toilet and before meals in comparison with the Control group. The majority of students from the intervention group agreed the program helped improving their handwashing behavior; girls and children with parents of lower educational levels tended to have a more favorable opinion. Consistent efforts and reinforcement are necessary for the maintenance of correct hand-washing practices. Full article

This study assessed raw vegetable sanitizing in Brazilian schools and identified barriers to standards. This experimental and quantitative study was conducted in 12 school food services in the Federal District (Brazil) public primary education institutions. Microbiological analyses were conducted with vegetable samples (before and after sanitizing) and water used in the sanitization process, collected before the process. The Petrifilm^®E. coli/Coliform Count Plates and COLIlert methods were used to evaluate vegetables and water samples, and a checklist of good practices was applied in each school food service to identify barriers to proper sanitization. Thirty-five samples of raw vegetables were offered to students, 32 samples of water, and 17 hygiene processes were evaluated. The results indicate that 76.5% (n = 13) of hygiene processes were considered unsatisfactory, with an average increase of 5.8 log CFU g⁻¹ (DV = 7.4) in the initial microbial load in 47.1% (n = 8) of the evaluated processes; moreover, 33.3% (n = 6) of the samples exceeded the tolerable limit, with an average value above 1.5 × 10³ CFU/g. Attention to food handler training and necessary organizational changes is essential to ensure safe food and promote healthy student eating habits, highlighting the importance of strengthening basic hygiene practices and following the parameters for sanitizing vegetables. Full article

Schistosomiasis, which affects a large number of people worldwide, is among the most overlooked parasitic diseases. The disease is mainly prevalent in sub-Saharan Africa, southeast Asian countries, and South America due to the lack of adequate sanitation. The disease is mainly associated with poor hygiene, sanitation, and contaminated water, so it is also known as a disease of poverty. Three Schistosoma species (S. mansoni, S. japonicum, and S. haematobium) cause significant human infections. Co-infections with Schistosoma and other parasites are widely common. All these parasites may cause intestinal or urogenital schistosomiasis, where the disease may be categorized into the acute, sensitized, and chronic phases. The disease is more prevalent among school children, which may cause anemia and reduce development. Chronic infections frequently cause significant liver, intestinal, and bladder damage. Women exposed to contaminated water while performing normal duties like washing clothes might acquire urogenital schistosomiasis (UGS), which can cause tissue damage and raise the risk of blood-borne disease transmission, including human immunodeficiency virus (HIV) transmission. Praziquantel (PZQ) is the World Health Organization (WHO)-prescribed treatment for individuals who are known to be infected, but it does not prevent further re-infections with larval worms. Vaccine development and new molecular-based diagnosis techniques have promised to be a reliable approach to the diagnosis and prevention of schistosomiasis. The current review emphasizes the recent advancement in the diagnosis of schistosomiasis by molecular techniques and the treatment of schistosomiasis by combined and alternative regimes of drugs. Moreover, this review has also focused on the recent outbreak of schistosomiasis, the development of vaccines, and their clinical trials. Full article

Ensuring access to water, sanitation, and hygiene (WASH) facilities, along with behavior change education in schools, is essential for fostering a conducive learning environment and promoting principles of inclusion, dignity, and equality. This study focuses on 12 primary schools in Anápolis, Brazil, with a total of 4394 students and 248 teachers. WASH assessments were conducted using a questionnaire, observations of water and sanitation facilities, and microbiological analysis. Between 2018 and 2020, the proportion of schools with safely managed drinking water increased from 42% to 92%. However, sanitation conditions in the schools were categorized as basic, with hygiene services rated as limited in 92% of the schools due to the absence of soap. While this study shows that Anápolis schools generally meet WASH guidelines for basic/advanced drinking water services, there is a crucial need for improvements in both hardware and software facilities to address sanitation and hygiene challenges. Full article

Hepatitis A (HAV) presents a significant global health concern with diverse clinical manifestations primarily transmitted through fecal–oral routes, emphasizing the critical role of sanitation and water cleanliness in transmission dynamics. Age-related variations, notably asymptomatic presentation in children, add complexity. The World Health Organization’s (WHO) endemicity classification aids in understanding prevalence and control strategies. This study examines 2023 South African epidemiological data on HAV cases, evaluating age distribution, incidence rates, and provincial disparities. Data from the national surveillance system and weather services were analyzed. Findings reveal distinct age-related trends, with the highest seroprevalence observed in the 5–9 age group with the most burdened areas located in the Western Cape, KwaZulu-Natal, and Gauteng provinces. Furthermore, seasonal rainfall variations correlate with increased incidence in Western Cape and KZN. The amalgamation of results suggest a potential epidemiological shift, emphasizing the need for updated immunization strategies. Noteworthy patterns, like the rise in 5–9-year-olds, may be influenced by factors such as school clustering and migration. Provincial disparities and the impact of climatic events underscore the necessity for dynamic vaccination strategies and surveillance network enhancements. This study highlights the urgency for improved understanding and response to HAV in South Africa. Full article

Good manufacturing practices play an important role in obtaining safe food and preventing foodborne diseases. To achieve this goal, food handlers must receive appropriate training to be aware of their responsibilities. In this work, compliance with specific personal hygiene requirements by food handlers was assessed in a cross-sectional study of traditional small retail establishments, namely butcher (n = 56) and fishmonger (n = 17) shops in Almada, Portugal. Food handlers (n = 140, of which 113 worked in butcher shops, and 27 worked in fishmonger shops) were interviewed for data collection, and retail establishments were audited considering specific hygiene requisites. In fishmonger shops, most food handlers are women (89%), aged 18 to 45 years (70%), with a high school degree, having worked for less than 5 years in this activity, while in butcher shops most food handlers are men (90%) over 45 years old (58%), with a basic education level, and more than 26 years of experience. Most food handlers (>95%) attended recent food safety and hygiene training courses and were able to recognize that hand sanitizers cannot replace a proper hand wash, and to identify Staphylococcus aureus transmission routes to food. However, approximately 23% of retail establishments failed to provide hot water in the handwashing basin and exhibited improper placement of handwashing instructions. Furthermore, these establishments did not implement corrective actions following non-conforming microbiological results of hand hygiene monitoring. These findings reinforce the need for consistent management commitment, and for providing food handlers with regular training, which is crucial for maintaining a strong food safety and hygiene culture in these traditional small retail establishments. Full article

Pandemics can result in large morbidity and mortality rates that can cause significant adverse effects on the social and economic situations of communities. Monitoring and predicting the spread of pandemics helps the concerned authorities manage the required resources, formulate preventive measures, and control the spread effectively. In the specific case of COVID-19, the UAE (United Arab Emirates) has undertaken many initiatives, such as surveillance and contact tracing by introducing mobile apps such as Al Hosn, containment of spread by limiting the gathering of people, online schooling and remote work, sanitation drives, and closure of public places. The aim of this paper is to predict the trends occurring in pandemic outbreak, with COVID-19 in the UAE being a specific case study to investigate. In this paper, a predictive modeling approach is proposed to predict the future number of cases based on the recorded history, taking into consideration the enforced policies and provided vaccinations. Machine learning models such as LASSO Regression and Exponential Smoothing, and deep learning models such as LSTM, LSTM-AE, and bi-directional LSTM-AE, are utilized. The dataset used is publicly available from the UAE government, Federal Competitiveness and Statistics Centre (FCSC) and consists of several attributes, such as the numbers of confirmed cases, recovered cases, deaths, tests, and vaccinations. An additional categorical attribute is manually added to the dataset describing whether an event has taken place, such as a national holiday or a sanitization drive, to study the effect of such events on the pandemic trends. Experimental results showed that the Univariate LSTM model with an input of a five-day history of Confirmed Cases achieved the best performance with an RMSE of 275.85, surpassing the current state of the art related to the UAE by over 30%. It was also found that the bi-directional LSTMs performed relatively well. The approach proposed in the paper can be applied to monitor similar infectious disease outbreaks and thus contribute to strengthening the authorities’ preparedness for future pandemics. Full article

Malnutrition among in-school children is a complex issue influenced by socio-economic, environmental, and health-related factors, posing significant challenges to their well-being and educational trajectories in developing countries. This review synthesized evidence on the multifaceted aspects of child malnutrition within the educational setting in developing countries. This review followed the six steps outlined by Arksey and O’Malley’s framework. Four main databases (PubMed, CENTRAL, JSTOR, and Scopus) were searched. Additional searches were conducted in WHO Library, ProQuest, HINARI, Google Scholar, and Google. Reference lists of eligible papers were checked. This review found that low family income, varying family sizes, parental employment status, and educational levels significantly impact malnutrition among in-school children and adolescents. Environmental elements, including rural/urban residence, household sanitation, and living conditions, also influence malnutrition. In addition, nutrition knowledge, dietary habits, nutrient deficiencies, physical activity, and prevalent health conditions compound the risk of malnutrition. This study underscores the extensive health impact of malnutrition on general health, specific nutrient deficiencies, fetal/maternal health concerns, and overall morbidity. Also, malnutrition affects school performance and attendance, impacting cognitive abilities, and academic achievements. Addressing these challenges requires comprehensive policy actions aligned with Sustainable Development Goals, emphasizing poverty alleviation, health literacy, and gender equity. Full article

Access to water, sanitation, and hygiene (WASH) resources in schools is critical for disease prevention and control, especially during public health emergencies. In Belize, systematic, national data on WASH in schools are needed to inform public health decisions and interventions. From December 2021 to January 2022, a national survey was sent electronically to government and government-aided primary and secondary schools in Belize (N = 308) to gather information on WASH services. From the survey, 12 pilot schools were selected based on the highest self-reported need for WASH resources to participate in additional evaluation and intervention, which included environmental nudges, supplemental supply provision, and hand hygiene education. To understand how the progression of the COVID-19 pandemic may have influenced hand hygiene, facility assessments to evaluate access to hand hygiene resources were conducted in person when most schools reopened for face-to-face learning during the pandemic (March 2022) and 15 months later (June 2023). Among the schools participating in the national survey (N = 221), 55% reported times when water was not available at the schools. Almost 9 in 10 schools (89%) had a functional handwashing station, and 47% reported always having soap for handwashing. Between baseline and follow-up at the 12 pilot schools, we observed decreases in the proportion of functional handwashing access points (−11%), functional handwashing access points accessible for individuals with disabilities (−17%) and small children (−29%), and functional alcohol-based hand rub dispensers (−13%). Despite the ongoing COVID-19 pandemic, we observed gaps in WASH resources in schools in Belize during the onsite assessments at the pilot schools. Schools should be encouraged and provided with WASH resources to maintain vigilance for disease control measures. Full article