Editorial: Can we afford to overlook hand hygiene again?

Greenland, Katie; Cairncross, Sandy; Cumming, Oliver; Curtis, Valérie

doi:10.1111/tmi.12055

Cited by 25 publications

(18 citation statements)

References 29 publications

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“…Moreover, co-infections are largely driven by environmental factors (Lisam and Lisam 2009, Greenland et al 2013, Taye et al 2014) -emphasising the dominance of the virus-environment dynamics during the Asymptomatic period. However, treating co-infections has the effect of increasing the body's immune response to the virus, thus reducing the viral load (Modjarrad et al 2010)which takes us back to the virus-human dynamic.…”

Section: Pattern Management Of the Virus-human-environment Dynamics Amentioning

confidence: 99%

Reducing the overall HIV-burden in South Africa: is ‘reviving ABC’ an appropriate fit for a complex, adaptive epidemiological HIV landscape?

Burman

Aphane

Delobelle

2015

African Journal of AIDS Research

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This article questions the recommendations to 'revive ABC (abstain, be faithful, condomise)' as a mechanism to 'educate' people in South Africa about HIV prevention as the South African National HIV Prevalence, Incidence and Behaviour Survey, 2012, suggests. We argue that ABC was designed as a response to a particular context which has now radically changed. In South Africa the contemporary context reflects the mass roll-out of antiretroviral treatment; significant bio-medical knowledge gains; a generalised population affected by HIV that has made sense of and embodied those diverse experiences; and a government committed to confronting the epidemic. We suggest that the situation can now be plausibly conceptualised as a complex, adaptive epidemiological landscape that could benefit from an expansion of the existing, 'descriptive' prevention paradigm towards strategies that focus on the dynamics of transmission. We argue for this shift by proposing a theoretical framework based on complexity theory and pattern management. We interrogate one educational prevention heuristic that emphasises the importance of risk-reduction through the lens of transmission, called A-3B-4C-T. We argue that this type of approach provides expansive opportunities for people to engage with the epidemic in contextualised, innovative ways that supersede the opportunities afforded by ABC. We then suggest that framing the prevention imperative through the lens of 'dynamic prevention' at scale opens more immediate opportunities, as well as developing a future-oriented mind-set, than the 'descriptive prevention' parameters can facilitate. The parameters of the 'descriptive prevention' paradigm, that maintain - and partially reinforce - the presence of ABC, do not have the flexibility required to develop the armamentarium of tools required to contribute to the management of a complex epidemiological landscape. Uncritically adhering to both the 'descriptive paradigm', and ABC, represents an historically dislocated form of prevention - with restrictive options for reducing the overall burden of HIV-related challenges in South Africa.

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Section: Pattern Management Of the Virus-human-environment Dynamics Amentioning

confidence: 99%

Reducing the overall HIV-burden in South Africa: is ‘reviving ABC’ an appropriate fit for a complex, adaptive epidemiological HIV landscape?

Burman

Aphane

Delobelle

2015

African Journal of AIDS Research

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“…26 There are limited data behind the prevention of pneumonia through WASH interventions, 27 though a recent estimate suggested that hand washing with soap could prevent over 600,000 deaths from diarrhea and pneumonia combined. 28 …”

Section: Public Health Measures For Prevention Of Childhood Pneumoniamentioning

confidence: 99%

Prevention and Control of Childhood Pneumonia and Diarrhea

Leung

Chisti

Pavia

2016

Pediatric Clinics of North America

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Pneumonia and diarrhea are the two leading infectious causes of death in children under 5 worldwide, most of which occur in low- and middle-income countries (LMICs) in sub-Saharan Africa and Southern Asia. The past decade has seen large reductions in global childhood mortality, in part due to expansion of non-specific public health interventions, as well as the roll out of vaccines against Streptococcus pneumoniae, Haemophilus influenzae, and rotavirus in LMICs. Recent studies have shown that the leading causes of childhood diarrhea vary geographically, and include rotavirus, norovirus, Cryptosporidium, Shigella, Enterotoxigenic Escherichia coli, Vibrio cholerae, and Campylobacter, underlining the critical need for development of new vaccines against diarrheal pathogens. Etiological studies of childhood pneumonia are ongoing, though previous reports have identified respiratory syncytial virus, S. pneumoniae, H. influenzae, and influenza virus as prominent contributors to the global burden of disease. Further progress in this field will depend on the international community’s commitment to fund and implement programs utilizing currently available vaccines, and the development of new vaccines against pathogens common to children in LMICs.

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“…Katukiza et al (2010) identified the Urine Diverting Dry Toilet (UDDT) and biogas latrines as possible good solutions for a specific urban slum in Uganda, but point out the lack of acceptance of these simple technologies. Furthermore, neither solution represents an integrated option for hand-washing, a necessary element for making any sanitation solution truly hygienic (Greenland et al, 2013). …”

Section: Introductionmentioning

confidence: 99%

Early testing of new sanitation technology for urban slums: The case of the Blue Diversion Toilet

Tobias

O’Keefe

Künzle

et al. 2017

Science of The Total Environment

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The toilets used most in informal urban settlements have detrimental consequences for the environment and human health due to the lack of proper collection and treatment of toilet waste. Concepts for safe, sustainable and affordable sanitation systems exist, but their feasibility and acceptance have to be investigated at an early stage of development, which is difficult due to the high costs of building working models. In this paper, we present an approach to estimate acceptance in a valid and representative form with only one working model, and apply it to test an innovative zero-emission toilet with recycling of wash water. Four basic principles were specified for investigation and nine hypotheses formulated to test the feasibility and acceptance of these principles: source separation of urine and feces with subsequent collection for resource recovery; provision of wash water in a separate cycle with on-site recovery through a membrane bioreactor; a convenient and attractive overall design; and a financially sustainable business plan. In Kampala (Uganda), in 2013, data was collected from 22 regular users, 308 one-time users and a representative sample of 1538 participants. Qualitative data was collected from the users, who evaluated their likes, perceived benefits, social norms and expected ease of use based on verbal and visual information. Most of the hypotheses were confirmed, indicating the feasibility and acceptance of the basic principles. Source separation and on-site water recovery were found to be feasible and accepted, provided users can be convinced that the emptying service and water recovery process work reliably. In the survey, the toilet was evaluated favorably and 51% of the participants agreed to be placed on a bogus waiting list. However, some design challenges were revealed, such as the size of the toilet, hiding feces from view and improving the separation of urine and water.

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Editorial: Can we afford to overlook hand hygiene again?

Cited by 25 publications

References 29 publications

Reducing the overall HIV-burden in South Africa: is ‘reviving ABC’ an appropriate fit for a complex, adaptive epidemiological HIV landscape?

Reducing the overall HIV-burden in South Africa: is ‘reviving ABC’ an appropriate fit for a complex, adaptive epidemiological HIV landscape?

Prevention and Control of Childhood Pneumonia and Diarrhea

Early testing of new sanitation technology for urban slums: The case of the Blue Diversion Toilet

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