Habibur Rahman

Epidemiology and Etiology of Sexually Transmitted Infection among Hotel-Based Sex Workers in Dhaka, Bangladesh

ABSTRACT The prevalence of sexually transmitted infections (STIs) and reproductive tract infections (RTIs) among hotel-based sex workers (HBSWs) in Dhaka, Bangladesh, was studied. A total of 400 HBSWs were enrolled in the study during April to July 2002. Endocervical swabs, high vaginal swabs, and blood samples from 400 HBSWs were examined for Neisseria gonorrhoeae (by culture), Chlamydia trachomatis (by PCR), Trichomonas vaginalis (by microscopy), antibody to Treponema pallidum (by both rapid plasma reagin and Treponema pallidum hemagglutination tests), and antibody to herpes simplex virus type 2 (HSV-2) (by enzyme-linked immunosorbent assay). Sociodemographic information as well as gynecological and obstetric information was collected. Among the HBSWs, 228 women (57%) were symptomatic and 172 (43%) were asymptomatic, 35.8% were positive for N. gonorrhoeae, 43.5% were positive for C. trachomatis, and 4.3% were positive for T. vaginalis. A total of 8.5% had syphilis, 34.5% were positive for HSV-2, and 86.8% were positive for at least one RTI or STI. There was no significant difference between the prevalences of STIs among the symptomatic and asymptomatic HBSWs. These data suggested a high prevalence of STIs, particularly gonorrhea and chlamydia, among HBSWs in Dhaka.

Piloting a low-cost hardware intervention to reduce improper disposal of solid waste in communal toilets in low-income settlements in Dhaka, Bangladesh

BackgroundBangladesh faces daunting challenges in addressing the sanitation needs of its urban poor. Maintaining the cleanliness and functionality of communal toilets is dependent upon periodic emptying of fecal sludge, and cooperation between users of communal toilets. Trash disposal into latrines can block the outflow pipes, rendering the toilets non-functional.MethodsPre-intervention: We conducted in-depth interviews with five operators of fecal sludge emptying equipment and five adult residents who were also caregivers of children. We identified factors contributing to improper disposal of trash into communal toilets, a barrier to operation of the equipment, in low-income communities of Dhaka, Bangladesh.Intervention design: We developed behavior change communication materials to discourage waste disposal in toilets, and promote use of waste bins. We conducted six focus group discussions with adult male, female, landlord and children to select the preferred design for waste bins to be placed inside toilets, and finalize communication materials.Post-intervention: We then pilot-tested an intervention package to promote appropriate trash disposal practices and thus facilitate periodic removal of fecal sludge when the latrine pits become full. We conducted 20 in-depth interviews and four focus group discussions with community residents, landlords and cleaners of communal toilets.ResultsBarriers to appropriate waste disposal included lack of private location for disposal of menstrual hygiene products, limited options for formal trash collection and disposal, and the use of plastic bags for disposing children’s feces. A pilot intervention including behavior change communication and trash bins was implemented in two urban slum communities. Spot checks confirmed that the bins were in place and used. Respondents described positive improvements in the appearance of the toilet and surrounding environment.ConclusionThe current practice on the part of local residents of disposing of waste into toilets impedes the safe removal of fecal sludge and impairs toilet functionality. Residents reported positive changes in toilet cleanliness and usability resulting from this intervention, and this both improves the user experience with toilets, and also promotes the sustainability of the entrepreneurial model of Vacutug operators supported by WSUP.

Book reviews : Maheshwari, Shri Ram (1985) Rural Development in India: A Public Policy in India. New Delhi: Sage Publications. 231 pp

a ’social welfare committee’ which has, in extremis, the power to initiate coercion (p. 199). Hence the justice/welfare debate has less to do with the toleration of delinquency than with the location of power (Harris and Webb, 1987), and the question is what the existence of this or that set of administrative arrangements tells us about the penality of a particular society. The book is preliminary, but should certainly be read, not least because there is no other like it. From its wealth of information we can extract both issues for conceptual analysis and topics for empirical research. The material is there in outline if we trouble to uncover it, and perhaps it would be unreasonable to ask for more. The high price will probably largely restrict sales to libraries. The presentation of the volume leaves something to be desired: it has a clear typeface on good quality paper, but it is adhesive bound rather than sewn so that it refuses to lie flat without cracking. There is no subject index and no final bibliography; and the existence of so many literals in the text suggests that more competent proof reading was required.

Book Review Department : Social Services in Nigeria — An Introduction, Andrew G. Onokerhorage, Kegan Paul International Ltd., 39 Store Street, London WCIE 700, 1984, pp 354

In sum this is a worthy project, very much oriented to the British context, whose real promise calls for a more tangible investment of length. At double the length the book could achieve what it ’ aims to provide, less by increas. ing the length of entries as by increasing their number. The value of the book to an inter, national readership lies in its clear exposition of some key concepts, particularly those which are somewhat peripheral to social work but increasingly impinge upon it. However, as there are alternative sources for such infornla, tion, the volume will probably be most helpful