Lindiwe Zungu

Using Geographic Information Systems and Spatial Analysis Methods to Assess Household Water Access and Sanitation Coverage in the SHINE Trial

Access to water and sanitation are important determinants of behavioral responses to hygiene and sanitation interventions. We estimated cluster-specific water access and sanitation coverage to inform a constrained randomization technique in the SHINE trial. Technicians and engineers inspected all public access water sources to ascertain seasonality, function, and geospatial coordinates. Households and water sources were mapped using open-source geospatial software. The distance from each household to the nearest perennial, functional, protected water source was calculated, and for each cluster, the median distance and the proportion of households within <500 m and >1500 m of such a water source. Cluster-specific sanitation coverage was ascertained using a random sample of 13 households per cluster. These parameters were included as covariates in randomization to optimize balance in water and sanitation access across treatment arms at the start of the trial. The observed high variability between clusters in both parameters suggests that constraining on these factors was needed to reduce risk of bias.

Cervical Precancerous Lesions and Cancer among Patients in the Gynaecology Outpatient Department at a Tertiary Hospital in South Africa

BACKGROUND The purpose of this study was to determine proportional rates of cervical precancerous lesions and cancer, and associations with socio-demographic variables, HIV status, and CD4 cell count. MATERIALS AND METHODS A retrospective comparative study was conducted targeting the medical records of all women over age 18 that were diagnosed histologically through colposcopy with cervical precancerous lesions and cancer from 1 December 2011 to 30 November 2012. RESULTS A total of 313 patient records were used for data analysis. The average age was 39.1 (SD=2.04) years. More than a third (37.1%) of the patients had CIN III or cervical cancer. There was a significant association between age, CD4 cell count, HIV status, and cervical lesions (p<0.05). Age was found to be an influential predictor of cervical lesions (OR=0.67, 95%CI: 0.46-0.98). CONCLUSIONS There exists an association between age and cervical lesions, with presentation of cervical precancerous lesions and cervical cancer at a younger age among HIV reactive patients. The National Guidelines should be brought in line with the National HIV Counseling and Testing Policy to offer Pap smears to all sexually active women that test HIV reactive during routine HIV Testing.

Environmental health factors associated with diarrhoeal diseases among under-five children in the Sebeta town of Ethiopia

The aim of this study was to assess and explore household environmental health factors associated with the occurrence of diarrhoea experienced by children under five years of age in Sebeta town of Ethiopia. A cross-sectional study, using stratified random sampling was used to conduct the research. A total of 477 households’ mothers/caregivers had participated in the study. The study showed that the prevalence of childhood diarrhoea was 9.9%. A number of risk factors including demographic variables, water and hygienic practices, and knowledge of risk factors showed significant association with childhood diarrhoea on bivariate analysis. The multivariate analysis showed that four variables were protective factors for childhood diarrhoea, including the type of toilet facility (AOR: 0.37; 95% CI 0.16 – 0.87; p = 0.023), availability of specific hand-washing places (AOR: 0.40; 95% CI 0.18 – 0.90; p = 0.026), availability of hand-washing facilities (AOR: 0.20; 95% CI 0.06 – 0.70; p = 0.012) and mothers’ knowledg...

What creates good experiences for EmOC clients in public health facilities in Ethiopia

Objective: To describe aspects that create positive experiences for emergency obstetric care (EmOC) clients in public health facilities in Ethiopia. Design: A qualitative contextual descriptive phenomenological design was used in this study. Subjects and setting: In-depth interviews were conducted with women who had complications during childbirth and received EmOC in three hospitals in Addis Ababa. Outcome measures: Content analysis was used to analyse data as it complies with the phenomenological data analysis. The data were analysed using the Atlas ti version 6.2 qualitative data analysis software. Results: Care that is life-saving, safe, timely, responsive and given in a clean environment, where the service carers show humility, respect, equal treatment and encouragement in an effort to meet the clients’ needs and expectations, creates a good experience. Conclusion: Clients’ experiences during the provision of EmOC influence their future decisions on whether to seek care or not. The findings of the study along with the developed guidelines will assist in the improvement of the provision and utilisation of EmOC at public health facilities in Ethiopia.

South African rural community understanding of fermented foods preparation and usage

Background: The benefits of fermented foods consumption have been demonstrated in a number of research reports. These qualities have been demonstrated, for example, to reduce childhood diseases such as diarrhea and malnutrition. Thus, fermented foods may be recommended for improving the health and nutritional quality of traditional African foods and regular inclusion of fermented foods as part of the daily diet would be desirable. Aims: Lack of knowledge and understanding toward fermented food preparation may limit their usage. This study explores the South African communitys understanding of fermented foods preparation and usage. Materials and Methods: This was a qualitative study using focus group interviews to determine the communitys understanding and their perception of fermented foods preparation in the rural villages of Odi, in Gauteng Province between May and June 2012. The target population was the caregivers of children under 5 years, attending the hospitals antenatal clinic at the time of study. The information was transcribed, coded, and analyzed using NVivo software. Results: Most caregivers were aware of food fermentation process, and some of them could not clearly differentiate between fermented and unfermented foods. Although most participants knew what fermented foods were, there were misconceptions on how they were made. This was exemplified by the undesirable artifacts, labeled as ingredients, in the fermentation process. Conclusion: Caregivers demonstrated a fair knowledge of fermented foods but lack a standard preparation procedure for these foods. There is an urgent need to educate communities and conduct a health promotion campaign on the fermented foods and probiotics.

Wastewater and solid waste disposal patterns of Dukem town households in Ethiopia

The objective of this descriptive, cross-sectional study was to assess wastewater and solid waste management by the households of Dukem, a town in Ethiopia. A total of 391 households were selected using stratified random sampling techniques. Face-to-face interviews were carried out with respondents by asking questions about wastewater and solid waste management in the households. A majority (75.1%) of households used unsafe wastewater disposal methods. Approximately two thirds (67.7%) of households had a temporary storage container in their compound in which to store solid waste. 53.3% of households used a safe solid waste disposal method. Only 4.9% of the households used waste as manure (compost) for home gardening. More than a quarter (28.1%) of households practised burning waste on their premises. The availability of safe wastewater disposal facilities was significantly associated with private home ownership and family size (p-value 0.05). Generally, there were inadequate domestic wastewater and solid waste disposal facilities in the studied households. Thus, there is a need for improved waste management in the households. Environmental health and health education programmes should be emphasised in order to improve practices of household waste management.

Access to Safe Drinking Water and Availability of Environmental Sanitation Facilities among Dukem Town Households in Ethiopia

Abstract The objective of this study was to assess the accessibility of water and environmental sanitation amongst households of Dukem town in Ethiopia. This was a cross-sectional study conducted among 391 households. Almost all the households had access to improved sources of drinking water. Majority of the households had access to water within a distance of upto 200 metres or less and had access to water within a time of 30 minutes or less. More than two-thirds of households had improved toilets (flush/pour-flush toilet, ventilated improved pit (VIP) latrine and traditional pit latrine). It is important to make water available by supplying with private or yard tap connections for underserved population and improved basic sanitation by promoting Total Sanitation Approach which aims to achieve universal access and use of toilets and the elimination of open defecation in the communities.