UNASSIGNED: Diarrheal disease is a global public health concern, particularly in low-income countries. In Ghana, widespread issues like inadequate sanitation, unsafe drinking water, malnutrition, and poor hygiene practices contribute to the high incidence of diarrhea. Climate change exacerbates these challenges by increasing the frequency and severity of conditions that spread diarrheal diseases. This study explores households\' knowledge, understanding, and management practices for diarrhea in climate change-vulnerable coastal communities.
UNASSIGNED: The study is set in Ghana\'s central (Mumford, Opetekwei) and eastern (Anyako, Anyanui-Atiteti) coastlines. Using a cross-sectional study design, a structured questionnaire was administered to randomly sampled households (n = 419) to collect quantitative data. The study collected qualitative data from focus group discussions (n = 8), with groups separated into men and women, key informant interviews, and observations of food, water, and sanitation conditions across the studied communities.
UNASSIGNED: The study found significant variations between the studied communities and socio-demographic variables except for the respondents\' gender. Multivariate regression analyses identified significant associations between socio-demographic variables (especially gender and educational status) and perceptions of diarrhea causes. The most used first management action against diarrhea is \'over-the-counter drugs\', followed by home-made traditional remedies. Significant differences were observed in the usage of management practices across the studied communities. Trust, affordability, and availability were identified as the main factors influencing households\' use of approved pharmaceutical drugs and traditional herbal remedies for managing behavior, with significant differences being observed across communities. The study recommends a multi-sectoral approach, including improved access to regularly flowing, safe water and sanitation facilities, education on preventing diarrhea, and adequate healthcare services. Community-based interventions such as promoting good hygiene practices at homes and community settings such as schools, lorry parks, funeral grounds, and recreational areas can also effectively reduce the burden of diarrhea.

Environmental mismatches are defined as changes in the environment that induce public health crises. Well known mismatches leading to chronic disease include the availability of technologies that facilitate unhealthy diets and sedentary lifestyles, both factors that adversely affect cardiovascular health. This commentary puts these mismatches in context with biota alteration, an environmental mismatch involving hygiene-related technologies necessary for avoidance of infectious disease. Implementation of hygiene-related technologies causes a loss of symbiotic helminths and protists, profoundly affecting immune function and facilitating a variety of chronic conditions, including allergic disorders, autoimmune diseases, and several inflammation-associated neuropsychiatric conditions. Unfortunately, despite an established understanding of the biology underpinning this and other environmental mismatches, public health agencies have failed to stem the resulting tide of increased chronic disease burden. Both biomedical research and clinical practice continue to focus on an ineffective and reactive pharmaceutical-based paradigm. It is argued that the healthcare of the future could take into account the biology of today, effectively and proactively dealing with environmental mismatch and the resulting chronic disease burden.

Urban inequalities are exacerbated due to rapid urbanisation. This is also evident within slums in low- and middle-income countries, where high levels of heterogeneity amongst the slum population lead to differential experiences in Water, Sanitation, and Hygiene (WASH) and housing access. This scoping review provides evidence of the interconnection of WASH and housing and presents barriers to access and the consequences thereof for slum dwellers. It does so while considering the social stratification amongst urban slum dwellers and their lived experiences. A systematic search of journal articles was conducted in November 2022 in PubMed, Scopus, and Web of Science. A total of 33 papers were identified which were full text reviewed and data extracted. Infrastructure, social and cultural, socio-economic, governance and policy and environmental barriers emerged as general themes. Barriers to WASH and housing were more frequently described concerning women and girls due to gender norms within WASH and the home. Barriers to WASH lead to compromised health, socio-economic burdens, and adverse social impacts, thus causing residents of slums to navigate their WASH mobility spatially and over time. Insights from this review underscore the need for an intersectional approach to understanding access inequalities to WASH and housing.

BACKGROUND: Environmental factors greatly impact infectious disease-related mortality, yet there\'s a lack of comprehensive global studies on the contemporary burden and trends. This study aims to evaluate the global burden and trends of infectious disease mortality caused by air pollution, unsafe water, poor sanitation, and non-optimal temperature across Socio-Demographic Index (SDI) regions from 1990 to 2019.
METHODS: This observational study utilized data from the Global Burden of Diseases Study to examine mortality rates from infectious diseases attributed to environmental risk factors between 1990 and 2019, including air pollution, unsafe water, sanitation, handwashing facilities (UWSH), and non-optimal temperatures. Age-standardized mortality rates (ASMRs) and estimated annual percentage change (EAPC) were utilized to present infectious disease mortality, and its trajectory influenced by environmental risk factors over the years. Nonlinear regression was conducted to explore the association between the SDI and ASMRs across regions from 1990 to 2019.
RESULTS: In 2019, global infectious disease deaths linked to air pollution, UWSH, and non-optimal temperature reached a startling 2,556,992. Disease mortality varied widely across SDI regions, with the highest number of deaths due to air pollution and UWSH in Low SDI regions, and deaths from non-optimal temperature primarily in High SDI regions. Age disparities emerged, with children under five and the elderly most affected. However, an increasing mortality trend was observed among seniors (65-69, 75-79, and over 80) in High SDI regions due to enteric infections linked to UWSH. Globally, a consistent decrease in ASMR was seen from 1990 to 2019 for all diseases connected to these factors, except for respiratory infections linked to non-optimal temperature.
CONCLUSIONS: Our study underscores the significant impact of air pollution, UWSH, and non-optimal temperatures on global infectious disease mortality, particularly among vulnerable groups such as children and the elderly. It\'s important to tackle these challenges with targeted interventions aiming to enhance environmental quality, improve water and sanitation systems, and control extreme temperatures. In addition, international cooperation is essential for bridging regional disparities and driving global public health initiatives forward, thereby helping achieve Sustainable Development Goals more effectively.

BACKGROUND: Adolescence is a pivotal stage in human development that presents unique challenges, especially for girls navigating the complexities of menstruation. Despite the importance of menstrual hygiene management for adolescent girls\' well-being, this vital aspect of personal health is often overlooked, particularly in regions where cultural stigma prevails. This study examines knowledge, attitude, and practice of menstrual hygiene management among in-school adolescent girls in Abuja, Nigeria.
METHODS: The study employed a cross-sectional mixed-method design, integrating quantitative surveys with focus group discussions. A survey was conducted among 420 adolescent girls across four government junior secondary schools through a multistage sampling technique. Also, Focus Group Discussions were conducted among 80 respondents in groups of 10 discussants. The quantitative data set was subjected to descriptive and inferential statistical analysis, while the qualitative data were analysed using content analysis.
RESULTS: Findings revealed that the majority (53.45%) of the respondents had good knowledge of menstruation and menstrual hygiene management. Junior Secondary School (JSS) 3 students [OR = 2,09; 95% CI = 1.24-3.52] and those who started menstruation at age 15 years and above [OR = 7.52; 95% CI = 1.43-39.49] were associated with increased odds of having good knowledge of menstrual hygiene management. The attitude of most respondents (70.08%) towards menstrual hygiene management was good. Those in the JSS 3 class [OR = 6.47; 95% CI = 3.34-12.54], respondents who are Muslim [OR = 2.29; 95% CI = 1.63-5.48], and those whose parents had tertiary education [OR = 3.58; 95% CI = 1.25-10.25] were more likely to demonstrate more positive attitudes compared to their counterparts whose parents do not have tertiary education. In relation to practice, about 3 in 5 (57.80%) reportedly practise good menstrual hygiene management. Respondents who practice traditional religion [OR = 0.33; 95% CI = 0.02-4.56] were less likely to practise good menstrual hygiene management, while respondents who are the third child of their parents [OR = 2.09; 95% CI = 1.04-4.23] were more likely to practise menstrual hygiene compared to respondents with other birth orders. Qualitative results showed that participants had good knowledge of menstruation and menstrual hygiene management, and mothers were the main source of menstruation-related information. Participants had mixed feelings and reactions during their first menstruation, with 3 in 5 participants reporting experiencing menstruation-related stigma restrictions when menstruating.
CONCLUSIONS: In-school adolescent girls in Abuja, Nigeria, have good menstruation-related knowledge and positive attitudes, as well as practise menstrual hygiene management. Students\' class and age at first menstruation were major factors associated with good knowledge of menstruation and menstrual hygiene management; respondents\' class, religion and parents\' educational qualification were associated with a positive attitude, while respondents\' religion and parity line were associated with menstrual hygiene practice. Future interventions should focus on conducting school and community-level awareness programs to increase knowledge and dispel myths and misconceptions about menstruation and menstrual hygiene management.

Barriers to achieving and sustaining access to water, sanitation, hygiene, cleaning, and waste management (WASH) in health care facilities include a lack of supportive policy environment and adequate funding. While guidelines exist for assessing needs and making initial infrastructure improvements, there is little guidance on how to develop budgets and policies to sustain WASH services. We conducted costing and advocacy activities in Thakurbaba municipality, Nepal, to develop a budget and operations and maintenance policy for WASH in health care facilities in partnership with the municipal government. Our objectives for this study were to (1) describe the process and methods used for costing and advocacy, (2) report the costs to achieve and maintain basic WASH services in the 8 health care facilities of Thakurbaba municipality, and (3) report the outcomes of advocacy activities and policy development. We applied bottom-up costing to enumerate the resources necessary to achieve and maintain basic WASH services and their costs. The annual costs to achieve, operate, and maintain basic access to WASH services ranged from US$4881-US$9695 per facility. Cost findings were used to prepare annual budgets recommended to achieve, operate, and maintain basic services, which were presented to the municipal government and incorporated into an operations and maintenance policy. To date, the municipality has adopted the policy and established a recovery fund of US$3831 for repair and maintenance of infrastructure and an additional US$153 per facility for discretionary WASH spending, which were to be replenished as they were spent. Advocacy at the national level for WASH in health care facilities is currently being championed by the municipality, and findings from this project have informed the development of a nationally costed plan for universal access. This study is intended to provide a roadmap for how cost data can be collected and applied to inform policy.

The global rise in antimicrobial resistance (AMR) poses a significant public health threat, especially in healthcare settings, where controlling the spread of antimicrobial genes is crucial. While person-to-person transmission remains the primary route for healthcare-associated infections (HAIs), hospital surfaces serve as key reservoirs for antimicrobial-resistant microorganisms. Regular cleaning and disinfection of these surfaces are essential. Microbial-based products for sanitizing hospital surfaces have emerged as promising tools to combat HAIs and AMR. However, a review of 32 publications found inconsistencies and potential risks. A total of 15 publications included hospital-based trials, while the rest were either in vitro or in situ assays, reviews, book chapters, or commentaries. In most of the hospital-based studies, specific strains of applied microorganisms were not identified, and the term \"probiotic\" was inaccurately used. These products mainly featured spores from Bacillus and Priestia genera, which was mainly hypothesized to work through competitive exclusion. Most hospital-based studies have shown that the application of microbial-based products resulted in a significant reduction in pathogens on surfaces, thereby contributing to a decrease in the incidence of healthcare-associated infections (HAIs). Further research is however needed to understand the effectiveness, mechanisms of action, and safety of microbial-based sanitizing agents. Strain-level identification is crucial for safety assessments, yet many reviewed products lacked this information. Consequently, there is a need for rigorous safety evaluations within existing regulatory frameworks to ensure the efficacy and safety of microbial-based cleaning products in healthcare settings.

Healthcare-acquired infections are a major problem in healthcare facility settings around the world. The Democratic Republic of the Congo (DRC) has over 2 million diarrhea patients hospitalized each year. These healthcare settings become high-risk environments for spreading diarrheal illnesses such as cholera. The objective of the Preventative Intervention for Cholera for 7 Days (PICHA7) program is to develop evidence-based water, sanitation, and hygiene (WASH) interventions to reduce cholera and other severe diarrheal diseases in the DRC. The study objective was to evaluate the effectiveness of PICHA7 program delivery in increasing handwashing with a cleansing agent at stool/vomit- and food-related events in a healthcare facility setting among diarrhea patients and patient attendants. A pilot of the PICHA7 program was conducted among 284 participants in 27 healthcare facilities from March 2020 to November 2021 in urban Bukavu in the South Kivu Province of the DRC. The standard arm received the standard message provided in the DRC to diarrhea patients on the use of oral rehydration solution and a basic WASH message at healthcare facility discharge. The PICHA7 arm received the PICHA7 WASH pictorial module delivered by a health promoter focused on handwashing with a cleansing agent at the bedside of the diarrhea patient in the healthcare facility and provision of a soapy water bottle (water and detergent powder). Within 24 h of intervention delivery, a three-hour structured observation of handwashing practices at stool/vomit- and food-related events (key events) was conducted in healthcare facilities of diarrhea patients and their attendants. Compared to the standard arm, there was significantly more handwashing with a cleansing agent at key events in the PICHA7 arm (40% vs. 15%) (odds ratio: 5.04; (95% confidence interval (CI): 2.01, 12.7)). These findings demonstrate that delivery of the PICHA7 WASH pictorial module and provision of a soapy water bottle to diarrhea patients and their attendants presents a promising approach to increase handwashing with a cleansing agent among this high-risk population in healthcare facilities in the eastern DRC.

Atopic dermatitis (AD) is a chronic inflammatory skin condition with a high prevalence worldwide. AD pathogenesis is complex and consists of immune system dysregulation and impaired skin barrier, influenced by genetic and environmental factors. The purpose of the review is to show the complex interplay between atopic dermatitis and the microbiota. Human microbiota plays an important role in AD pathogenesis and the course of the disease. Dysbiosis is an important factor contributing to the development of atopic diseases, including atopic dermatitis. The gut microbiota can influence the composition of the skin microbiota, strengthening the skin barrier and regulating the immune response via the involvement of bacterial metabolites, particularly short-chain fatty acids, in signaling pathways of the gut-skin axis. AD can be modulated by antibiotic intake, dietary adjustments, hygiene, and living conditions. One of the promising strategies for modulating the course of AD is probiotics. This review offers a summary of how the microbiota influences the development and treatment of AD, highlighting aspects that warrant additional investigation.

BACKGROUND: Hygienic behavior as such belongs to health behavior, acquired at home, at school, at workplace or through the mass-media.
OBJECTIVE: The aim of the study was to analyze the perception of personal hygiene among different age groups and the sociodemographic factors related to hygiene behavior.
METHODS: The author\'s questionnaire for children and seniors concerning selected hygienic behavior was used. The questionnaire was conducted in two groups: 200 primary school children in age: 8-11 years; 109 girls and 91 boys and 200 older people: young-old (60-74 years) and old-old (75+); 110 women and 90 men.
RESULTS: Girls longer than boys take morning hygiene behavior, but statistically boys spend more time on evening washing, cleaning and brushing. Seniors hygienic behavior depend on age: young-old are more likely take a shower every day (51.79%) than seniors in the old-old group (29.86%). The same statistically significant difference was noticed in case of washing hands before a meal.
CONCLUSIONS: Children care more about personal hygiene than older people. Age, not gender, is a factor determining the frequency of hygiene practices among older people. Young-old care more about personal hygiene than old-old.
UNASSIGNED: Zachowania higieniczne należą do zachowań zdrowotnych nabywanych w domu, szkole, miejscu pracy lub za pośrednictwem środków masowego przekazu.
UNASSIGNED: Celem pracy była analiza postrzegania higieny osobistej w różnych grupach wiekowych oraz czynników socjodemograficznych związanych z zachowaniami higienicznymi.
UNASSIGNED: Zastosowano autorską ankietę dla dzieci i seniorów dotyczącą wybranych zachowań higienicznych. Badanie przeprowadzono w dwóch grupach: 200 dzieci ze szkół podstawowych w wieku 8-11 lat;109 dziewcząt, 91 chłopców oraz 200 osób starszych: młodszych starszych (60-74 lat) i starszych starszych (75-89); 110 kobiet i 90 mężczyzn.
UNASSIGNED: Dziewczęta dłużej niż chłopcy przestrzegają porannych zasad higieny, jednak statystycznie chłopcy spędzają więcej czasu na wieczornym myciu i szczotkowaniu zębów. Zachowania higieniczne seniorów zależą od wieku: młodsi starsi częściej biorą prysznic codziennie (51,79%) niż starsi starsi (29,86%). Tę samą różnicę istotną statystycznie zaobserwowano w przypadku mycia rąk przed posiłkiem.
UNASSIGNED: Dzieci bardziej niż osoby starsze dbają o higienę osobistą. Wiek jest czynnikiem determinującym częstotliwość wykonywania praktyk higienicznych wśród osób starszych. Dbanie o higienę osobistą jest na niewystarczającym poziomie, zarówno wśród dzieci w wieku szkolnym, jak i osób powyżej 60 roku życia. Treści programowe realizowane na przedmiocie edukacja zdrowotna powinny zostać uzupełnione o problematykę z zakresu zachowań higienicznych.