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- Kang, S, et al.
(författare)
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Are better existing WASH practices in urban slums associated with a lower long-term risk of severe cholera? A prospective cohort study with 4 years of follow-up in Mirpur, Bangladesh
- 2022
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 12:9, s. e060858-
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Tidskriftsartikel (refereegranskat)abstract
- To investigate the association between existing household water quality, sanitation and hygiene (WASH) practices and severe cholera risk in a dense urban slum where cholera is highly endemic.Design, setting and participantsWe assembled a large prospective cohort within a cluster randomised trial evaluating the effectiveness of oral cholera vaccine. Our dynamic cohort population (n=193 576) comprised individuals living in the ‘non-intervention’ clusters of the trial, and were followed over 4 years. This study was conducted in a dense urban slum community of Dhaka, Bangladesh and cholera surveillance was undertaken in 12 hospitals serving the study area.Primary outcome measureFirst severe cholera episode detected during follow-up period.MethodsWe applied a machine learning algorithm on a training subpopulation (n=96 943) to develop a binary (‘better’, ‘not better’) composite WASH variable predictive of severe cholera. The WASH rule was evaluated for performance in a separate validation subpopulation (n=96 633). Afterwards, we used Cox regression models to evaluate the association between ‘better’ WASH households and severe cholera risk over 4 years in the entire study population.ResultsThe ‘better’ WASH rule found that water quality and access were the most significant factors associated with severe cholera risk. Members of ‘better’ WASH households, constituting one-third of the population, had a 47% reduced risk of severe cholera (95% CI: 29 to 69; p<0.001), after adjusting for covariates. The protective association between living in a ‘better’ WASH household and severe cholera persisted in all age groups.ConclusionsSalutary existing household WASH practices were associated with a significantly reduced long-term risk of severe cholera in an urban slum of Dhaka. These findings suggest that WASH adaptations already practised in the community may be important for developing and implementing effective and sustainable cholera control programmes in similar settings.Trial registration numberThis article is a re-analysis of data from a cluster randomized trial; can be found on ClinicalTrials.govNCT01339845
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- Razzak, S. B. A., et al.
(författare)
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Quantitative and qualitative assessments of microbial contamination in some bottled and tap water with their drug resistant pattern
- 2021
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Ingår i: International Food Research Journal. - 1985-4668. ; 28:5, s. 945-952
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Tidskriftsartikel (refereegranskat)abstract
- The present work focussed on the concerns of the existence of coliform, faecal coliform, and other pathogens in both tap water and commercially available bottled water, along with the drug resistant pattern of the isolates. The physico-chemical features of the bottled water samples were satisfactory, but most of the tap water exceeded the marginal limit. A total of 21 samples (10 of tap water and 11 of bottled water) were collected and processed for microbiological analysis. All the samples were found to be contaminated with total viable bacteria up to 10(8) CFU/mL. Among the 21 samples, seven samples were found to be contaminated with E. coli up to 10(6) CFU/mL, and six samples had Klebsiella spp. up to 10(2) CFU/mL. Faecal contamination was totally absent in all bottled water, but present in four tap water samples. Fungi was found in six samples within the range of 10(2) to 10(3) CFU/mL. Surprisingly, Staphylococcus spp. were observed in all bottled water. Vibrio spp. were detected in three samples. An elevated number of faecal coliforms, Klebsiella spp., Salmonella spp., Shigella spp., Vibrio spp., and Pseudomonas spp. were estimated among the tap water samples up to 10(5) CFU/mL. The water samples, especially tap water, collected from the different areas were microbiologically unsafe, as few pathogenic microorganisms were found in several samples. This indicated as public health threat. Most of the isolates from both tap and bottled water samples were found to be resistant against more than one antibiotic tested, which is extremely alarming for the consumers. Very few antibiotics were found to be effective against the bacterial isolates. (C) All Rights Reserved.
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