Daily Archives: June 14, 2015

Handwashing found Effective for Preventing Intestinal Parasitic Infections

Mahmud MA, Spigt M, Bezabih AM, Pavon IL, Dinant GJ, Velasco RB. Efficacy of Handwashing with Soap and Nail Clipping on Intestinal Parasitic Infections in School-Aged Children: A Factorial Cluster Randomized Controlled Trial. PLoS Medicine 2015 Jun 9;12(6):e1001837. doi: 10.1371/journal.pmed.1001837.

BACKGROUND: Intestinal parasitic infections are highly endemic among school-aged children in resource-limited settings. To lower their impact, preventive measures should be implemented that are sustainable with available resources. The aim of this study was to assess the impact of handwashing with soap and nail clipping on the prevention of intestinal parasite reinfections.

METHODS AND FINDINGS: In this trial, 367 parasite-negative school-aged children (aged 6-15 y) were randomly assigned to receive both, one or the other, or neither of the interventions in a 2 × 2 factorial design. Assignment sequence was concealed. After 6 mo of follow-up, stool samples were examined using direct, concentration, and Kato-Katz methods. Hemoglobin levels were determined using a HemoCue spectrometer. The primary study outcomes were prevalence of intestinal parasite reinfection and infection intensity. The secondary outcome was anemia prevalence. Analysis was by intention to treat. Main effects were adjusted for sex, age, drinking water source, latrine use, pre-treatment parasites, handwashing with soap and nail clipping at baseline, and the other factor in the additive model. Fourteen percent (95% CI: 9% to 19%) of the children in the handwashing with soap intervention group were reinfected versus 29% (95% CI: 22% to 36%) in the groups with no handwashing with soap (adjusted odds ratio [AOR] 0.32, 95% CI: 0.17 to 0.62). Similarly, 17% (95% CI: 12% to 22%) of the children in the nail clipping intervention group were reinfected versus 26% (95% CI: 20% to 32%) in the groups with no nail clipping (AOR 0.51, 95% CI: 0.27 to 0.95). Likewise, following the intervention, 13% (95% CI: 8% to 18%) of the children in the handwashing group were anemic versus 23% (95% CI: 17% to 29%) in the groups with no handwashing with soap (AOR 0.39, 95% CI: 0.20 to 0.78). The prevalence of anemia did not differ significantly between children in the nail clipping group and those in the groups with no nail clipping (AOR 0.53, 95% CI: 0.27 to 1.04). The intensive follow-up and monitoring during this study made it such that the assessment of the observed intervention benefits was under rather ideal circumstances, and hence the study could possibly overestimate the effects when compared to usual conditions.

CONCLUSIONS: Handwashing with soap at key times and weekly nail clipping significantly decreased intestinal parasite reinfection rates. Furthermore, the handwashing intervention significantly reduced anemia prevalence in children. The next essential step should be implementing pragmatic studies and developing more effective approaches to promote and implement handwashing with soap and nail clipping at larger scales.

Metals in Drinking Water, Murmansk Region, Russia

Doushkina EV, Dudarev AA, Sladkova YN, Zachinskaya IY, Chupakhin VS, Goushchin IV, Talykova LV, Nikanov AN. [Metallic content of water sources and drinkable water in industrial cities of Murmansk region]. [Article in Russian] Meditsina truda i promyshlennaia ekologiia. 2015;(2):29-34.

Performed in 2013, sampling of centralized and noncentralized water-supply and analysis of engineering technology materials on household water use in 6 cities of Murmansk region (Nikel, Zapolyarny, Olenegorsk, Montchegorsk, Apatity, Kirovsk), subjected to industrial emissions, enabled to evaluate and compare levels of 15 metals in water sources (lakes and springs) and the cities’ drinkable waters. Findings are that some cities lack sanitary protection zones for water sources, most cities require preliminary water processing, water desinfection involves only chlorination. Concentrations of most metals in water samples from all the cities at the points of water intake, water preparation and water supply are within the hygienic norms. But values significantly (2-5 times) exceeding MACs (both in water sources and in drinkable waters of the cities) were seen for aluminium in Kirovsk city and for nickel in Zapolarny and Nikel cities. To decrease effects of aluminium, nickel and their compounds in the three cities’ residents (and preserve health of the population and offsprings), the authors necessitate specification and adaptation of measures to purify the drinkable waters from the pollutants. In all the cities studied, significantly increased concentrations of iron and other metals were seen during water transportation from the source to the city supply–that necessitates replacement of depreciated water supply systems by modern ones. Water taken from Petchenga region springs demonstrated relatively low levels of metals, except from strontium and barium.