skip to main content

Explore Research Products in the NSF-PAR

  • NSF Public Access
  • Search Results
  • In pursuit of ‘safe’ water: the burden of personal injury from water fetching in 21 low-income and middle-income countries
Title: In pursuit of ‘safe’ water: the burden of personal injury from water fetching in 21 low-income and middle-income countries
Introduction Water fetching for household needs can cause injury, but documentation of the burden of harm globally has been limited. We described the frequency, characteristics and correlates of water-fetching injuries in 24 sites in 21 low-income and middle-income countries in Asia, Africa and Latin America and the Caribbean. Methods In a survey of 6291 randomly selected households, respondents reported whether and how they had experienced water-fetching injuries. Responses were coded for injury type, mechanism, bodily location and physical context. We then identified correlates of injury using a multilevel, mixed-effects logistic regression model. Results Thirteen per cent of respondents reported at least one water-fetching injury. Of 879 injuries, fractures and dislocations were the most commonly specified type (29.2%), and falls were the most commonly specified mechanism (76.4%). Where specified, 61.1% of injuries occurred to the lower limbs, and dangerous terrain (69.4%) was the most frequently reported context. Significant correlates included being female (aOR=1.50, 95% CI 1.15 to 1.96); rural (aOR=4.80, 95% CI 2.83 to 8.15) or periurban residence (aOR=2.75, 95% CI 1.64 to 4.60); higher household water insecurity scores (aOR=1.09, 95% CI 1.07 to 1.10) and reliance on surface water (aOR=1.97, 95% CI 1.21 to 3.22) or off-premise water sources that required queueing (aOR=1.72, 95% CI 1.19 to 2.49). Conclusion These data suggest that water-fetching injuries are an underappreciated and largely unmeasured public health challenge. We offer guidelines for comprehensive data collection on injuries to better capture the true burden of inadequate water access. Such data can guide the design of interventions to reduce injury risk and promote equitable water access solutions.  more » « less
Award ID(s):
1759972
NSF-PAR ID:
10271580
Author(s) / Creator(s):
; ; ; ; ;
Date Published:
Journal Name:
BMJ Global Health
Volume:
5
Issue:
10
ISSN:
2059-7908
Page Range / eLocation ID:
e003328
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. ; ; ; ; ; ( , BMJ Open)
    null (Ed.)
    Objective To assess the links between structural and household determinants of household water insecurity and test three water insecurity measures against self-reported diarrhoea, dengue fever and perceived stress in the middle-income and low-income urban areas of Torreón, Mexico. Design Cross-sectional household survey conducted in two waves (rainy and dry seasons). Participants 500 households selected via multistage cluster sample in selected communities. Socioeconomic status determined the selection of participant neighbourhoods; five were identified in low socioeconomic status neighbourhoods and five in low-medium socioeconomic status neighbourhoods. We examine how the context of urban water provision is related to a new cross-culturally valid Household Water Insecurity Experiences (HWISE) Scale. Primary outcome measures The HWISE Scale, self-reported diarrhoea, dengue fever and the Perceived Stress Scale. Results Water system intermittency (adjusted OR (AOR) 3.96, 95% CI 2.40 to 6.54, p<0.001), unpredictability (AOR 2.24, 95% CI 1.34 to 3.74, p=0.002) and the dry season (AOR 3.47, 95% CI 2.18 to 5.52, p<0.001) were structural correlates of the HWISE Scale. This study also found that the HWISE Scale was associated with two health outcomes, self-reported diarrhoea (AOR 1.09, 95% CI 1.03 to 1.15, p=0.002) and perceived stress (β=0.28, SE=0.07, t =4.30, p<0.001), but not self-reported dengue fever (AOR 1.02, 95% CI 0.98 to 1.06). A 3-item hygiene subscore and a 3-item water worry subscore were also both positively associated with self-reported diarrhoea and perceived stress. Conclusion Short-form screeners of water insecurity may be useful for assessing certain health risks by lay survey workers in settings with limited healthcare resources, particularly in lieu of more expensive microbiological tests that require specialised training and facilities. 
    more » « less
  2. ; ; ; ; ; ; ; ; ; ; et al ( , BMC Public Health)
    Abstract Background

    HIV/AIDS remains a major public health problem globally. The majority of people living with HIV are from Sub-Saharan Africa, particularly adolescent girls and young women (AGYW) aged 15-24 years. HIV testing is crucial as it is the gateway to HIV prevention, treatment, and care; therefore this study determined the prevalence and factors associated with self-reported HIV testing among AGYW in Rwanda.

     Methods

    We conducted secondary data analysis on the AGYW using data extracted from the nationally representative population-based 2019/2020 cross-sectional Rwanda Demographic and Health Survey (DHS). We described the characteristics of study participants and determined the prevalence of HIV testing and associated factors using the multivariable logistic regression model. We adjusted all our analyses for unequal sampling probabilities using survey weights.

     Results

    There were a total of 5,732 AGYW, with the majority (57%) aged 15-19 years, 83% were not living with a man, 80% were from rural areas, 29% were from the East region, and 20% had a history of pregnancy. Self-reported HIV testing prevalence was 55.4% (95%CI: 53.7 to 57.0%). The odds of ever having an HIV test were significantly higher for those aged 20-24 years (aOR 2.87, 95%CI: 2.44 to 3.37); with higher education (aOR 2.41, 95%CI:1.48 to 3.93); who were rich (aOR 2.06, 95%CI:1.57 to 2.70); with access to at least one media (aOR 1.64, 95%CI: 1.14 to 2.37); who had ever been pregnant (aOR 16.12, 95%CI: 9.60 to 27.07); who ever had sex (aOR 2.40, 95%CI: 1.96 to 2.95); and those who had comprehensive HIV knowledge (aOR 1.34, 95%CI: 1.17 to 1.54).

     Conclusions

    We report an unmet need for HIV testing among AGYW in Rwanda. We recommend a combination of strategies to optimize access to HIV testing services, especially among the 15-19 years adolescent girls, including facility-based testing, school and community outreach, awareness campaigns on HIV testing, and home-based testing through HIV self-testing.

     
    more » « less
  3. ; ; ; ; ( , Journal of Athletic Training)
    Context Temporal prediction of lower extremity (LE) injury risk will benefit clinicians by allowing them to better leverage limited resources and target athletes most at risk. Objective To characterize instantaneous risk of LE injury by demographic factors sex, sport, body mass index (BMI), and previous injury history. Instantaneous injury risk was defined as injury risk at any given point in time following baseline measurement. Design Descriptive epidemiology study. Setting NCAA Division I athletic program. Patients or Other Participants 278 NCAA Division I varsity student-athletes (119 males, 159 females). Main Outcome Measure(s) LE injuries were tracked for 237±235 days. Sex-stratified univariate Cox regression models investigated the association between time to first LE injury and BMI, sport, and previous LE injury history. Relative risk ratios and Kaplan-Meier curves were generated. Variables identified in the univariate analysis were included in a multivariate Cox regression model. Results Females displayed similar instantaneous LE injury risk compared to males (HR=1.29, 95%CI=[0.91,1.83], p=0.16). Overweight athletes (BMI>25 kg/m2) had similar instantaneous LE injury risk compared with athletes with BMI<25 kg/m2 (HR=1.23, 95%CI=[0.84,1.82], p=0.29). Athletes with previous LE injuries were not more likely to sustain subsequent LE injury than athletes with no previous injury (HR=1.09, 95%CI=[0.76,1.54], p=0.64). Basketball (HR=3.12, 95%CI=[1.51,6.44], p=0.002) and soccer (HR=2.78, 95%CI=[1.46,5.31], p=0.002) athletes had higher risk of LE injury than cross-country athletes. In the multivariate model, females were at greater LE injury risk than males (HR=1.55, 95%CI=[1.00,2.39], p=0.05), and males with BMI>25 kg/m2 were at greater risk than all other athletes (HR=0.44, 95%CI=[0.19,1.00], p=0.05). Conclusions In a collegiate athletic population, previous LE injury history was not a significant contributor to risk of future LE injury, while being female or being male with BMI>25 kg/m2 resulted in increased risk of LE injury. Clinicians can use these data to extrapolate LE injury risk occurrence to specific populations. 
    more » « less
  4. ; ; ( , PLOS ONE)
    Kumar, Mohan (Ed.)
    Background Breastfeeding has several benefits for both mothers and their children. Despite strong evidence in support of the practice, its prevalence has remained low worldwide, particularly in Ethiopia. Therefore, this study is aimed to assess breastfeeding knowledge, attitude, and self-efficacy among mothers with index infants and young children in the rural community of Southwest Ethiopia. Methods A community-based cross-sectional study was conducted between March and April 2022 as baseline data for a cluster of randomized control trials. Multistage sample techniques followed by systematic random sampling techniques were employed. The Chi-square and Fisher’s exact probability tests were used to assess the baseline differences in the sociodemographic characteristics of the two groups. An independent sample t-test was used to determine the mean differences. Multivariate logistic regression analysis was used to evaluate the association. All tests were two-tailed, and a statistically significant association was declared at a p-value # 0.05. Results A total of 516 mothers (258 from the intervention and 258 from the control group) were interviewed. A total of 516 mothers (258 from the intervention group and 258 from the control group) were interviewed. Except for the child’s sex and age, no significant difference was observed between the intervention and control groups in terms of socio-demographic variables (p > 0.05). Independent t-tests found no significant difference between the two groups (p > 0.05) in terms of the mean score of maternal breastfeeding knowledge, attitude and self-efficacy at baseline. After adjusting for other covariates, maternal age (AOR = 1.44, 95% CI: 0.69, 3.07), educational status (AOR = 1.87, 95% CI: 0.56,2.33), occupation (AOR = 1.79, 95% CI, 1.04, 3.69), ANC (antenatal care) (AOR = 1.88, 95% CI, 1.11, 4.09), received breastfeeding information 2022 Project Survey for Award #1735038 11 (AOR = 1.69, 95% CI, 1.33, 5.04), postnatal care (PNC) (AOR = 3.85, 95% CI, 2.01, 5.77) and parity (AOR = 2.49, 95% CI, 1.08, 4.19) were significantly associated high level breastfeeding knowledge. The positive attitude was associated with maternal age (AOR = 2.41, 95% CI, 1.18, 5.67), education status (AOR = 1.79, 95% CI, 0.99,4.03), ANC (AOR = 2.07, 95% CI, 1.44,5.13), last child breastfeeding history (AOR = 1.77, 95% CI, 1.21,4.88) and high level of breastfeeding knowledge (AOR = 2.02, 95% CI, 1.56,4.04). Finally, high breastfeeding self-efficacy was associated with ANC (AOR = 1.88, 95% CI 1.04,3.83), parity (AOR = 4.05, 95% CI, 1.49, 5.03) and high knowledge level (AOR = 1.69, 95% CI, 0.89,2.85). Conclusions The study concluded that mothers in both the intervention and control groups have a low level of breastfeeding knowledge, a neutral attitude, and medium self-efficacy. Therefore, nutrition education interventions using tailored messages appropriate to the sociocultural context in the rural setting should be developed and evaluated continuously. 
    more » « less
  5. ; ; ; ; ; ; ; ( , Australasian Journal on Ageing)
    Abstract Objectives

    To investigate the burden of peripheral intravenous catheters (PIVCs) in older hospitalised patients.

     Methods

    A cross‐sectional prospective observational study (2014/2015) to describe the characteristics, indications and outcomes of PIVCs among patients aged ≥65 from 65 Australian hospitals.

     Results

    Amongst 2179 individual PIVCs (in 2041 patients, mean age 77.6 years, 45% female, 58% in NSW), 43% were inserted by doctors and 74% used that day, meaning 25% were ‘idle’. Overall, 18% (393/2179) exhibited signs of PIVC‐related complications. Most commonly exhibited PIVC‐related complications were tenderness (4.1%) and local redness (1.8%). Nearly one in three (29.1%) dressings was soiled, loosened or had come off, and only 36.8% had the time and date documented on the dressing. Both infusing IV medications (aOR 1.74, 95% CI 1.28–2.38,p < 0.001) and inserting the PIVC in a non‐upper limb vein (aOR 3.40 compared to forearm [reference site], 95% CI 1.62–7.17,p < 0.001) were independently associated with PIVC failure. Phlebitis was exhibited in 7% (154) of the patients. Only infusing intravenous medications increased the likelihood of developing symptoms of phlebitis (aOR 1.61, 95% CI 1.01–2.57,p = 0.05). Increasing age was inversely associated with symptoms of phlebitis. Among the 1575 patients (79%) who rated their PIVC experience using the Likert scale 0–10 (where 10 = ‘best possible’), the median score was 8 (IQR 6–10). Age in highest quartile (>84 years) was independently associated with lower likelihood of a high score (aOR 0.71, 95% CI 0.54–0.94,p = 0.02).

     Conclusions

    Given 1 in 5 PIVCs were identified with having complications, further research should focus on optimising PIVC use in older patients.

     
    more » « less
  • Citation Formats
  • MLA
  • APA
  • Chicago
  • BibTeX
  • Save / Share this Record
  • Send to Email