ABSTRACT Open defecation (OD) has become a concern in many developing countries, including Nigeria, with negative consequences for both individual and public health. So far, a valid scale to measure attitudes toward OD is lacking. This gap motivated the development of Attitudes Toward Open Defecation Scale (ATODS). A sequential exploratory mixed-methods design was adopted to develop and validate ATODS, including one qualitative survey (n = 20) and two descriptive cross-sectional surveys (n = 442) and (n = 322) among residents of two local government areas in Ondo North Senatorial District, Nigeria. The results provide support for the content validity, reliability, and construct validity of ATODS. The final scale included 21 items grouped into two dimensions explaining 36% of the common variance: Cognitive-evaluative attitudes = 24.91% and behavioural-normative orientation = 11.39% of the variance explained. ATODS showed internal consistency ranging from 0.74 to 0.82 for the factors. The two-factor ATODS was also subjected to a good model fit using structural equation modelling, which revealed a good fit. The findings show that ATODS is a valid and reliable measurement tool of attitudes toward OD. The scale is useful to benchmark attitudinal change interventions and could open up research into psychosocial determinants of attitudes toward OD in different settings and populations.
ABSTRACT Microplastic pollution is an increasing concern in wastewater-affected aquatic systems, yet direct monitoring remains limited in many industrial regions. This study presents a secondary data-driven screening framework for assessing relative microplastic risk in wastewater-affected water bodies of the Baddi–Barotiwala–Nalagarh industrial belt, India. A dataset of 24 sites was compiled from regulatory reports, published literature, hydrological information, and indicators of industrial activity. Because direct microplastic measurements were unavailable for most locations, relative microplastic loading potential was estimated using a proxy-based approach informed by total suspended solids, chemical oxygen demand, flow conditions, industrial density, treatment-related context, and retention characteristics. Descriptive statistics, exploratory correlation analysis, and a composite Microplastic Risk Index were used to identify priority locations. The results indicated higher relative risk in industrial drains, stagnant ponds, and low-flow wastewater receiving waters near dense industrial activity, while upstream and better-flushed sites ranked lower. Estimated loading patterns were positively associated with particulate-rich wastewater conditions and industrial pressure, and negatively associated with flow velocity. The framework is intended as a screening and prioritization tool rather than a substitute for direct field measurement. It may help regulators and industrial managers target limited monitoring resources toward likely hotspot locations in data-limited industrial regions.
Handpump corrosion poses a major sustainability challenge for rural drinking water supply in Cameroon. This cross-sectional economic assessment analysed functionality data from 20,572 handpumps across 310 municipalities (2010-2022), combined with cost evaluation methods adapted from industrialized contexts. Corrosion accounts for 15-20% of handpump failures, representing 7.85-8.9 billion FCFA (11.7-13.3 million USD) in immobilized capital. An estimated 470,800 rural residents lose access to safe water due to corrosion, generating annual indirect costs of 2.52 billion FCFA (3.77 million USD), largely from health impacts. Regional disparities are pronounced, with the Far North, Centre, and North regions concentrating 51% of total costs. Life-cycle cost analysis shows that corrosion-resistant materials achieve 57% savings over 20 years despite 27% higher upfront costs. Preventive strategies based on groundwater chemistry could reduce corrosion-related costs by 40-60%, highlighting the need for national quality standards and life-cycle-based procurement.
ABSTRACT Diagram showing study design and key findings on food insecurity, water insecurity, and their overlap among rural households in Zahedan and Chabahar. Food and water security are essential for human well-being, yet remain major challenges in disadvantaged and arid regions. This study assessed the prevalence and determinants of household food insecurity (FI), water insecurity (WI), and their co-occurrence in rural Zahedan and Chabahar in southeast Iran. A cross-sectional survey was conducted among 499 households using the Household Food Insecurity Access Scale (HFIAS), the Household Water Insecurity Experiences (HWISE) Scale, and demographic and socioeconomic data. Statistical analyses identified predictors of each condition and their overlap. FI was widespread with district-specific patterns: severe FI was more common in Zahedan (26.8% vs. 14%, p < 0.001), while moderate FI was more prevalent in Chabahar (51.4% vs. 26.6%, p<0.0001). WI was significantly higher in Chabahar compared with Zahedan. Concurrent FI and WI were significantly higher in Chabahar than in Zahedan (18.4% vs. 12.2%, p = 0.001). The household welfare index emerged as the strongest protective factor against FI, WI, and their co-occurrence. These findings reveal substantial and overlapping vulnerabilities in rural southeast Iran and underscore the need for integrated, multisectoral interventions focused on poverty reduction, water infrastructure improvements, and housing stability to enhance household resilience.
ABSTRACT This article examines processes and dynamics within Global South–North collaborations in water, sanitation, and hygiene (WASH) research. Using a qualitative approach, the research explored the experiences of 26 participants, including researchers, and research managers from both the Global North and South, who were involved in international WASH (Water, Sanitation, and Hygiene) research collaborations. We analyse their experience and views on participation in research collaborations and the fair and equitable conduct of transboundary research. The main objective was to understand the barriers to achieving equitable WASH research partnerships. The interviews revealed practical insights into the dynamics of South–North research collaborations aligned with six principles for global research partnerships: (1) set the agenda together, (2) manage power dynamics, (3) specify roles and responsibilities, (4) promote mutual learning, (5) share results and apply study findings, and (6) build long-term partnerships. Our study calls for a shift toward truly transformative partnerships entailing transparent project development, a rethink of research funding modalities and sharing of research results to enable more ethical forms of transboundary research. The article closes with key factors on how to address asymmetries in transboundary research arrangements and achieve genuine collaborative enquiry and research.
Legionnaires' disease is an infection caused by Legionella, a waterborne pathogen found in aquatic environments, particularly hot water plumbing systems and cooling towers. A selection of 29 Legionella pneumophila strains isolated from hotels hot water systems were typed by monoclonal antibodies, pulsed-field gel electrophoresis (PFGE) and new generation sequencing (NGS). MAb analysis results demonstrated a prevalence of MAb 3/1 negative isolates (n = 100%), with six subgroups of Camperdown (30%), seven Oxford (35%) and seven OLDA (35%). PFGE analysis showed three different clones, some of which are present in several buildings in different Moroccan cities. After sequencing, SBT (sequence-based type) analysis showed 3 sequence types (STs) with a high prevalence of ST1 found in 13 strains (65%), followed by ST560 in 4 (20%), and a new ST was found in 3 samples (15%), to which ESGLI assigned the ST number ST2897. 46% of ST1 are Oxford, 23% of Camperdown and 31% of OLDA. These findings revealed the genetic diversity of environmental L. pneumophila strains in Morocco, enriching the database and providing a useful basis for epidemiological investigations related to travel-associated diseases.HIGHLIGHTSGenetic diversity of environmental L. pneumophila sg1 isolates in Morocco. SBT analysis revealed three sequence types (STs) with a high prevalence of ST1. A new ST was discovered in three samples (15%), to which ESGLI assigned the ST number ST2897. PFGE analysis showed three different clones, some of which are present in several buildings in different Moroccan cities.
Rapid urbanization in Vientiane Capital, Lao PDR, overwhelms sanitation infrastructure, with 80% reliance on on-site systems, 1.4% centralized sewerage coverage, only 20% fecal sludge (FS) treated, and 64% of households never desludged, posing severe public health and water quality risks. This study developed a scenario-based policy framework targeting Sanitation Vision 2035 goals (100% coverage, 50% FS treatment/transport, and 50% resource recovery) through data management, regulatory enforcement, technical standards, urban planning, and community engagement. Mixed methods across four central districts (population 380,197) included 230 stratified random household surveys, 12 semistructured stakeholder interviews, wastewater effluent analyses (n = 56), and secondary data. Empirical findings revealed irregular desludging (36% never desludged or blockage-driven), unsafe wastewater disposal (45% to public drains), effluent non-compliance (biochemical oxygen demand (BOD5) 72-147 mg/L exceeding 30 mg/L standard), and citywide BOD5 pollution loads of 19,010 kg/day. The governance gaps include institutional overlaps and insufficient regulatory enforcement. This proposed framework models a potential increase in FS treatment from 20 to 50% by 2035 through multisectoral interventions (centralized databases, operator licensing with penalties, certification standards, and fee incentives), offering a replicable approach to sustainable urban sanitation.
In southwestern coastal Bangladesh, salinity intrusion, tidal surges, and flooding make groundwater unsuitable for drinking, making rainwater a vital source for drinking. This study evaluates physicochemical and microbial quality of harvested rainwater in Koyra Upazila and assesses non-carcinogenic health risks. Contamination levels were evaluated using water quality and heavy metal pollution indices. A total of 93 samples were collected from 31 locations: two from storage tanks for microbial (Fecal Coliform, Total Coliform), physicochemical (pH, TDS, EC, Turbidity), and heavy metal (Pb, Zn, Fe) analyses. Additionally, one sample was collected from each household vessels for microbial analysis only, allowing comparison of microbial quality between storage tanks and household water. Most physicochemical parameters met WHO and Bangladesh standards except turbidity (38.7%) and pH (12.9%). Pb (0.048 +/- 0.008 mg/L) exceeded limits in all samples. Fe and Zn were within Bangladesh standards, though Fe exceeded WHO limits in 29.03%. Microbial contamination was higher in household vessels than storage tanks. Heavy Metal Pollution Indices (HPI) and Heavy Metal Evaluation Indices (HEI) indicated slight to moderate contamination due to Pb. Although all non-carcinogenic risk values were below 1, children showed the highest hazard index (0.463-0.985), indicating greater vulnerability. The findings highlight potential health risks and need for regular monitoring and improved household water treatment.
The graphical abstract illustrates sanitation challenges in rural communities, including unimproved latrines, open defecation, limited financial capacity, and poor WASH conditions. The intervention involved community awareness activities, engagement of local artisans and suppliers, partnerships between NGOs and government institutions, and the use of community savings groups to support sanitation marketing. The study applied 230 household surveys, 28 key informant interviews, 5 focus group discussions, and an Analytical Hierarchy Process (AHP)-based Sanitation Sustainability Index (SSI) assessment to evaluate the effectiveness and sustainability of the interventions. The findings showed toilet coverage of 94.78%, open defecation reduced to 5.22%, and an SSI score of 77%, with financial support and community participation identified as major contributors to sustainable rural sanitation improvement.Sustainable Development Goal 6.2 targets ending open defecation and ensuring access to adequate sanitation and hygiene. Even though about 3.4 billion people still lack safely managed sanitation services globally, particularly in rural areas. Prior research has mainly looked at household occupants and short-term effects of interventions, leaving uncertainty about the long-term sustainability of sanitation marketing and how key factors work together to sustain behavior change. To address this, the study examined the long-term sustainability of sanitation marketing projects in Mandwanga and Mnara wards in Mtama District, Lindi Region, Tanzania. It used a mixed-methods design, drawing quantitative data from 230 randomly selected households and qualitative data from 28 key informant interviews (KIIs) with government, NGOs, and sanitation providers as well as five focus group discussions (FGDs). Using descriptive statistics, Chi-square tests, and the Analytical Hierarchy Process (AHP), the study produced a composite sustainability score and a Sanitation Sustainability Index (SSI). Community engagement, affordability, and access to finance were identified as the most critical factors. The SSI of 77% suggests high sustainability and increased household investment, though financial barriers remain. Overall, the study supports strategies to maintain sanitation adoption and reduce or end open defecation.HIGHLIGHTSThis study in Mtama district found that sanitation marketing significantly improves hygiene and toilet access, with a Sustainability Score Index of 77%. Success depends on community involvement, financial support, and integration with CLTS. Key challenges include affordability for low-income households, highlighting the need for microfinance and policy support to sustain progress toward SDG 6.2.
Graphical abstract presenting assessment of WASH conditions in healthcare facilities in Pakistan using the WASH FIT tool.This study aimed to evaluate the WASH (water, sanitation, and hygiene) status of healthcare facilities (HCFs) in Pakistan using the World Health Organization's WASH Facility Improvement Tool (WASH FIT). A simple descriptive, cross-sectional study was conducted in various HCFs, selected through stratified purposive sampling from seven cities in the three regions of Pakistan (i.e., Sindh, Punjab, and the Capital Territory). Data were collected from the staff of the nominated HCF. Simple descriptive statistics and Fisher's Exact test were applied to present data, and a p-value of <0.05 was considered statistically significant. Overall, compliance of HCFs with WASH FIT standards was suboptimal. Only 35.7% (n = 5) of HCFs were categorized in the 'Good' WASH category. Reliable drinking water criteria were fulfilled by 50.0% (n = 7) of the HCFs, while 57.1% (n = 8) had safe waste segregation and disposal arrangements. Similarly, functional hand hygiene infrastructure was available in 57.1% (n = 8) of assessed areas. A significant association was found between WASH status and HCF type. Most HCFs required urgent improvements in infrastructure and management to achieve WASH FIT standards. Better monitoring, resource allocation, and training systems are crucial to ensure patient-centered care and infection prevention in HCFs in Pakistan
Packaged and refilled bottled water (PRBW) sources are being used to meet drinking water needs. However, the magnitude of rise of PRBW as the main source of drinking water for households is not well captured by the Sustainable Development Goal (SDG) indicator, which relies on a broad 'improved' category for classifying sources. Furthermore, the extent to which PRBW sources may be displacing other 'improved' sources (e.g., piped) is poorly known. This study examined these concerns in 10 Latin American and Caribbean countries, which have datasets from at least three time points between 2001 and 2022. PRBW sources increased in all 10 countries, with 4 countries having >= 50% of households identifying PRBW as their main drinking water source in their most recent survey. During this same period, 9 of 10 countries reported a decrease in reliance on piped to premise as the main drinking water source. Up to 100% of this decrease could be accounted for by the corresponding rise in PRBW use in 8 of the 10 countries. The drivers and potential adverse implications of the shift in reliance on PRBWs from other improved water sources for daily household drinking needs should be further deliberated within the water SDG.
Rapid urbanization and climate change affect water quality in developing countries. In Blantyre, Malawi, poor sanitation, industrial discharge, and microbial contamination compromise public health. Studies of water quality on integrating Geographic Information Systems (GIS) with multivariate statistics remain limited. This study investigated the spatial variability of physicochemical and microbiological parameters in urban water sources, using GIS, Water Quality Index (WQI), and principal component analysis (PCA). 20 sites (rivers, boreholes, and kiosks) were sampled for pH, turbidity, total dissolved solids (TDS), nitrates, and Escherichia coli. Results showed spatial variation in water quality. All sources exceeded World Health Organization limits for E. coli: rivers (754.8 colony-forming units [CFU]/100 mL), boreholes (79.0 CFU/100 mL), and kiosks (1.0 CFU/100 mL). Spatial interpolation revealed TDS concentrations of 540.8 mg/L in rivers, 345.4 mg/L in kiosks, and 265.8 mg/L in boreholes. Mean turbidity was 2.0 NTU in rivers, 2.2 NTU in boreholes, and 0.5 NTU in kiosks. WQI analysis showed that 44% of sources were unsuitable for drinking, and PCA identified TDS, turbidity, and E. coli as the dominant pollution drivers. These findings highlight public health risks from microbial contamination and urban land-use pressures, requiring integrated water management strategies that link environmental protection, sanitation, and health surveillance.
Access to safe water, sanitation, and hygiene (WASH) is a fundamental human right and a critical public health challenge in refugee camps like Nguenyiel. This community-based cross-sectional study of 398 households assessed WASH service utilization in Nguenyiel Refugee Camp from March to April 2024. While 74.9% of respondents reported nominal access to at least one WASH service, only 25.1% had access to both functional water points and latrines. The study revealed stark inequalities and critical utilization gaps: 79.9% of households lacked hand-washing stations, and only 2.5% consistently used soap after toilet visits. Multivariate analysis identified significant demographic disparities, with females 48% less likely to have adequate WASH access than males (Adjusted odds ratio 0.518, p = 0.035). Water collection burdens fell exclusively on women (62.8%) and girls (37.2%), exposing them to gender-based violence risks and lost opportunities. Additionally, 92.7% of households experienced weekly water scarcity. Factors such as marital status, disease awareness, and the availability of hand-washing areas significantly predicted service accessibility. Targeted interventions must prioritize gender-equitable infrastructure and behavioral shifts to move beyond nominal access toward safe, reliable WASH utilization.
With increasing population growth, sustainable waste management remains a global challenge. This study evaluated the effects of using defatted black soldier fly larvae meal (BSFLM) instead of fishmeal (FM) on the growth performance of Nile tilapia (Oreochromis niloticus). The black soldier fly larvae were reared using fecal sludge and organic waste as substrates, harvested at the prepupal stage, and then defatted. Three isonitrogenous diets (30% crude protein) were formulated in which BSFLM substituted FM at 0% (control, diet 1), 50% (diet 2) and 100% (diet 3) on a protein basis. A 90-day feeding trial was conducted using 270 Nile tilapia fingerlings (9.62 +/- 0.22 g) in a completely randomized design. The fingerlings were distributed into three groups of three replicates (30 fingerlings per net hapa). There was a decrease in final body weight (47.73, 42.98 and 34.57 g) with increased substitution of BSFLM for diets 1, 2 and 3, respectively (p = 0.018). Diet 2 exhibited the highest survival rate (95.56%). The economic profit index recorded for diets 1 and 2 was not significantly different. Based on these results, BSFLM can effectively replace fish meal by 50%, with no detrimental effect on growth.
Ensuring access to water, sanitation, and hygiene (WASH) facilities and services remains an important challenge in Ethiopian schools. This study used photovoice, a participatory photography-based method, to explore both WASH challenges and opportunities in two primary school settings, and to engage stakeholders in a collective reflection. Two purposively selected public primary schools in Jimma Town were selected to participate in the study, involving 10 teachers and 10 students. Participants captured their surroundings during task-based activities and afterwards analyzed and discussed the photos. These findings were presented and discussed with 75 relevant stakeholders during an advocacy event. Findings revealed that school WASH challenges originate from broader systemic factors. These systemic gaps deflected responsibility and contributed to inadequate maintenance, infrastructure deterioration, and poor behaviors. Despite these constraints, participants demonstrated individual and collective efforts in maintaining positive WASH practice where facilities allowed. Notably, the study demonstrated the unique value of photovoice as both a research and advocacy tool. This study highlights the interconnectedness of systemic governance, institutional maintenance, infrastructure functionality, and community behavior in shaping WASH outcomes in urban primary schools in Ethiopia.
Poor biowaste management contributes to greenhouse gas (GHG) emissions such as methane (CH4), carbon dioxide (CO2), and nitrous oxide (N2O). Black soldier fly larvae (BSFL, Hermetia illucens) bioconversion offers a sustainable approach for treating organic wastes while reducing emissions and recovering valuable resources. However, the global warming potential (GWP) associated with BSFL treatment of different waste substrates remains insufficiently characterized. This study quantified GHG emissions (CH4, CO2, N2O, and NH3) during BSFL bioconversion of human faecal matter (FM), pig manure (PM), and chicken manure (CM) using calibrated gas sensors. Emissions from BSFL-treated substrates were compared with those of untreated controls, and a cradle-to-gate life cycle assessment (LCA) was conducted to determine GWP in CO2-equivalent (CO2-eq). In the control treatments, GWP was highest in CM (0.194 kg CO2-eq), followed by FM (0.072 kg CO2-eq) and PM (0.005 kg CO2-eq). BSFL treatment significantly reduced emissions across all substrates, resulting in GWP values of 0.011 kg CO2-eq for CM, 0.006 kg CO2-eq for FM, and 0.001 kg CO2-eq for PM. The greatest reduction was observed in CM, indicating that BSFL treatment was effective for this substrate. These findings demonstrate that BSFL bioconversion can substantially reduce GHG emissions from organic wastes while supporting a circular bioeconomy approach to waste valorization.
Thermophilic composting of source-separated human feces offers a strategy to reduce storage time and enhance hygienic safety in urine-diverting dry toilet (UDDT) systems. Bench-scale insulated batch reactors were operated for 30 days with three feces-to-sawdust (F/S) ratios (60, 40, and 30%, total solids [TS] basis) and monitored for temperature, moisture, volatile solids (VS), and thermotolerant coliforms (Escherichia coli). Sustained thermophilic conditions (>50 degrees C) were achieved at F/S = 30%, resulting in >60% VS reduction within approximately 7 days. E. coli concentrations declined below detection by day 14, and a modeled 5-log reduction was achieved within approximately 26 days under sustained thermophilic exposure. A coupled mathematical model describing organic matter degradation, moisture evolution, temperature-dependent kinetics, and pathogen inactivation was calibrated against experimental data from the optimized configuration. Model performance was strong for moisture prediction (R-2 = 0.76) and moderate for VS reduction (R-2 = 0.57), reflecting substrate heterogeneity. Sensitivity analysis demonstrated that hygienization time is highly dependent on the effective inactivation constant, supporting the incorporation of a safety factor in field applications. The framework enables performance-based engineering design of mixed, passively aerated UDDT composting chambers, providing a process-based alternative to empirical storage guidelines when sustained thermophilic conditions can be verified. [GRAPHICS] .
Flow diagram summarising the study design, findings, and implications. Left panel (Study Context): urban low-income setting in Nzeng-Ayong, Libreville, Gabon; 949 household surveys and 175 water analyses/laboratory tests. Middle panel (Environmental and Behavioral Risks): chemical exceedances of WHO guidelines for barium (Ba & sup2;(+)) and iron (Fe); detection of enteric pathogens (ETEC, EIEC/Shigella, Giardia lamblia, Cryptosporidium spp.); behavioural risk factors including outdoor latrine use, low handwashing frequency, and unsafe water storage; leading to co-occurrence of chemical and microbial contamination with poor WASH conditions. Right panel (Health Impact): multivariate regression results showing improved water storage associated with lower incidence (IRR < 1); sanitation access (latrines/toilets) associated with IRR = 0.87; handwashing before meals associated with IRR = 1.19. Footer note: cross-sectional associations only, no causal inference, reverse causality possible. Access to drinking water is vital for preventing waterborne diseases, especially in rapidly urbanizing areas with limited sanitation infrastructure. This study investigates health risks associated with drinking water quality and household Water, Sanitation, and Hygiene (WASH) practices in Nzeng-Ayong, a densely populated district of Libreville, Gabon, undergoing rapid urban growth and infrastructure strain. A mixed-methods approach combined household surveys (n = 949), physicochemical and microbiological analyses of water samples (35 samples from seven sites, yielding 175 analyses), and interviews with local health authorities. Results show barium and iron concentrations exceeding World Health Organization guidelines in several non-controlled sources, alongside prevalent detection of pathogenic bacteria (Escherichia coli, Shigella) and protozoa (Cryptosporidium spp.). Negative binomial regression identified that improved water storage facilities (IRR = 0.893; p = 0.014) and access to sanitation (IRR = 0.873; p = 0.043) were significantly associated with lower incidence of waterborne diseases. Conversely, handwashing and in-home water treatment showed an unexpected positive association (IRR > 1.0), likely reflecting reverse causality bias where households perceiving higher risk are more diligent. This study supports the case for prioritizingWASH infrastructure investment and regulation of water quality to mitigate the persistent burden of waterborne disease exposure in Nzeng-Ayong.
This study examines the historical development of sanitation improvements in one English rural district, focusing on how service delivery evolved in relation to national economic growth, legislation and local municipal decisions. Using 75 years of Medical Officer of Health reports, the analysis shows that greywater drainage improvements preceded advances in human waste management. Between 1900 and 1950, the district transitioned from pit latrines to container-based sanitation (CBS). Initially, earth-treated pails were emptied onto gardens, but twice-weekly bucket-latrine collections soon became standard - a universal, free service prioritising the poorest villages. Sewerage first appeared in 1910 for a small number of settlements but only expanded widely after 1950, achieving near-universal coverage by the 1970s. We estimate that the district reached the SDG 6.2 benchmark of safely managed sanitation around 1950, based on extensive CBS use. This transition occurred alongside economic growth from a GDP per capita of $7,800 in 1900 to $11,700 in 1950 (2020 USD), with near-universal sewerage reached at $21,900 in 1975. The findings show that safely managed rural sanitation can be achieved through phased, long-term transitions and that CBS - now typically viewed as an urban service model - can play an important supportive role.
