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      Water Quality, Sanitation, and Hygiene Conditions in Schools and Households in Dolakha and Ramechhap Districts, Nepal: Results from A Cross-Sectional Survey

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          Abstract

          This study assessed drinking water quality, sanitation, and hygiene (WASH) conditions among 708 schoolchildren and 562 households in Dolakha and Ramechhap districts of Nepal. Cross-sectional surveys were carried out in March and June 2015. A Delagua water quality testing kit was employed on 634 water samples obtained from 16 purposively selected schools, 40 community water sources, and 562 households to examine water quality. A flame atomic absorption spectrophotometer was used to test lead and arsenic content of the same samples. Additionally, a questionnaire survey was conducted to obtain WASH predictors. A total of 75% of school drinking water source samples and 76.9% point-of-use samples (water bottles) at schools, 39.5% water source samples in the community, and 27.4% point-of-use samples at household levels were contaminated with thermo-tolerant coliforms. The values of water samples for pH (6.8–7.6), free and total residual chlorine (0.1–0.5 mg/L), mean lead concentration (0.01 mg/L), and mean arsenic concentration (0.05 mg/L) were within national drinking water quality standards. The presence of domestic animals roaming inside schoolchildren’s homes was significantly associated with drinking water contamination (adjusted odds ratio: 1.64; 95% confidence interval: 1.08–2.50; p = 0.02). Our findings call for an improvement of WASH conditions at the unit of school, households, and communities.

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          Most cited references57

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          A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

          The Lancet, 380(9859), 2224-2260
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            Guidelines for Drinking Water Quality

            (2011)
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              Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries

              Objective To estimate the burden of diarrhoeal diseases from exposure to inadequate water, sanitation and hand hygiene in low- and middle-income settings and provide an overview of the impact on other diseases. Methods For estimating the impact of water, sanitation and hygiene on diarrhoea, we selected exposure levels with both sufficient global exposure data and a matching exposure-risk relationship. Global exposure data were estimated for the year 2012, and risk estimates were taken from the most recent systematic analyses. We estimated attributable deaths and disability-adjusted life years (DALYs) by country, age and sex for inadequate water, sanitation and hand hygiene separately, and as a cluster of risk factors. Uncertainty estimates were computed on the basis of uncertainty surrounding exposure estimates and relative risks. Results In 2012, 502 000 diarrhoea deaths were estimated to be caused by inadequate drinking water and 280 000 deaths by inadequate sanitation. The most likely estimate of disease burden from inadequate hand hygiene amounts to 297 000 deaths. In total, 842 000 diarrhoea deaths are estimated to be caused by this cluster of risk factors, which amounts to 1.5% of the total disease burden and 58% of diarrhoeal diseases. In children under 5 years old, 361 000 deaths could be prevented, representing 5.5% of deaths in that age group. Conclusions This estimate confirms the importance of improving water and sanitation in low- and middle-income settings for the prevention of diarrhoeal disease burden. It also underscores the need for better data on exposure and risk reductions that can be achieved with provision of reliable piped water, community sewage with treatment and hand hygiene.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                18 January 2017
                January 2017
                : 14
                : 1
                : 89
                Affiliations
                [1 ]Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, P.O. Box, CH-4002 Basel, Switzerland; akina.shrestha@ 123456unibas.ch (A.S.); jana.gerold@ 123456unibas.ch (J.G.); severine.erismann@ 123456unibas.ch (S.E.); sanjay.sagar@ 123456unibas.ch (S.S.); christian.schindler@ 123456unibas.ch (C.S.); peter.odermatt@ 123456unibas.ch (P.O.); juerg.utzinger@ 123456unibas.ch (J.U.)
                [2 ]University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland
                [3 ]School of Medical Sciences, Kathmandu University, P.O. Box 11008, Dhulikhel, Nepal; rajendrakoju@ 123456gmail.com
                [4 ]Aquatic Ecology Centre, School of Science, Kathmandu University, P.O. Box 6250, Dhulikhel, Nepal; subodh.sharma@ 123456ku.edu.np
                Author notes
                [* ]Correspondence: gueladio.cisse@ 123456unibas.ch ; Tel.: +41-61-284-8304; Fax: +41-61-284-8105
                Article
                ijerph-14-00089
                10.3390/ijerph14010089
                5295339
                28106779
                3ebb273c-72c1-4ec3-b1a4-7febac3aa916
                © 2017 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 18 November 2016
                : 09 January 2017
                Categories
                Article

                Public health
                cross-sectional survey,drinking water quality,hygiene,nepal,sanitation,schoolchildren
                Public health
                cross-sectional survey, drinking water quality, hygiene, nepal, sanitation, schoolchildren

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