Assessing Students’ Knowledge on WASH-Related Diseases Khaldoon A. Mourad.pdf

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Received:18April2019;Accepted:6June2019;Published:10June2019
Abstract:Water-,sanitation-,andhygiene-relateddiseasesarekillingmanypeopleeachyearindevelopingcountries,includingRwanda,andchildrenundertheageof?,knowledgeondiseasescausedbycontactwithhumanfaeces,andknowledgeoncausesandpreventionofselectedWASH--,regardingstudents’wastedisposalpractices,%uselatrines,%practiceopendefecationinbushes,%,%respondedthattheywereawareofcholera,%ofdiarrhoea,%ofdysentery,%ofmalaria,%ofshigellosis,%,between50–99%,couldnotidentifythemaincausesoftheWASH--relateddiseases’,theprovisionofwaterandsanitationinfrastructuresshouldgowiththeprovisionofhealtheducationonhowtoavoidthesediseasesandpossiblewaystoimprovethewell-:Rwanda;sanitation;hygiene;education;assessment;,sanitation,erm(WASH)representsagrowingmovementfocusingonimprovingqualityoflifebyreducingWASH-relateddiseases[1].SomeoftheWASH-relateddiseasesarepresentedbelow:(1)Diarrhoea,whichisusuallycausedbyenterotoxigenicEscherichiacoli[2].Diarrhoeaisresponsibleforabout21%ofallunder-?vedeaths[3];aboutthree-quartersofamillionchildrendiefromdiarrhoeaeveryyear[4].Inadequatesanitation,hygiene,esstosafewaterincreasetheincidenceofdiarrhoeadiseasesanddeaths,urindevelopingcountries,includingmostAfricancountries[5–7].(2);sourcesofinfectionsincludestandingwater,seafood,grains,andunpeeledfruitandvegetables[8].,50%ofpeoplewithseverecholerawilldie,butpromptandadequatetreatmentreducesdeathsfromseverecholeratolessthan1%ofcases[5].ManycountriesatSub-SaharanAfricaarebroadlya?ectedbymanycholeracases[9].,16,2052;doi:.,16,20522of8(3)TrachomaisaninfectioncausedbyChlamydiatrachomatisthata?,withitsimpactsmostlyoccurringindevelopingcountries,aspoverty,crowdedlivingconditions,andpoorsanitationhelpinspreadingthedisease[10].(4),fever,andstomachcramps[11].Bowen[12].(5),whichkillsaround150,000peopleeveryyear[13].(6)MalariaisonthelistofAcquiredImmunode?ciencySyndromeAIDS-relatedopportunisticurinindividualsinfectedwithhumanimmunode?ciencyvirus(HIV)[14].Inpregnantwomen,theco-infectionwithmalariaandHIVisassociatedwithanaemia,lowbirthweight,andincreasedriskofinfantmortalitytoagreaterextentthaninfectionwitheitherdiseasealone[15].Malariamortalityisusuallyhigherinlow-ecountries,suchasmostoftheAfricancounties[16].Malariaisavector-bornediseasethatrequiresbetterwaterresourcesmanagementtoreduceitstransmission[17].Improvingwater,sanitation,andhygienepracticeshelpsinreducingthespreadofwaterbornediseases[18].Moreover,ensuringahygienicenvironment,cleanwater,andadequatesanitationcanpreventinfectionsassociatedwithHIV/AIDS[19].TheUnitedNations(UN)identi?edcriticalproblemsassociatedwithWASH-relateddiseases,especiallyindevelopingcountries,,theUnitedNations’SustainableDevelopmentGoal6:“esstowaterandsanitationforall”,aimedatsolvingtheseissuesbyprovidingsafewaterandsanitationforallby2030becausethebettermanagementoffreshwaterandsanitationarethepillarsofhumanhealth,environmentalsustainability,andeconomicprosperity[20].AlthoughRwandamettheMillenniumDevelopmentGoals(MDGs),thetreatedwastewatersovernmentalmonitoring,whichisconsideredabigchallengetoachievetheSustainableDevelopmentGoals(SDGs)in2030[21].Rwandafacesmanybarrierstoachievingimprovedsanitation,includingthehighpopulationdensityinthecities,thelackofspaceforlatrinesinsomeareas,suchasKigalicity,andthecosts[22].ThepoorhygienepracticesesstoimprovedwaterandsanitationfacilitiesinRwandaincreasesWASH-relatedmortalityandmorbidity[23–25].In2016,theRwandaBiomedicalCentrecon?rmedtheoutbreakofnon-bloodydiarrhoea,typhoid,shigellosis,,?ooddispersaloffaecalcontaminants,watershortages,poorsanitationandhygienepractices,andinsu?cientknowledgeareamongthekeycausesleadingtoincreasedrisksofoutbreaksofwaterbornediseasessuchascholera[26].AccordingtotheRwandaBiomedicalCentre,from2010to2017,seventeencholeraoutbreakswererecorded,,poorhygiene,lackoflatrines(manyhouseholdssharedonelatrine),non-functionalwatertaps,non-chlorinatedwater,andusingsurfacewaterasalatrine[26,27].Thispaperassessesstudents’knowledgeonwater-,sanitation-,andhygiene-relateddiseasesinrandomlyselectedruralandurbanschoolsinMusanzeDistrictinRwanda,withafocusonhumanwastedisposalpractices,diseasescausedbycontactwithhumanfaeces,andthecausesandpreventionofsomeWASH-,16,,16,,Tanzania,Tanzania,?vedividedprovinces:intofiveprovinces:CityCityofKigali,ofKigali,EasternEastProvince,ernNorthernProvince,Province,NorthernWesternProvince,Province,WesternandSouthernProvince,Province,andeachofSouthernProvince,whicheachhasofthreewhichtoeighthasdistrictsthreeto[28].eightThisresearchdistrictswas[28].conductedThisresearchinMusanzewasDistrict,conductedoneofthein?veMusanzeDistrict,districtsoneofthatthemakefivedistrictsupNorthernthatProvincemakeofupRwandaNorthern(FigureProvince1;[29]).TheofpopulationRwanda(FigureofMusanze1;[29]).isTheabout370,[30].populationofMusanzeisabout370,[30].(threeruralandthreeurban),representingatotalStudentsstudentfrompopulationsixrandomlyof2900,(thrstudents’eeruralagesandwerethreebetweenurban),’sof2900,[31]’sizefromageseachwereschool,(about3%).an’sKrejcieand[31]Morgantableusedwastheusedfollowingtoselectformulathetosampledeterminesizethefromsampleeachsizeschool,[32]:whichpresentsanacceptablemarginoferror(about3%).222anusedtheSfollowing=XNP(1?formP)/dula(N?to1)determine+XP(1?P)thesamplesize[32]:(1)whereSistherequiredsampleS=Xsize;2NP(1X2?isP)/dthetable2(Nvalue?1)+ofXchi-square2P(1?P)foronedegreeoffreedomat(1)thedesiredcon?dencelevel;Nispopulationsize;Pisthepopulationproportion;;X2isthetablevalueofchi-squareforonedegreeoffreedomatthedesiredTableconfidence1presentsthelevelpopulation;Nispopulationsizeandlocationsize;;.(SPSS)(IBMcorporation,Armonk,NY,USA).(SPSS)(IBMcorporation,Armonk,NY,USA).’%%,thereweremorefemalesinurbanareas(%)comparedtoruralareas(%).Ruralareasappearedtohavemorestudents(%)comparedtourbanareas(%)(Table2).,16,’%%,thereweremorefemalesinurbanareas(%)comparedtoruralareas(%).Ruralareasappearedtohavemorestudents(%)comparedtourbanareas(%)(Table2).%%%100%LocationofschoolCount281206487Urban%%%100%Count6645091173Total%%%100%,overall,%,%usedlatrines,%,acrossbothruralandurbanschools,%usedopendefecationinbushes,%usedopendefecationinruralareas,%,%,diarrhoea,dysentery,shigellosis,,malariaisawater-,studentsmentioneddi?,%mentionedcholera,%mentioneddiarrhoea,%mentioneddysentery,%mentionedmalaria,%mentionedshigellosis,%mentionedtyphoid,%,whileshigellosisandmalariaweretheleastmentioned(Table3).Table3alsoshowsthat,ingeneral,,thedi?,,itwastheoppositeforcholera,,16,**********Rural%%%%%%%%100%LocationofschoolCount251150**********Urban%%%%%%%%100%Count6683112631191451173Total%%%%%%%%100%-,viral,andparasiticpathogenslivinginwatercontaminatedbyhumanfaecalandanimalfaecalmatterfrommunicipalsewage,septictanks,,drinkingdirtywaterthatispollutedbyhumanfaeces,poors