Prioritisation of Faecal-Oral Disease Transmission Pathways in Secondary Schools MELERUCHI WAMI m.wami@lboro.ac.uk
OUTLINE Problem Statement Approach to solution Progress so far What s next?
WASH needs are BASIC and require UNIVERSAL access Household Schools Healthcare facilities Workplaces Market places Prisons etc
GLOBALLY Water (844million people lacked basic) Sanitation (2.3billion people lacked basic) Hygiene -insufficient data (UNICEF report in 2015) 58% in south Asia, south-east Asia and sub-saharan Africa In 2016: School age population was 1.8bn (370m in sub-saharan Africa) 44% attend primary schools and 37% in secondary schools
Poor WASH has several implications Reduced productivity Insecurity/violence Faecal-Oral Disease (FOD) transmission Absenteeism, esp for menstruating girls Lack of concentration during classes leading to poor performance High school drop-out rate
Poor WASH School children Risk of Faecal- Oral Disease
Faecal-oral disease transmission fluid bacteria finger children faecal matter/ pathogens viruses helminth s protozoa pathways flies food flood hosts elderly immunocompromise d pregnant women
Faecal-oral disease transmission PATHOGEN Bacteria Viruses Helminths Protozoa etc PATHWAY Flies Fingers Fluid Food flood HOST Children The elderly Immunocompromised individuals Regular individuals
FAECAL-ORAL DISEASE TRANSMISSION NETWORK Bacteria Viruses Helminths Food Flies fingers Flood Fluid Day students Boarding students Boys Girls
WASH interventions seek to intercept FOD transmission route by barring faecal pathogens from accessing pathways thereby reducing transmission to host, but
What is the risk of faecal contamination within the school environment? What pathways pose the greatest risk of FOD within the school environment? What pathway(s) should be targeted by interventions to maximise impact?
RESEARCH GOAL To improve the quality of life of students in southern Nigeria by improving their health through prioritization of barriers of faecal-oral disease transmission pathways. RESEARCH AIM To prioritise faecal-oral disease transmission pathways in school sanitation in Southern Nigeria. SIMILAR RESEARCH around improving quality of life of students
Logical structure of research RESEARCH GOAL To improve the quality of life of students in southern Nigeria by improving their health through prioritization of barriers of faecaloral disease transmission pathways. RESEARCH AIM To prioritise faecal-oral disease transmission pathways in school sanitation in Southern Nigeria RESEARCH OBJECTIVE 1 RESEACRH OBJECTIVE 3 RESEARCH OBJECTIVE 2 To assess the risks of diarrhoeal diseases in the To assess WASH conditions in selected schools in Rivers To prioritise faecal-oral pathways by comparing the outcomes of the risk selected schools in Rivers State, Southern Nigeria State, Southern Nigeria assessments carried out in RO2 What is the state of WASH in schools in Southern Nigeria, and what trends in WASH infrastructure are identified? What are the drivers for improving sanitation in schools? Within selected school settings, how often do incidences of diarrhoea occur? What behaviours and practices increase the risk of diarrhoeal disease within the schools? What environmental conditions within the schools increase the risk of diarrhoeal disease? What pathways are more accessible to pathogens transmitted via the faecal-oral route? Which identified risks have the greatest impact? What are the identified critical pathways? What are the greatest risk factors in schools for transmission of faecal oral infections? What schools are at the greatest risk? Which school students are at greatest risk to diarrhoeal disease? What intervention(s) would have the greatest impact?
How? Ranking results from comparative risk assessments of each pathway has the possibility to determine pathways to FOD with higher priority.
Approach Characterise selected schools by assessing WASH conditions in the schools Assess risk of FOD from named pathway using SaniPath or similar tools By comparison, determine pathway with greatest influence /highest priority within selected schools
APPROACH Sanipath QMRA Develop an assessment tool context-specific, i.e. tailored towards school environment
Work done so far Background on faecal matter Faecal-oral pathogen pathways Water and sanitation in developing countries Global disease burden from diarrhoea in developing countries
WHAT S NEXT? Literature *elements and dynamics of disease transmission *disease transmission risk *elements of risk *hazards *exposure *vulnerability analysis Fieldwork
Thank you for listening