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Publications (35)
Soil household floors are common in low- and middle-income countries (LMICs) and can serve as reservoirs of enteric pathogens. Cement-based floors may interrupt pathogen transmission, but little is known about pathogen survival or removal from cement-based surfaces. This study investigated the survival of Escherichia coli, an indicator of fecal con...
Soil-transmitted helminths, like Ascaris , are significant contributors to disease burden in low- and middle-income countries (LMICs). Infections are associated with growth faltering and mortality in children and are often transmitted through contact with eggs in fecally contaminated soil. Interventions, like replacing household soil floors with ce...
Soil household floors are common in low- and middle-income countries (LMICs) and can serve as reservoirs of enteric pathogens. Cement-based floors may interrupt pathogen transmission, but little is known about pathogen survival or removal from cement-based surfaces. This study investigated the survival of Escherichia coli ( E. coli ), an indicator...
Background
A number of studies have detected relationships between weather and diarrhea. Few have investigated associations with specific enteric pathogens. Understanding pathogen-specific relationships with weather is crucial to inform public health in low-resource settings that are especially vulnerable to climate change.
Objectives
Our objectiv...
Background:
Diarrheal disease is a leading cause of childhood morbidity and mortality globally. Household water, sanitation, and handwashing (WASH) interventions can reduce exposure to diarrhea-causing pathogens, but meteorological factors may impact their effectiveness. Information about effect heterogeneity under different weather conditions is...
Awareness of the threats of climate change is engendering distress in increasingly documented ways, with young people particularly affected. Experiences such as climate distress and eco-anxiety have implications for the health and wellbeing of societies, economies, and for climate action, including mental health, agency to address the crisis, and f...
Background:
Centralized chlorination of urban piped water supplies has historically contributed to major reductions in waterborne illness. In locations without effective centralized water treatment, point-of-use (POU) chlorination for households is widely promoted to improve drinking water quality and health. Realizing these health benefits requir...
Background: Climate change may influence the effectiveness of environmental interventions. We investigated if climate and environment modified the effect of low-cost, point-of-use water, sanitation, and handwashing (WASH) interventions on diarrhea and predicted intervention effectiveness under climate change scenarios.
Methods: We analyzed data fro...
Background
Understanding pathogen-specific relationships with climate is crucial to informing interventions under climate change.
Methods
We matched spatiotemporal temperature, precipitation, surface water, and humidity data to data from a trial in rural Bangladesh that measured diarrhea and enteropathogen prevalence in children 0-2 years from 201...
Over 2 billion people globally lack access to safely managed drinking water. In contrast to the household-level, manually implemented treatment products that have been the dominant strategy for gaining low-cost access to safe drinking water, passive chlorination technologies have the potential to treat water and reduce reliance on individual behavi...
The world is not on track to meet Sustainable Development Goal 6.1 to provide universal access to safely managed drinking water by 2030. Removal of priority microbial contaminants by disinfection is one aspect of ensuring water is safely managed. Passive chlorination (also called in-line chlorination) represents one approach to disinfecting drinkin...
The large and multidisciplinary literature on water for domestic use and gender has two primary foci: (1) the negative health and well-being impacts of inadequate access to safe water, and (2) the effects of women’s participation in water allocation and management decisions. These foci are reflected in both the research and policy literatures. Smal...
Healthy development of the gut microbiome provides long-term health benefits. Children raised in countries with high infectious disease burdens are frequently exposed to diarrhoeal pathogens and antibiotics, which perturb gut microbiome assembly. A recent cluster-randomized trial leveraging >4,000 child observations in Dhaka, Bangladesh, found that...
COVID-19 has created shortages of personal protective equipment. In resource-constrained situations, limited cycles of disinfection and extended use of gloves is recommended by the U.S. Centers for Disease Control and Prevention to conserve supplies. However, these guidelines are based on limited evidence. In this study, serial cycles of hand hygie...
Many healthcare professionals have been forced, under acute shortages, to extend medical exam gloves beyond their intended single use. Despite limited available literature, the CDC proposed a set of guidelines for repeated exam gloves use, indicating a maximum number of treatments for three widely available disinfectants. This study examines how th...
Financially sustainable strategies are needed to increase access to safe drinking water in low-income settings. We designed a novel in-line chlorine doser that employs the Venturi principle to automatically add liquid chlorine at the point of water collection (tap outflows). The Venturi does not require electricity or moving parts, and users do not...
Expanding drinking water chlorination could substantially reduce the burden of disease in low- and middle-income countries, but the taste of chlorinated water often impedes adoption. We developed a Monte Carlo simulation to estimate the effect of people's choice to accept or reject drinking water based on chlorine taste and their subsequent exposur...
Background: The COVID-19 pandemic has created global shortages of personal protective equipment (PPE) such as medical exam gloves, forcing healthcare workers to either forgo or reuse PPE to keep themselves and patients safe from infection. In severely resource-constrained situations, limited cycles of disinfection and extended use of gloves is reco...
The World Health Organization and the United States Centers for Disease Control have recommended universal face masking by the general public to slow the spread of COVID-19. A number of recent studies have evaluated the filtration efficiency and pressure differential (an indicator of breathability) of various, widely available materials that the ge...
Background
Soil-transmitted helminths and Giardia duodenalis are responsible for a large burden of disease globally. In low-resource settings, household finished floors (eg, concrete floors) might reduce transmission of soil-transmitted helminths and G duodenalis.
Methods
In a prospective cohort of children nested within two randomised trials in r...
Accurate estimates of the burden of SARS-CoV-2 infection are critical to informing pandemic response. Confirmed COVID-19 case counts in the U.S. do not capture the total burden of the pandemic because testing has been primarily restricted to individuals with moderate to severe symptoms due to limited test availability. Here, we use a semi-Bayesian...
Background: Soil-transmitted helminths (STH) and Giardia duodenalis are responsible for a large burden of disease globally. In low-resource settings, household finished floors (e.g., concrete floors) may reduce transmission of STH and G. duodenalis.
Methods: In a prospective cohort of children nested within two randomised trials in rural Bangladesh...
Accurate estimates of the burden of SARS-CoV-2 infection are critical to informing pandemic response. Current confirmed COVID-19 case counts in the U.S. do not capture the total burden of the pandemic because testing has been primarily restricted to individuals with moderate to severe symptoms due to limited test availability. Using a semi-Bayesian...
Diarrheal illnesses from enteric pathogens are a leading cause of death in children under five in low-and-middle income countries (LMICs). Sanitation is one way to reduce the spread of enteric pathogens in the environment; however, few studies have investigated the effectiveness of sanitation in rural LMICs in reducing pathogens in the environment....
Background
Previous blinded trials of household water treatment interventions in low-income settings have failed to detect a reduction in child diarrhoea. Technological advances have enabled the development of automated in-line chlorine dosers that can disinfect drinking water without electricity, while also allowing users to continue their typical...
Sanitation research focuses primarily on containing human waste and preventing disease; thus, it has traditionally been dominated by the fields of environmental engineering and public health. Over the past 20 years, however, the field has grown broader in scope and deeper in complexity, spanning diverse disciplinary perspectives. In this article, w...
Chlorination is a low-cost, effective method for drinking water treatment, but aversion to the taste or smell of chlorinated water can limit use of chlorine treatment products. Forced choice triangle tests were used to evaluate chlorine detection and acceptability thresholds for two common types of chlorine among adults in Dhaka, Bangladesh, where...
Point-of-use water treatment with chlorine is underutilized in low-income households. The Zimba, an automated batch chlorinator, requires no electricity or moving parts, and can be installed at shared water points with intermittent flow. We conducted a small-scale trial to assess the acceptability and quality of Zimba-treated municipal water. Field...
The number of people served by networked systems that supply intermittent and contaminated drinking water is increasing. In these settings, centralized water treatment is ineffective, while household-level water treatment technologies have not been brought to scale. This study compares a novel low-cost technology designed to passively (automaticall...
Introduction Point-of-use water treatment may reduce diarrheal disease but has been poorly adopted and inconsistently used among low-income households. Community-level water treatment, such as automated disinfection at shared water points, has received little attention in part because appropriate technologies are lacking. The ZIMBA is a batch chlor...
