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Intensive urban agriculture is expanding in Cameroon, which increases the risks of environmental pollution, particularly in the lowlands. This study assessed the seasonal characteristics of some potentially toxic elements and their ecological risks during the dry and wet seasons in urban agricultural soils in four lowlands in Yaoundé. The area and seasonal variation of some potentially toxic elements (Cu, Pb, Zn, Cd, Cr, and Ni) were evaluated using mixed-effects modeling. The pollution status of these elements in the soil was evaluated and interpreted using parameters such as the single pollution (SPI) and Nemerow composite pollution (NCPI) indices. In addition, the effect of these metals in the environment was assessed using the potential ecological risk index (PERI). The distribution of all the studied elements showed an area effect, while a seasonal effect was only noticeable for Cu. The concentration of Cu, Pb, and Zn was higher than the recommended threshold values in one of the areas sampled, while Cr exceeded these threshold values in all areas during both seasons. Cr exhibited the highest SPI among all studied elements during the dry and wet seasons in all areas. Except for the NCPI in one area, where grade V (strong) soil pollution was recorded during the wet season, the soil from all the study areas exhibited a slight pollution level (grade III) with a mean NCPI between 1 and 2. The PERI value of all areas was below the reference values during both seasons, suggesting an overall low potential contamination risk of the soil biota. The results indicate that preventive action to limit the heavy metal contamination in the lowlands of Yaoundé needs to be taken, for instance, through the promotion of more sustainable use of agrochemicals like pesticides and mineral fertilizers.

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Managing the increasing amount and complexity of municipal solid waste poses a growing challenge to the entire WHO European Region, with serious implications for human health and well-being. Addressing this requires moving beyond technical innovations to better understand and integrate a wide range of factors, including cultural contexts. By examining evidence from a broad array of disciplines in peer-reviewed and grey literature, as well as case studies from the Region, this report opens up a systematic engagement with the role of culture in waste management practices and how this fosters or undermines conditions for health and well-being. While highlighting various tensions between cultural forces at multiple scales, the evidence suggests that culturally grounded approaches to waste management can yield higher rates of public participation and cross-sectoral collaboration, be more sustainable in the long term, and lead to better health and well-being for the wider public, particularly for groups with heavier health burdens associated with waste. The evidence provides a sound basis for strengthening existing policy frameworks and identifying areas in which culture can be a driver for improved policies that are supported by all stakeholders.

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Worldwide the pressure on water is increasing. In parts of Sub-Saharan Africa (SSA), natural wetlands constitute the only accessible water resources, providing water free of charge, agricultural potential and livelihoods in otherwise uninhabitable landscapes, which is why they are being used extensively. The degradation and contamination of water which result from the use of wetlands has the potential to spread disease-causing microorganisms and provide increased breeding habitats for disease vectors, Despite this importance, case studies are lacking and knowledge gaps remain about whether and how different kinds of wetland use influence the exposure to health risks and transmission of infectious diseases. This descriptive literature review aimed at identifying publications from peer-reviewed journals and book chapters that (i) address water-related infectious diseases in SSA wetlands and (ii) link those diseases to use-related exposures. The resulting overview includes 27 publications and shows that depending on the type of use, people in wetlands are exposed to different risk factors and water-related infectious diseases. Exposure to infectious agents depends on occupational characteristics, and time spent in wetlands. Disease transmission is driven by users' contact to water, characteristics of pathogens and vectors of disease. The amount of available literature varies significantly. Whereas several publications have linked crop production and the domestic use of wetland water to contraction of diseases, fewer are available on health risks identified with pastoralism in wetlands and other uses. Some risk factors are well researched, such as irrigation schemes favouring schistosomiasis prevalence. For others, including proximity of pastoralists to their livestock and the associated trachoma risk, knowledge remains limited. This review establishes connections of selected diseases with different transmission pathways that are linked to specific risk factors, transmission pathways and resulting diseases. All of these have been integrated into a detailed conceptual framework which simplifies the complexity of the relationships, while at the same time identifying missing links which might provide stimulus for future research tackling the potential research gaps. It concludes that socio-cultural and behavioural considerations regarding the wetland users are not sufficiently evaluated and should receive increased attention in future investigations.

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Доступ к надлежащим услугам водоснабжения, санитарии и гигиены (WASH) – это неотъемлемое право каждого человека, в том числе и каждого ребенка. Обеспечение доступности этих услуг в школах предусмотрено Повесткой дня в области устойчивого развития на период до 2030 г. и является приоритетной задачей Протокола по проблемам воды и здоровья к Конвенции об охране и использовании трансграничных водотоков и международных озер 1992 года. В данной публикации приводятся общие сведения о положении дел в области водоснабжения, санитарии и гигиены в школах стран Общеевропейского региона. Фактические данные получены из научной литературы, национальных и международных исследований, а также на основании изучения материалов ситуационных исследований. Они свидетельствуют об определенном прогрессе в политике и выполнении целевых показателей, связанных с WASH, но при этом указывают и на то, что этот прогресс не приводит к надлежащему развитию таких услуг в школах. Пробелы и трудности в этой сфере могут быть обусловлены ненадлежащими стандартами, неэффективной координацией усилий и неадекватными показателями для мониторинга и надзора. Более того, во всем регионе наблюдаются неравенства и несправедливые различия, которые часто не получают должного внимания. Состояние систем WASH не соответствует целям, которые ставились в стратегиях, равно как и потребностям учащихся, негативно сказываясь на их здоровье, благополучии и школьной успеваемости. Основные проблемы, существующие в регионе, связаны с недостаточной чистотой и обеспеченностью расходными материалами, а также с техническим обслуживанием санитарно-технических сооружений и доступностью безопасной питьевой воды. Для эффективной выработки политики необходимо обеспечить базу фактических данных, в особенности по таким оставленным без внимания темам, как гигиена менструального периода.

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Wetlands can be both a blessing and a curse. They are beneficial sources of safe water and nutrition and places from which humans derive their livelihoods. At the same time, wetlands are known to be sources of disease-causing microorganisms and invertebrates that can threaten human health. Safe water, sanitation and personal hygiene (WASH) are crucial preconditions for the prevention of disease transmission. And of special importance for people living in wetlands, depending on and being exposed to them. WASH should be prioritized especially in those wetlands that are subject to intensive use, that have a poor sanitation infrastructure, and which at the same time only provide limited water resources. However, despite this critical importance, WASH in wetlands is not well characterized in literature. This study therefore aimed at providing insights into the water, sanitation and hygiene conditions and behavioural determinants of households in wetlands by presenting the case of a rural wetland in East Africa. The mixed method approach included a broad set of empirical data collected during a household survey (n=400), an observational WASH assessment (n=397) and in-depth interviews (n=20) conducted from January to March 2015 in Ewaso Narok Swamp in Kenya. Different user groups of the wetland were targeted. The study in Ewaso Narok Swamp showed that wetland users' water supply and storage, sanitation and personal hygiene conditions were inadequate for large parts of the community and significantly differed between groups. Whereas the WASH conditions of people working in the service sector were rather positive, for pastoralists, they were correspondingly negative. The WASH behaviour was also perceived to be inadequate influenced by a variety of determining factors. The observational index as applied in this study indicated to be a valuable, rapid and efficient tool for assessing domestic WASH and for detecting differences between different groups in wetlands. Combined with the quantitative and qualitative data, the approach served as a very helpful model to develop a multi-layered understanding of WASH conditions and related behaviour. The people in the researched wetland use by far less improved water sources and sanitation facilities than the nationwide average for rural populations. Since Ewaso Narok Swamp serves as a model case for the domestic WASH conditions in a rural wetland in semiarid East Africa, this fact make the study relevant not only at a national, but also at an international level. The results underline the previously formulated need of an integrative approach that first and foremost complements wetland management by public health interventions. In order to improve WASH conditions and to change behaviour in the long term, interventions should include the provision of clean water and sanitation infrastructure, as well as widespread health education. The approach proved to be useful for wetland environments and will be integrated into the development of a health impact assessment tool for wetlands. Moreover, it can be adopted in other contexts.

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Adequate access to water, hygiene and sanitation (WASH) is every human’s and child’s right. Ensuring WASH accessibility in schools is encompassed in the 2030 Agenda for Sustainable Development and is a priority area under the Protocol on Water and Health to the 1992 Convention on the Protection and Use of Transboundary Watercourses and International Lakes. This publication summarizes the status of WASH in schools in the pan-European region. Available evidence was retrieved from scientific literature, national and international surveys and a desk review of case studies. The data show general progress in WASH policies and targets, but a concurrent lack of translation of this progress into efficient improvement of WASH in schools. Gaps and challenges are found as a result of non-comprehensive standards, inefficient coordination and inadequate surveillance and monitoring indicators. Further, neglected disparities and inequalities are observed through the region. WASH conditions do not reflect policies’ aspirations and are not adequate to pupils’ needs, affecting their health, well-being and performance at school. The main challenges across the region are related in particular to inadequate cleanliness and provision of consumables, as well as maintenance of sanitation facilities and accessibility to safe drinking-water. Policy-making needs to be supported by evidence-based information, especially on neglected topics such as menstrual hygiene management.

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Our knowledge relating to water contamination from point and diffuse sources has increased in recent years and there have been many studies undertaken focusing on effluent from sewage plants or combined sewer overflows. However, there is still only a limited amount of microbial data on non-point sources leading to diffuse pollution of surface waters. In this study, the concentrations of several indicator micro-organisms and pathogens in the upper reaches of a river system were examined over a period of 16 months. In addition to bacteria, diffuse pollution caused by Giardia lamblia and Cryptosporidium spp. was analysed. A single land use type predestined to cause high concentrations of all microbial parameters could not be identified. The influence of different land use types varies between microbial species. The microbial concentration in river water cannot be explained by stable non-point effluent concentrations from different land use types. There is variation in the ranking of the potential of different land use types resulting in surface water contamination with regard to minimum, median and maximum effects. These differences between median and maximum impact indicate that small-scale events like spreading manure substantially influence the general contamination potential of a land use type and may cause increasing micro-organism concentrations in the river water by mobilisation during the next rainfall event.

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The objective of this study was to assess the quality of harvested rainwater in the Mekong Delta (MD), Vietnam for local (roof types, storage system and duration) and spatial (proximity of industry, main roads, coastline) conditions. 78 harvested rainwater samples were collected in the MD and analyzed for pH, turbidity, TDS, COD, nutrients (NH4, NO3, NO2, o-PO4), trace metals and coliforms. The results show that thatch roofs lead to an increase of pollutants like COD (max 23.2 mgl(-1)) and turbidity (max 10.1 mgl(-1)) whereas galvanized roofs lead to an increase of Zn (max 2.2 mgl(-1)). The other local and spatial parameters had no or only minor influence on the quality of household harvested rainwater. However, lead (Pb) (max. 16.9 µgl(-1)) and total coliforms (max. 102 500 CFU100 ml(-1)) were recorded at high concentrations, probably due to a variety of household-specific conditions such as rainwater storage, collection and handling practices.

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In Germany, protozoal parasites are detected frequently in surface waters. This study aims to assess the parasitological pollution in a river course and two of its tributaries under regular weather conditions. Cryptosporidium was detected in 67% of all samples. The median concentration was 4 oocysts/100l. Giardia lamblia were detected in 90% of the samples. The median concentration of G. lamblia was 22 cysts/100l and increased significantly following the river course. A statistically significant correlation was found between both parasites and the faecal indicators Clostridium perfringens and Escherichia coli. The intermittent occurrence of Cryptosporidium in the streams investigated was ascribed primarily to diffuse pollution, particularly during rainfall events. The relatively frequent detection of G. lamblia derived mainly from sewage treatment plants. The pathogen concentrations observed present a relevant public health risk as the river is used for recreational activities and agricultural purposes.

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The authors extracted from the PubMed and ScienceDirect bibliographic databases all articles published between 1998 and 2009 that were relevant to climate change and food- and waterborne diseases. Any material within each article that provided information about a relevant pathogen and its relationship with climate and climate change was summarized as a key fact, entered into a relational knowledge base, and tagged with the terminology (predefined terms) used in the field. These terms were organized, quantified, and mapped according to predefined hierarchical categories. For noncholera Vibrio sp. and Cryptosporidium sp., data on climatic and environmental influences (52% and 49% of the total number of key facts, respectively) pertained to specific weather phenomena (as opposed to climate change phenomena) and environmental determinants, whereas information on the potential effects of food-related determinants that might be related to climate or climate change were virtually absent. This proportion was lower for the other pathogens studied (Campylobacter sp. 40%, Salmonella sp. 27%, Norovirus 25%, Listeria sp. 8%), but they all displayed a distinct concentration of information on general food-and water-related determinants or effects, albeit with little detail. Almost no information was available concerning the potential effects of changes in climatic variables on the pathogens evaluated, such as changes in air or water temperature, precipitation, humidity, UV radiation, wind, cloud coverage, sunshine hours, or seasonality. Frequency profiles revealed an abundance of data on weather and food-specific determinants, but also exposed extensive data deficiencies, particularly with regard to the potential effects of climate change on the pathogens evaluated. A reprioritization of public health research is warranted to ensure that funding is dedicated to explicitly studying the effects of changes in climate variables on food- and waterborne diseases.

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The PubMed and ScienceDirect bibliographic databases were searched for the period of 1998-2009 to evaluate the impact of climatic and environmental determinants on food- and waterborne diseases. The authors assessed 1,642 short and concise sentences (key facts), which were extracted from 722 relevant articles and stored in a climate change knowledge base. Key facts pertaining to temperature, precipitation, water, and food for 6 selected pathogens were scrutinized, evaluated, and compiled according to exposure pathways. These key facts (corresponding to approximately 50,000 words) were mapped to 275 terminology terms identified in the literature, which generated 6,341 connections. These relationships were plotted on semantic network maps to examine the interconnections between variables. The risk of campylobacteriosis is associated with mean weekly temperatures, although this link is shown more strongly in the literature relating to salmonellosis. Irregular and severe rain events are associated with Cryptosporidium sp. outbreaks, while noncholera Vibrio sp. displays increased growth rates in coastal waters during hot summers. In contrast, for Norovirus and Listeria sp. the association with climatic variables was relatively weak, but much stronger for food determinants. Electronic data mining to assess the impact of climate change on food- and waterborne diseases assured a methodical appraisal of the field. This climate change knowledge base can support national climate change vulnerability, impact, and adaptation assessments and facilitate the management of future threats from infectious diseases. In the light of diminishing resources for public health this approach can help balance different climate change adaptation options.

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Urine contains a considerable amount of nutrients and potentially could be used as supplement commercial mineral fertilizer; however, it carries risk of contamination. The effect of urine storage as a simple treatment method was examined under tropical conditions. Initial concentrations of total coliforms (2.3 x 10(5) CFU/100 mL), E. coli (<1.0 x 10(4) CFU/100 mL), and Salmonella sp. were less than detection limit after four weeks. Open storage led to nitrogen losses of 90%, whereas closed storage containers retained 93% of total nitrogen. Under storage, the N:P ratio of 8:1 in fresh urine changed to 14:1 in the supernatant and to 1:12 in the precipitate, and 100% of magnesium and 96% of calcium was precipitated. A model showed that, depending on plant requirements, using the mixture of supernatant and precipitate as fertilizer for crops such as cassava was reasonable. To fertilize crops such as rice, however, additional P and K was needed. The nutrient-based flux of heavy metals to soils was negligible.

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Septage is widely acknowledged as a major source of infectious pathogens while disposal of septage, and the operation and maintenance of septic tanks, is not regulated in many developing countries. Twenty untreated septage and septage sludge samples were taken from Can Tho City, Vietnam to examine their pathogen content, and indicator micro-organisms. Escherichia coli and Enterococcus spp. were detected in all samples, regardless of sludge storage time. Phages were detected in 80% of samples. Salmonella spp. were detected in 70% of the untreated septage and 60% of septage sludge samples. Concentrations of phages and bacteria tested in septage sludge after many years of tank storage were much higher than the expected levels. Helminth ova were present in 95% of untreated septage samples with an average of 450 oval(-1), and were detected in all septage sludge samples with an average of 16,000 oval(-1). Twelve varieties of helminth ova were identified. More helminth ova varieties in higher concentrations were found in septage than those reported from stool samples. The varieties' frequency ranged from 10% to 50% and Ascaris lumbricoides predominated. Results show that pathogens and indicator micro-organisms, especially helminth ova, accumulate in sludge. Thus helminth ova should be considered when septage sludge is treated and used for agriculture. Proper health protection measures must be applied for people handling septage.

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Plastic plug-flow bio-digesters have been promoted as a good option for improved treatment of manure and wastewater in developing countries although minimal information has been published on their hygienic status. This bench-scale study replicates bio-digester conditions to evaluate the reduction of pathogen and indicator microorganisms at three different hydraulic retention times (HRT) in the anaerobic treatment of pig manures at 30 degrees C for 50 days. Results showed that physicochemical values differed between HRTs. Gas production efficiency was better for longer HRTS. The accumulated sludge at the reactor's base increased with longer HRT. Phages and bacteria examined were reduced, but none was completely eliminated. Log10 reduction of bacteria ranged from 0.54 to 2.47. Phages ranged from 1.60 to 3.42. The reduction of organisms at HRT = 30 days was about one log10 unit higher than HRT = 15 days and about two log10 units higher than HRT = 3 days. The results indicate that the reduction of tested organisms increases with HRT. However the hygienic quality of the liquid effluent does not meet required quality values for surface and irrigation water. Longer HRTs are recommended to increase gas yield and achieve higher pathogen reduction. More barriers should be applied while handling bio-digester outputs to minimise risks to environmental and human health.

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Campylobacter sp. can regularly be found in wastewater-affected surface waters. The occurrence of Campylobacter sp. in rivers, treated sewage and combined sewer overflows was analysed in a catchment with sparse annual precipitation. During regular treatment the reduction efficacy for Campylobacter sp. varies between 1.75 and 3.5 log(10). However, Campylobacter sp. concentrations do not increase downstream in the river as more sewage treatment plants discharge into it. During rain events, the Campylobacter sp. concentration in the river upstream of any sewage plant rises and in the sewer overflow water it is more than 150-fold higher than the average concentration in the river water at the river mouth. The highest Campylobacter sp. loads and the highest risk of infection occur during summertime after heavy rainfall. Risk management strategies should focus on problems regarding water scarcity, reuse of sewage effluent and the impact of heavy rain events.

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Different land use patterns were investigated for their potential as non-point sources of coliphage emissions into surface waters. Water samples were taken regularly at five locations in the upper reaches of the river Swist, Germany. Samples of surface and subsurface run-off were taken within the same catchment area after rainfall events using a newly developed device that made it possible to collect current concentrations of the effluent compounds. The water quality was examined for the occurrence of somatic coliphages and F(+)-specific RNA-bacteriophages as well as for various bacteria over the period of a hydrological year. The potential of various bacteria as indicators for the occurrence of phages was evaluated using statistical correlations. The load of coliphages varied depending on the land use type, but it did not differ as much as the bacterial parameters. River sections in intensively used areas turned out to be more contaminated than in less intensively used regions. The concentrations of phages from surface and subsurface run-off in most samples were quite low for all land use types and did not show conspicuous variations of surface and subsurface run-off within one land use type. Therefore, high concentrations of phages in river water cannot be explained only by non-point effluent from open ground. Following consideration of the statistical results, conventional indicator bacteria seem not to be reliable indicator organisms for coliphages and subsequently for human pathogen viruses. The detected concentrations of coliphages in several water samples of river sections surrounded by intensively used areas underpin an existing health risk in the use of river water for e.g. recreational activities or irrigation.

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Six sewage treatment plants (STP) were investigated over a 12-month period in order to measure the microbiological load of untreated municipal wastewater and to evaluate the removal efficiencies of different treatment systems. The STP investigated can be classified into three categories: bigger plants with tertiary treatment, smaller plants with enhanced secondary treatment, and very small compact facilities. The plants studied had a considerable quantitative impact on the hydrology of the catchment area; consequently, it was anticipated that the microbiological load of the effluent would also be significant. Eighty samples were taken from the influent and effluent of the STP, regardless of weather conditions, and several bacterial and two parasitological parameters were analysed. The average microbiological reduction of each STP was dependent on its capacity and treatment procedures and varied between 1.9 and 3.5log10. Small compact facilities had a significantly lower removal efficiency (2.0+/-1log10) and discharged treated wastewater with a poorer microbiological quality compared to larger plants with tertiary treatment or with enhanced secondary treatment (2.8log10). Final sand filtration and extensive intermediate settling considerably improved the overall microbiological removal efficiency. During the study period, the microbiological water quality of the receiving water course was not significantly impaired by the discharge of any of the investigated plants; however, the compact facilities showed critical treatment deficiencies. In particular, the reduction of Giardia cysts was insufficient (<1.5log10) compared to that of the bigger plants (>3.0log10). In order to quantify the overall impact of microbiological loads on the receiving watercourse in this catchment area, it is also necessary to assess the pollution from combined sewer overflow basins and diffuse pollution. This will be considered in subsequent studies.

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