- INTRODUCTION
- MATERIALS AND METHODS
- RESULTS
- Study enrollment and participants.
- Descriptive data on study participant educational and wealth characteristics.
- Drinking water: source, treatment methods, storage, and availability.
- Household sanitation facilities and disposal of child’s feces.
- Hand hygiene.
- Influence of length of time knowing HIV status.
- DISCUSSION
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
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1.
UNAIDS, 2017. HIV Fact Sheet, July 2017. Available at: http://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf. Accessed September 15, 2017.
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UNAIDS, 2015. Kenya. Available at: http://www.unaids.org/en/regionscountries/countries/kenya. Accessed December 19, 2016.
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Nkenfou CN, Nana CT, Payne VK, 2013. Intestinal parasitic infections in HIV infected and non-infected patients in a low HIV prevalence region, West-Cameroon. PLoS One 8: e57914.
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Kipyegen CK, Shivairo RS, Odhiambo RO, 2012. Prevalence of intestinal parasites among HIV patients in Baringo, Kenya. Pan Afr Med J 13: 37.
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Gumbo T, Sarbah S, Gangaidzo IT, Ortega Y, Sterling CR, Carville A, Tzipori S, Wiest PM, 1999. Intestinal parasites in patients with diarrhea and human immunodeficiency virus infection in Zimbabwe. AIDS 13: 819–821.
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Ngwenya BN, Kagathi DL, 2006. HIV/AIDS and access to water: a case study of home-based care in Ngamiland Botswana. Phys Chem Earth Parts 31: 669–680.
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World Health Organization, 2010. Priority Interventions HIV/AIDS Prevention, Treatment and Care in the Health Sector. Geneva, Switzerland: WHO.
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Wegelin-Schuringa M, Kamminga E, de Graaf S, 2003. HIV/AIDS and Its Implications for the Water Sanitation. 29th WEDC International Conference, Abuja, Nigeria, September 22–26, 2003.
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Mermin J, Bunnell R, Lule J, Opio A, Gibbons A, Dybul M, Kaplan J, 2005. Developing an evidence-based, preventive care package for persons with HIV in Africa. Trop Med Int Health 10: 961–970.
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11.
Peletz R, Mahin T, Elliott M, Harris MS, Chan KS, Cohen MS, Bartam JK, Clasen TF, 2013. Water, sanitation, and hygiene interventions to improve health among people living with HIV/AIDS: a systematic review. AIDS 27: 2593–2601.
-
12.
Yates T, Lantagne D, Mintz E, Quick R, 2015. The impact of water, sanitation, and hygiene interventions on the health and well-being of people living with HIV: a systematic review. J Acquir Immune Defic Syndr 68 (Suppl 3): S318–S330.
-
13.
Peletz R, Simunyama M, Sarenje K, Baisley K, Filteau S, Kelly P, Clasen T, 2012. Assessing water filtration and safe storage in households with young children of HIV-positive mothers: a randomized, controlled trial in Zambia. PLoS One 7: e46548.
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Barzilay EJ et al. 2011. Diarrhea prevention in people living with HIV: an evaluation of a point-of-use water quality intervention in Lagos, Nigeria. AIDS Care 23: 330–339.
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Abebe LS, Smith JA, Narkiewicz S, Oyanedel-Craver V, Conaway M, Singo A, Amidou S, Mojapelo P, Brant J, Dillingham R, 2014. Ceramic water filters impregnated with silver nanoparticles as a point-of-use water-treatment intervention for HIV-positive individuals in Limpopo Province, South Africa: a pilot study of technological performance and human health benefits. J Water Health 12: 288–300.
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16.
Colford JM Jr. et al. 2005. A randomized, controlled trial of in-home drinking water intervention to reduce gastrointestinal illness. Am J Epidemiol 161: 472–482.
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17.
Harris JR, Greene SK, Thomas TK, Ndivo R, Okanda J, Masaba R, Nyangau I, Thigpen MC, Hoekstra RM, Quick RE, 2009. Effect of a point-of-use water treatment and safe water storage intervention on diarrhea in infants of HIV-infected mothers. J Infect Dis 200: 1186–1193.
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18.
Walson J, Singa B, Sangare L, Naulikha J, Piper B, Richardson B, Otieno PA, Mbogo LW, Berkley JA, John-Stewart G, 2012. Empiric deworming to delay HIV disease progression in adults with HIV who are ineligible for initiation of antiretroviral treatment (the HEAT study): a multi-site, randomised trial. Lancet Infect Dis 12: 925–932.
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Lule JR et al. 2005. Effect of home-based water chlorination and safe storage on diarrhea among persons with human immunodeficiency virus in Uganda. Am J Trop Med Hyg 73: 926–933.
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Huang DB, Zhou J, 2007. Effect of intensive handwashing in the prevention of diarrhoeal illness among patients with AIDS: a randomized controlled study. J Med Microbiol 56: 659–663.
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21.
Mugambe RK, Tumwesigye NM, Larkan F, 2013. Barriers to accessing water, sanitation, and hygiene practice and associated factors among people living with HIV/AIDS home based care services in Gondar city, Ethiopia. BMC Public Health 12: 1057.
-
22.
Yallew WW, Terefe MW, Herchline TE, Sharma HR, Bitew BD, Kifle MW, Tetemke DM, Tefera MA, Adane MM, 2012. Assessment of water, sanitation, and hygiene practice and associated factors among people living with HIV/AIDS home based care services in Gondar city, Ethiopia. BMC Public Health 12: 1057.
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WaterAid, 2014. Assessing the Water, Sanitation, and Hygiene Needs of People Living with HIV and AIDS in Papua New Guinea. East Sepik, Papua New Guinea: WaterAid.
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WaterAid, 2010. Access to Water, Sanitation, and Hygiene for People Living with HIV and AIDS: A Cross-Sectional Study in Nepal. Kathmandu, Nepal: WaterAid.
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Nkongo D, Chonya C, 2009. Access to Water and Sanitation for People Living with HIV and AIDS: An Exploartory Study. Dar es Salaam, Tanzania: WaterAid/AMREF.
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Water, Sanitation, and Hygiene Characteristics among HIV-Positive Households Participating in the Global Enteric Multicenter Study in Rural Western Kenya, 2008–2012
Kathrine A. Schilling
Kathrine A. Schilling
Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;
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Alex O. Awuor
Alex O. Awuor
Centers for Disease Control and Prevention, Kenya Medical Research Institute, Kisumu, Kenya;
Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya;
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Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya;
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Anu Rajasingham
Anu Rajasingham
Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;
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Fenny Moke
Fenny Moke
Centers for Disease Control and Prevention, Kenya Medical Research Institute, Kisumu, Kenya;
Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya;
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Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya;
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Richard Omore
Richard Omore
Centers for Disease Control and Prevention, Kenya Medical Research Institute, Kisumu, Kenya;
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Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya;
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Manase Amollo
Manase Amollo
Centers for Disease Control and Prevention, Kenya Medical Research Institute, Kisumu, Kenya;
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Tamer H. Farag
Tamer H. Farag
Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, Maryland;
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Dilruba Nasrin
Dilruba Nasrin
Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, Maryland;
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James P. Nataro
James P. Nataro
Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, Maryland;
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Karen L. Kotloff
Karen L. Kotloff
Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, Maryland;
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Myron M. Levine
Myron M. Levine
Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, Maryland;
Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia;
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Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia;
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Tracy Ayers
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Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;
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Kayla Laserson
Kayla Laserson
Centers for Disease Control and Prevention, Kenya Medical Research Institute, Kisumu, Kenya;
Centers for Disease Control and Prevention India, Delhi, India;
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Centers for Disease Control and Prevention India, Delhi, India;
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Anna Blackstock
Anna Blackstock
Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;
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Richard Rothenberg
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School of Public Health, Georgia State University, Atlanta, Georgia;
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Christine E. Stauber
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School of Public Health, Georgia State University, Atlanta, Georgia;
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Eric D. Mintz
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Robert F. Breiman
Robert F. Breiman
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Centers for Disease Control and Prevention, Nairobi, Kenya;
Emory Global Health Institute, Emory University, Atlanta, Georgia
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Ciara E. O’Reilly
Ciara E. O’Reilly
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Diarrheal illness, a common occurrence among people living with human immunodeficiency virus (PLHIV), is largely preventable through access to safe drinking water quality, sanitation, and hygiene (WASH) facilities. We examined WASH characteristics among households with and without HIV-positive residents enrolled in the Global Enteric Multicenter Study (GEMS) in rural Western Kenya. Using univariable logistic regression, we examined differences between HIV-positive and HIV-negative households in regard to WASH practices. Among HIV-positive households, we explored the relationship between the length of time knowing their HIV status and GEMS enrollment. No statistically significant differences were apparent in the WASH characteristics among HIV-positive and HIV-negative households. However, we found differences in the WASH characteristics among HIV-positive households who were aware of their HIV status ≥ 30 days before enrollment compared with HIV-positive households who found out their status < 30 days before enrollment or thereafter. Significantly more households aware of their HIV-positive status before enrollment reported treating their drinking water (odds ratio [OR] confidence interval [CI]: 2.34 [1.12, 4.86]) and using effective water treatment methods (OR [CI]: 9.6 [3.09, 29.86]), and had better drinking water storage practices. This suggests that within this region of Kenya, HIV programs are effective in promoting the importance of practicing positive WASH-related behaviors among PLHIV.
Author Notes
Financial support: The Global Enteric Multicenter Study was funded by the Bill & Melinda Gates Foundation through the University of Maryland, School of Medicine, Center for Vaccine Development, Baltimore, MD. Additional support for technical assistance with GEMS in Kenya was provided by the U.S. Agency for International Development through an Inter-Agency Agreement with the U.S. Centers for Disease Control and Prevention.
Authors’ addresses: Kathrine A. Schilling, Anu Rajasingham, Tracy Ayers, Anna Blackstock, Eric D. Mintz, and Ciara E. O’Reilly, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: schil1ka@gmail.com, idb4@cdc.gov, eyk6@cdc.gov, hyp9@cdc.gov, edm1@cdc.gov, and bwf1@cdc.gov. Alex O. Awuor, Fenny Moke, and Richard Omore, Centers for Disease Control and Prevention, Kenya Medical Research Institute, Kisumu, Kenya, and Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya, E-mails: aawuor@kemricdc.org, mokefenny@gmail.com, and omorerichard@gmail.com. Manase Amollo, Centers for Disease Control and Prevention, Kenya Medical Research Institute, Kisumu, Kenya, E-mail: mamollo@pedaids.org. Tamer H. Farag, Dilruba Nasrin, James P. Nataro, Karen L. Kotloff, and Myron M. Levine, Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, MD, E-mails: faragt@uw.edu, dnasrin@medicine.umaryland.edu, jpn2r@virginia.edu, kkotloff@medicine.umaryland.edu, and mlevine@medicine.umaryland.edu. Kayla Laserson, CDC India, New Delhi, India, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, and Centers for Disease Control and Prevention, Kenya Medical Research Institute Kisumu, Kenya, E-mail: kel4@cdc.gov. Richard Rothenberg and Christine E. Stauber, School of Public Health, Georgia State University, Atlanta, GA, E-mails: rrothenberg@gsu.edu and cstauber@gsu.edu. Robert F. Breiman, Emory Global Health Institute, Emory University, Atlanta, GA, Centers for Disease Control and Prevention, Nairobi, Kenya, and Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: rfbreiman@emory.edu.
- INTRODUCTION
- MATERIALS AND METHODS
- RESULTS
- Study enrollment and participants.
- Descriptive data on study participant educational and wealth characteristics.
- Drinking water: source, treatment methods, storage, and availability.
- Household sanitation facilities and disposal of child’s feces.
- Hand hygiene.
- Influence of length of time knowing HIV status.
- DISCUSSION
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
UNAIDS, 2017. HIV Fact Sheet, July 2017. Available at: http://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf. Accessed September 15, 2017.
-
2.
World Health Organization, 2016. 10 Facts on HIV/AIDS. Available at: http://www.who.int/features/factfiles/hiv/en/. Accessed December 20, 2016.
-
3.
UNAIDS, 2015. Kenya. Available at: http://www.unaids.org/en/regionscountries/countries/kenya. Accessed December 19, 2016.
-
4.
Nkenfou CN, Nana CT, Payne VK, 2013. Intestinal parasitic infections in HIV infected and non-infected patients in a low HIV prevalence region, West-Cameroon. PLoS One 8: e57914.
-
5.
Kipyegen CK, Shivairo RS, Odhiambo RO, 2012. Prevalence of intestinal parasites among HIV patients in Baringo, Kenya. Pan Afr Med J 13: 37.
-
6.
Gumbo T, Sarbah S, Gangaidzo IT, Ortega Y, Sterling CR, Carville A, Tzipori S, Wiest PM, 1999. Intestinal parasites in patients with diarrhea and human immunodeficiency virus infection in Zimbabwe. AIDS 13: 819–821.
-
7.
Ngwenya BN, Kagathi DL, 2006. HIV/AIDS and access to water: a case study of home-based care in Ngamiland Botswana. Phys Chem Earth Parts 31: 669–680.
-
8.
World Health Organization, 2010. Priority Interventions HIV/AIDS Prevention, Treatment and Care in the Health Sector. Geneva, Switzerland: WHO.
-
9.
Wegelin-Schuringa M, Kamminga E, de Graaf S, 2003. HIV/AIDS and Its Implications for the Water Sanitation. 29th WEDC International Conference, Abuja, Nigeria, September 22–26, 2003.
-
10.
Mermin J, Bunnell R, Lule J, Opio A, Gibbons A, Dybul M, Kaplan J, 2005. Developing an evidence-based, preventive care package for persons with HIV in Africa. Trop Med Int Health 10: 961–970.
-
11.
Peletz R, Mahin T, Elliott M, Harris MS, Chan KS, Cohen MS, Bartam JK, Clasen TF, 2013. Water, sanitation, and hygiene interventions to improve health among people living with HIV/AIDS: a systematic review. AIDS 27: 2593–2601.
-
12.
Yates T, Lantagne D, Mintz E, Quick R, 2015. The impact of water, sanitation, and hygiene interventions on the health and well-being of people living with HIV: a systematic review. J Acquir Immune Defic Syndr 68 (Suppl 3): S318–S330.
-
13.
Peletz R, Simunyama M, Sarenje K, Baisley K, Filteau S, Kelly P, Clasen T, 2012. Assessing water filtration and safe storage in households with young children of HIV-positive mothers: a randomized, controlled trial in Zambia. PLoS One 7: e46548.
-
14.
Barzilay EJ et al. 2011. Diarrhea prevention in people living with HIV: an evaluation of a point-of-use water quality intervention in Lagos, Nigeria. AIDS Care 23: 330–339.
-
15.
Abebe LS, Smith JA, Narkiewicz S, Oyanedel-Craver V, Conaway M, Singo A, Amidou S, Mojapelo P, Brant J, Dillingham R, 2014. Ceramic water filters impregnated with silver nanoparticles as a point-of-use water-treatment intervention for HIV-positive individuals in Limpopo Province, South Africa: a pilot study of technological performance and human health benefits. J Water Health 12: 288–300.
-
16.
Colford JM Jr. et al. 2005. A randomized, controlled trial of in-home drinking water intervention to reduce gastrointestinal illness. Am J Epidemiol 161: 472–482.
-
17.
Harris JR, Greene SK, Thomas TK, Ndivo R, Okanda J, Masaba R, Nyangau I, Thigpen MC, Hoekstra RM, Quick RE, 2009. Effect of a point-of-use water treatment and safe water storage intervention on diarrhea in infants of HIV-infected mothers. J Infect Dis 200: 1186–1193.
-
18.
Walson J, Singa B, Sangare L, Naulikha J, Piper B, Richardson B, Otieno PA, Mbogo LW, Berkley JA, John-Stewart G, 2012. Empiric deworming to delay HIV disease progression in adults with HIV who are ineligible for initiation of antiretroviral treatment (the HEAT study): a multi-site, randomised trial. Lancet Infect Dis 12: 925–932.
-
19.
Lule JR et al. 2005. Effect of home-based water chlorination and safe storage on diarrhea among persons with human immunodeficiency virus in Uganda. Am J Trop Med Hyg 73: 926–933.
-
20.
Huang DB, Zhou J, 2007. Effect of intensive handwashing in the prevention of diarrhoeal illness among patients with AIDS: a randomized controlled study. J Med Microbiol 56: 659–663.
-
21.
Mugambe RK, Tumwesigye NM, Larkan F, 2013. Barriers to accessing water, sanitation, and hygiene practice and associated factors among people living with HIV/AIDS home based care services in Gondar city, Ethiopia. BMC Public Health 12: 1057.
-
22.
Yallew WW, Terefe MW, Herchline TE, Sharma HR, Bitew BD, Kifle MW, Tetemke DM, Tefera MA, Adane MM, 2012. Assessment of water, sanitation, and hygiene practice and associated factors among people living with HIV/AIDS home based care services in Gondar city, Ethiopia. BMC Public Health 12: 1057.
-
23.
WaterAid, 2014. Assessing the Water, Sanitation, and Hygiene Needs of People Living with HIV and AIDS in Papua New Guinea. East Sepik, Papua New Guinea: WaterAid.
-
24.
WaterAid, 2010. Access to Water, Sanitation, and Hygiene for People Living with HIV and AIDS: A Cross-Sectional Study in Nepal. Kathmandu, Nepal: WaterAid.
-
25.
Nkongo D, Chonya C, 2009. Access to Water and Sanitation for People Living with HIV and AIDS: An Exploartory Study. Dar es Salaam, Tanzania: WaterAid/AMREF.
-
26.
National AIDS and STI Control Programme (NASCOP), Kenya, 2014. Kenya AIDS Indicator Survey 2012: Final Report. Nairobi, Kenya: NASCOP.
-
27.
Kotloff KL et al. 2012. The global enteric multicenter study (GEMS) of diarrheal disease in infants and young children in developing countries: epidemiologic and clinical methods of the case/control study. Clin Infect Dis 55 (Suppl 4): S232–S245.
-
28.
Adazu K et al. 2005. Health and demographic surveillance in rural western Kenya: a platform for evaluating interventions to reduce morbidity and mortality from infectious diseases. Am J Trop Med Hyg 73: 1151–1558.
-
29.
Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention (CDC), 2009. Health and Demographic Surviellance System Report for 2009. Kisumu, Kenya: KEMRI/CDC.
-
30.
Kimanga DO et al. 2014. Prevalence and incidence of HIV infection, trends, and risk factors among persons aged 15–64 years in Kenya: results from a nationally representative study. J Acquir Immune Defic Syndr 66 (Suppl 1): S13–S26.
-
31.
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