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Article ; Online: A fuzzy inference-based index for piped water supply service quality in a complex, low-income urban setting.

Gaiffe, Marie / Dross, Camille / Bwenge Malembaka, Espoir / Ross, Ian / Cumming, Oliver / Gallandat, Karin

2023 Volume 243, Page(s) 120316

Abstract: Sustainable Development Goal (SDG) 6 calls for universal access to safely managed drinking water services. We studied the evolution of the water supply service between January 2017 and December 2021 in the town of Uvira (South Kivu, Democratic Republic ... ...

Abstract	Sustainable Development Goal (SDG) 6 calls for universal access to safely managed drinking water services. We studied the evolution of the water supply service between January 2017 and December 2021 in the town of Uvira (South Kivu, Democratic Republic of the Congo) where large investments were made to improve the water supply infrastructure during this period, including a new 2,000-m
MeSH term(s)	Water Quality ; Water Supply ; Drinking Water ; Cities ; Water Microbiology
Chemical Substances	Drinking Water
Language	English
Publishing date	2023-07-05
Publishing country	England
Document type	Journal Article
ZDB-ID	202613-2
ISSN	1879-2448 ; 0043-1354
ISSN (online)	1879-2448
ISSN	0043-1354
DOI	10.1016/j.watres.2023.120316
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Article ; Online: Household Disinfection Interventions to Prevent Cholera Transmission: Facilitators, Barriers, Training, and Evidence Needs.

Heylen, Camille / Ali, Cawo / Gallandat, Karin / Lantagne, Daniele / String, Gabrielle

The American journal of tropical medicine and hygiene

2021 Volume 105, Issue 3, Page(s) 611–621

Abstract: There are two common household disinfection interventions to prevent interhousehold transmission of cholera: household spraying, whereby a team disinfects cholera patients' households, and household disinfection kits (HDKs), whereby cleaning materials ... ...

Abstract	There are two common household disinfection interventions to prevent interhousehold transmission of cholera: household spraying, whereby a team disinfects cholera patients' households, and household disinfection kits (HDKs), whereby cleaning materials are provided to cholera patients' family members. Currently, both interventions lack evidence, and international agencies recommend HDK distribution; however, household spraying remains widely implemented. To understand this disconnect, we conducted 14 key informant interviews with international and national responders and a study in Haiti assessing HDK efficacy using two training modules including 20 household surveys and 327 surfaces samples before and after cleaning. During interviews, 80% of the international-level informants discussed evidence gaps for both interventions, and 60% preferred HDKs. Conversely, no national-level informants knew what an HDK was; therefore, they all preferred spraying. Informants discussed behavior changes, bleach perceptions, and implementation as facilitators and/or barriers to implementing both interventions. In households, training with demonstrations regarding the use of HDK led to increased reductions of Escherichia coli (P < 0.001) and Vibrio spp. (P < 0.001) on surfaces after participants cleaned the household compared with a hygiene promotion session only. These results emphasize the gap between the current international-level policy and the realities of cholera response programs, highlight the need for evidence to align household disinfection recommendations, and underscore the importance of the dissemination and training of responders and affected populations regarding methods to prevent intrahousehold cholera transmission.
MeSH term(s)	Cholera/prevention & control ; Cholera/transmission ; Disinfectants ; Disinfection/economics ; Disinfection/methods ; Evidence-Based Medicine ; Family Characteristics ; Haiti ; Household Products ; Humans ; Implementation Science ; Infection Control/economics ; Infection Control/methods ; Patient Education as Topic ; Pilot Projects ; Sodium Hypochlorite ; Stakeholder Participation
Chemical Substances	Disinfectants ; Sodium Hypochlorite (DY38VHM5OD)
Language	English
Publishing date	2021-07-06
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2942-7
ISSN	1476-1645 ; 0002-9637
ISSN (online)	1476-1645
ISSN	0002-9637
DOI	10.4269/ajtmh.20-1314
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Article ; Online: A fuzzy inference-based index for piped water supply service quality in a complex, low-income urban setting

Gaiffe, Marie / Dross, Camille / Bwenge Malembaka, Espoir / Ross, Ian / Cumming, Oliver / Gallandat, Karin

Water Research. 2023 Sept., v. 243 p.120316-

2023

Abstract	Sustainable Development Goal (SDG) 6 calls for universal access to safely managed drinking water services. We studied the evolution of the water supply service between January 2017 and December 2021 in the town of Uvira (South Kivu, Democratic Republic of the Congo) where large investments were made to improve the water supply infrastructure during this period, including a new 2,000-m³ tank, 56 community taps and 1,191 private taps. Across 16 geographic clusters in the town, we assessed water service accessibility, water quantity, continuity, and affordability, based on data provided by the construction team and the utility. We combined these dimensions into a single index ranging 0–100% according to rules defined using the fuzzy inference Mamdani method. Our results show that despite substantial increases in accessibility (i.e. proportion of households with a private tap or within 200 m of a community tap), overall service quality remained unsatisfactory, with a maximum index value of 38.1%, and worsened in many parts of the town due to limitations of the water production capacity after major flooding events and persistent electricity supply issues. The estimated amount of water supplied per user per day remained under 20 L during >95% of the observation period, with a decreasing trend. Pumps operated 58% of the time on average and the frequency of days without electricity supply increased over time. Our study highlights the important gap between upgrades in water supply infrastructure and improvements in the quality of service. The analysis of potential future scenarios for Uvira indicates that increasing production capacity is priority to improve overall service quality. Our results demonstrate that meeting SDG6 will be challenging in complex urban settings and will not only require sustained investments in water supply infrastructure but also in systems management and in energy supply.
Keywords	affordability ; electricity ; energy ; evolution ; infrastructure ; research ; sustainable development ; water ; water quantity ; water supply ; Democratic Republic of the Congo ; Wash ; Service ; Fuzzy inference ; Cholera ; AFD ; cap ; CDF ; CI ; DRC ; GPS ; IWA ; JMP ; km ; L ; NGO ; OCHA ; SDG ; UNICEF ; VF ; WHO
Language	English
Dates of publication	2023-09
Publishing place	Elsevier Ltd
Document type	Article ; Online
ZDB-ID	202613-2
ISSN	1879-2448 ; 0043-1354
ISSN (online)	1879-2448
ISSN	0043-1354
DOI	10.1016/j.watres.2023.120316
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Selection of a Biosafety Level 1 (BSL-1) surrogate to evaluate surface disinfection efficacy in Ebola outbreaks: Comparison of four bacteriophages.

Gallandat, Karin / Lantagne, Daniele

PloS one

2017 Volume 12, Issue 5, Page(s) e0177943

Abstract: The 2014 West African Ebola virus disease outbreak was the largest to date, and conflicting, chlorine-based surface disinfection protocols to interrupt disease transmission were recommended. We identified only one study documenting surface disinfection ... ...

Abstract	The 2014 West African Ebola virus disease outbreak was the largest to date, and conflicting, chlorine-based surface disinfection protocols to interrupt disease transmission were recommended. We identified only one study documenting surface disinfection efficacy against the Ebola virus, showing a >6.6 log reduction after 5-minute exposure to 0.5% sodium hypochlorite (NaOCl) based on small-scale tests (Cook et al. (2015)). In preparation for future extensive, large-scale disinfection efficacy experiments, we replicated the Cook et al. experiment using four potential BSL-1 surrogates selected based on similarities to the Ebola virus: bacteriophages MS2, M13, Phi6, and PR772. Each bacteriophage was exposed to 0.1% and 0.5% NaOCl for 1, 5, and 10 minutes on stainless steel. MS2 and M13 were only reduced by 3.4 log and 3.5 log after a 10-minute exposure to 0.5% NaOCl, and would be overly conservative surrogates. Conversely, PR772 was too easily inactivated for surrogate use, as it was reduced by >4.8 log after only 1-minute exposure to 0.5% NaOCl. Phi6 was slightly more resistant than the Ebola virus, with 4.1 log reduction after a 5-minute exposure and not detected after a 10-minute exposure to 0.5% NaOCl. We therefore recommend Phi6 as a surrogate for evaluating the efficacy of chlorine-based surface disinfectants against the Ebola virus.
MeSH term(s)	Bacteriophages/drug effects ; Disease Outbreaks ; Disinfectants/pharmacology ; Disinfection/methods ; Dose-Response Relationship, Drug ; Hemorrhagic Fever, Ebola/prevention & control ; Humans ; Models, Biological ; Sodium Hypochlorite/pharmacology ; Time Factors
Chemical Substances	Disinfectants ; Sodium Hypochlorite (DY38VHM5OD)
Language	English
Publishing date	2017-05-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0177943
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: A systematic review of chlorine-based surface disinfection efficacy to inform recommendations for low-resource outbreak settings.

Gallandat, Karin / Kolus, Riley C / Julian, Timothy R / Lantagne, Daniele S

American journal of infection control

2020 Volume 49, Issue 1, Page(s) 90–103

Abstract: Background: Infectious diseases can be transmitted via fomites (contaminated surfaces/objects); disinfection can interrupt this transmission route. However, disinfection guidelines for low-resource outbreak settings are inconsistent and not evidence- ... ...

Abstract	Background: Infectious diseases can be transmitted via fomites (contaminated surfaces/objects); disinfection can interrupt this transmission route. However, disinfection guidelines for low-resource outbreak settings are inconsistent and not evidence-based. Methods: A systematic review of surface disinfection efficacy studies was conducted to inform low-resource outbreak guideline development. Due to variation in experimental procedures, outcomes were synthesized in a narrative summary focusing on chlorine-based disinfection against 7 pathogens with potential to produce outbreaks in low-resource settings (Mycobacterium tuberculosis, Vibrio cholerae, Salmonella spp., hepatitis A virus, rotavirus, norovirus, and Ebola virus). Results: Data were extracted from 89 laboratory studies and made available, including 20 studies on relevant pathogens used in combination with surrogate data to determine minimum target concentration × time ("CT") factors. Stainless steel (68%) and chlorine-based disinfectants (56%) were most commonly tested. No consistent trend was seen in the influence of chlorine concentration and exposure time on disinfection efficacy. Disinfectant application mode; soil load; and surface type were frequently identified as influential factors in included studies. Conclusions: This review highlights that surface disinfection efficacy estimates are strongly influenced by each study's experimental conditions. We therefore recommend laboratory testing to be followed by field-based testing/monitoring to ensure effectiveness is achieved in situ.
MeSH term(s)	Chlorine/pharmacology ; Disease Outbreaks/prevention & control ; Disinfectants/pharmacology ; Disinfection ; Humans ; Norovirus
Chemical Substances	Disinfectants ; Chlorine (4R7X1O2820)
Keywords	covid19
Language	English
Publishing date	2020-05-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review ; Systematic Review
ZDB-ID	392362-9
ISSN	1527-3296 ; 0196-6553
ISSN (online)	1527-3296
ISSN	0196-6553
DOI	10.1016/j.ajic.2020.05.014
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Article: Residual Maintenance Using Sodium Hypochlorite, Sodium Dichloroisocyanurate, and Chlorine Dioxide in Laboratory Waters of Varying Turbidity

Gallandat, Karin / Lantagne, Daniele / Stack, David / String, Gabrielle

Water. 2019 June 25, v. 11, no. 6

2019

Abstract: Sodium hypochlorite (NaOCl) and sodium dichloroisocyanurate (NaDCC) are commonly used for household water treatment (HWT); chlorine dioxide (ClO ... 2 ... ) is a potential new HWT option. We compared the residual maintenance of NaOCl, NaDCC, and ClO ... ...

Abstract	Sodium hypochlorite (NaOCl) and sodium dichloroisocyanurate (NaDCC) are commonly used for household water treatment (HWT); chlorine dioxide (ClO<inf>2</inf>) is a potential new HWT option. We compared the residual maintenance of NaOCl, NaDCC, and ClO<inf>2</inf> over 24 hours using recommended dosages (2 and 4 mg/L) in waters of varying turbidity (0–300 NTU, from kaolin clay or creek-bottom sediments) and total organic carbon (TOC) concentrations (0–100 mg/L), for a total of 324 reactors. NaOCl and NaDCC had similar free chlorine decay rates, and ClO<inf>2</inf> decayed more rapidly across all of the tested conditions. Little variability was observed across clay-based turbidity levels and TOC concentrations. With a dosage of 2 mg/L, a residual ≥0.2 mg/L was maintained at 30 NTU for NaOCl and 100 NTU for NaDCC; for ClO<inf>2</inf>, 4 mg/L were required to maintain ≥0.2 mg/L under all conditions except at zero turbidity. Comparisons with data from the literature suggest that the three compounds would inactivate E. coli, rotavirus, and Giardia cysts within 1 hour under all conditions, except 300 NTU for NaOCl and NaDCC. All three disinfectants are similarly efficacious for this usage; however, differences are seen in decay rates that may influence disinfectant selection depending on water storage time.
Keywords	chlorine ; chlorine dioxide ; clay ; disinfectants ; Escherichia coli ; Giardia ; kaolin ; Rotavirus ; sediments ; sodium dichloroisocyanurate ; sodium hypochlorite ; storage time ; total organic carbon ; turbidity ; water storage ; water treatment
Language	English
Dates of publication	2019-0625
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2521238-2
ISSN	2073-4441
ISSN	2073-4441
DOI	10.3390/w11061309
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Lessons learned from conducting six multi-country mixed-methods effectiveness research studies on water, sanitation, and hygiene (WASH) interventions in humanitarian response.

Lantagne, Daniele / Lehmann, Lilian / Yates, Travis / Gallandat, Karin / Sikder, Mustafa / Domini, Marta / String, Gabrielle

BMC public health

2021 Volume 21, Issue 1, Page(s) 560

Abstract: Background: Provision of safe water, sanitation, and hygiene (WASH) to affected populations in humanitarian emergencies is necessary for dignity and communicable disease control. Additional evidence on WASH interventions is needed in humanitarian ... ...

Abstract	Background: Provision of safe water, sanitation, and hygiene (WASH) to affected populations in humanitarian emergencies is necessary for dignity and communicable disease control. Additional evidence on WASH interventions is needed in humanitarian settings. Between 2008 and 2019, we completed six multi-country, mixed-methods effectiveness studies in humanitarian response on six different WASH interventions. In each evaluation, we conducted: key informant interviews; water point observations and water quality testing; household surveys with recipients, including survey and water quality testing; focus group discussions; and/or, secondary data analysis. The research questions were: "What is the effectiveness of [intervention] in reducing the risk of diarrhea/cholera transmission; and, what programmatic factors lead to higher effectiveness?" Discussion: In all six multi-country, mixed-methods evaluations, policy-relevant outcomes were obtained. We found, in our individual research results, that: interventions could reduce the risk of disease in humanitarian contexts; this reduction of risk did not always occur, as there were large ranges in effectiveness; and, implementation factors were crucial to intervention effectiveness. When collaboratively reviewing our research process across evaluations, we found strategies for successfully conducting this research included: 1) working with partners to identify and evaluate programs; 2) rapidly obtaining approvals to deploy; and, 3) conducting research methodologies consistently. Personal connections, in-person communication, trust, and experience working together were key factors for success in identifying partners for evaluation. Successes in evaluation deployment occurred with flexibility, patience, commitment of adequate time, and understanding of processes; although we note access and security concerns in insecure contexts precluded deployment. Consistent and robust protocols, flexibility, and a consistent researcher on the ground in each context allowed for methodological consistency and high-quality results. Conclusions: In conclusion, we have found multi-country, mixed-methods results to be one crucial piece of the WASH evidence base in humanitarian contexts. This is particularly because evaluations of reductions in risk from real-world programming are policy-relevant, and are directly used to improve programming. In future, we need to flexibly work with donors, agencies, institutions, responders, local governments, local responders, and beneficiaries to design safe and ethical research protocols to answer questions related to WASH interventions effectiveness in humanitarian response, and, improve WASH programming.
MeSH term(s)	Humans ; Hygiene ; Sanitation ; Water ; Water Quality ; Water Supply
Chemical Substances	Water (059QF0KO0R)
Language	English
Publishing date	2021-03-22
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-021-10597-z
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Article ; Online: Selection of a Biosafety Level 1 (BSL-1) surrogate to evaluate surface disinfection efficacy in Ebola outbreaks

Karin Gallandat / Daniele Lantagne

PLoS ONE, Vol 12, Iss 5, p e

Comparison of four bacteriophages.

2017 Volume 0177943

Abstract	The 2014 West African Ebola virus disease outbreak was the largest to date, and conflicting, chlorine-based surface disinfection protocols to interrupt disease transmission were recommended. We identified only one study documenting surface disinfection efficacy against the Ebola virus, showing a >6.6 log reduction after 5-minute exposure to 0.5% sodium hypochlorite (NaOCl) based on small-scale tests (Cook et al. (2015)). In preparation for future extensive, large-scale disinfection efficacy experiments, we replicated the Cook et al. experiment using four potential BSL-1 surrogates selected based on similarities to the Ebola virus: bacteriophages MS2, M13, Phi6, and PR772. Each bacteriophage was exposed to 0.1% and 0.5% NaOCl for 1, 5, and 10 minutes on stainless steel. MS2 and M13 were only reduced by 3.4 log and 3.5 log after a 10-minute exposure to 0.5% NaOCl, and would be overly conservative surrogates. Conversely, PR772 was too easily inactivated for surrogate use, as it was reduced by >4.8 log after only 1-minute exposure to 0.5% NaOCl. Phi6 was slightly more resistant than the Ebola virus, with 4.1 log reduction after a 5-minute exposure and not detected after a 10-minute exposure to 0.5% NaOCl. We therefore recommend Phi6 as a surrogate for evaluating the efficacy of chlorine-based surface disinfectants against the Ebola virus.
Keywords	Medicine ; R ; Science ; Q
Subject code	600
Language	English
Publishing date	2017-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Water, Sanitation, and Cholera in Sub-Saharan Africa.

Sikder, Mustafa / Deshpande, Aniruddha / Hegde, Sonia T / Malembaka, Espoir Bwenge / Gallandat, Karin / Reiner, Robert C / Lessler, Justin / Lee, Elizabeth C / Azman, Andrew S

Environmental science & technology

2023 Volume 57, Issue 28, Page(s) 10185–10192

Abstract: Improvements in water and sanitation should reduce cholera risk though the associations between cholera and specific water and sanitation access measures remain unclear. We estimated the association between eight water and sanitation measures and annual ... ...

Abstract	Improvements in water and sanitation should reduce cholera risk though the associations between cholera and specific water and sanitation access measures remain unclear. We estimated the association between eight water and sanitation measures and annual cholera incidence access across sub-Saharan Africa (2010-2016) for data aggregated at the country and district levels. We fit random forest regression and classification models to understand how well these measures combined might be able to predict cholera incidence rates and identify high cholera incidence areas. Across spatial scales, piped or "other improved" water access was inversely associated with cholera incidence. Access to piped water, septic or sewer sanitation, and septic, sewer, or "other improved" sanitation were associated with decreased district-level cholera incidence. The classification model had moderate performance in identifying high cholera incidence areas (cross-validated-AUC 0.81, 95% CI 0.78-0.83) with high negative predictive values (93-100%) indicating the utility of water and sanitation measures for screening out areas that are unlikely to be at high cholera risk. While comprehensive cholera risk assessments must incorporate other data sources (e.g., historical incidence), our results suggest that water and sanitation measures could alone be useful in narrowing the geographic focus for detailed risk assessments.
MeSH term(s)	Humans ; Water ; Sanitation ; Cholera/epidemiology ; Cholera/prevention & control ; Water Supply ; Africa South of the Sahara/epidemiology
Chemical Substances	Water (059QF0KO0R)
Language	English
Publishing date	2023-07-06
Publishing country	United States
Document type	Journal Article
ISSN	1520-5851
ISSN (online)	1520-5851
DOI	10.1021/acs.est.3c01317
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Household spraying in cholera outbreaks: Insights from three exploratory, mixed-methods field effectiveness evaluations.

Gallandat, Karin / Huang, Annie / Rayner, Justine / String, Gabrielle / Lantagne, Daniele S

PLoS neglected tropical diseases

2020 Volume 14, Issue 8, Page(s) e0008661

Abstract: Household spraying is a commonly implemented, yet an under-researched, cholera response intervention where a response team sprays surfaces in cholera patients' houses with chlorine. We conducted mixed-methods evaluations of three household spraying ... ...

Abstract	Household spraying is a commonly implemented, yet an under-researched, cholera response intervention where a response team sprays surfaces in cholera patients' houses with chlorine. We conducted mixed-methods evaluations of three household spraying programs in the Democratic Republic of Congo and Haiti, including 18 key informant interviews, 14 household surveys and observations, and 418 surface samples collected before spraying, 30 minutes and 24 hours after spraying. The surfaces consistently most contaminated with Vibrio cholerae were food preparation areas, near the patient's bed and the latrine. Effectiveness varied between programs, with statistically significant reductions in V. cholerae concentrations 30 minutes after spraying in two programs. Surface contamination after 24 hours was variable between households and programs. Program challenges included difficulty locating households, transportation and funding limitations, and reaching households quickly after case presentation (disinfection occurred 2-6 days after reported cholera onset). Program advantages included the concurrent deployment of hygiene promotion activities. Further research is indicated on perception, recontamination, cost-effectiveness, viable but nonculturable V. cholerae, and epidemiological coverage. We recommend that, if spraying is implemented, spraying agents should: disinfect surfaces systematically until wet using 0.2/2.0% chlorine solution, including kitchen spaces, patients' beds, and latrines; arrive at households quickly; and, concurrently deploy hygiene promotion activities.
MeSH term(s)	Chlorine ; Cholera/epidemiology ; Cholera/prevention & control ; Congo/epidemiology ; Disease Outbreaks/prevention & control ; Disinfection/methods ; Family Characteristics ; Female ; Haiti/epidemiology ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Surveys and Questionnaires ; Toilet Facilities ; Vibrio cholerae
Chemical Substances	Chlorine (4R7X1O2820)
Language	English
Publishing date	2020-08-31
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2429704-5
ISSN	1935-2735 ; 1935-2735
ISSN (online)	1935-2735
ISSN	1935-2735
DOI	10.1371/journal.pntd.0008661
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