Water insecurity and gender‐based violence: A global review of the evidence

We reviewed the existing literature documenting the association between water insecurity and gender-based violence to (1) describe the characteristics and contexts of available studies, and (2) identify and classify documented gender-based violence across domains of water insecurity (access, affordability, adequacy, reliability, and safety). 18 peer-reviewed articles mentioned associations between water insecurity and gender-based violence. All studies were conducted in sub-Saharan Africa and South Asia and were published in English. The most common manifestation of the relationship between water insecurity and gender-based violence was an increased risk of sexual and physical violence for women who walked long distances to access water. This was followed by intimate partner violence sparked by the inability to meet domestic obligations due to household water inadequacy. Despite these trends, the domains of water insecurity, and the types of violence experienced by women, were often intertwined. We conclude that there is a dearth of information assessing gender-based violence and water insecurity, especially in Latin America, North America, and Southeast Asia, and involving locally-based scholars. We suggest that the spectrum of what is considered “violence” in relation to water insecurity be expanded and that scholars and practitioners adopt the term “gender-based water violence” to describe water-related stressors that are so extreme as to threaten human health and well-being, particularly that of women and girls. Finally, we encourage the development of cross-culturally validated measures of gender-based violence, which can be deployed in conjunction with standardized measures of water insecurity, to evaluate interventions that target these linked threats to global health

Water Insecurity, Self-reported Physical Health, and Objective Measures of Biological Health in the Peruvian Amazon

ObjectivesThis study examines the associations between water insecurity, self-reported physical health, and objective measures of biological health among 225 Awajún adults (107 women; 118 men) living in the Peruvian Amazon, a “water-abundant” region.MethodsA survey, which included multiple measures of self-reported physical health, and objective measures of biological health such as blood pressure and nutritional and immune biomarkers.ResultsGreater water insecurity was associated with multiple measures of self-reported physical health, including higher incidence of reported diarrhea, nausea, back pain, headaches, chest pain, fatigue, dizziness, overall poor perceived health, and “being sick.” These symptoms align with the physical strain associated with water acquisition and with drinking contaminated water. A significant association between higher water insecurity and lower systolic blood pressure emerged, which may be linked to dehydration. None of the other biomarkers, including those for nutrition, infection, and stress were significantly associated with water insecurity scores.ConclusionsThese analyses add to the growing body of research examining the associations between water insecurity and health. Biocultural anthropologists are well-positioned to continue probing these connections. Future research will investigate relationships between measures of water insecurity and biomarkers for gastrointestinal infection and inflammation in water-scarce and water-abundant contexts

Water Insecurity and Gender-based Violence: A Global Review of the Evidence

We reviewed the existing literature documenting the association between water insecurity and gender-based violence to (1) describe the characteristics and contexts of available studies, and (2) identify and classify documented gender-based violence across domains of water insecurity (access, affordability, adequacy, reliability, and safety). 18 peer-reviewed articles mentioned associations between water insecurity and gender-based violence. All studies were conducted in sub-Saharan Africa and South Asia and were published in English. The most common manifestation of the relationship between water insecurity and gender-based violence was an increased risk of sexual and physical violence for women who walked long distances to access water. This was followed by intimate partner violence sparked by the inability to meet domestic obligations due to household water inadequacy. Despite these trends, the domains of water insecurity, and the types of violence experienced by women, were often intertwined. We conclude that there is a dearth of information assessing gender-based violence and water insecurity, especially in Latin America, North America, and Southeast Asia, and involving locally-based scholars. We suggest that the spectrum of what is considered “violence” in relation to water insecurity be expanded and that scholars and practitioners adopt the term “gender-based water violence” to describe water-related stressors that are so extreme as to threaten human health and well-being, particularly that of women and girls. Finally, we encourage the development of cross-culturally validated measures of gender-based violence, which can be deployed in conjunction with standardized measures of water insecurity, to evaluate interventions that target these linked threats to global health.This article is categorized under:Engineering Water \u3e Water, Health, and SanitationHuman Water \u3e Rights to Wate

Prevalence of paramyxoviruses in bats in six areas of Madre de Dios and Puno, Peru with two levels of anthropogenic disturbance

Los Andes tropicales que comprende la región de Madre de Dios, Perú, es considerada una zona de conservación para la biodiversidad; sin embargo, el reciente desarrollo de la zona a través de la pavimentación de la carretera interoceánica (CIO) ha ocasionado un impacto antropogénico en la región. Este estudio tuvo como objetivo identificar la prevalencia de paramixovirus, patógenos emergentes de importancia para la salud pública y animal, en murciélagos capturados a lo largo de los tramos de la CIO sujetos a diferentes grados de perturbación ecológica. La captura se hizo entre octubre de 2009 a octubre de 2010 en tres zonas altamente perturbadas y tres zonas con un grado de perturbación moderado a ligero; además, en la Reserva Nacional de Tambopata como grupo control. Se analizaron muestras de bazo mediante la técnica de RT-PCR semianidado que detecta las regiones conservadas del gen de la polimerasa. Se capturaron 436 murciélagos de 24 géneros y 35 especies, encontrándose una prevalencia de paramixovirus de 10.3% (IC 95%: 7.6-13.6%). La prevalencia fue de 15.7% en lugares clasificados con alto grado de perturbación ecológica, siendo significativamente mayor (p=0.009) que en lugares con moderado grado de perturbación (5.6%) y en la zona control (8.3%). La especie Artibeus planisrostris mostró la más alta frecuencia de infección (37%). Mediante el análisis de secuencia se identificaron tres muestras positivas a paramixovirus agrupadas dentro del género Morbillivirus (no clasificada) en las especies Carollia brevicuda y C. perspicillata; así como miembros del género Rubulavirus (Mapuera virus) en tres muestras de murciélagos adultos de la especie Sturnira lilium colectados en el distrito de Iberia.The tropical Andes, comprising the Madre de Dios region, are a hotspot for biodiversity conservation. Recent development of the area through paving of the interoceanic highway (IOH) resulted in anthropogenic impacts in the region. This study aimed to identify the prevalence of emerging pathogens of public and animal health importance such as Paramyxoviruses among bats trapped along areas of IOH with different ecological impacts. Samples from six study sites along the IOH were collected from October 2009 to October 2010: three highly disturbed areas and three areas with low disturbance. A site located at the Tambopata National Reserve was selected as an undisturbed environment for control. Bat spleens were tested for Paramyxoviruses by nested PCR targeting the conserved motifs of the polymerase gene. A total of 436 bats from 24 different genera were captured, of which 45 (10.32%; CI 95%: 7.6-13.6%) were positive for Paramyxoviruses. The prevalence was higher in areas with more disturbance than in mildly disturbed areas (15.7 vs. 5.6%, p=0.009). The prevalence in the control area was 8.3%. The species Artibeus planirostris showed the highest infection frequency (37%, 17/45). Three positive bats were adults of the Sturnira lilium species collected from one location in Iberia District. Sequence analysis placed these viruses in the Rubulavirus genera (Mapuera virus). The remaining viruses were related to an unclassified Morbillivirus found in bat samples in Brazil during 2013

Exploring perceptions of the impact of climate change in three regions in Peru

El cambio climático es atribuido directa o indirectamente a la actividad humana y se considera como la mayor amenaza a la salud pública del siglo XXI. Tiene impactos sobre el acceso al agua, la alimentación, en la agricultura y medios de vida, y en la salud de las personas. El objetivo de este texto es evaluar las percepciones del cambio climático en niños, niñas, adolescentes, autoridades y representantes de organizaciones juveniles, de mujeres y que trabajan con la niñez en las regiones de Cusco, Loreto y Piura, en Perú. Para ello se realizó un estudio cualitativo que utilizó la técnica de Fotovoz con doce adolescentes y entrevistas a profundidad con veintidós actores clave. Para el análisis se utilizaron las narrativas en las fotos y el análisis temático de las entrevistas. En las tres regiones se identificaron cambios extremos en el clima. En la región de Cusco reconocieron el cambio de temperatura con sequías y heladas, mientras que en Loreto y Piura manifestaron aumento en la intensidad de lluvias. En general, estos cambios afectaron la agricultura. El cuidado del agua como recurso, tanto en su acceso y calidad, fue una gran preocupación para todos los participantes. El estudio concluye que no se identifica el concepto de cambio climático como tal, sin embargo, describen cambios y variaciones en el clima que afectan sus actividades diarias, en particular la agricultura. Un tema transversal a todas las regiones fue el cuidado y uso del recurso del agua. Además, los jóvenes se mostraron particularmente entusiasmados en colaborar en iniciativas futuras contra el cambio climático

Seroprevalence and Risk Factors for Rickettsia and Leptospira Infection in Four Ecologically Distinct Regions of Peru.

Rickettsia and Leptospira spp. are under-recognized causes of acute febrile disease worldwide. Rickettsia species are often placed into the spotted fever group rickettsiae (SFGR) and typhus group rickettsiae (TGR). We explored the antibody prevalence among humans for these two groups of rickettsiae in four regions of Peru (Lima, Cusco, Puerto Maldonado, and Tumbes) and for Leptospira spp. in Puerto Maldonado and Tumbes. We also assessed risk factors for seropositivity and collected serum samples and ectoparasites from peri-domestic animals from households in sites with high human seroprevalence. In total, we tested 2,165 human sera for antibodies (IgG) against SFGR and TGR by ELISA and for antibodies against Leptospira by a microscopic agglutination test. Overall, human antibody prevalence across the four sites was 10.6% for SFGR (ranging from 6.2% to 14.0%, highest in Tumbes) and 3.3% for TGR (ranging from 2.6% to 6.4%, highest in Puerto Maldonado). Factors associated with seroreactivity against SFGR were male gender, older age, contact with backyard birds, and working in agriculture or with livestock. However, exposure to any kind of animal within the household decreased the odds ratio by half. Age was the only variable associated with higher TGR seroprevalence. The prevalence of Leptospira was 11.3% in Puerto Maldonado and 5.8% in Tumbes, with a borderline association with keeping animals in the household. We tested animal sera for Leptospira and conducted polymerase chain reaction (PCR) to detect Rickettsia species among ectoparasites collected from domestic animals in 63 households of seropositive participants and controls. We did not find any association between animal infection and human serostatus

Identification of Leptospira and Bartonella among rodents collected across a habitat disturbance gradient along the Inter-Oceanic Highway in the southern Amazon Basin of Peru.

BACKGROUND: The southern Amazon Basin in the Madre de Dios region of Peru has undergone rapid deforestation and habitat disruption, leading to an unknown zoonotic risk to the growing communities in the area. METHODOLOGY/PRINCIPAL FINDINGS: We surveyed the prevalence of rodent-borne Leptospira and Bartonella, as well as potential environmental sources of human exposure to Leptospira, in 4 communities along the Inter-Oceanic Highway in Madre de Dios. During the rainy and dry seasons of 2014-2015, we captured a total of 97 rodents representing 8 genera in areas that had experienced different degrees of habitat disturbance. Primarily by using 16S metagenomic sequencing, we found that most of the rodents (78%) tested positive for Bartonella, whereas 24% were positive for Leptospira; however, the patterns differed across seasons and the extent of habitat disruption. A high prevalence of Bartonella was identified in animals captured across both trapping seasons (72%-83%) and the relative abundance was correlated with increasing level of land disturbance. Leptospira-positive animals were more than twice as prevalent during the rainy season (37%) as during the dry season (14%). A seasonal fluctuation across the rainy, dry, and mid seasons was also apparent in environmental samples tested for Leptospira (range, 55%-89% of samples testing positive), and there was a high prevalence of this bacteria across all sites that were sampled in the communities. CONCLUSIONS/SIGNIFICANCE: These data indicate the need for increased awareness of rodent-borne disease and the potential for environmental spread along the communities in areas undergoing significant land-use change

Economic Burden of Dengue Virus Infection at the Household Level Among Residents of Puerto Maldonado, Peru.

Dengue virus (DENV) was reintroduced to Peru in the 1990s and has been reported in Puerto Maldonado (population ~65,000) in the Peruvian southern Amazon basin since 2000. This region also has the highest human migration rate in the country, mainly from areas not endemic for DENV. The objective of this study was to assess the proportion of household income that is diverted to costs incurred because of dengue illness and to compare these expenses between recent migrants (RMs) and long-term residents (LTRs). We administered a standardized questionnaire to persons diagnosed with dengue illness at Hospital Santa Rosa in Puerto Maldonado from December 2012 to March 2013. We compared direct and indirect medical costs between RMs and LTRs. A total of 80 participants completed the survey, of whom 28 (35%) were RMs and 52 (65%) were LTRs. Each dengue illness episode cost the household an average of US$105 (standard deviation [SD] = 107), representing 24$56, SD = 87), especially lost wages. The proportion of household income diverted to dengue illness did not differ significantly between RM and LTR households. The study highlights the significant financial burden incurred by households when a family member suffers dengue illness

DENGUE INFECTION IN PUERTO MALDONADO, PERU: HUMAN MIGRATION AND ECONOMIC IMPACT

Dengue virus (DENV) is an arbovirus with global distribution that affects more than 100 countries worldwide. This Flavivirus was reintroduced to Peru in the 1990s and has disseminated across several areas in the country, especially in the urban centers of the Amazon Basin. In Peru, the virus is transmitted by an anthropophilic mosquito, Aedes aegypti. Dengue has been increasing in the southern Peruvian city of Puerto Maldonado since 2000, when it was first reported there. This region has the highest human migration rate in the country, and incomers to the city are mainly from non-endemic areas for DENV. The unique migratory movement situation of this city may pose a differential risk for between recent migrants (RM) and long-term residents (LTR). In this scenario, this study was designed to a) describe the seroprevalence of dengue infection among residents of Puerto Maldonado and evaluate the influence that migration history and knowledge, attitudes and practices (KAP) related to dengue control and prevention may have on serostatus for DENV, b) to identify spatial patterns of risk for DENV infection for residents in Puerto Maldonado, considering migration background, services and infrastructure, socioeconomic status and to assess the proportion of household income that is diverted to costs incurred due to dengue illness and to compare these expenses between RM and LTR, defined respectively as residency in Puerto Maldonado for less than or greater than 5 years. A secondary objective was to describe the demographic and socioeconomic characteristics of RM and LTR in Puerto Maldonado. To achieve this we conducted a cross-sectional serosurvey and administered a KAP questionnaire to members of randomly selected households, 2012. Sera were screened for antibody to DENV by ELISA and confirmed by plaque reduction neutralization test (PRNT). We also measured other socioeconomic variables and income. To assess the household income diverted to dengue expenses we administered a standardized questionnaire to persons diagnosed with dengue disease. We compared costs incurred between RM and LTR. In order to evaluate the spatial patterns of DENV infection collected the information and geographic location where the serosurvey and questionnaire were administered. We explored the data for clustering patterns, identified clusters and tested the distance of some features in the city with DENV infection. The results of this study showed a seroprevalence of 54% (95% CI: 49.6; 58.5), which was similar among RM and LTR. RM comprised 11% of this study population. Multivariate analysis indicated that higher values of KAPi (p=0.020) and household monthly income (p=0.009) were associated with antibody positivity, while migration status remained non-significant. For our findings regarding DENV expenses, twenty-eight of the 80 participants (35%), were RM. Each dengue disease episode cost the household an average of US$105 (SD=107), representing 24$ 56, SD=87), especially lost wages. The outcomes from spatial pattern analysis broadened the perspective of DENV infection in this city. We located areas where DENV infection clustered. As before, higher income and KAP score were predictors of infection, but the distance of the households to flooding areas was negatively associated to DENV prevalence. Therefore, with each meter away from these areas the prevalence decreased about 1% (OR: 0.999; 95% CI: 0.998; 0.999). From the serosurvey study, we concluded that the seroprevalence of DENV showed an association with risk behaviors and socio-economic status. The rather uncommon lower seroprevalence that is portrayed in Puerto Maldonado, as compared with other Peruvian cities like Iquitos, in Loreto, is likely due to the relative recent emergence of DENV in the city. Nonetheless, when exploring further the findings of this study with the spatial patterns, we were able to determine areas of higher risk in the urban area. In contrast, costs did not differ significantly between RM and LTR households. However, the study did highlight the significant financial burden incurred by households when a family member suffers dengue disease. Despite the limitations of this study, such as the lack of longitudinal information or entomological data, these findings can help guide DENV transmission prevention and vector control. Especially since this re-emergent virus is becoming a global concern and the efforts to develop an efficient vaccine continue

Water insecurity is associated with gender-based violence: A mixed-methods study in Indonesia

Gender Based Violence (GBV) is a global pandemic and water insecurity is increasing in intensity and extent. This study explores the association between these two global health threats. Cross-sectional, quantitative data were collected via surveys (n = 365 adult women) to measure household water insecurity (HWI) and women's experiences of GBV in the last year. Qualitative data were collected from semi-structured interviews (n = 24 men and women), two focus group discussions (n = 25 men and women) and a multi-stakeholder meeting (n = 35 men and women) to explore experiences, attitudes and risk factors associated with HWI and GBV. Multivariate logistic regression analysis showed that women in water insecure households were more than twice as likely to report experiencing GBV in the last year (OR = 2.2, CI: 1.0–4.9, p = 0.051). Examining household water insecurity scores as a continuous variable revealed an increased odds of reporting GBV with each increase in the HWISE score (OR = 1.1, CI: 1.0; 1.1, p < 0.001). Qualitative data indicates that the intersection between HWI, a patriarchal social organization and a caste system produced water-related conflicts between intimate partners, between daughters-in-law and their in-laws, and between masters and enslaved women. These results are presented using an integrated theoretical framework – a Feminist Political Ecology of Health (FPEH) – to illustrate the many ways women encounter and experience multi-dimensional forms of violence across scales in connection to water insecurity. The combination of robust qualitative and quantitative data presented in this study suggests that HWI may be causally related to GBV in this context