Physicochemical and Microbiological Quality of Roof-harvested Rainwater in Urban Areas: A Review

This work proposes to consider the quality of roof-collected rainwater. There are three main stages. In the first stage, rainfall washes out the urban atmosphere with contaminants from aerosols and gases. The second stage refers to the catchment, where there is contamination due to the wash-off of particles settled on the roof’s surface roofing materials. The third stage refers to the first-flush, storage and plumbing system. In each stage, different processes take place and add specific contaminants to the initial precipitation. Only in the third stage, after the discard of the high-polluted initial rainwater, some physical processes (for example sedimentation and correction of pH) can also improve the quality of the rainwater harvest. This approach offers a clear view of the overall contamination processes that take place in a rainwater harvesting system.The most common microbiological and physicochemical contaminants that can be found in rainwater harvesting system were considered, together with the eventual presence of waterborne pathogens and emerging chemical contaminants, according to an extensive review of previous scientific works. Keywords: Rainwater, Physicochemical, Microbiological, Contaminants, waterborne DOI: 10.7176/JEES/12-10-05 Publication date:October 31st 202

Uptake and continuation of HIV pre‐exposure prophylaxis among women of reproductive age in two health facilities in Kisumu County, Kenya

Abstract Introduction In 2020, Kenya had 19,000 new HIV infections among women aged 15+ years. Studies have shown sub‐optimal oral pre‐exposure prophylaxis (PrEP) use among sub‐populations of women. We assessed the uptake and continuation of oral PrEP among women 15–49 years in two health facilities in Kisumu County, Kenya. Methods A retrospective cohort of 262 women aged 15–49 years, initiated into oral PrEP between 12 November 2019 and 31 March 2021, was identified from two health facilities in the urban setting of Kisumu County, Kenya. Data on baseline characteristics and oral PrEP continuation at months 1, 3 and 6 were abstracted from patient records and summarized using descriptive statistics. Missing data in the predictor variables were imputed within the joint modelling multiple imputation framework. Using logistic regression, we evaluated factors associated with the discontinuation of oral PrEP at month 1. Results Of the 66,054 women screened, 320 (0.5%) were eligible and 262 (82%) were initiated on oral PrEP. Uptake was higher among women 25–29 years as compared to those 15–24 years (77% vs. 33%). Oral PrEP continuation declined significantly with increasing duration of follow‐up; 37% at month 1, 21% at month 3 and 12% at month 6 (p<0.05). In the adjusted analysis, women 15–24 years had lower adjusted odds of continuing at month 1 than women ≥25 years (adjusted odds ratio [aOR]: 0.41, 95% CI: 0.21–0.82). There was no association between being sero‐discordant and continuation of oral PrEP at month 1 (aOR; 1.21, 95% CI 0.59–2.50). Women from the sub‐county hospital were more likely to continue at month 1 of follow‐up compared to women enrolled in the county referral hospital (aOR 5.11; 95% CI 2.24–11.70). Conclusions The low eligibility for oral PrEP observed among women 15–49 years in an urban setting with high HIV prevalence calls for a review of the screening process to validate the sensitivity of the screening tool and its proper application. The low uptake and continuation among adolescent girls and young women underscores the need to identify and address specific patient‐ and facility‐level barriers affecting different sub‐populations at risk for HIV acquisition