WASH for WORMS: a cluster-randomized controlled trial of the impact of a community integrated water, sanitation, and hygiene and deworming intervention on soil-transmitted helminth infections

Water, sanitation, and hygiene (WASH) interventions have been proposed as an important complement to deworming programs for sustainable control of soil-transmitted helminth (STH) infections. We aimed to determine whether a community-based WASH program had additional benefits in reducing STH infections compared with community deworming alone. We conducted the WASH for WORMS cluster-randomized controlled trial in 18 rural communities in Timor-Leste. Intervention communities received a WASH intervention that provided access to an improved water source, promoted improved household sanitation, and encouraged handwashing with soap. All eligible community members in intervention and control arms received albendazole every 6 months for 2 years. The primary outcomes were infection with each STH, measured using multiplex real-time quantitative polymerase chain reaction. We compared outcomes between study arms using generalized linear mixed models, accounting for clustering at community, household, and individual levels. At study completion, the integrated WASH and deworming intervention did not have an effect on infection with Ascaris spp. (relative risk [RR] 2.87, 95% confidence interval [CI]: 0.66-12.48, P = 0.159) or Necator americanus (RR 0.99, 95% CI: 0.52-1.89, P = 0.987), compared with deworming alone. At the last follow-up, open defecation was practiced by 66.1% (95% CI: 54.2-80.2) of respondents in the control arm versus 40.2% (95% CI: 25.3-52.6) of respondents in the intervention arm (P = 0.005). We found no evidence that the WASH intervention resulted in additional reductions in STH infections beyond that achieved with deworming alone over the 2-year trial period. The role of WASH on STH infections over a longer period of time and in the absence of deworming remains to be determined

WASH for WORMS: a cluster-randomized controlled trial of the impact of a community integrated water, sanitation, and hygiene and deworming intervention on soil-transmitted helminth infections

Water, sanitation, and hygiene (WASH) interventions have been proposed as an important complement to deworming programs for sustainable control of soil-transmitted helminth (STH) infections. We aimed to determine whether a community-based WASH program had additional benefits in reducing STH infections compared with community deworming alone. We conducted the WASH for WORMS cluster-randomized controlled trial in 18 rural communities in Timor-Leste. Intervention communities received a WASH intervention that provided access to an improved water source, promoted improved household sanitation, and encouraged handwashing with soap. All eligible community members in intervention and control arms received albendazole every 6 months for 2 years. The primary outcomes were infection with each STH, measured using multiplex real-time quantitative polymerase chain reaction. We compared outcomes between study arms using generalized linear mixed models, accounting for clustering at community, household, and individual levels. At study completion, the integrated WASH and deworming intervention did not have an effect on infection with Ascaris spp. (relative risk [RR] 2.87, 95% confidence interval [CI]: 0.66-12.48, P = 0.159) or Necator americanus (RR 0.99, 95% CI: 0.52-1.89, P = 0.987), compared with deworming alone. At the last follow-up, open defecation was practiced by 66.1% (95% CI: 54.2-80.2) of respondents in the control arm versus 40.2% (95% CI: 25.3-52.6) of respondents in the intervention arm (P = 0.005). We found no evidence that the WASH intervention resulted in additional reductions in STH infections beyond that achieved with deworming alone over the 2-year trial period. The role of WASH on STH infections over a longer period of time and in the absence of deworming remains to be determined

Maria Elisabeth S. Weking. Studi Perencanaan Peningkatan Perkerasan Lentur Dengan Metode Bina Marga Dan Perkiraan Rencana Anggaran Biaya Pada Pembangunan Ruas Jalan Watowiti – Waiklibang Flores Timur Ntt (Sta 00+000 –

Jalan raya yang merupakan salah satu sarana transportasi darat adalah salah satu bagian yang terpenting dalam menumbuhkan, mendukung dan memperlancar laju pertumbuhan ekonomi suatu daerah. Menyikapi hal tersebut pembangunan dan pengembangan jalan menjadi salah satu prioritas pembangunan Nasional. Salah satu pembangunan jalan yang bisa dilakukan pemerintah adalah dengan meningkatkan kapasitas dan kualitas jalan itu sendiri. Kondisi perkerasan jalan pada ruas jalan Watowiti – Waiklibang Kecamatan Larantuka di berbagai tempat mengalami kerusakan yang dapat mengakibatkan kecelakaan bagi pengguna jalan tersebut. Kerusakan yang dimaksud adalah terdapat keretakan dan juga lubang – lubang pada permukaan aspal serta kerusakan banyak terjadi pada pinggiran jalan yang di akibatkan oleh banyaknya kendaraan berat yang melewati jalan tersebut karena kegiatan pembangunan jalan yang masih aktif setiap tahunnya berupa lalu lintas alat berat. selain itu terdapat tempat pengambilan pasir (quary), yang dapat menyebabkan arus lalu lintas kurang efektif sehingga menghambat arus mobilisasi, orang, barang dan jasa. Ruas jalan Watowiti - Waiklibang merupakan salah satu jalan Propinsi dan termasuk dalam jalan kolektor berdasarkan klasifikasi jalan fungsional di Indonesia dengan system jaringan jalan primer. Ruas jalan tersebut merupakan jalan luar kota, memiliki simpang tak bersinyal dan memiliki dua arah. Jalan tersebut terletak di Kecamatan Larantuka, sebagai akses jalan untuk menghubungkan daerah - daerah antar ibukota kabupaten/kota dan jalan strategis Propinsi. Disamping itu sebagai sarana penghubung untuk kepentingan masyarakat Kabupaten Flores Timur secara umum dan lebih khusus untuk masyarakat Larantuka dan sekitarnya. Dari hasil data lapangan dan perhitungan perencanaan perkerasan lentur dan biayanya pada jalan Watowiti - Waiklibang Kabupaten Flores Timur Provinsi Nusa Tenggara Timur di peroleh kesimpulan sebagai berikut : 1. Tebal perkerasan lentur dengan lebar jalan 6 meter menggunakan Lapis Aspal Beton (Laston) dan lapis pondasi dengan mutu kelas B adalah sebagai berikut : Sta 0+000 s/d Sta 01+600: TPL=12.2cm; TLPA = 20cm; TPB = 25cm Sta 01+600 s/d Sta03+000: TPL=12cm; TLPA = 20cm; TPB = 25cm 2. Total biaya pekerjaan perkerasan lentur adalah Rp. 20,385,934,231.50 (termasuk keuntungan dan Overhead 15% serta PPN 10%). Kata Kunci : Perkerasan Lentur, Campuran Lasto

Analisis Implementasi Model Bisnis On Demand Service Mobile Platform terhadap Tingkat Kepuasan Pelanggan Gojek di Indonesia

The influence of the role of technology today, bringing competition in the business world will be more stringent over time. Technology in the modern world is a very important role in supporting the company's business processes that will have a positive impact on the company. For example, business people in the field of transportation. PT. Gojek Indonesia is one of the online services transportation business that utilizes mobile technology platform to support the business process model on demand service used by Gojek companies so that the services provided to customers run well and in line with expectations of business opportunities in Indonesia. Gojek companies are examples of startup companies in Indonesia that use mobile platform technology. In this study using descriptive method that starts with a survey to find the necessary data such as the data downloader of the Gojek application in the play store and the reviews or comments given by the customer to the application. These data will then be analyzed to see the level of satisfaction of customers or users of mobile platform-based services

A cluster-randomised controlled trial integrating a community-based water, sanitation and hygiene programme, with mass distribution of albendazole to reduce intestinal parasites in Timor-Leste: the WASH for WORMS research protocol

INTRODUCTION: There is limited evidence demonstrating the benefits of community-based water, sanitation and hygiene (WASH) programmes on infections with soil-transmitted helminths (STH) and intestinal protozoa. Our study aims to contribute to that evidence base by investigating the effectiveness of combining two complementary approaches for control of STH: periodic mass administration of albendazole, and delivery of a community-based WASH programme. METHODS AND ANALYSIS: WASH for WORMS is a cluster-randomised controlled trial to test the hypothesis that a community-based WASH intervention integrated with periodic mass distribution of albendazole will be more effective in reducing infections with STH and protozoa than mass deworming alone. All 18 participating rural communities in Timor-Leste receive mass chemotherapy every 6 months. Half the communities also receive the community-based WASH programme. Primary outcomes are the cumulative incidence of infection with STH. Secondary outcomes include the prevalence of protozoa; intensity of infection with STH; as well as morbidity indicators (anaemia, stunting and wasting). Each of the trial outcomes will be compared between control and intervention communities. End points will be measured 2 years after the first albendazole distribution; and midpoints are measured at 6 months intervals (12 months for haemoglobin and anthropometric indexes). Mixed-methods research will also be conducted in order to identify barriers and enablers associated with the acceptability and uptake of the WASH programme. ETHICS AND DISSEMINATION: Ethics approval was obtained from the human ethics committees at the University of Queensland, Australian National University, Timorese Ministry of Health, and University of Melbourne. The results of the trial will be published in peer-reviewed journals presented at national and international conferences, and disseminated to relevant stakeholders in health and WASH programmes. This study is funded by a Partnership for Better Health--Project grant from the National Health and Research Council (NHMRC), Australia. TRIAL REGISTRATION NUMBER: ACTRN12614000680662; Pre-results