Human waste management in first phase response, protecting ground water and human health: a case study from Haiyan 2013

This briefing paper presents a case study of a Peepoo implementation in first phase humanitarian response. The case is taken from the Philippines, post typhoon Haiyan in 2013 and aims to demonstrate a safe way of handling of human waste without risking the contamination of water. This briefing paper will outline how the organisations, ACF, arche noVa, Oxfam and Red Cross implemented the Peepoo solution and lesson learnt so far. Some of the key lessons learnt in the projects were that; it is preferred to have the Peepoos stocked locally in order to have them available for phase one in humanitarian response; training implementing staff on Peepoo prior to the intervention increases the probability of success; and exit strategies must be set up in order to secure good sanitation practices after the implementing organisations stop distributing Peepoos

Pooled OR estimates in subgroups according to the diagnostic criteria for ID in studies assessing the association between maternal infection and ID in children.

Pooled OR estimates in subgroups according to the diagnostic criteria for ID in studies assessing the association between maternal infection and ID in children.</p

PRISMA flow chart showing study selection process.

PRISMA flow chart showing study selection process.</p

Sensitivity analysis after each study was excluded.

Sensitivity analysis after each study was excluded.</p

Pooled OR estimates in subgroups according to the publication year for studies assessing the association between maternal infection and ID in children.

Pooled OR estimates in subgroups according to the publication year for studies assessing the association between maternal infection and ID in children.</p

Main characteristics of included studies.

BackgroundThere is arguing evidence regarding the association between maternal infections during pregnancy and the risk of intellectual disability (ID) in children. This systematic review and meta-analysis are essential to determine and address inconsistent findings between maternal infections during pregnancy and the risk of ID in children.MethodsThe MOOSE and PRISMA guidelines were followed to perform and report on this study. The Medline/PubMed, Web of Science, Embase, and Scopus databases were searched from inception up to March 15, 2023, to identify potentially eligible studies. Inclusion and exclusion criteria were applied, as well as the Newcastle-Ottawa Scale was used to assess the methodological quality of studies included. The included studies were divided into two types based on the participants: (1) ID-based studies, which involved children with ID as cases and healthy children as controls and evaluated maternal infection in these participants; (2) infection-based studies, which assessed the prevalence or incidence of ID in the follow-up of children with or without exposure to maternal infection. We used Random-effects models (REM) to estimate the overall pooled odds ratio (OR) and 95% confidence intervals (CIs). The between-studies heterogeneity was assessed with the χ2-based Q-test and I2 statistic. Subgroup and sensitivity analyses were applied to explore the source of heterogeneity and results consistency.ResultsA total of eight studies including 1,375,662 participants (60,479 cases and 1,315,183 controls) met the eligibility criteria. The REM found that maternal infection significantly increased the risk of ID in children (OR, 1.33; 95% CI, 1.21–1.46; I2 = 64.6). Subgroup analysis showed a significant association for both infection-based (OR, 1.27; 95%CI, 1.15–1.40; I2 = 51.2) and ID-based (OR, 1.44; 95%CI, 1.19–1.74; I2 = 77.1) studies. Furthermore, subgroup analysis based on diagnostic criteria revealed a significant association when maternal infection or ID were diagnosed using ICD codes (OR, 1.33; 95% CI, 1.20–1.48; I2 = 75.8).ConclusionOur study suggests that maternal infection during pregnancy could be associated with an increased risk of ID in children. This finding is consistent across different types of studies and diagnostic criteria. However, due to the heterogeneity and limitations of the included studies, we recommend further longitudinal studies to confirm the causal relationship and the underlying mechanisms.</div

Search strategy.

BackgroundThere is arguing evidence regarding the association between maternal infections during pregnancy and the risk of intellectual disability (ID) in children. This systematic review and meta-analysis are essential to determine and address inconsistent findings between maternal infections during pregnancy and the risk of ID in children.MethodsThe MOOSE and PRISMA guidelines were followed to perform and report on this study. The Medline/PubMed, Web of Science, Embase, and Scopus databases were searched from inception up to March 15, 2023, to identify potentially eligible studies. Inclusion and exclusion criteria were applied, as well as the Newcastle-Ottawa Scale was used to assess the methodological quality of studies included. The included studies were divided into two types based on the participants: (1) ID-based studies, which involved children with ID as cases and healthy children as controls and evaluated maternal infection in these participants; (2) infection-based studies, which assessed the prevalence or incidence of ID in the follow-up of children with or without exposure to maternal infection. We used Random-effects models (REM) to estimate the overall pooled odds ratio (OR) and 95% confidence intervals (CIs). The between-studies heterogeneity was assessed with the χ2-based Q-test and I2 statistic. Subgroup and sensitivity analyses were applied to explore the source of heterogeneity and results consistency.ResultsA total of eight studies including 1,375,662 participants (60,479 cases and 1,315,183 controls) met the eligibility criteria. The REM found that maternal infection significantly increased the risk of ID in children (OR, 1.33; 95% CI, 1.21–1.46; I2 = 64.6). Subgroup analysis showed a significant association for both infection-based (OR, 1.27; 95%CI, 1.15–1.40; I2 = 51.2) and ID-based (OR, 1.44; 95%CI, 1.19–1.74; I2 = 77.1) studies. Furthermore, subgroup analysis based on diagnostic criteria revealed a significant association when maternal infection or ID were diagnosed using ICD codes (OR, 1.33; 95% CI, 1.20–1.48; I2 = 75.8).ConclusionOur study suggests that maternal infection during pregnancy could be associated with an increased risk of ID in children. This finding is consistent across different types of studies and diagnostic criteria. However, due to the heterogeneity and limitations of the included studies, we recommend further longitudinal studies to confirm the causal relationship and the underlying mechanisms.</div

Sub-group analysis of the pooled prevalence and odds ratios for the association between maternal infection and intellectual disability.

Sub-group analysis of the pooled prevalence and odds ratios for the association between maternal infection and intellectual disability.</p

Publication bias for four studies having adjusted odds ratio, indication that there is no publication bias in these studies.

Publication bias for four studies having adjusted odds ratio, indication that there is no publication bias in these studies.</p

Forest plot for the association between maternal infection and ID.

Subgroups are based on different type of studies (infection-based- and ID-based- studies). The center of each square represents the OR, the area of the square is the weighted percentage in the meta-analysis and the horizontal line indicates the 95% CI. % weight: weight of each study compared with all the studies.</p