Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-16 (of 16 Records) |
Query Trace: Gelting R[original query] |
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Global VAX: A U.S. contribution to global COVID-19 vaccination efforts, 2021-2023
Dahl BA , Tritter B , Butryn D , Dahlke M , Browning S , Gelting R , Fleming M , Ortiz N , Labrador J , Novak R , Fitter D , Bell E , McGuire M , Rosenbaum R , Pulwer R , Wun J , McCaffrey A , Chowdhury M , Parks N , Cunningham M , Mounts A , Curry D , Richardson D , Grant G . Vaccine 2024 In December 2021 the U.S. Government announced a new, whole-of-government $1.8 billion effort, the Initiative for Global Vaccine Access (Global VAX) in response to the global COVID-19 pandemic. Using the foundation of decades of U.S. government investments in global health and working in close partnership with local governments and key global and multilateral organizations, Global VAX enabled the rapid acceleration of the global COVID-19 vaccine rollout in selected countries, contributing to increased COVID-19 vaccine coverage in some of the world's most vulnerable communities. Through Global VAX, the U.S. Government has supported 125 countries to scale up COVID-19 vaccine delivery and administration while strengthening primary health care systems to respond to future health crises. The progress made by Global VAX has paved the way for a stronger global recovery and improved global health security. |
Topical Collection: Advancements in hydrogeological knowledge of Haiti for recovery and development
Adamson JK , Gutierrez A , Perez-Monforte S , Rodriquez-Vera M , LaVanchy GT , Jean-Baptiste G , Emmanuel E , Moliere E , Gelting R , Miner WJ , Dykstra S . Hydrogeol J 2022 30 (5) 1345-1348 Haiti’s groundwater resources are poorly understood and scarcely researched, despite their importance as the principal source for water supply. The knowledge gap and its role of inhibiting informed relief, recovery and investments in development are described, along with an update on progress towards the UN Sustainable Development Goals. This essay leads a topical collection of seven articles that advance hydrogeological knowledge of Haiti. Additional data, research and monitoring are identified as urgently needed for the nation’s sustainable development. © 2022, The Author(s). |
The impact of water sanitation and hygiene (WASH) improvements on hand hygiene at two Liberian hospitals during the recovery phase of an Ebola epidemic
Kanagasabai U , Enriquez K , Gelting R , Malpiedi P , Zayzay C , Kendor J , Fahnbulleh S , Cooper C , Gibson W , Brown R , Nador N , Williams DE , Chiriboga D , Niescierenko M . Int J Environ Res Public Health 2021 18 (7) Fourteen years of civil war left Liberia with crumbling infrastructure and one of the weakest health systems in the world. The 2014–2015 Ebola virus disease (EVD) outbreak exposed the vulnerabilities of the Liberian health system. Findings from the EVD outbreak highlighted the lack of infection prevention and control (IPC) practices, exacerbated by a lack of essential services such as water, sanitation, and hygiene (WASH) in healthcare facilities. The objective of this intervention was to improve IPC practice through comprehensive WASH renovations conducted at two hospitals in Liberia, prioritized by the Ministry of Health (MOH). The completion of renovations was tracked along with the impact of improvements on hand hygiene (HH) practice audits of healthcare workers pre-and post-intervention. An occurrence of overall HH practice was defined as the healthcare worker practicing compliant HH before and after the care for a single patient encounter. Liberia Government Hospital Bomi (LGH Bomi) and St. Timothy Government Hospital (St. Timothy) achieved World Health Organization (WHO) minimum global standards for environmental health in healthcare facilities as well as Liberian national standards. Healthcare worker (HCW) overall hand hygiene compliance improved from 36% (2016) to 89% (2018) at LGH Bomi hospital and from 86% (2016) to 88% (2018) at St. Timothy hospital. Improved WASH services and IPC practices in resource-limited healthcare settings are possible if significant holistic WASH infrastructure investments are made in these settings. |
"Back to the future": Time for a renaissance of public health engineering
Gelting RJ , Chapra SC , Nevin PE , Harvey DE , Gute DM . Int J Environ Res Public Health 2019 16 (3) Public health has always been, and remains, an interdisciplinary field, and engineering was closely aligned with public health for many years. Indeed, the branch of engineering that has been known at various times as sanitary engineering, public health engineering, or environmental engineering was integral to the emergence of public health as a distinct discipline. However, in the United States (U.S.) during the 20th century, the academic preparation and practice of this branch of engineering became largely separated from public health. Various factors contributed to this separation, including an evolution in leadership roles within public health; increasing specialization within public health; and the emerging environmental movement, which led to the creation of the U.S. Environmental Protection Agency (EPA), with its emphasis on the natural environment. In this paper, we consider these factors in turn. We also present a case study example of public health engineering in current practice in the U.S. that has had large-scale positive health impacts through improving water and sanitation services in Native American and Alaska Native communities. We also consider briefly how to educate engineers to work in public health in the modern world, and the benefits and challenges associated with that process. We close by discussing the global implications of public health engineering and the need to re-integrate engineering into public health practice and strengthen the connection between the two fields. |
Strengthening healthcare facilities through Water, Sanitation, and Hygiene (WASH) Improvements: A Pilot Evaluation of "WASH FIT" in Togo
Weber N , Martinsen AL , Sani A , Assigbley EKE , Azzouz C , Hayter A , Ayite K , Baba AAB , Davi KM , Gelting R . Health Secur 2018 16 S54-s65 Water, sanitation, and hygiene (WASH) services in healthcare facilities are essential to ensure quality health care and to facilitate infection, prevention, and control practices. They are critical to responding to outbreaks and preventing healthcare-associated infections and, therefore, critical to global health security. Many healthcare facilities in low- and middle-income settings have limited WASH services. One tool to address this issue is the World Health Organization (WHO) and United Nations Children's Fund (UNICEF) Water and Sanitation for Health Facility Improvement Tool, or "WASH FIT." WASH FIT is a continuous improvement tool based on key WHO environmental health and infection, prevention, and control standards. While using WASH FIT, internal teams regularly perform self-assessments at their facilities, using up to 65 WASH indicators to develop and implement an improvement plan. The Ministry of Health and Social Protection (MSPS) in Togo, with support from WHO and the US Centers for Disease Control and Prevention (CDC), piloted this tool in 3 healthcare facilities. The pilot included facility assessments at 3 time points and in-depth interviews and document review 7 months after initiating WASH FIT. Facilities made improvements without significant external financial or material support. On average, pilot facilities improved from 18% of total indicators meeting standards at baseline to 44% after 7 months. Examples included improved drinking water supply, medical waste segregation, and increased soap at handwashing stations. Participants reported improvements in staff and patient satisfaction, hand hygiene, and occupational safety. Findings suggest that WASH FIT, coupled with training and supervision, may help facilities improve WASH services and practices, thus contributing to global health security. Based on these findings, the Togolese MSPS plans to scale up nationwide. Les services d'eau, d'assainissement, et d'hygiene (WASH) dans les etablissements de sante sont essentiels pour assurer des soins de qualite et faciliter les pratiques de prevention et controle des infections. Ils sont essentiels pour repondre aux epidemies et prevenir les infections associees aux soins de sante, et donc a la securite sanitaire mondiale. De nombreux pays a revenu faible ou intermediaire ont des services WASH limites dans les etablissements de soins. Un outil recemment publie pour remedier cette situation est l'outil WASH FIT [Water and Sanitation for Health Facility Improvement Tool] de l'Organisation mondiale de la Sante (OMS) et le Fonds des Nations Unies (UNICEF) pour l'amelioration de l'eau et l'assainissement dans les formations sanitaires. WASH FIT est un outil d'amelioration continue base sur les normes de l'OMS en matiere de sante environnementale et de prevention et controle des infections. Lors de l'utilisation de WASH FIT, les equipes internes effectuent regulierement des auto-evaluations dans leurs installations en utilisant jusqu'a 65 indicateurs pour elaborer et mettre en oeuvre leur plan d'amelioration. Le ministere de la Sante et de la Protection Sociale (MSPS) du Togo, avec le soutien de l'OMS et les Centres pour le controle et la prevention des maladies (CDC), a fait un pilotage de cet outil dans 3 centres de sante. Ce pilotage comprenait 3 evaluations dans chaque formation sanitaire, des interviews approfondies, et une revue documentaire, 7 mois apres l'initiation du WASH FIT. Les formations sanitaires ont realise des progres, sans aide financiere ou materielle exterieure. En moyenne, les formations sanitaires sont passees de 18% des indicateurs atteignant les standards au depart, a 44% apres 7 mois. Les exemples incluent l'approvisionnement en eau potable, le tri des dechets medicaux, et le savon aux points de lavage des mains. Les participants ont signale des ameliorations dans la satisfaction du personnel et des patients, l'hygiene des mains, et la securite au travail. Les resultats indiquent que WASH FIT, associe a la formation et a la supervision, pourrait etre un outil pour aider les formations sanitaires a ameliorer les services et pratiques WASH, contribuant ainsi a la securite sanitaire mondiale. Sur la base de ces resultats, le MSPS prevoit une extension a l'echelle nationale. |
Applying a new framework for public health systems recovery following emergencies and disasters: The example of Haiti following a major earthquake and cholera outbreak
Fitter DL , Delson DB , Guillaume FD , Schaad AW , Moffett DB , Poncelet JL , Lowrance D , Gelting R . Am J Trop Med Hyg 2017 97 4-11 Emergencies can often directly impact health systems of an affected region or country, especially in resource-constrained areas. Health system recovery following an emergency is a complex and dynamic process. Health system recovery efforts have often been structured around the World Health Organization's health systems building blocks as demonstrated by the Post-Disaster Needs Assessment. Although this structure is valuable and well known, it can overlook the intricacies of public health systems. We retrospectively examine public health systems recovery, a subset of the larger health system, following the 2010 Haiti earthquake and cholera outbreak, through the lens of the 10 essential public health services. This framework illustrates the comprehensive nature of and helps categorize the activities necessary for a well-functioning public health system and can complement other assessments. Outlining the features of a public health system for recovery in structured manner can also help lay the foundation for sustainable long-term development leading to a more robust and resilient health system. |
A systems analysis of irrigation water quality in an environmental assessment of an E. coli O157: H7 outbreak in the United States linked to iceberg lettuce
Gelting RJ , Baloch MA , Zarate-Bermudez M , Hajmeer MN , Yee JC , Brown T , Yee BJ . Agric Water Manag 2015 150 (3) 111-118 A foodborne Escherichia coli O157:H7 outbreak in December 2006 included 77 illnesses reported in Iowa and Minnesota. Epidemiologic investigations by health departments in those states and the U.S. Centers for Disease Control and Prevention (CDC) identified shredded iceberg lettuce (Lactuca sativa L.) as the vehicle of transmission. The U.S. Food and Drug Administration (FDA) and Minnesota and California public health agencies traced the lettuce to several growing regions in California based on information from a lettuce processor in Minnesota.Samples from an environmental investigation initiated by the California Food Emergency Response Team (CalFERT) revealed a genetic match between the outbreak strain and environmental samples from a single farm, leading to an in-depth systems-based analysis of the irrigation water system on that farm. This paper presents findings from that systems-based analysis, which assessed conditions on the farm potentially contributing to contamination of the lettuce. The farm had three sources of irrigation water: groundwater from onsite wells, surface water delivered by a water management agency and effluent from wastewater lagoons on nearby dairy farms. Wastewater effluent was blended with the other sources and used only to irrigate animal feed crops. However, water management on the farm, including control of wastewater blending, appeared to create potential for cross-contamination. Pressure gradients and lack of backflow measures in the irrigation system might have created conditions for cross-contamination of water used to irrigate lettuce. The irrigation network on the farm had evolved over time to meet various needs, without an overall analysis of how that evolution potentially created vulnerabilities to contamination of irrigation water. The type of systems analysis described here is one method for helping to ensure that such vulnerabilities are identified and addressed. A preventive, risk-based management approach, such as the Water Safety Plan process for drinking water, may also be useful in managing irrigation water quality. |
Sustainability of water, sanitation and hygiene interventions in Central America
Sabogal RI , Medlin E , Aquino G , Gelting RJ . J Water Sanit Hyg Dev 2014 4 (1) 89-99 The American Red Cross and U. S. Centers for Disease Control and Prevention collaborated on a sustainability evaluation of post-hurricane water, sanitation and hygiene (WASH) interventions in Central America. In 2006 and 2009, we revisited six study areas in rural El Salvador, Guatemala, Honduras and Nicaragua to assess sustainability of WASH interventions finalized in 2002, after 1998's Hurricane Mitch. We used surveys to collect data, calculate indicators and identify factors that influence sustainability. Regional sustainability indicator results showed there was a statistically significant decline in access to water. The presence of sanitation facilities had not changed since the beginning of the project; however, maintenance and use of latrines declined but continued to meet the goal of 75% use after 7 years. The hygiene indicator, hand washing, initially declined and then increased. Declines in water access were due to operational problems related to storm events and population changes. Sanitation facilities were still present and sometimes used even though they reached or surpassed their original design life. Changes in hygiene practices appeared related to ongoing hygiene promotion from outside organizations. These results provide useful input for making WASH programs more sustainable and informing future, more in-depth research into factors influencing sustainability. |
Development of Haiti's rural water, sanitation and hygiene workforce
Hubbard B , Lockhart G , Gelting RJ , Bertrand F . J Water Sanit Hyg Dev 2014 4 (1) 159-163 In 2009 the Haitian Directorate of Potable Water and Sanitation (DINEPA) identified an inadequately trained and under-staffed rural workforce as one of their main institutional challenges. Plans to address this challenge were impacted by the devastating earthquake of January 12, 2010 and the cholera outbreak of October 2010, both of which further complicated Haiti's already poor water and sanitation conditions. Recognizing the importance of DINEPA's institutional priorities, donor and technical assistance groups provided needed support to improve the country's conditions and build the rural water and sanitation workforce. This report describes how DINEPA and the US Centers for Disease Control and Prevention (CDC) collaborated to design and implement a training program for 264 potable water and sanitation technicians for rural areas. The paper also describes the initial field activities of the newly trained technicians and the immediate impact of their work in the rural water, sanitation and hygiene sector. |
Development of indicators for measuring outcomes of water safety plans
Lockhart G , Oswald WE , Hubbard B , Medlin E , Gelting RJ . J Water Sanit Hyg Dev 2014 4 (1) 171-181 Water safety plans (WSPs) are endorsed by the World Health Organization as the most effective method of protecting a water supply. With the increase in WSPs worldwide, several valuable resources have been developed to assist practitioners in the implementation of WSPs, yet there is still a need for a practical and standardized method of evaluating WSP effectiveness. In 2012, the Centers for Disease Control and Prevention (CDC) published a conceptual framework for the evaluation of WSPs, presenting four key outcomes of the WSP process: institutional, operational, financial and policy change. In this paper, we seek to operationalize this conceptual framework by providing a set of simple and practical indicators for assessing WSP outcomes. Using CDC's WSP framework as a foundation and incorporating various existing performance monitoring indicators for water utilities, we developed a set of approximately 25 indicators of institutional, operational, financial and policy change within the WSP context. These outcome indicators hold great potential for the continued implementation and expansion of WSPs worldwide. Having a defined framework for evaluating a WSP's effectiveness, along with a set of measurable indicators by which to carry out that evaluation, will help implementers assess key WSP outcomes internally, as well as benchmark their progress against other WSPs in their region and globally. |
Water, sanitation and hygiene in Haiti: past, present, and future
Gelting R , Bliss K , Patrick M , Lockhart G , Handzel T . Am J Trop Med Hyg 2013 89 (4) 665-70 Haiti has the lowest rates of access to improved water and sanitation infrastructure in the western hemisphere. This situation was likely exacerbated by the earthquake in 2010 and also contributed to the rapid spread of the cholera epidemic that started later that same year. This report examines the history of the water, sanitation, and hygiene (WASH) sector in Haiti, considering some factors that have influenced WASH conditions in the country. We then discuss the situation sine the earthquake and subsequent cholera epidemic, and the responses to those events. Finally, drawing on Haiti's National Plan of Action for the Elimination of Cholera in Haiti 2013-2022, we suggest some actions that could help bring about long-term WASH improvements for the future. Because the current WASH situation has evolved over decades of limited attention and resources, it will take a long-term, sustained effort to improve the situation. |
The food-water nexus: irrigation water quality, risks to food safety, and the need for a systems-based preventive approach
Gelting RJ , Baloch MA . J Environ Health 2012 75 (3) 40-41 This year’s World Water Day focused on | the food-water nexus with the theme | “Water and Food Security: The World is | Thirsty Because We are Hungry.” While much | of the emphasis under this theme focused on | the quantities of water used for food production, the quality of water is also important to | that function. Water quality can also have significant effects on health. In this context, the | quality of irrigation water can have profound | impacts on the microbiological integrity of | food. Irrigation water has been implicated as a | possible source of pathogens in produce linked | to major disease outbreaks in the U.S. and Europe. Many sources of irrigation water are subject to inputs of pathogenic loads from point | and nonpoint sources stemming from multiple | land uses in watersheds (Pachepsky, Shelton, | Mclain, Patel, & Mandrell, 2011). Research on | the potential effects of irrigation water quality on food safety therefore requires a systemsbased environmental assessment on the watershed scale that accounts for various factors that | may influence irrigation water quality. |
Water Safety Plan demonstration projects in Latin America and the Caribbean: lessons from the field
Rinehold A , Corrales L , Medlin E , Gelting RJ . Water Supply 2011 11 (3) 297-308 A Water Safety Plan (WSP) is a preventive, risk management approach to ensure drinking water safety. This emerging methodology is being increasingly applied in both industrialized and lower income countries worldwide. In 2006, the U.S. Centers for Disease Control and Prevention (CDC) and other local, national, and international partners in Latin America and the Caribbean (LAC) initiated a series of WSP demonstration projects. The objectives were to raise WSP awareness, build capacity, and promote adoption of the WSP approach while identifying those factors that aid or hinder water safety planning efforts in resource-challenged settings. This paper presents eleven lessons learned from these WSP demonstration projects, including the importance of assembling a well-supported interagency team, long-term commitment to WSP implementation, adherence to a water quality monitoring plan, and determining how WSP impacts will be evaluated prior to WSP initiation. To assist in supporting future WSP activity in the region, this paper shares experiences that led to these successes, challenges, and lessons learned. |
Irrigation water issues potentially related to the 2006 multistate E. coli O157:H7 outbreak associated with spinach
Gelting RJ , Baloch MA , Zarate-Bermudez MA , Selman C . Agric Water Manag 2011 98 (9) 1395-1402 A multistate Escherichia coli O157:H7 outbreak in August and September 2006 was found to be associated with consumption of fresh bagged spinach traced to California. The California Food Emergency Response Team (CALFERT), consisting of personnel from the California Department of Public Health Food and Drug Branch (FDB) and the U.S. Food and Drug Administration (FDA) undertook an environmental investigation to determine how and why the spinach became contaminated. At the invitation of FDA and FDB, the Centers for Disease Control and Prevention (CDC) also participated in the environmental investigation. This paper presents findings from the portion of the environmental investigation focusing on environmental factors related to irrigation water that may have contributed to contamination of the spinach and hence to the outbreak. Analysis of the available data suggests that depths to groundwater and groundwater-surface water interactions may pose risks to ready-to-eat crops. These risks should be further evaluated and quantified to understand and identify the factors that contributed to this and similar outbreaks. One implication of this analysis is the need to continue to conceptually broaden the scope of produce-related outbreak investigations. Where feasible, investigation strategies should integrate possible contamination sources beyond those actually found on the farms that are identified as sources of produce involved in outbreaks. |
A community demand-driven approach toward sustainable water and sanitation infrastructure development
Hubbard B , Sarisky J , Gelting R , Baffigo V , Seminario R , Centurion C . Int J Hyg Environ Health 2011 214 (4) 326-34 In September 2001, Cooperative Assistance and Relief Everywhere, Peru Country Office (CARE Peru), obtained funding from the United States Agency for International Development (USAID) to implement community-supported, condominial water and sanitation interventions in Manuel Cardozo Davila, a settlement in Iquitos, Peru. With technical support from the Centers for Disease Control and Prevention (CDC), CARE Peru's Urban Environmental Health Models (Modelos Urbanos de Salud Ambiental [MUSA]) project built on previous work from implementing the Protocol for Assessing Community Excellence in Environmental Health in this same community. The project led to the municipal water supply distribution system being extended 1.3 kilometers into the Southern zone of Iquitos, where it connected to the condominial water system. Altogether, 1030 households were connected to the water supply system after the installation of a condominial water and sewerage system in Cardozo. Diarrheal disease decreased by 37% for children less than 5 years of age from 2003 to 2004. This paper illustrates the strategy used by CARE Peru in conjunction with the Cardozo community to assure that the local demand for improved water and sanitation was met. |
Water safety plans: CDC's role
Gelting R . J Environ Health 2009 72 (4) 44-5 Working with numerous public health | partners, the Centers for Disease | Control and Prevention (CDC) recently began a new initiative to support implementation of Water Safety Plans (WSPs) | in Latin American and Caribbean countries. | WSPs are a relatively new methodology being | promoted by the World Health Organization | (WHO) to assess and manage risk factors in | drinking water systems from source to consumer (Figure 1). Each year, poor water quality and inadequate sanitation and hygiene | account for 1.8 million deaths worldwide | among children. These poor water conditions have significant economic effects, not | only due to lost wages from illness but also | from time spent gathering water (mostly by | women and girls) for household use. In Latin | America and the Caribbean, an estimated 50 | million persons lack access to an improved | water supply. |
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