A cross-sectional survey covering 976 households in 41 rural villages covered by the Rural Health Improvement Scheme in Sarawak was carried out to determine the type of latrines they have and their usage of pourflush latrines. The survey was carried out by inspection and interview. Fifty-six percent of the households had pourflush latrines and upon inspection 91.3% of them showed signs of recent use. Based on the interview, ninety percent of the women responded that they always use the latrine for defecation. It was also reported that 86.5% of the husbands and 47.6% of the children below five years, always used the latrine for defecation. The most common reason for not using the latrine among adults was the lack of water to flush the latrines as well as not being home when the need arises. The reason for using the latrines were to keep the compound clean, convenience and health reasons. It is recommended that building latrines continue to be a prerequisite for getting water supply under the program and that non health-related reasons be emphasized in health education which aim to motivate people to build and use the latrines.
An intensive health education programme geared towards increasing community's knowledge and inducing some changes in the attitude and behavioural factors towards the use of latrines.
Idiopathic chronic anal fissure is believed to be a consequence of a traumatic acute anodermal tear followed by recurrent inflammation and poor healing due to relative tissue ischaemia secondary to internal sphincter spasm. This pilot trial compared the efficacy of a novel manufactured ano-coccygeal support attached to a standard toilet seat (Colorec) to the standard procedure of lateral internal sphincterotomy (LIS) for chronic anal fissure.
Polyelectrolyte-complex bilayer membrane (PCBM) was fabricated using biodegradable chitosan and alginate polymers for subsequent application in the treatment of bathroom greywater. In this study, the properties of PCBMs were studied and it was found that the formation of polyelectrolyte network reduced the molecular weight cut-off (MWCO) from 242kDa in chitosan membrane to 2.71kDa in PCBM. The decrease in MWCO of PCBM results in better greywater treatment efficiency, subsequently demonstrated in a greywater filtration study where treated greywater effluent met the household reclaimed water standard of <2 NTU turbidity and <30ppm total suspended solids (TSS). In addition, a further 20% improvement in chemical oxygen demand (COD) removal was achieved as compared to a single layer chitosan membrane. Results from this study show that the biodegradable PCBM is a potential membrane material in producing clean treated greywater for non-potable applications.
The effect of toilets, piped water, and maternal literacy on infant mortality was analyzed using data from the Malaysian Family Life Survey collected in 1976-1977. The effect of toilets and piped water on infant mortality was dependent on whether or not mothers were literate. The impact of having toilets was greater among the illiterate than among the literate, but the impact of piped water was greater among the literate than among the illiterate. The effect on the infant mortality rate for toilets decreased from 130.7 +/- 17.2 deaths in the absence of literate mothers to 76.2 +/- 25.9 deaths in the presence of literate mothers. The reduction in the mortality rate for maternal literacy dropped from 44.4 +/- 14.1 deaths without toilets to -10.1 +/- 23.9 deaths with toilets. Reductions in mortality rates for piped water increased from 16.7 +/- 12.7 deaths without literate mothers to 36.8 +/- 21.0 deaths with literate mothers. Similarly, reductions in the mortality rate for maternal literacy rose from 44.4 +/- 14.1 deaths in the absence of piped water to 64.5 +/- 19.5 deaths in the presence of piped water. The results from a logistic model provided inferences similar to those from ordinary least squares. The authors infer that literate mothers protect their infants especially in unsanitary environments lacking toilets, and that when piped water is introduced, they use it more effectively to practice better hygiene for their infants.
Mothers' recall data collected in Malaysia in 1976-1977 are analyzed to study correlates of mortality of 5471 infants. Respondent population is 1262 women living in 52 primary sampling units of Peninsular Malaysia. Lengths of unsupplemented and supplemented breastfeeding and presence of piped household water and toilet sanitation are related to infant mortality in regressions that also control other correlates. The analysis is disaggregated into three periods of infancy. Through six months of feeding, unsupplemented breastfeeding is more strongly associated with fewer infant deaths than is supplemented breastfeeding. Type of sanitation is generally more strongly associated with mortality than is type of water supply. The effects of breastfeeding and the environmental variables are shown to be strongly interactive and to change systematically during the course of infancy. Breastfeeding is more strongly associated with infant survival in homes without piped water or toilet sanitation. In homes with both modern facilities, supplemented breastfeeding has no significant effect, and unsupplemented breastfeeding is statistically significant only for mortality in days 8-28. Presence of modern water and sanitation systems appears unimportant for mortality of infants who are breastfed without supplementation for six months.
Access to improved water and sanitation is essential. We describe these practices in Malaysia using data from a nationwide community survey and used logistic regression to assess the determinants. Of the 7978 living quarters (LQs), 58.3% were in urban areas. About 2.4%, 0.5% and 27.4% of LQs had non-improved water sources, non-improved toilet types and improper domestic waste disposal, respectively. Open burning was practiced by 26.1%. Water source was a problem for long houses (10.5%), squatters (8.5%) and shared houses (4.0%). Non-improved toilet types were 11.9% for squatters and 4.8% for shared houses. Improper domestic waste disposal practices were higher for occupants of village houses (64.2%), long houses (54.4%), single houses (45.8%) and squatters (35.6%). An increase in education or income level was associated with a decrease in improper domestic waste disposal methods. House type significantly affected water and sanitation after adjusting for the effects of other variables. Lower household income was associated with non-improved toilet types and improper domestic waste disposal. Lower education and rural location influenced domestic waste disposal. The water and toilet facilities in Malaysia were generally good, while domestic waste management practices could be improved. There remain pockets of communities with environmental challenges for the nation.
This paper presents the socio-economic profile of households in the Family Dynamics Study (FDS) (1997-2001) and makes comparisons with the earlier Functional Groups Study (FGS) (1992-1996). For the current study, FGS villages with a high prevalence of child malnutrition were purposively selected. In each village selected, all households were included, and interviews with a structured questionnaire were conducted in April-May 1998. Incomes were generally low and incidence of poverty was high; 49.6% of the households were under the poverty line income, of which 37.2% were poor and 12.4% were hard core poor. Overall, only 23.2% of heads of households were in agricultural occupations, others being primarily waged workers and petty traders. Livestock rearing was widespread (57.8%), and most households (90.4%) owned at least one motorised vehicle, the most common being the motorcycle. The majority of households had refrigerators (73.6%), washing machines (58.8%), and televisions (91.1%); but telephones (42.2%), mobile phones (6.1%) and computers (2.3%) were less common. Although 99.7% of households had electricity supply and 95.1% had either a flush or pour flush latrine, only 57.4% had piped water supply. In comparison to the FGS, poverty in the current study is lower (49.6% of FDS households are poor compared to 55.2% of FGS households), the proportion of household heads in agricultural occupations is also lower (26.9% compared to 55.3%), while all other socioeconomic indicators were better, except for piped water supply, which remains inadequate for households in the current study.