Emergency Response and Recovery Branch, Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA, USA.
United Nations High Commissioner for Refugees, Case Postale 2500, CH-1211 Genève 2 Dépôt, Geneva, Switzerland.
Int J Hyg Environ Health. 2021 May;234:113745. doi: 10.1016/j.ijheh.2021.113745. Epub 2021 Mar 31.
Given the increasing frequency and duration of humanitarian emergencies worldwide, there is a need to identify a greater range of effective and contextually appropriate water, sanitation and hygiene (WASH) interventions. Typical sanitation systems may be poorly suited for some of the conditions in which humanitarian emergencies can occur, such as in drought-prone regions. Urine-diversion dry toilets (UDDTs) are one potential alternative sanitation option which can be used in these conditions. Between 2014 and 2016, the U.S. Centers for Disease Control and Prevention (CDC) partnered with local agencies to evaluate the acceptability of UDDTs in a refugee camp in Ethiopia. The overall goals were to provide evidence regarding the level of adoption and satisfaction with UDDTs in this emergency context and the factors associated with satisfaction. Two cross-sectional surveys were conducted 18-months apart, using a stratified design to sample UDDT and latrine users for comparison. The proportion who reported to use their UDDT consistently was 88.8% (95% CI 85.1-92.5) in the first survey and 93.4% (95% CI 90.6-96.2) in the second survey. Reported satisfaction levels were significantly higher among respondents in the second survey (p < 0.0001), where 97.0% (95% CI 95.1-98.9) of respondents stated either that they were mostly or very satisfied with their UDDT. There was no significant difference detected in satisfaction between UDDT and latrine users (p = 0.28). Using a multivariable logistic regression model, we identified several factors associated with a higher level of satisfaction with UDDTs. Those who had previously (before coming to the camp) used a pit latrine (AOR = 4.2; 95% CI 1.4-12.7) or had no sanitation system (AOR = 2.4; 95% CI 1.3-4.4) relative to a pour-flush toilet, had a clean UDDT (AOR = 2.8; 95% CI 1.7-4.6), had been in the camp for a longer time period (AOR = 2.3; 95% CI 1.7-3.0), did not share their UDDT (AOR = 1.8; 95% CI 1.0-3.0) and had used their UDDT for a longer time period (AOR = 1.7; 95% CI 1.2-2.4) had higher odds of satisfaction. The findings demonstrate that UDDTs have been effectively introduced and utilized in this context and this may have implications for other humanitarian settings where they can be similarly managed.
鉴于全球人道主义紧急情况的频率和持续时间不断增加，需要确定更广泛的有效且符合具体情况的水、环境卫生和个人卫生（WASH）干预措施。典型的卫生系统可能不太适合人道主义紧急情况可能发生的某些情况，例如在干旱地区。尿液分流干式厕所（UDDT）是一种潜在的替代卫生选择，可以在这些情况下使用。2014 年至 2016 年期间，美国疾病控制与预防中心（CDC）与当地机构合作，在埃塞俄比亚的一个难民营评估 UDDT 的可接受性。总体目标是提供有关在这种紧急情况下采用和对 UDDT 的满意度的证据，以及与满意度相关的因素。使用分层设计，在两次相隔 18 个月的横断面调查中对 UDDT 和厕所使用者进行抽样比较。第一次调查中，报告一致使用 UDDT 的比例为 88.8%（95%CI 85.1-92.5），第二次调查中为 93.4%（95%CI 90.6-96.2）。第二次调查中报告的满意度水平显著更高（p<0.0001），97.0%（95%CI 95.1-98.9）的受访者表示对 UDDT 非常满意或基本满意。UDDT 和厕所使用者之间的满意度没有差异（p=0.28）。使用多变量逻辑回归模型，我们确定了与 UDDT 更高满意度相关的几个因素。与抽水马桶相比，那些在来营地之前（来营地之前）使用过坑式厕所（AOR=4.2；95%CI 1.4-12.7）或没有卫生系统（AOR=2.4；95%CI 1.3-4.4）的人，使用清洁的 UDDT（AOR=2.8；95%CI 1.7-4.6），在营地时间较长（AOR=2.3；95%CI 1.7-3.0），没有共用 UDDT（AOR=1.8；95%CI 1.0-3.0）且使用 UDDT 的时间较长（AOR=1.7；95%CI 1.2-2.4）的人满意度更高。研究结果表明，UDDT 在这种情况下已经得到有效引入和利用，这可能对其他可以类似管理的人道主义环境产生影响。
