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Monday 24 August 2015

No one is safe from toilet diseases – Expert


In commemoration of the World Toilet Day held on Wednesday, the Secretary-General, Association of Public Health Physicians of Nigeria, Dr. Sunday Aderibigbe, speaks with MOTUNRAYO JOEL on toilet related diseases

What are some of the infections one can contract from using a dirty toilet?


 Toilet seats are not common vectors (transmission channels) of infections. If you use the toilet seat in the usual manner, it is very unlikely that you will become infected with any disease-causing microbe. The possibility of contracting a disease from a toilet seat is theoretically possible but extremely unlikely. One can be at risk of contracting infectious diseases (faeco-oral diseases) from dirty toilets not because of sitting on dirty toilet seats but from touching toilet surfaces with one’s hands. These are surfaces that have been contaminated by germs, for example the door knob on entering/exiting toilet or touching the tap attached to the sink. Faeco-oral diseases are infections that one can contract from using the toilet without observing the basic personnel hygiene. Examples of faeco-oral infections are cholera, dysentery, poliomyelitis, hepatitis A, hepatitis E, rotavirus gastroenteritis, salmonelosis, poliomyelitis, ascariasis,

 Which of there infections affects women more, and what are the symptoms, treatment?

 They all affect both sexes equally. The issue is they affect those with poor hand hygiene more. However, people especially women have a wrong notion that when they have vaginal discharge or itching, it is toilet disease. This is not true. Conditions that give these symptoms are most times not contacted by using dirty toilets but rather are either sexually transmitted or transmitted through formites or intimate contact with clothing of people who have such conditions.


Are children likely to get infected with the faeco-oral infections you mentioned earlier?
Yes they can have these faeco-oral diseases.
Can one contract Sexually Transmitted Diseases from dirty toilets?
No, one does not have to worry about contracting STDS such as herpes, gonorrhoea, syphilis and HIV through dirty toilet seats. These diseases are spread via unprotected skin to skin sexual contact. Most of the viruses or bacteria that cause them die very quickly outside the body so it is very unlikely that they can be transmitted through a dirty toilet seat.
Till date, people still use pit latrines, what infections are they likely to contract?
Again, they are prone to the faeco-oral infections. In actual fact they are more prone to these infections because contact with faeces is more common with usage of pit latrines than with conventional modern toilets.
What should be the proper state of a toilet?

There should be privacy, it should be properly designated (gender specific), clean, ventilated, odour free, vector (rat, flies) proof. There should be water and soap (preferably liquid or flake) for sanitation after use of the toilet.
How many people should share a toilet and why?
It may be difficult to give a specific figure because in public places like airports, hotels and so on, many people use the same toilets. The basic issue however is that when the toilet is used, it should be kept clean for the next person who is going to use it. Also there should be enough water to keep the hygiene intact.
Who are those more prone to toilet disease and why?
As I explained earlier, those who don’t adhere to basic hand hygiene principles are more prone to contracting infections from the toilet through the faeco-oral route.
Some people think open defecation is safer, that is, one can’t contract any infection. What is your take?
No, it is not true. One can contract infections like hookworm infestation and schistosomia from open area where people defecate. Also poor hygiene could result from not washing hands with soap and water post use of toilet. Furthermore, we are likely to do such commonly not far from our residence, organisms from these open air disposal of sewage may find their way to the water source and/or farms where they get back to us.
What can be done to discourage open defecation?
There should be health education for the populace on the dangers inherent in open defecation and then government at all levels should provide toilet facilities (VIP toilets most especially) within the limits of their resources. Communities too should be mobilised to provide toilet facilities in their communities because the government cannot provide everything. Most importantly these toilet facilities should be maintained and kept clean in order to prevent spread of infection. This means water supply would have to be maintained too at these facilities.
The state of toilets in some government schools is alarming, what is your advice to the government?
The government should ensure the provision of proper ratio of one toilet to about 30 students, with separate toilets for male and females. The toilet should be kept clean and maintained. There should be health education and re-education of personnel and environmental hygiene, most especially a lot should be emphasised on hand washing.
Can one get genital herpes from toilet seats?
Genital herpes is a sexually transmitted infection and is unlikely to be transmissible through toilet seats.
What are bladder infections?
A bladder infection, also known as cystitis, is a bacterial infection in the bladder. Though, some people call a bladder infection a urinary tract infection, which refers to a bacterial infection anywhere in the urinary tract, such as the bladder, kidneys, ureters, or the urethra. Bladder infections are caused by germs or bacteria that enter through the urethra and travel into the bladder.
Is bladder infection possible through toilet seats?
This is possible but very unlikely.
What is chalymdia and what are its symptoms and treatment?
Chlamydia is a sexually transmitted disease that should be treated quickly in order to avoid complications. It is caused by bacteria that are usually spread through sexual contact. People with chlamydia often don’t have any outward symptoms. Therefore, if somebody thinks they may have been exposed to the disease, you should get tested right away. People of all ages and both sexes can get chlamydia. However, having sexual relations with several partners without using protection can greatly increase the chances of contracting the disease. In addition, men and women under the age of 25 tend to have a higher risk of being infected with chlamydia. Women, in particular, also have a higher risk. Additionally, pregnant women can pass the bacteria to their babies when they are born.
Many people do not notice the symptoms of chlamydia. If symptoms do appear, they usually come between one to three weeks after one has been infected. Some of the most common symptoms include: burning feeling during urination, discharge from the penis or vagina, pain in the lower abdomen, painful sexual intercourse in women and pain in the testicles in men.
Since bacteria cause chlamydia, the disease can often be treated with antibiotics. No matter which antibiotic the victim is given, the dosage instructions have to be carefully complied with to make sure the infection clears up fully. This usually takes two weeks at most, during which time one will need to refrain from sexual contact.
What is the connection between inadequate toilets and outbreak of diseases?
When there are inadequate toilet facilities, the people resort to open defecation. When this happens, a number of things then follow; the faeces gets washed up into bodies of water which may be the only source of drinking water in that community and then when the people fetch such water for drinking, an outbreak of infections occur. Alternatively, flies and vermin may come into contact with the faeces and then come into the houses and rest on uncovered food thereby transmitting the diseases from the faeces unto the food. Again because people have direct contact with faecal matter, they are prone to having faeco-oral infections especially when hand hygiene is not maintained.
What is your view on people who build kitchens close to public toilets?
For all the reasons enumerated above, this should be discouraged. In most cases, these public toilets may not be maintained at the utmost level of hygiene and basic sanitation may not be maintained leading to transmission of diseases through flies.
Is it advisable to use public toilets?
The truth is that people would have to use it at one time or the other for example (airports, hotels, halls etc). The most important thing is to maintain these toilet facilities at the highest level of cleanliness and ensure that water supply and soap for washing hands are not lacking. Once these are ensured, then risk of infection becomes very low.
Source: PUNCH.

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