Oliver Cummings
Biographic Data
| ID | 1734356 |
|---|---|
| NAME | Oliver Cummings |
| GIVEN NAMES | Oliver |
| FAMILY NAME | Cummings |
| SIGNATURE | CUMMINGS O |
| AFFILIATIONS | London School of Hygiene & Tropical Medicine |
| ORCID | 0000-0002-5074-8709 |
| VERIFIED | Yes |
| TOTAL WORKS | 46 |
| TOTAL CITATIONS | 7 |
| AUTHOR COUNT | 46 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2013 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 2 |
Hazard analysis and critical control points for foods consumed by children aged 6–24 months in Maputo, Mozambique
Diarrhoeal disease remains a significant cause of mortality among children under five, particularly in high-burden settings where food consumed by young children is frequently contaminated. Understanding food preparation, feeding, and storage practices for children aged 6–24 months is essential to inform interventions that reduce diarrhoeal disease. Using the Hazard Analysis and Critical Control Points (HACCP) approach, we identified critical con…
Enablers and barriers of handwashing with soap in low-income settlements of Mombasa, Kenya
Handwashing with soap (HWWS) is an effective public health preventive measure. Review studies indicate that interventions on handwashing with soap reduce the risk of diarrhoeal diseases by approximately 30% and respiratory tract infections by up to 17% (Ross, Bick, Ayieko, et al., 2023; Wolf, Hubbard, Brauer, et al., 2022). Studies have also shown that HWWS, combined with interventions on water and sanitation, results in improved growth outcomes …
Effectiveness of domestic food hygiene interventions on the microbiological quality of child food and childhood diarrhoea
Background Foodborne diseases are an important cause of global morbidity and mortality, particularly among children who often experience diarrhoeal illnesses linked to foodborne enteric infections. Evidence on the effectiveness of interventions to reduce diarrhoea remains limited. This review synthesised evidence on the effectiveness of domestic food hygiene interventions on microbiological quality of child food and diarrhoea in children under fi…
Genomic diversity of diarrheagenic multidrug-resistant Escherichia coli across asymptomatic children and livestock in Nairobi, Kenya
Diarrheagenic Escherichia coli represents a critical public health threat, yet their genomic characteristics in community settings remain poorly described. We sequenced 77 multidrug-resistant isolates from children (n = 59), livestock (n = 17), and food (n = 1) in peri-urban Nairobi, Kenya. Phylogenetic analysis revealed polyphyletic diversity across phylogroups and sequence types without host-specific clustering. We detected high-risk lineages S…
Behavioural factors influencing hand hygiene practices across domestic, institutional and public community settings
INTRODUCTION: This systematic review sought to understand barriers and enablers to hand hygiene in community settings. METHODS: Eligible studies addressed hand hygiene in a community setting, included a qualitative component, and were published in English between 1 January 1980 and 29 March 2023. Studies were excluded if in healthcare settings or were animal research. We searched PubMed, Web of Science, EMBASE, CINAHL, Global Health, Cochrane Lib…
We have the evidence but governments must now build the systems to deliver on hand hygiene
Featured VideoDisclaimer: this video summarises a scientific article published by BMJ Publishing Group Limited (BMJ)
Minimum material requirements for hand hygiene in community settings
BACKGROUND: This systematic review assessed the minimum requirements necessary to create an enabling environment for sustained hand hygiene practices: quantity of water and soap, and number, spacing, location, and design of hand hygiene facilities. METHODS: We searched PubMed, Web of Science, EMBASE, CINAHL, Global Health, Cochrane Library, Global Index Medicus, Scopus, PAIS Index, WHO IRIS, UN Digital Library and World Bank eLibrary, and consult…
Efficacy and effectiveness of hand hygiene-related practices used in community settings for removal of organisms from hands
Background This systematic review collected and synthesised evidence on the efficacy and effectiveness of commonly used hand hygiene materials and methods for removing or inactivating pathogens on hands in community settings. The evidence was generated to support the development of the WHO Guidelines for Hand Hygiene in Community Settings. Methods We searched PubMed, Web of Science, EMBASE, CINAHL, Global Health, Cochrane Library, Global Index Me…
Effectiveness of measures taken by governments to support hand hygiene in community settings
INTRODUCTION: This systematic review aimed to identify and evaluate the implementation of government measures that support equitable and sustained hand hygiene practices in community settings. METHODS: We systematically searched 12 databases, including PubMed, Web of Science, EMBASE, CINAHL, Global Health, Cochrane Library, Global Index Medicus, Scopus, PAIS Index, WHO IRIS, UN Digital Library and World Bank eLibrary for peer-reviewed and grey li…
Interventions to improve hand hygiene in community settings
INTRODUCTION: This systematic review identified and examined the theories, barriers and enablers, behaviour change techniques (BCTs), and design features of interventions that have been leveraged to improve and sustain hand hygiene in community settings. It was conducted to support the development of the WHO Guidelines for Hand Hygiene in Community Settings. METHODS: We searched PubMed, Web of Science, EMBASE, CINAHL, Global Health, Cochrane Libr…
Gender equality and quality of life must be central to the design and delivery of sanitation
box Sanitation is critical to improving quality of life and gender equality
Determinants of access to basic handwashing facilities and handwashing with soap in low-income areas of four Kenyan cities
Handwashing with soap is an effective public health measure against infectious disease and is enabled by availability of handwashing facilities, soap and sufficient water. However, access to handwashing facilities in low-income urban areas is often low, which hinders effective handwashing with soap. We assessed access to basic handwashing facilities and handwashing with soap practices in low-income areas across four cities in Kenya. A cross-secti…
Validity of a visual analogue scale to measure and value the perceived level of sanitation
Two billion people globally lack access to a basic toilet, and sanitation is a critical determinant of health and well-being. Evaluations of sanitation programmes typically measure disease or behaviour, and visual analogue scales (VASs) have not been used to measure users’ feelings about their level of sanitation. In this study, we assess the validity of a horizontal sanitation VAS numbered 0–10, with end anchors ‘best imaginable’ and ‘worst imag…
Association of Water, Sanitation, Hygiene and Animal Ownership With Relapse to Acute Malnutrition Among Children Aged 6–59 Months in Mali, South Sudan and Somalia
Children successfully treated through community-based management of acute malnutrition (CMAM) frequently relapse to acute malnutrition (AM) following recovery and discharge. This prospective cohort study examined associations between relapse and household water, sanitation and hygiene (WASH) conditions, as well as animal ownership, in Mali, South Sudan and Somalia. Between April 2021 and June 2022, 1115 children were enrolled, with 964 children f…
Integration of a Wash Component in the Standard National Protocol for Treatment of Severe Acute Malnutrition in Children Aged 6–59 Months in Northern Senegal—A Costing Study
Severe acute malnutrition (SAM) affects 12.2 million children globally. Integrating a water, sanitation and hygiene (WASH) kit in outpatient SAM treatment can improve recovery rates by preventing WASH-related diseases and complications, but its cost at scale remains unknown. This study estimates the cost of integrating a WASH kit, composed of chlorine-based water treatment, safe water storage with a lid, soap, and a hygiene promotion component in…
Water, sanitation and hygiene (Wash)
Despite some progress, universal access to safe water, sanitation and hygiene (WASH) by 2030—a remit of Sustainable Development Goal 6—remains a distant prospect in many countries. Policy-makers and implementers of the WASH sector are challenged to track a new path. This research aimed to identify core orienting themes of the sector, as legacies of past processes, which can provide insights for its future. We reviewed global policy, science and p…
Associations between Shared Sanitation, Stunting and Diarrhoea in Low-Income, High Density Urban Neighbourhoods of Maputo, Mozambique - a Cross-Sectional Study
Use of an improved shared latrine is associated with decreased odds of stunting. There is no evidence of an association between latrine improvement and diarrhoea. Further investigation is necessary to isolate attributes of shared sanitation facilities that may reduce health risks
How can global guidelines support sustainable hygiene systems
One Health Wash
While the One Health framework is now widely accepted as a strength in understanding antimicrobial resistance (AMR), its application in intervention design to prevent and control drug-resistant infections across humans, animals, and the environment remains weak. The potential for infection prevention and control measures to contribute to the AMR agenda is recognised in rhetoric, but evidence to guide action is patchy and uncoordinated. While wate…
A cluster-randomised controlled equivalence trial of the Surprise Soap handwashing intervention among older children living in a refugee settlement in Sudan
INTRODUCTION: Increasing handwashing with soap (HWWS) among older children in emergency settings can have a large public health impact, however, evidence on what works is limited. One promising approach is the 'Surprise Soap' intervention in which a novel soap with an embedded toy is delivered to children in a short, participatory household session that includes a glitter game and HWWS practice. Here, we evaluate this intervention against a stand…
Risk factors for diarrheagenic Escherichia coli infection in children aged 6–24 months in peri-urban community, Nairobi, Kenya
Escherichia coli commonly inhabits the gut of humans and animals as part of their microbiota. Though mostly innocuous, some strains have virulence markers that make them pathogenic. This paper presents results of a cross-sectional epidemiological study examining prevalence of diarrheagenic E . coli (DEC) pathotypes in stool samples of asymptomatic healthy children (n = 540) in Dagoretti South subcounty, Nairobi, Kenya. E . coli was cultured and p…
Risk factors for food contamination among children discharged from community management of acute malnutrition programmes in South Sudan
Children under-5 years of age are particularly vulnerable to severe acute malnutrition (SAM), and the risk factors associated with relapse to SAM are poorly understood. Possible causes are asymptomatic or symptomatic infection with enteric pathogens, with contaminated food as a critical transmission route. This cross-sectional study comprised a household survey with samples of child food (n = 382) and structured observations of food preparation (…
Milk Product Safety and Household Food Hygiene Influence Bacterial Contamination of Infant Food in Peri-Urban Kenya
BACKGROUND: Milk is a common infant food in peri-urban Kenya that can transmit diarrhea-causing enteric pathogens. Little is known about how contamination of milk at point of purchase and household handling of milk-based infant foods contribute to infant exposure to enteric pathogens. OBJECTIVE: To compare the prevalence and concentrations of bacterial indicator organisms and enteric pathogens in unpackaged, fresh pasteurized, and ultra-high temp…
A Mixed Methods Process Evaluation of a Food Hygiene Intervention in Low-Income Informal Neighbourhoods of Kisumu, Kenya
Future interventions should seek to explicitly target contextual factors such as secondary caregivers and promote food hygiene interventions as independent of each other
Using path analysis to test theory of change
MapSan trial registration: NCT02362932 Feb-13-2015
How does sanitation influence people's quality of life? Qualitative research in low-income areas of Maputo, Mozambique
Preventing infectious disease has often been the primary rationale for public investment in sanitation. However, broader aspects of sanitation such as privacy and safety are important to users across settings, and have been linked to mental wellbeing. The aim of this study is to investigate what people most value about sanitation in low-income areas of Maputo, Mozambique, to inform a definition and conceptual model of sanitation-related quality o…
Water and Sanitation in Urban America, 2017–2019
Objectives. To estimate the population lacking at least basic water and sanitation access in the urban United States. Methods. We compared national estimates of water and sanitation access from the World Health Organization/United Nations Children’s Fund Joint Monitoring Program with estimates from the US Department of Housing and Urban Development on homelessness and the American Community Survey on household water and sanitation facilities. Res…
Open Defecation and Childhood Stunting in India
Poor sanitation remains a major public health concern linked to several important health outcomes; emerging evidence indicates a link to childhood stunting. In India over half of the population defecates in the open; the prevalence of stunting remains very high. Recently published data on levels of stunting in 112 districts of India provide an opportunity to explore the relationship between levels of open defecation and stunting within this popul…
Systematic review
Effectiveness of a rural sanitation programme on diarrhoea, soil-transmitted helminth infection, and child malnutrition in Odisha, India
BACKGROUND: A third of the 2·5 billion people worldwide without access to improved sanitation live in India, as do two-thirds of the 1·1 billion practising open defecation and a quarter of the 1·5 million who die annually from diarrhoeal diseases. We aimed to assess the effectiveness of a rural sanitation intervention, within the context of the Government of India's Total Sanitation Campaign, to prevent diarrhoea, soil-transmitted helminth infect…
Burden of disease from inadequate water, sanitation and hygiene in low‐ and middle‐income settings
Systematic review
Pit Latrine Emptying Behavior and Demand for Sanitation Services in Dar Es Salaam, Tanzania
Pit latrines are the main form of sanitation in unplanned areas in many rapidly growing developing cities. Understanding demand for pit latrine fecal sludge management (FSM) services in these communities is important for designing demand-responsive sanitation services and policies to improve public health. We examine latrine emptying knowledge, attitudes, behavior, trends and rates of safe/unsafe emptying, and measure demand for a new hygienic la…
The cost of a knowledge silo
Divisions between communities, disciplinary and practice, impede understanding of how complex interventions in health and other sectors actually work and slow the development and spread of more effective ones. We test this hypothesis by re-reviewing a Cochrane-standard systematic review (SR) of water, sanitation and hygiene (WASH) interventions' impact on child diarrhoea morbidity: can greater understanding of impacts and how they are achieved be…
Impact of drinking water, sanitation and handwashing with soap on childhood diarrhoeal disease
Shared latrines in Maputo, Mozambique
BACKGROUND: Approximately 18% of Sub-Saharan Africa's urban population relies on shared sanitation facilities, which are shared by one or more households. While there is growing recognition of sanitation's relationship with stress and well-being - particularly among women - most research has focused on rural populations and the transition from open defecation and/or unimproved latrines to private shared sanitation. This study explores sanitation-…
Setting priorities for humanitarian water, sanitation and hygiene research
Recent systematic reviews have highlighted a paucity of rigorous evidence to guide water, sanitation and hygiene (WASH) interventions in humanitarian crises. In June 2017, the Research for Health in Humanitarian Crises (R2HC) programme of Elrha, convened a meeting of representatives from international response agencies, research institutions and donor organisations active in the field of humanitarian WASH to identify research priorities, discuss …
Shared Sanitation Management and the Role of Social Capital
Shared sanitation-sanitation facilities shared by multiple households-is increasingly common in rapidly growing urban areas in low-income countries. However, shared sanitation facilities are often poorly maintained, dissuading regular use and potentially increasing disease risk. In a series of focus group discussions and in-depth interviews, we explored the determinants of shared sanitation management within the context of a larger-scale health i…
Oral Contact Events and Caregiver Hand Hygiene
Childhood diarrhea is one of the leading causes of morbidity and mortality in children under five in low and middle-income countries, second only to respiratory illness. The mouthing behavior that is common in children exposes them to fecal-orally transmitted pathogens that can result in diarrhea; however, there is a need for further evidence on specific exposure routes. This study describes the frequency and diversity of two important routes of …
The implications of three major new trials for the effect of water, sanitation and hygiene on childhood diarrhea and stunting
BACKGROUND: Three large new trials of unprecedented scale and cost, which included novel factorial designs, have found no effect of basic water, sanitation and hygiene (WASH) interventions on childhood stunting, and only mixed effects on childhood diarrhea. Arriving at the inception of the United Nations' Sustainable Development Goals, and the bold new target of safely managed water, sanitation and hygiene for all by 2030, these results warrant t…
Burden of disease from inadequate water, sanitation and hygiene for selected adverse health outcomes
BACKGROUND: To develop updated estimates in response to new exposure and exposure-response data of the burden of diarrhoea, respiratory infections, malnutrition, schistosomiasis, malaria, soil-transmitted helminth infections and trachoma from exposure to inadequate drinking-water, sanitation and hygiene behaviours (WASH) with a focus on low- and middle-income countries. METHODS: For each of the analysed diseases, exposure levels with both suffici…
Hygiene During Childbirth
Background: Infections acquired during labour and delivery are a significant cause of maternal and child morbidity and mortality. Adherence to hand hygiene protocols is a critical component of infection prevention strategies, but few studies have closely examined the hand hygiene of health care providers with sufficient detail to understand infection risks and prioritize prevention strategies. Methods: This observational study was conducted in si…
Enteric Pathogen Diversity in Infant Foods in Low-Income Neighborhoods of Kisumu, Kenya
Pediatric diarrheal disease remains the second most common cause of preventable illness and death among children under the age of five, especially in low and middle-income countries (LMICs). However, there is limited information regarding the role of food in pathogen transmission in LMICs. For this study, we examined the frequency of enteric pathogen occurrence and co-occurrence in 127 infant weaning foods in Kisumu, Kenya, using a multi-pathogen…
Distribution of hygiene kits during a cholera outbreak in Kasaï-Oriental, Democratic Republic of Congo
Between Week (W) 28-48 of the 2018 cholera outbreak in Kasaï-Oriental, there were 667 suspected cholera cases with a 5% case fatality rate (CFR). Across seven HCFs supported by MSF, 196 patients were admitted with suspected cholera between W43-W47 and hygiene kit were provided to patients upon admission and health promotion at the HCF was conducted to accompanying household contacts 5-6 times per day. Distribution of hygiene kits was limited and …
Risk factors for child food contamination in low‐income neighbourhoods of Maputo, Mozambique
In low- and middle-income countries, food may be a critical transmission route for pathogens causing childhood diarrhoea, but basic food hygiene is often overlooked in public health strategies. Characterising child food contamination and its risk factors could help prioritise interventions to reduce foodborne diarrhoeal disease, especially in low-income urban areas where the diarrhoeal disease burden is often high. This cross-sectional study comp…
Water and Sanitation in Urban America, 2017–2019
Objectives. To estimate the population lacking at least basic water and sanitation access in the urban United States. Methods. We compared national estimates of water and sanitation access from the World Health Organization/United Nations Children’s Fund Joint Monitoring Program with estimates from the US Department of Housing and Urban Development on homelessness and the American Community Survey on household water and sanitation facilities. Res…
Using path analysis to test theory of change
MapSan trial registration: NCT02362932 Feb-13-2015
Effectiveness of behaviour change techniques used in hand hygiene interventions targeting older children – A systematic review
How does sanitation influence people's quality of life? Qualitative research in low-income areas of Maputo, Mozambique
Preventing infectious disease has often been the primary rationale for public investment in sanitation. However, broader aspects of sanitation such as privacy and safety are important to users across settings, and have been linked to mental wellbeing. The aim of this study is to investigate what people most value about sanitation in low-income areas of Maputo, Mozambique, to inform a definition and conceptual model of sanitation-related quality o…
Milk Product Safety and Household Food Hygiene Influence Bacterial Contamination of Infant Food in Peri-Urban Kenya
BACKGROUND: Milk is a common infant food in peri-urban Kenya that can transmit diarrhea-causing enteric pathogens. Little is known about how contamination of milk at point of purchase and household handling of milk-based infant foods contribute to infant exposure to enteric pathogens. OBJECTIVE: To compare the prevalence and concentrations of bacterial indicator organisms and enteric pathogens in unpackaged, fresh pasteurized, and ultra-high temp…
A Mixed Methods Process Evaluation of a Food Hygiene Intervention in Low-Income Informal Neighbourhoods of Kisumu, Kenya
Future interventions should seek to explicitly target contextual factors such as secondary caregivers and promote food hygiene interventions as independent of each other
How can global guidelines support sustainable hygiene systems
Child Nutrition and Water Access (34 works) · Medicine (32 works) · Environmental health (29 works) · Hygiene (26 works) · Public health (22 works) · Sanitation (22 works) · Global Maternal and Child Health (17 works) · Nursing (14 works) · Geography (11 works) · Psychological intervention (9 works)