Sarah Lebu | University of California, Berkeley (original) (raw)

Papers by Sarah Lebu

Research paper thumbnail of Shared sanitation in informal settlements: A systematic review and meta-analysis of prevalence, preferences, and quality

International journal of hygiene and environmental health, Jul 1, 2024

Research paper thumbnail of The case for shared sanitation access in informal settlements: A dialogue on science, policy, and practice integration

Research paper thumbnail of Bioprocessing of Organic Municipal Solid Waste for Biomethane and Biohydrogen Production

CRC Press eBooks, May 7, 2024

Research paper thumbnail of Evaluation of Social Acceptance and Market for Human Excreta-Derived Products

CRC Press eBooks, May 7, 2024

Research paper thumbnail of Adaptive strategies to enhance water security and resilience in low- and middle-income countries: A critical review

Science of the total environment, May 1, 2024

Research paper thumbnail of Shifting from traditional infrastructure planning to a collaborative approach: lessons from the Freetown sanitation master plan

Journal of Water Sanitation and Hygiene for Development, Nov 30, 2023

Research paper thumbnail of Reflective questioning to guide socially just global health reform: a narrative review and expert elicitation

International Journal for Equity in Health, Jan 4, 2024

Recent research has highlighted the impacts of colonialism and racism in global health, yet few s... more Recent research has highlighted the impacts of colonialism and racism in global health, yet few studies have presented concrete steps toward addressing the problems. We conducted a narrative review to identify published evidence that documented guiding frameworks for enhancing equity and inclusion in global health research and practice (GHRP). Based on this narrative review, we developed a questionnaire with a series of reflection questions related on commonly reported challenges related to diversity, inclusion, equity, and power imbalances. To reach consensus on a set of priority questions relevant to each theme, the questionnaire was sent to a sample of 18 global health experts virtually and two rounds of iterations were conducted. Results identified eight thematic areas and 19 reflective questions that can assist global health researchers and practitioners striving to implement socially just global health reforms. Key elements identified for improving GHRP include: (1) aiming to understand the historical context and power dynamics within the areas touched by the program; (2) promoting and mobilizing local stakeholders and leadership and ensuring measures for their participation in decision-making; (3) ensuring that knowledge products are co-produced and more equitably accessible; (4) establishing a more holistic feedback and accountability system to understand needed reforms based on local perspectives; and (5) applying systems thinking to addressing challenges and encouraging approaches that can be sustained long-term. GHRP professionals should reflect more deeply on how their goals align with those of their in-country collaborators. The consistent application of reflective processes has the potential to shift GHRP towards increased equity.

Research paper thumbnail of Sex specific differences in HIV status disclosure and care engagement among people living with HIV in rural communities in Kenya and Uganda

PLOS global public health, Apr 7, 2023

Research paper thumbnail of Effectiveness of the Swachh Bharat Mission and barriers to ending open defecation in India: a systematic review

Frontiers in Environmental Science

In 2016, nearly 60% of the population of India practiced open defecation (OD), which was 4 times ... more In 2016, nearly 60% of the population of India practiced open defecation (OD), which was 4 times the global rate, and reducing OD in India will be essential in meeting Sustainable Development Goal (SDG) 6.2 and improving global public health. The government of India launched the Swachh Bharat Mission (SBM) in 2014 with one key goal for all Indian states to achieve OD-free (ODF) status by 2019. Despite reports from the Government of India on the success of SBM, the true ODF status of Indian states is still unknown. A systematic review of peer-reviewed literature was conducted to assess the impact of SBM on OD in India, evaluate the barriers to reducing OD, and provide recommendations for future interventions to reduce or eliminate OD in India. A total of 237 publications were screened, and 22 were selected for inclusion. While the Prime Minister declared India ODF in 2019, studies suggest that the government monitoring system overestimates numbers of ODF villages and toilet coverage....

Research paper thumbnail of On-site sanitation system emptying practices and influential factors in Asian low- and middle-income countries: A systematic review

Hygiene and Environmental Health Advances

Research paper thumbnail of Biochar as a novel technology for treatment of onsite domestic wastewater: A critical review

Frontiers in Environmental Science

Globally, about 2.7 billion people depend on onsite sanitation systems (OSS) (e.g., septic tanks)... more Globally, about 2.7 billion people depend on onsite sanitation systems (OSS) (e.g., septic tanks) for their sanitation needs. Although onsite sanitation systems help in providing primary treatment for domestic wastewater, they don’t effectively remove nutrients, pathogens, and other inorganic contaminants. Previous studies have posited that the use of post treatment systems which incorporate biochar leads to improved contaminant removal efficiency. However, the mechanism through which contaminants are removed and factors potentially affecting the removal are still understudied. To fill this knowledge gaps, this review discusses factors which affect efficiency of biochar in removing contaminants found in onsite domestic wastewater, modifications applied to improve the efficiency of biochar in removing contaminants, mechanisms through which different contaminants are removed and constraints in the use of biochar for onsite wastewater treatment. It was noted that the removal of contami...

Research paper thumbnail of Soil-transmitted helminths: A critical review of the impact of co-infections and implications for control and elimination

PLOS Neglected Tropical Diseases

Researchers have raised the possibility that soil-transmitted helminth (STH) infections might mod... more Researchers have raised the possibility that soil-transmitted helminth (STH) infections might modify the host’s immune response against other systemic infections. STH infections can alter the immune response towards type 2 immunity that could then affect the likelihood and severity of other illnesses. However, the importance of co-infections is not completely understood, and the impact and direction of their effects vary considerably by infection. This review synthesizes evidence regarding the relevance of STH co-infections, the potential mechanisms that explain their effects, and how they might affect control and elimination efforts. According to the literature reviewed, there are both positive and negative effects associated with STH infections on other diseases such as malaria, human immunodeficiency virus (HIV), tuberculosis, gestational anemia, pediatric anemia, neglected tropical diseases (NTDs) like lymphatic filariasis, onchocerciasis, schistosomiasis, and trachoma, as well ...

Research paper thumbnail of “I was still very young”: agency, stigma and HIV care strategies at school, baseline results of a qualitative study among youth in rural Kenya and Uganda

Journal of the International AIDS Society

Research paper thumbnail of Sexual partnership concurrency and age disparities associated with sexually transmitted infection and risk behavior in rural communities in Kenya and Uganda

International Journal of Infectious Diseases

OBJECTIVES We examined sex-specific associations between partner age-disparity and relationship c... more OBJECTIVES We examined sex-specific associations between partner age-disparity and relationship concurrency on Neisseria gonorrhoeae and/or Chlamydia trachomatis (NG/CT) infection, higher-risk relationships, and condom use as proxies for HIV risk. METHODS Data were collected in 2016 from 2179 adults in 12 communities in Uganda and Kenya. Logistic regression models examined associations of age-disparity and relationship concurrency on NG/CT, condom use, and higher-risk (commercial sex and other higher-risk) relationships, in past 6-months, controlling for covariates. RESULTS Partner age and relationship concurrency were associated with NG/CT in women, but not men: relative to women in age-disparate relationships, women in age-disparate and homogeneous relationships had higher odds of NG/CT (aOR=3.82, 95%CI:1.46-9.98). Among men and women, partnership concurrency was associated with higher-risk partnerships. Additionally, relative to those with a single age-homogenous partner, those with concurrent age-homogenous partners had higher odds of condom use (men: aOR=2.85, 95%CI=1.89-4.31; women: aOR=2.99, 95%CI=1.52-5.89). Concurrent age-disparate partnerships were associated with condom use among men only (aOR=4.02, 95%CI: 2.54-6.37). CONCLUSIONS Findings underscore the importance of targeted HIV prevention efforts for couples in age-disparate and concurrent relationships.

Research paper thumbnail of Additional file 1 of Promoting gender equity in very young adolescents: targeting a window of opportunity for social emotional learning and identity development

Research paper thumbnail of Treatment failure and its associated factors among children receiving highly active antiretroviral therapy in Ethiopia: A systematic review and meta-analysis

Research paper thumbnail of Additional file 1 of Adolescent, caregiver and community experiences with a gender transformative, social emotional learning intervention

Research paper thumbnail of Additional file 2 of Adolescent, caregiver and community experiences with a gender transformative, social emotional learning intervention

Research paper thumbnail of Adolescent, caregiver and community experiences with a gender transformative, social emotional learning intervention

International Journal for Equity in Health, 2021

Background Inequitable gender norms, beliefs and behaviors, are shaped by learning experiences du... more Background Inequitable gender norms, beliefs and behaviors, are shaped by learning experiences during key developmental stages in an individual’s life course, and can have negative impacts on health and well-being outcomes. Very early adolescence represents one stage when formative learning experiences about gender inequity can have the potential to support or hinder more equitable gender norms, beliefs and behaviors. The aim of this qualitative study was to evaluate the effect of a gender transformative, social emotional learning intervention for very young adolescents (VYAs) that included experiential learning with peers, parents/caregivers and community members. Methods This study examined the effects of an intervention designed to provide social emotional learning opportunities for adolescents ages 10–11 in Dar es Salaam, Tanzania. The qualitative sample included 279 participants. Qualitative methods included 102 in-depth interviews with VYAs, 22 focus groups with 117 VYAs, 60 i...

Research paper thumbnail of Study Protocol of a Distance Learning Intervention to Support Social Emotional Learning and Identity Development for Adolescents Using Interactive Mobile Technology

Frontiers in Public Health, 2021

Background: The maturational period from age 10 to 14—often referred to as very young adolescents... more Background: The maturational period from age 10 to 14—often referred to as very young adolescents (VYAs)—represents a dynamic period of learning and neurobehavioral development as individuals transition from childhood to adolescence. This developmental period presents a window of opportunity for strategic investment to improve trajectories of health, education and well-being among young people. More specifically, neurodevelopmental changes during pubertal maturation influence neural circuitry involved in processing emotions, risks, rewards and social relationships. Technology can be leveraged to create social emotional learning experiences for VYAs and provide opportunities for flexible, distance learning in low-income countries. The aim of this study protocol is to detail how insights from developmental science can be used to inform the intervention design, implementation and evaluation of a distance learning, social emotional learning intervention for VYAs.Methods: This study will...

Research paper thumbnail of Shared sanitation in informal settlements: A systematic review and meta-analysis of prevalence, preferences, and quality

International journal of hygiene and environmental health, Jul 1, 2024

Research paper thumbnail of The case for shared sanitation access in informal settlements: A dialogue on science, policy, and practice integration

Research paper thumbnail of Bioprocessing of Organic Municipal Solid Waste for Biomethane and Biohydrogen Production

CRC Press eBooks, May 7, 2024

Research paper thumbnail of Evaluation of Social Acceptance and Market for Human Excreta-Derived Products

CRC Press eBooks, May 7, 2024

Research paper thumbnail of Adaptive strategies to enhance water security and resilience in low- and middle-income countries: A critical review

Science of the total environment, May 1, 2024

Research paper thumbnail of Shifting from traditional infrastructure planning to a collaborative approach: lessons from the Freetown sanitation master plan

Journal of Water Sanitation and Hygiene for Development, Nov 30, 2023

Research paper thumbnail of Reflective questioning to guide socially just global health reform: a narrative review and expert elicitation

International Journal for Equity in Health, Jan 4, 2024

Recent research has highlighted the impacts of colonialism and racism in global health, yet few s... more Recent research has highlighted the impacts of colonialism and racism in global health, yet few studies have presented concrete steps toward addressing the problems. We conducted a narrative review to identify published evidence that documented guiding frameworks for enhancing equity and inclusion in global health research and practice (GHRP). Based on this narrative review, we developed a questionnaire with a series of reflection questions related on commonly reported challenges related to diversity, inclusion, equity, and power imbalances. To reach consensus on a set of priority questions relevant to each theme, the questionnaire was sent to a sample of 18 global health experts virtually and two rounds of iterations were conducted. Results identified eight thematic areas and 19 reflective questions that can assist global health researchers and practitioners striving to implement socially just global health reforms. Key elements identified for improving GHRP include: (1) aiming to understand the historical context and power dynamics within the areas touched by the program; (2) promoting and mobilizing local stakeholders and leadership and ensuring measures for their participation in decision-making; (3) ensuring that knowledge products are co-produced and more equitably accessible; (4) establishing a more holistic feedback and accountability system to understand needed reforms based on local perspectives; and (5) applying systems thinking to addressing challenges and encouraging approaches that can be sustained long-term. GHRP professionals should reflect more deeply on how their goals align with those of their in-country collaborators. The consistent application of reflective processes has the potential to shift GHRP towards increased equity.

Research paper thumbnail of Sex specific differences in HIV status disclosure and care engagement among people living with HIV in rural communities in Kenya and Uganda

PLOS global public health, Apr 7, 2023

Research paper thumbnail of Effectiveness of the Swachh Bharat Mission and barriers to ending open defecation in India: a systematic review

Frontiers in Environmental Science

In 2016, nearly 60% of the population of India practiced open defecation (OD), which was 4 times ... more In 2016, nearly 60% of the population of India practiced open defecation (OD), which was 4 times the global rate, and reducing OD in India will be essential in meeting Sustainable Development Goal (SDG) 6.2 and improving global public health. The government of India launched the Swachh Bharat Mission (SBM) in 2014 with one key goal for all Indian states to achieve OD-free (ODF) status by 2019. Despite reports from the Government of India on the success of SBM, the true ODF status of Indian states is still unknown. A systematic review of peer-reviewed literature was conducted to assess the impact of SBM on OD in India, evaluate the barriers to reducing OD, and provide recommendations for future interventions to reduce or eliminate OD in India. A total of 237 publications were screened, and 22 were selected for inclusion. While the Prime Minister declared India ODF in 2019, studies suggest that the government monitoring system overestimates numbers of ODF villages and toilet coverage....

Research paper thumbnail of On-site sanitation system emptying practices and influential factors in Asian low- and middle-income countries: A systematic review

Hygiene and Environmental Health Advances

Research paper thumbnail of Biochar as a novel technology for treatment of onsite domestic wastewater: A critical review

Frontiers in Environmental Science

Globally, about 2.7 billion people depend on onsite sanitation systems (OSS) (e.g., septic tanks)... more Globally, about 2.7 billion people depend on onsite sanitation systems (OSS) (e.g., septic tanks) for their sanitation needs. Although onsite sanitation systems help in providing primary treatment for domestic wastewater, they don’t effectively remove nutrients, pathogens, and other inorganic contaminants. Previous studies have posited that the use of post treatment systems which incorporate biochar leads to improved contaminant removal efficiency. However, the mechanism through which contaminants are removed and factors potentially affecting the removal are still understudied. To fill this knowledge gaps, this review discusses factors which affect efficiency of biochar in removing contaminants found in onsite domestic wastewater, modifications applied to improve the efficiency of biochar in removing contaminants, mechanisms through which different contaminants are removed and constraints in the use of biochar for onsite wastewater treatment. It was noted that the removal of contami...

Research paper thumbnail of Soil-transmitted helminths: A critical review of the impact of co-infections and implications for control and elimination

PLOS Neglected Tropical Diseases

Researchers have raised the possibility that soil-transmitted helminth (STH) infections might mod... more Researchers have raised the possibility that soil-transmitted helminth (STH) infections might modify the host’s immune response against other systemic infections. STH infections can alter the immune response towards type 2 immunity that could then affect the likelihood and severity of other illnesses. However, the importance of co-infections is not completely understood, and the impact and direction of their effects vary considerably by infection. This review synthesizes evidence regarding the relevance of STH co-infections, the potential mechanisms that explain their effects, and how they might affect control and elimination efforts. According to the literature reviewed, there are both positive and negative effects associated with STH infections on other diseases such as malaria, human immunodeficiency virus (HIV), tuberculosis, gestational anemia, pediatric anemia, neglected tropical diseases (NTDs) like lymphatic filariasis, onchocerciasis, schistosomiasis, and trachoma, as well ...

Research paper thumbnail of “I was still very young”: agency, stigma and HIV care strategies at school, baseline results of a qualitative study among youth in rural Kenya and Uganda

Journal of the International AIDS Society

Research paper thumbnail of Sexual partnership concurrency and age disparities associated with sexually transmitted infection and risk behavior in rural communities in Kenya and Uganda

International Journal of Infectious Diseases

OBJECTIVES We examined sex-specific associations between partner age-disparity and relationship c... more OBJECTIVES We examined sex-specific associations between partner age-disparity and relationship concurrency on Neisseria gonorrhoeae and/or Chlamydia trachomatis (NG/CT) infection, higher-risk relationships, and condom use as proxies for HIV risk. METHODS Data were collected in 2016 from 2179 adults in 12 communities in Uganda and Kenya. Logistic regression models examined associations of age-disparity and relationship concurrency on NG/CT, condom use, and higher-risk (commercial sex and other higher-risk) relationships, in past 6-months, controlling for covariates. RESULTS Partner age and relationship concurrency were associated with NG/CT in women, but not men: relative to women in age-disparate relationships, women in age-disparate and homogeneous relationships had higher odds of NG/CT (aOR=3.82, 95%CI:1.46-9.98). Among men and women, partnership concurrency was associated with higher-risk partnerships. Additionally, relative to those with a single age-homogenous partner, those with concurrent age-homogenous partners had higher odds of condom use (men: aOR=2.85, 95%CI=1.89-4.31; women: aOR=2.99, 95%CI=1.52-5.89). Concurrent age-disparate partnerships were associated with condom use among men only (aOR=4.02, 95%CI: 2.54-6.37). CONCLUSIONS Findings underscore the importance of targeted HIV prevention efforts for couples in age-disparate and concurrent relationships.

Research paper thumbnail of Additional file 1 of Promoting gender equity in very young adolescents: targeting a window of opportunity for social emotional learning and identity development

Research paper thumbnail of Treatment failure and its associated factors among children receiving highly active antiretroviral therapy in Ethiopia: A systematic review and meta-analysis

Research paper thumbnail of Additional file 1 of Adolescent, caregiver and community experiences with a gender transformative, social emotional learning intervention

Research paper thumbnail of Additional file 2 of Adolescent, caregiver and community experiences with a gender transformative, social emotional learning intervention

Research paper thumbnail of Adolescent, caregiver and community experiences with a gender transformative, social emotional learning intervention

International Journal for Equity in Health, 2021

Background Inequitable gender norms, beliefs and behaviors, are shaped by learning experiences du... more Background Inequitable gender norms, beliefs and behaviors, are shaped by learning experiences during key developmental stages in an individual’s life course, and can have negative impacts on health and well-being outcomes. Very early adolescence represents one stage when formative learning experiences about gender inequity can have the potential to support or hinder more equitable gender norms, beliefs and behaviors. The aim of this qualitative study was to evaluate the effect of a gender transformative, social emotional learning intervention for very young adolescents (VYAs) that included experiential learning with peers, parents/caregivers and community members. Methods This study examined the effects of an intervention designed to provide social emotional learning opportunities for adolescents ages 10–11 in Dar es Salaam, Tanzania. The qualitative sample included 279 participants. Qualitative methods included 102 in-depth interviews with VYAs, 22 focus groups with 117 VYAs, 60 i...

Research paper thumbnail of Study Protocol of a Distance Learning Intervention to Support Social Emotional Learning and Identity Development for Adolescents Using Interactive Mobile Technology

Frontiers in Public Health, 2021

Background: The maturational period from age 10 to 14—often referred to as very young adolescents... more Background: The maturational period from age 10 to 14—often referred to as very young adolescents (VYAs)—represents a dynamic period of learning and neurobehavioral development as individuals transition from childhood to adolescence. This developmental period presents a window of opportunity for strategic investment to improve trajectories of health, education and well-being among young people. More specifically, neurodevelopmental changes during pubertal maturation influence neural circuitry involved in processing emotions, risks, rewards and social relationships. Technology can be leveraged to create social emotional learning experiences for VYAs and provide opportunities for flexible, distance learning in low-income countries. The aim of this study protocol is to detail how insights from developmental science can be used to inform the intervention design, implementation and evaluation of a distance learning, social emotional learning intervention for VYAs.Methods: This study will...