Fecal Indicator Bacteria Contamination of Fomites and Household Demand for Surface Disinfection Products: A Case Study from Peru

Julian, Timothy R.; MacDonald, Luke H.; Guo, Yayi; Marks, Sara; Kosek, Margaret; Yori, Pablo Peñataro; Pinedo, Silvia Rengifo; Schwab, Kellogg J.

doi:10.4269/ajtmh.12-0425

Cited by 22 publications

(19 citation statements)

References 16 publications

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“…This is consistent with the literature demonstrating that non-dietary mouthing contacts are higher than dietary mouthing contacts [41,42]. Previous studies have demonstrated that soil in the domestic environment and on children's toys can be an exposure route to faecal pathogens [23][24][25], and that visibly dirty object-to- mouth contacts are associated with EE in young children [36]. However, despite the growing evidence, there are few interventions targeting this high-risk behaviour.…”

Section: Discussionsupporting

confidence: 90%

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Prospective cohort study of child mouthing of faeces and fomites in Dhaka, Bangladesh (CHoBI7 Program)

Parvin

Uddin

Bhuyian

et al. 2020

Tropical Med Int Health

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Objective To characterise childhood mouthing and handling behaviours and to assess the association between hand‐to‐object and object‐to‐mouth contacts and diarrhoea prevalence in young children in urban Dhaka, Bangladesh. Methods A prospective cohort study was conducted among 494 children under 5 years of age in Dhaka, Bangladesh. This study was nested within the randomised controlled trial of the Cholera Hospital‐Based Intervention for 7 Days (CHoBI7) mobile health (mHealth) program. The CHoBI7 mHealth program focuses on promoting handwashing with soap and water treatment to diarrhoea patients and their household members through mobile messages and a single in person visit. Mouthing and handling of faeces and fomites among young children was measured by five‐hour structured observation and caregiver reports. Diarrhoea surveillance data was collected monthly for 12 months. Results Fifty five percent of caregivers reported that their child put a visibly dirty fomite (object or soil) in their mouth in the past week. Caregivers reported that 50% of children had mouthed visibly dirty objects, 26% had mouthed dirt, and 2% had mouthed faeces. Forty five percent of children were observed mouthing a visibly dirty fomite during structured observation, 40% of children were observed mouthing a visibly dirty object, 10% were observed mouthing soil, and one child (0.2%) was observed mouthing faeces. Mouthing of visibly dirty fomites was highest for children 12‐18 months of age with 69% of these children having caregiver reports and 54% having observed events. Children with caregiver reports of mouthing faeces had a significantly higher odds of diarrhoea over the subsequent month (Odds Ratio: 4.54; 95% Confidence Interval: 1.06, 19.48). Conclusion These findings demonstrate that mouthing of contaminated fomites among young children is frequent in urban environments in Bangladesh, and that mouthing faeces is associated with a significantly higher odds of diarrhoea. Interventions are urgently needed to protect young children from faecal pathogens in their play spaces.

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Section: Discussionsupporting

confidence: 90%

“…Previous studies have demonstrated that soil is an exposure pathway for enteric infections [21,22]. Fomites such as children's toys and plates can also serve as transmission routes for enteric pathogens [23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Prospective cohort study of child mouthing of faeces and fomites in Dhaka, Bangladesh (CHoBI7 Program)

Parvin

Uddin

Bhuyian

et al. 2020

Tropical Med Int Health

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“…coli concentrations may be due to E . coli contamination of laundry as observed in the United States and/or by use of soil or sand as a cleaning aid, as observed in Peru [ 36 , 37 ]. These findings further support the work of Pickering et al (2011) that shows female caretakers’ activities can dramatically influence their hand contamination [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

A Pilot Study on Integrating Videography and Environmental Microbial Sampling to Model Fecal Bacterial Exposures in Peri-Urban Tanzania

Julian

Pickering

2015

PLoS ONE

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Diarrheal diseases are a leading cause of under-five mortality and morbidity in sub-Saharan Africa. Quantitative exposure modeling provides opportunities to investigate the relative importance of fecal-oral transmission routes (e.g. hands, water, food) responsible for diarrheal disease. Modeling, however, requires accurate descriptions of individuals’ interactions with the environment (i.e., activity data). Such activity data are largely lacking for people in low-income settings. In the present study, we collected activity data and microbiological sampling data to develop a quantitative microbial exposure model for two female caretakers in peri-urban Tanzania. Activity data were combined with microbiological data of contacted surfaces and fomites (e.g. broom handle, soil, clothing) to develop example exposure profiles describing second-by-second estimates of fecal indicator bacteria (E. coli and enterococci) concentrations on the caretaker’s hands. The study demonstrates the application and utility of video activity data to quantify exposure factors for people in low-income countries and apply these factors to understand fecal contamination exposure pathways. This study provides both a methodological approach for the design and implementation of larger studies, and preliminary data suggesting contacts with dirt and sand may be important mechanisms of hand contamination. Increasing the scale of activity data collection and modeling to investigate individual-level exposure profiles within target populations for specific exposure scenarios would provide opportunities to identify the relative importance of fecal-oral disease transmission routes.

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“…More specifically, surfaces were found to harbor significant concentrations of fecal indicators, fomites, and diarrheal pathogens in Tanzanian 47 and Peruvian households. 48 Recently, published evidence has shown that environmental conditions in the household are linked to impaired childhood growth and other indicators of gut enteropathy in rural Bangladesh. 49 Unlike water quality studies, the collection of pathogens from surfaces is not standard practice in the water, hygiene, and sanitation research field, and the importance of household hygiene may have been underestimated in previous research as a result.…”

Section: Discussionmentioning

confidence: 99%

Modeling Risk Categories to Predict the Longitudinal Prevalence of Childhood Diarrhea in Indonesia

Sima¹,

Ng²,

Elimelech³

2013

The American Society of Tropical Medicine and Hygiene

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Abstract. We present an innovative approach for analyzing diarrheal prevalence data that uses latent variables to model the relationships between multiple, interdependent environmental risk factors, and socioeconomic mediators. This strategy was applied to elucidate diarrheal longitudinal prevalence risk factors in children 1-4 years of age in lowincome areas of Jakarta, Indonesia. Through a prospective cohort study, we identified 257 children who had at least one episode of diarrhea. At the onset of the study, we collected responses to 44 indicators, covering a wide range of previously identified diarrhea risk factors, including demographic and socioeconomic factors. We used exploratory factor analysis to uncover four latent categories of risk factors and their respective indicators from the initial pool of 44 indicators. Thereafter, we used structural equation modeling to model the relationships between the four risk categories and diarrheal longitudinal prevalence, controlling for socioeconomic and demographic covariates. Our final model elucidated several pathways to longitudinal diarrheal prevalence. Most notably, poverty exerts its effect on increased diarrheal prevalence via dual pathways: poor household hygiene and food quality, controlling for covariates. Implications of this and other findings for disease control in Jakarta are discussed.

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Fecal Indicator Bacteria Contamination of Fomites and Household Demand for Surface Disinfection Products: A Case Study from Peru

Cited by 22 publications

References 16 publications

Prospective cohort study of child mouthing of faeces and fomites in Dhaka, Bangladesh (CHoBI7 Program)

Prospective cohort study of child mouthing of faeces and fomites in Dhaka, Bangladesh (CHoBI7 Program)

A Pilot Study on Integrating Videography and Environmental Microbial Sampling to Model Fecal Bacterial Exposures in Peri-Urban Tanzania

Modeling Risk Categories to Predict the Longitudinal Prevalence of Childhood Diarrhea in Indonesia

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