Fecal Sampling of Soil, Food, Hand, and Surface Samples from Households in Urban Slums of Dhaka, Bangladesh: An Evidence-Based Development of Baby Water, Sanitation, and Hygiene Interventions

Enteric pathogen infections are a leading cause of morbidity and mortality globally, with the highest disease burden in low-income countries. Hands act as intermediaries in enteric pathogen transmission, transferring enteric pathogens between people and the environment through contact with fomites, food, water, and soil. In this study, we conducted a systematic review of prevalence and concentrations of fecal indicator microorganisms (i.e., E. coli, fecal coliform) and enteric pathogens on hands. We identified 84 studies, reporting 35,440 observations of hand contamination of people in community or household settings. The studies investigated 44 unique microorganisms, of which the most commonly reported indicators were E. coli and fecal coliforms. Hand contamination with 12 unique enteric pathogens was reported, with adenovirus and norovirus as the most frequent. Mean E. coli prevalence on hands was 62% [95% CI 40%–82%] and mean fecal coliform prevalence was 66% [95% CI 22%–100%]. Hands were more likely to be contaminated with E. coli in low/lower-middle-income countries (prevalence: 69% [95% CI 48%–88%]) than in upper-middle/high-income countries (6% [95% CI 2%–12%]). The Review also highlights the importance of standardizing hand sampling methods, as hand rinsing was associated with greater fecal contamination compared to other sampling methods.

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“…U.S., 16 Tanzanina, 60 Mexico, 61 Tanzania, 30 Tanzania, 62 Bangladesh, 63 Zimbabwe, 64 Zimbabwe, 65 Indonesia, 66…”

Section: Country Incomementioning

confidence: 99%

Hands Are Frequently Contaminated with Fecal Bacteria and Enteric Pathogens Globally: A Systematic Review and Meta-analysis

et al. 2023

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Hands are frequently contaminated with fecal bacteria and enteric pathogens globally: A systematic review and meta-analysis

Cantrell

Sylvestre

Scheidegger

et al. 2022

Preprint

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Enteric pathogen infections are a leading cause of morbidity and mortality globally, with the highest disease burden in low-income countries. Hands act as intermediaries in enteric pathogen transmission, transferring enteric pathogens between people and the environment through contact with food, water, and soil. In this study, we conducted a systematic review of prevalence and concentrations of fecal indicator microorganisms (i.e., E. coli, fecal coliform) and enteric pathogens on hands. We identified eighty studies, reporting 31,305 observations of hand contamination of people in community or household settings. The studies investigated 45 unique microorganisms, of which the most commonly reported indicators were E. coli and fecal coliforms. Hand contamination with 14 unique enteric pathogens was reported, with adenovirus and rotavirus as the most frequent. Mean E. coli prevalence on hands was 40% [95% CI 18%-62%] and mean fecal coliform prevalence was 42% [95% CI 16%-69%]. Hands were more likely to be contaminated with E. coli in low/lower-middle-income countries (prevalence: 49% [25% - 72%]) than in upper-middle/high-income countries (6% [1% - 12%]). In low/lower-middle income countries, E. coli prevalence was higher in urban compared to rural settings (52% mean prevalence in urban versus 33% in rural), although substantial heterogeneity between studies limited confidence in this finding. The review also highlighted the importance of standardizing hand sampling methods, as hand rinsing was associated with greater fecal contamination compared to other sampling methods.

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Identifying Potential Determinants of Faecal Contamination on Domestic Floors in Three Settings in Rural Kenya: A Mixed Methods Analysis

Legge,

Kazungo,

Muli

et al. 2024

Environ�Health�Insights

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Observational evidence suggests that household floors may be an important domain for the transmission of enteric and parasitic infections. However, little work has been done to investigate how household floors can become contaminated with human and animal faeces. This study uses a mixed methods approach to postulate the proximal and distal determinants of household floor contamination with faeces in groups of rural villages in 3 counties in Kenya (Bungoma, Kwale and Narok). Quantitative data was collected through a household census and analysed descriptively and using mixed effects logistic regression models. Qualitative data was collected through unstructured observations of daily routines and in-depth interviews. These data were analysed thematically with case memos produced for routine activities that were hypothesised to be determinants of floor contamination. Possible proximal determinants of floor contamination included; (1) animal contact with floors; (2) child faeces disposal, and; (3) floor cleaning routines. Distal determinants are suggested to be rooted in the socioeconomic, environmental, and cultural context in which households were located and included; (1) the type and number of animals owned by households; (2) presence/absence of dedicated shelters for housing animals at night, which impacted whether sleeping or cooking areas were exposed to animals; (3) Accessibility of inside spaces to poultry and other roaming animals; (4) ownership of an improved floor; (5) ability of animals to access neighbours compounds; (6) seasonal changes in weather. These results will be of use in identifying the contexts in which faecal contamination of domestic floors may be contributing towards transmission of enteric and parasitic infections and in designing effective interventions to prevent this exposure.

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Fecal Sampling of Soil, Food, Hand, and Surface Samples from Households in Urban Slums of Dhaka, Bangladesh: An Evidence-Based Development of Baby Water, Sanitation, and Hygiene Interventions

Cited by 4 publications

References 21 publications

Hands Are Frequently Contaminated with Fecal Bacteria and Enteric Pathogens Globally: A Systematic Review and Meta-analysis

Hands Are Frequently Contaminated with Fecal Bacteria and Enteric Pathogens Globally: A Systematic Review and Meta-analysis

Hands are frequently contaminated with fecal bacteria and enteric pathogens globally: A systematic review and meta-analysis

Identifying Potential Determinants of Faecal Contamination on Domestic Floors in Three Settings in Rural Kenya: A Mixed Methods Analysis

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