Occurrence of Host-Associated Fecal Markers on Child Hands, Household Soil, and Drinking Water in Rural Bangladeshi Households

Boehm, Alexandria B.; Wang, Dan; Ercümen, Ayşe; Shea, Meghan M.; Harris, Angela; Shanks, Orin C.; Kelty, Catherine A.; Ahmed, Alvee; Mahmud, Zahid Hayat; Arnold, Benjamin F.; Chase, Claire; Kullmann, Craig Phillip; Colford, John M.; Luby, Stephen P.; Pickering, Amy J.

doi:10.1021/acs.estlett.6b00382

Cited by 77 publications

(132 citation statements)

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“…However, exposure to ruminant feces as a transmission pathway for enteric illness is underexplored in the WASH field. Similar results regarding the high prevalence of ruminant contamination has been reported for households in rural and urban/peri-urban informal settlements in Bangladesh [12] and Tanzania [10]. In addition, Barnes et al [59] showed an association between domestic animal presence/ownership and household drinking water contamination.…”

Section: Discussionsupporting

confidence: 71%

“…Water quality indicators (i.e., MST molecular markers and FIB) were used in various analyses in binary (presence/absence) and continuous form (concentration of the molecular marker in the water sample). When continuous variables were used for FIB data, substitutions for NDs were necessary because the data were log 10 -transformed [12]. As such, NDs for FIB (E. coli and enterococci) were replaced with 0.5 CFU per 100mL water sample.…”

Section: Data Analysis-water Samplesmentioning

confidence: 99%

“…Overall, there is a lack of understanding of how various household attributes and human behaviors affect stored water quality. Although studies in Tanzania [10], Peru [11], and Bangladesh [12] all reported contamination of stored drinking water supplies, none identified pathways of contamination that would describe a majority of contamination events. In addition, a recent study of stored water quality in rural and peri-urban Tanzania [13] explored how various factors (e.g., human behavior and household and water characteristics) were associated with stored water quality.…”

Section: Introductionmentioning

confidence: 99%

“…Their use to identify sources of fecal contamination is referred to as MST (microbial source tracking). While MST methods have been used within high-income countries to identify sources of environmental contamination [31], they have rarely been applied in low-and middle-income countries [6,12,[32][33][34][35][36][37].…”

Section: Introductionmentioning

confidence: 99%

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Ruminant Fecal Contamination of Drinking Water Introduced Post-Collection in Rural Kenyan Households

Hamzah

Boehm

Davis

et al. 2020

IJERPH

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In sub-Saharan Africa, many families travel to collect water and store it in their homes for daily use, presenting an opportunity for the introduction of fecal contamination. One stored and one source water sample were each collected from 45 households in rural Kenya. All 90 samples were analyzed for fecal indicator bacteria (E. coli and enterococci) and species-specific contamination using molecular microbial source tracking assays. Human (HF183), avian (GFD), and ruminant (BacR) contamination were detected in 52, two, and four samples, respectively. Stored water samples had elevated enterococci concentrations (p < 0.01, Wilcoxon matched pairs test) and more frequent BacR detection (89% versus 27%, p < 0.01, McNemar's exact test) relative to source water samples. fsQCA (fuzzy set qualitative comparative analysis) was conducted on the subset of households with no source water BacR contamination to highlight combinations of factors associated with the introduction of BacR contamination to stored water supplies. Three combinations were identified: (i) ruminants in the compound, safe water extraction methods, and long storage time, (ii) ruminants, unsafe water extraction methods, and no soap at the household handwashing station, and (iii) long storage time and no soap. This suggests that multiple pathways contribute to the transmission of ruminant fecal contamination in this context, which would have been missed if data were analyzed using standard regression techniques.

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Section: Discussionsupporting

confidence: 71%

Section: Data Analysis-water Samplesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ruminant Fecal Contamination of Drinking Water Introduced Post-Collection in Rural Kenyan Households

Hamzah

Boehm

Davis

et al. 2020

IJERPH

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“…A laboratory supervisor received the environmental samples within 4 hours of collection and analyzed the samples for E. coli using the IDEXX-Quanti-tray ® 2000 technique with Colilert-24 media (IDEXX Laboratories, Westbrook, Seattle, WA) [31] to quantify the most probable number (MPN) of E. coli per unit of sample. E. coli is commonly used as an indicator of fecal contamination in water, food, and environmental samples [13,32,33]. We chose to use E. coli to allow for comparison with other studies.…”

Section: Laboratory Sample Processingmentioning

confidence: 99%

Quantitative assessment of fecal contamination in multiple environmental sample types in urban communities in Dhaka, Bangladesh using SaniPath microbial approach

Amin

Rahman

Raj

et al. 2019

Preprint

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Rapid urbanization has led to a growing sanitation crisis in urban areas of Bangladesh and potential exposure to fecal contamination in the urban environment due to inadequate sanitation and poor fecal sludge management. Limited data are available on environmental fecal contamination associated with different exposure pathways in urban Dhaka. We conducted a cross-sectional study to explore the magnitude of fecal contamination in the environment in low-income, high-income, and transient/floating neighborhoods in urban Dhaka. Ten samples were collected from each of 10 environmental compartments in 10 different neighborhoods (4 low-income, 4 high-income and 2 transient/floating neighborhoods). These 1,000 samples were analyzed with the IDEXX-Quanti-Tray technique to determine most-probable-number (MPN) of E. coli. Samples of open drains (6.91 log 10 MPN/100 mL), surface water (5.28 log 10 MPN/100 mL), floodwater (4.60 log 10 MPN/100 mL), produce (3.19 log 10 MPN/serving), soil (2.29 log 10 MPN/gram), and street food (1.79 log 10 MPN/gram) had the highest mean log 10 E. coli contamination compared to other samples. The contamination concentrations did not differ between low-income and high-income neighborhoods for shared latrine swabs, open drains, municipal water, produce, and street foodsamples. E. coli contamination were significantly higher (p <0.05) in low-income neighborhoods compared to high-income for soil (0.91 log 10 MPN/gram, 95% CI, 0.39, 1.43), bathing water (0.98 log 10 MPN/100 mL, 95% CI, 0.41, 1.54), nonmunicipal water (0.64 log 10 MPN/100 mL, 95% CI, 0.24, 1.04), surface water (1.92 log 10 MPN/100 mL, 95% CI, 1.44, 2.40), and floodwater (0.48 log 10 MPN/100 mL, 95% CI, 0.03, 0.92) samples. E. coli contamination were significantly higher (p<0.05) in low-income neighborhoods compared to transient/floating neighborhoods for drain water, bathing water, non-municipal water and surface water.Future studies should examine behavior that brings people into contact with the environment and assess the extent of exposure to fecal contamination in the environment through multiple pathways and associated risks.

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Interventions to improve disposal of child faeces for preventing diarrhoea and soil-transmitted helminth infection

Majorin

Torondel

Chan

et al. 2019

Cochrane Database of Systematic Reviews

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BackgroundDiarrhoea and soil‐transmitted helminth (STH) infections represent a large disease burden worldwide, particularly in low‐income countries. As the aetiological agents associated with diarrhoea and STHs are transmitted through faeces, the safe containment and management of human excreta has the potential to reduce exposure and disease. Child faeces may be an important source of exposure even among households with improved sanitation.ObjectivesTo assess the effectiveness of interventions to improve the disposal of child faeces for preventing diarrhoea and STH infections.Search methodsWe searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL, MEDLINE, Embase, and 10 other databases. We also searched relevant conference proceedings, contacted researchers, searched websites for organizations, and checked references from identified studies. The date of last search was 27 September 2018.Selection criteriaWe included randomized controlled trials (RCTs) and non‐randomized controlled studies (NRS) that compared interventions aiming to improve the disposal of faeces of children aged below five years in order to decrease direct or indirect human contact with such faeces with no intervention or a different intervention in children and adults.Data collection and analysisTwo review authors selected eligible studies, extracted data, and assessed the risk of bias. We used meta‐analyses to estimate pooled measures of effect where appropriate, or described the study results narratively. We assessed the certainty of the evidence using the GRADE approach.Main resultsSixty‐three studies covering more than 222,800 participants met the inclusion criteria. Twenty‐two studies were cluster RCTs, four were controlled before‐and‐after studies (CBA), and 37 were NRS (27 case‐control studies (one that included seven study sites), three controlled cohort studies, and seven controlled cross‐sectional studies). Most study sites (56/69) were in low‐ or lower middle‐income settings. Among studies using experimental study designs, most interventions included child faeces disposal messages along with other health education messages or other water, sanitation, and hygiene (WASH) hardware and software components. Among observational studies, the main risk factors relevant to this review were safe disposal of faeces in the latrine or defecation of children under five years of age in a latrine.Education and hygiene promotion interventions, including child faeces disposal messages (no hardware provision)Four RCTs found that diarrhoea incidence was lower, reducing the risk by an estimated 30% in children under six years old (rate ratio 0.71, 95% confidence interval (CI) 0.59 to 0.86; 2 trials, low‐certainty evidence). Diarrhoea prevalence measured in two other RCTs in children under five years of age was lower, but evidence was low‐certainty (risk ratio (RR) 0.93, 95% CI 0.84 to 1.04; low‐certainty evidence).Two controlled cohort studies that evaluated such an intervention in Bangladesh did not detect a difference on diarrhoe...

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Occurrence of Host-Associated Fecal Markers on Child Hands, Household Soil, and Drinking Water in Rural Bangladeshi Households

Cited by 77 publications

References 46 publications

Ruminant Fecal Contamination of Drinking Water Introduced Post-Collection in Rural Kenyan Households

Ruminant Fecal Contamination of Drinking Water Introduced Post-Collection in Rural Kenyan Households

Quantitative assessment of fecal contamination in multiple environmental sample types in urban communities in Dhaka, Bangladesh using SaniPath microbial approach

Interventions to improve disposal of child faeces for preventing diarrhoea and soil-transmitted helminth infection

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