Addressing Fecal Contamination in Rural Kenyan Households: The Roles of Environmental Interventions and Animal Ownership.

Autor:	Swarthout JM; Department of Civil and Environmental Engineering, Tufts University, Medford, Massachusetts 02155, United States., Mureithi M; Innovations for Poverty Action, Nairobi 00200, Kenya., Mboya J; Innovations for Poverty Action, Nairobi 00200, Kenya.; Department of Civil and Environmental Engineering, University of California, Berkeley, Berkeley, California 94720, United States., Arnold BF; Francis I. Proctor Foundation, Department of Ophthalmology and Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California 94158, United States., Wolfe MK; Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia 30322, United States., Dentz HN; Institute for Global Nutrition, University of California, Davis, Davis, California 95616, United States., Lin A; Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, Santa Cruz, California 95064, United States., Arnold CD; Institute for Global Nutrition, University of California, Davis, Davis, California 95616, United States., Rao G; Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States., Stewart CP; Institute for Global Nutrition, University of California, Davis, Davis, California 95616, United States., Clasen T; Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia 30322, United States., Colford JM Jr; School of Public Health, Division of Epidemiology, University of California, Berkeley, Berkeley, California 94720, United States., Null C; Mathematica, Washington, District of Columbia 20002, United States., Pickering AJ; Department of Civil and Environmental Engineering, Tufts University, Medford, Massachusetts 02155, United States.; Department of Civil and Environmental Engineering, University of California, Berkeley, Berkeley, California 94720, United States.; Chan Zuckerberg Biohub San Francisco, San Francisco, California 94158, United States.
Jazyk:	angličtina
Zdroj:	Environmental science & technology [Environ Sci Technol] 2024 Jun 04; Vol. 58 (22), pp. 9500-9514. Date of Electronic Publication: 2024 May 17.
DOI:	10.1021/acs.est.3c09419
Abstrakt:	Combined water, sanitation, and handwashing (WSH) interventions could reduce fecal contamination along more transmission pathways than single interventions alone. We measured Escherichia coli levels in 3909 drinking water samples, 2691 child hand rinses, and 2422 toy ball rinses collected from households enrolled in a 2-year cluster-randomized controlled trial evaluating single and combined WSH interventions. Water treatment with chlorine reduced E. coli in drinking water. A combined WSH intervention improved water quality by the same magnitude but did not affect E. coli levels on hands or toys. One potential explanation for the limited impact of the sanitation intervention (upgraded latrines) is failure to address dog and livestock fecal contamination. Small ruminant (goat or sheep) ownership was associated with increased E. coli levels in stored water and on child hands. Cattle and poultry ownership was protective against child stunting, and domesticated animal ownership was not associated with child diarrhea. Our findings do not support restricting household animal ownership to prevent child diarrheal disease or stunting but do support calls for WSH infrastructure that can more effectively reduce household fecal contamination.
Databáze:	MEDLINE
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