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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/15893

Title: Quantitative assessment of exposure to fecal contamination in urban environment across nine cities in low-income and lower-middle-income countries and a city in the United States
Authors: Wang, Yuke
Mairinger, Wolfgang
Raj, Suraja J.
Yakubu, Habib
Siesel, Casey
Green, Jamie
Durry, Sarah
Joseph, George
Rahman, Mahbubur
Amin, Nuhu
Hassan, Md. Zahidul
Wicken, James
Dourng, Dany
Larbi, Eugene
Adomako, Lady Asantewa B.
Senayah, Ato Kwamena
Doe, Benjamin
Buamah, Richard
Tetteh-Nortey, Joshua Nii Noye
Kang, Gagandeep
Karthikeyan, Arun
Roy, Sheela
Brown, Joe
Muneme, Bacelar
Sene, Seydina O.
Tuffuor, Benedict
Mugambe, Richard K.
Bateganya, Najib Lukooya
Trevor Surridge, Trevor
Ndashe, Grace Mwanza
Ndashe, Kunda
Ban, Radu
Schrecongost, Alyse
Moe, Christine L.
Keywords: Exposure assessment
Multi-city
WASH
Fecal
Pathway
LLMIC
Issue Date: 23-Oct-2021
Publisher: Science of the Total Environment
Abstract: Background: During 2014 to 2019, the SaniPath Exposure Assessment Tool, a standardized set ofmethods to evaluate risk of exposure to fecal contamination in the urban environment throughmultiple exposure pathways,was deployed in 45 neighborhoods in ten cities, including Accra and Kumasi, Ghana; Vellore, India; Maputo, Mozambique; Siem Reap, Cambodia; Atlanta, United States; Dhaka, Bangladesh; Lusaka, Zambia; Kampala, Uganda; Dakar, Senegal. Objective: Assess and compare risk of exposure to fecal contamination via multiple pathways in ten cities. Methods: In total, 4053 environmental samples, 4586 household surveys, 128 community surveys, and 124 school surveys were collected. E. coli concentrations were measured in environmental samples as an indicator of fecal contamination magnitude. Bayesian methodswere used to estimate the distributions of fecal contamination concentration and contact frequency. Exposure to fecal contamination was estimated by the Monte Carlo method. The contamination levels of ten environmental compartments, frequency of contact with those compartments for adults and children, and estimated exposure to fecal contamination through any of the surveyed environmental pathways were compared across cities and neighborhoods. Results: Distribution of fecal contamination in the environment and human contact behavior varied by city. Universally, food pathways were the most common dominant route of exposure to fecal contamination across cities in low-income and lower-middle-income countries. Risks of fecal exposure via water pathways, such as open drains, flood water, and municipal drinking water, were site-specific and often limited to smaller geographic areas (i.e., neighborhoods) instead of larger areas (i.e., cities). Conclusions: Knowledge of the relative contribution to fecal exposure from multiple pathways, and the environmental contamination level and frequency of contact for those “dominant pathways” could provide guidance for Water, Sanitation, and Hygiene (WASH) programming and investments and enable local governments and municipalities to improve intervention strategies to reduce the risk of exposure to fecal contamination.
URI: http://hdl.handle.net/123456789/15893
Appears in Collections:College of Architecture and Planning

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