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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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