Risk of Exposure to Fecal Contamination in 10 Neighborhoods Across Dhaka, Bangladesh

CL Moe, J Green, S Raj, Y Wang, N Amin, S Ali, M Rahman, I Hasan, Z Hasan, S Haque, G Joseph American Society of Tropical Medicine and Hygiene Conference (October 2018)

Dhaka, Bangladesh has experienced rapid population growth and challenges meeting sanitation service demands. Poor sanitation and fecal sludge management can lead to fecal contamination in the urban environment. To understand risk of exposure to fecal contamination, an assessment of 10 environmental pathways was conducted using the SaniPath Tool. Data were collected from 10 neighborhoods (6 low-income, 2 mixed-income, and 2 high-income) throughout Dhaka between April-June 2017. 1000 environmental samples were collected from shared latrines, public play areas, produce in markets, street food, open drains, flood waters, surface waters, bathing water, municipal water, and non-municipal water. Samples were analyzed using IDEXX-Colilert-24® Quanti-Tray/2000 to determine most probable number (MPN) of E. coli. Behavior surveys were conducted with households, school children, and community groups to understand interaction with the environment. Using Bayesian methods, the behavioral and microbiological data were used to estimate the percentage of the population exposed and mean dose of fecal exposure (E. coli) for each environmental pathway in each neighbourhood. For adults, consumption of raw produce was the dominant exposure pathway (i.e. makes greatest contribution to total exposure) in 6 of the 10 neighborhoods. The percentage of adults exposed to fecal contamination through ingestion of raw produce ranged from 78-99% and the mean dose ranged from 104.8 to 107.5 MPN of E. coli ingested/month. The most common dominant pathway of exposure amongst children (8/10 neighborhoods) was accidental ingestion of drain water from playing in, or passing through, open drains (up to 94% exposed; mean dose of 107.8 MPN of E. coli ingested/month). Ingestion of fecal contamination via produce and street food was a high risk throughout Dhaka, while exposure to fecal contamination via municipal drinking water was mainly greater risk for those living in the south of the city. These results can guide city-wide WASH programming to prioritize interventions aimed at dominant exposure pathways and increase the potential for public health impact.

What does SaniPath tell us about exposure to fecal contamination in 12 neighborhoods in 3 cities?

CL Moe

22nd Annual SuSanA Meeting (August 2016)

This presentation, given by Dr. Christine Moe, compared the latest results of the SaniPath Study from three different study sites: Accra, Ghana; Vellore, India; and Maputo, Mozambique and discussed the reliability of the SaniPath Tool data. The presentation was given at the 22nd Annual SuSanA meeting in Stockholm. SuSanA is “an open international alliance” bringing together individuals who are interested in sustainable sanitation, and who are “dedicated to understanding viable and sustainable sanitation solutions.”

You can watch Dr. Moe’s presentation below:

Characterizing Determinants of Hand Contamination in Low-Income Neighborhoods of Accra, Ghana

T Osborne, K Robb, J Ampofo, K Baker, D Berendes, C Null, H Reese, Y Wang, H Yakubu, and CL Moe

UNC Water and Health 2015 (October 2015)

This poster was prepared by Taylor Osborne. The poster presents a sub-study of SaniPath Phase 1 in Accra, Ghana, which assessed the correlation between E. coli and enterococci handrinse concentrations in different urban settings. This poster was presented at the 2015 UNC Water & Health Conference: Where Science Meets Policy. The annual conference is hosted by the UNC Water Institute focuses on “drinking water supply, sanitation, hygiene and water resources in both the developing and developed worlds with a strong public health emphasis.”