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S Raj, Y Wang, A White, N Kishore, J Michiel, C Siesel, CL Moe

UNC Water and Health Conference (October 2018) Suraja Raj presented a poster at the UNC Water and Health Conference in October, 2018, highlighting new developments related to the new SaniPath Tool. The SaniPath Tool examines human exposure to fecal contamination in low-resource urban settings. It provides guidance for primary data collection, automated exposure analysis, and results visualizations that are accessible to people from a range of scientific backgrounds. This poster describes the development of a tool that allows users to plan a SaniPath deployment, set up and manage mobile data collection, analyze results, and generate reports. The tool guides users through steps of implementing the tool–from planning to data analysis. The tool is composed of a project planning and management interface, mobile data collection and data repository, and a data analysis and visualization dashboard. The tool can be customized to suit context-specific data collection needs. The SaniPath Tool is built on an integrated system of existing open source technologies and a tailored project management interface. It guides users through project configuration, training, and deployment by automating the customization and analysis processes. The Tool also uses an open source mobile data collection software, KoboToolbox (KT), which provides the backbone of data collection and storage. Data is collected via downloadable mobile forms used on Android devices and is uploaded to KT, which is paired with Enketo for online web data entry or editing. The tool automatically retrieves data from KT and generates exposure assessments for each study site and exposure pathway. Users can view and analyze the collected data, access data visualizations, and create a draft final report. The services are deployed on Amazon Web Services (AWS) infrastructure and backups are stored in S3 buckets for redundant data storage. The SaniPath Tool is an innovative use of mHealth in the WASH sector and can serve as an example of how open source software can be used to synthesize and analyze complex information and encourage public health evidence-based decision-making about urban sanitation investment.

J Green, S Raj, Y Wang, D Duong, M Yakushima, S Chhun, H Yakubu, J Michiel, J Wicken, CL Moe



At the 2017 UNC Water and Health Conference in Chapel Hill, North Carolina, Jamie Green presented a poster on an assessment of Exposure to Fecal Contamination in Informal Settlements and Formal Neighborhoods of Siem Reap, Cambodia. The CGSW’s Sanipath Tool was used to assess the risk of exposure to fecal contamination in 5 environmental pathways in 5 neighborhoods (3 formal and 2 informal settlements). Overall, there were large variations in exposure risks within formal neighborhoods and informal settlements. Results show that raw produce posed one of the greatest risks of exposure to fecal contamination across all five neighborhoods (100% of adults exposed to dose ranging from 7.59E05 to 1.78E07 CFU/month from produce). Participants in all neighborhoods reported bottled water and well water as main sources of drinking water, while few reported drinking municipal water. No E. coli was found in municipal water, while bottled water and well water had moderate amount of E. coli. The lowest dose of exposure for floodwater was found in the only neighborhood with a drainage system (4.79E02 CFU/month). Results from this study provide evidence for decision makers to prioritize efforts to reduce exposure to fecal contamination in Siem Reap.

Y Wang, CL Moe, P Teunis



In May, 2017, Yuke (Andrew) gave an oral presentation at the UNC Water Microbiology Conference in Chapel Hill, NC about the SaniPath study in Accra, Ghana. The presentation explained how simulated behaviors were generated based on structured observations and how these simulations could be utilized to  generate fecal microbe transfer networks that can inform frequency, duration, and sequences of behaviors.


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