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Exposure to Fecal Contamination in 3 Low-Income Urban Settings: Results from the SaniPath Tool

S Raj, Y Wang, K Robb, H Yakubu, D Berendes, N Wellington, J Ampofo, G Kang, S Roy, A Kartikieyan, J Brown, N Lazaro, B Muneme, I VanHaren, A Kirby, CL Moe

Suraja Raj presented the results from an in-depth two-year investigation of the implementation of the SaniPath Tool in Accra, Ghana; Vellore, India; and Maputo, Mozambique, at the FSM4 conference. The main finding from each deployment is that the SaniPath Tool can effectively determine the level of risk that each pathway for fecal contamination presents to neighborhood residents, and the proportion of residents that are at risk.

The SaniPath Tool uses a combination of behavioral surveys (community, school, and household surveys), and environmental samples (surface water, public latrine surfaces, raw produce, drains, flood water, municipal drinking water, and bathing water), to determine which pathway presents the greatest risk to residents. The level of risk is established based on Bayesian analysis using the dosage of E.coli in the pathway, as well as how frequently and the mannerisms in which residents interact with each pathway. Data for this study was collected from 5 neighborhoods in Accra, 2 neighborhoods in Vellore, and 2 neighborhoods in Maputo, with the cross-sectional data collected between April-June 2016 in Accra, February-March 2014 in Vellore, and April-May 2016 in Maputo. Throughout the study, the SaniPath Tool proved to be helpful in assessing public health risks from exposure to fecal contamination due to inadequate sanitation services and fecal sludge management, and would therefore be a useful tool for decision-makers who need to plan for and prioritize sanitation investments.

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