Volume 93, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



We examined pathways of exposure to fecal contamination of human and animal origin in 24 villages in Odisha, India. In a cross-sectional study during the monsoon season, fecal exposure via community water sources ( = 123) and in the home ( = 137) was assessed using human- and nonhuman-associated microbial source tracking (MST) markers and fecal coliforms (FCs). Detection rates and marker concentrations were examined to pinpoint pathways of human fecal exposure in the public and domestic domains of disease transmission in study communities. Human fecal markers were detected much more frequently in the domestic domain (45% of households) than in public domain sources (8% of ponds; 4% of groundwater drinking sources). Animal fecal markers were widely detected in both domains (74% of ponds, 96% of households, 10% of groundwater drinking sources), indicating ubiquitous risks of exposure to animal feces and zoonotic pathogens. This study confirms an often suggested contamination link from hands to stored water in the home in developing countries separately for mothers' and children's hands and both human and animal fecal contamination. In contrast to MST markers, FCs provided a poor metric to assess risks of exposure to fecal contamination of human origin in this rural setting.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Johnson HL, Liu L, Fischer-Walker C, Black RE, , 2010. Estimating the distribution of causes of death among children age 1–59 months in high-mortality countries with incomplete death certification. Int J Epidemiol 39: 11031114.[Crossref] [Google Scholar]
  2. Prüss-Üstün A, Bos R, Gore F, Bartram J, , 2008. Safer Water, Better Health: Costs, Benefits and Sustainability of Interventions to Protect and Promote Health. Geneva, Switzerland: World Health Organization. [Google Scholar]
  3. Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colford JM, , 2005. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis. Lancet Infect Dis 5: 4252.[Crossref] [Google Scholar]
  4. Zambrano LD, Levy K, Menezes NP, Freeman MC, , 2014. Human diarrhea infections associated with domestic animal husbandry: a systematic review and meta-analysis. Trans R Soc Trop Med Hyg 108: 313325.[Crossref] [Google Scholar]
  5. Curtis V, Cairncross S, Yonli R, , 2000. Review: domestic hygiene and diarrhoea - pinpointing the problem. Trop Med Int Health 5: 2232.[Crossref] [Google Scholar]
  6. Cairncross S, Blumenthal U, Kolsky P, Moraes L, Tayeh A, , 1996. The public and domestic domains in the transmission of disease. Trop Med Int Health 1: 2734.[Crossref] [Google Scholar]
  7. Wuertz S, Wang D, Reischer GH, Farnleitner AH, Hagedorn C, Blanch AR, Harwood VJ, , 2011. Library-independent bacterial source tracking methods. , eds. Microbial Source Tracking: Methods, Applications, and Case Studies. New York, NY: Springer, 61112.[Crossref] [Google Scholar]
  8. Odagiri M, Schriewer A, Hanley K, Wuertz S, Pravash M, Panigrahi P, Jenkins M, , 2015. Validation of Bacteroidales quantitative PCR assays targeting human and animal fecal contamination in the public and domestic domains in India. Sci Total Environ 502: 462470.[Crossref] [Google Scholar]
  9. Clasen T, Boisson S, Routray P, Torondel B, Bell M, Cumming O, Ensink J, Freeman M, Jenkins M, Odagiri M, Ray S, Sinha A, Suar M, Schmidt W-P, , 2014. Effectiveness of a rural sanitation programme on diarrhoea, soil-transmitted helminth infection, and child malnutrition in Odisha, India: a cluster-randomised trial. The Lancet Global Health 2: e645e653.[Crossref] [Google Scholar]
  10. Clasen T, Boisson S, Routray P, Cumming O, Jenkins M, Ensink JH, Bell M, Freeman MC, Peppin S, Schmidt WP, , 2012. The effect of improved rural sanitation on diarrhoea and helminth infection: design of a cluster-randomized trial in Orissa, India. Emerg Themes Epidemiol 9: 17.[Crossref] [Google Scholar]
  11. Wuertz S, Miller W, Bambic D, McBride G, , 2011. Quantification of Pathogens and Sources of Microbial Indicators for QMRA in Recreational Waters: WERF Report PATH2R08. London, United Kingdom: IWA Publishing, 200 pp. [Google Scholar]
  12. Pickering AJ, Davis J, Walters SP, Horak HM, Keymer DP, Mushi D, Strickfaden B, Chynoweth JS, Liu J, Blum A, Rogers K, Boehm AB, , 2010. Hands, water, and health: fecal contamination in Tanzanian communities with improved, non-networked water supplies. Environ Sci Technol 44: 32673272.[Crossref] [Google Scholar]
  13. Standard Methods, 2001. Standard Methods for the Examination of Water and Wastewater American Public Health Association & American Water Works. Washington, DC: Association/Water Environment Federation. [Google Scholar]
  14. Mattioli MC, Pickering AJ, Gilsdorf RJ, Davis J, Boehm AB, , 2013. Hands and water as vectors of diarrheal pathogens in Bagannoyo, Tanzania. Environ Sci Technol 47: 355363.[Crossref] [Google Scholar]
  15. Schriewer A, Goodwin KD, Sinigalliano CD, Cox AM, Wanless D, Bartkowiak J, Ebentier DL, Hanley KT, Ervin J, Deering LA, Shanks OC, Peed LA, Meijer WG, Griffith JF, Santodomingo J, Jay JA, Holden PA, Wuertz S, , 2013. Performance evaluation of canine-associated Bacteroidales assays in a multi-laboratory comparison study. Water Res 47: 69096920.[Crossref] [Google Scholar]
  16. Ferguson AS, Mailloux BJ, Ahmed KM, van Geen A, McKay LD, Culligan PJ, , 2011. Hand-pumps as reservoirs for microbial contamination of well water. J Water Health 9: 708717.[Crossref] [Google Scholar]
  17. Graham JP, Polizzotto ML, , 2013. Pit latrines and their impacts on groundwater quality: a systematic review. Environ Health Perspect 121: 521530.[Crossref] [Google Scholar]
  18. Kotloff KL, Blackwelder WC, Nasrin D, Nataro JP, Farag TH, van Eijk A, Adegbola RA, Alonso PL, Breiman RF, Faruque ASG, Saha D, Sow SO, Sur D, Zaidi AKM, Biswas K, Panchalingam S, Clemens JD, Cohen D, Glass RI, Mintz ED, Sommerfelt H, Levine MM, , 2012. The global enteric multicenter study (GEMS) of diarrheal disease in infants and young children in developing countries: epidemiologic and clinical methods of the case/control study. Clin Infect Dis 55: S232S245.[Crossref] [Google Scholar]
  19. Pinfold JV, , 1990. Fecal contamination of water and fingertip-rinses as a method for evaluating the effect of low-cost water-supply and sanitation activities on fecooral disease transmission. 2. A hygiene intervention study in rural north-east Thailand. Epidemiol Infect 105: 377389.[Crossref] [Google Scholar]
  20. Trevett AF, Carter RC, Tyrrel SF, , 2004. Water quality deterioration: a study of household drinking water quality in rural Honduras. Int J Environ Health Res 14: 273283.[Crossref] [Google Scholar]
  21. Mattioli MC, Boehm AB, Davis J, Harris AR, Mrisho M, Pickering AJ, , 2014. Enteric pathogens in stored drinking water and on caregiver's hands in Tanzanian households with and without reported cases of child diarrhea. PLoS ONE 9: e84939.[Crossref] [Google Scholar]
  22. Parker AH, Youlten R, Dillon M, Nussbaumer T, Carter RC, Tyrrel SF, Webster J, , 2010. An assessment of microbiological water quality of six water source categories in north-east Uganda. J Water Health 8: 550560.[Crossref] [Google Scholar]
  23. Edberg SC, Rice EW, Karlin RJ, Allen MJ, , 2000. Escherichia coli: the best biological drinking water indicator for public health protection. J Appl Microbiol 88: 106116.[Crossref] [Google Scholar]
  24. Fujioka RS, Tenno K, Kansako S, , 1988. Naturally-occurring fecal coliforms and fecal Streptococci in Hawaiis fresh-water streams. Toxic Assess 3: 613630.[Crossref] [Google Scholar]
  25. Ensink JHJ, Mahmood T, Dalsgaard A, , 2007. Wastewater-irrigated vegetables: market handling versus irrigation water quality. Trop Med Int Health 12: 27.[Crossref] [Google Scholar]
  26. Pickering AJ, Julian TR, Marks SJ, Mattioli MC, Boehm AB, Schwab KJ, Davis J, , 2012. Fecal contamination and diarrheal pathogens on surfaces and in soils among Tanzanian households with and without improved sanitation. Environ Sci Technol 46: 57365743.[Crossref] [Google Scholar]
  27. Pickering AJ, Julian TR, Mamuya S, Boehm AB, Davis J, , 2011. Bacterial hand contamination among Tanzanian mothers varies temporally and following household activities. Trop Med Int Health 16: 233239.[Crossref] [Google Scholar]

Data & Media loading...

  • Received : 20 Dec 2014
  • Accepted : 23 May 2015
  • Published online : 02 Sep 2015

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error