1921
Volume 98, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645
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Abstract

Abstract.

pathotypes (i.e., enteropathogenic and enterotoxigenic) have been identified among the pathogens most responsible for moderate-to-severe diarrhea in low- and middle-income countries (LMICs). Pathogenic are transmitted from infected human or animal feces to new susceptible hosts via environmental reservoirs such as hands, water, and soil. Commensal , which includes nonpathogenic strains, are widely used as fecal bacteria indicator, with their presence associated with increased likelihood of enteric pathogens and/or diarrheal disease. In this study, we investigated contamination in environmental reservoirs within households ( = 142) in high-population density communities of Harare, Zimbabwe. We further assessed the interconnectedness of the environmental compartments by investigating associations between, and household-level risk factors for, contamination. From the data we collected, the source and risk factors for contamination are not readily apparent. One notable exception is the presence of running tap water on the household plot, which is associated with significantly less contamination of drinking water, handwashing water, and hands after handwashing. In addition, levels on hands after washing are significantly associated with handwashing water contamination, hand contamination before washing, and diarrhea incidence. Finally, we observed that animal ownership increases contamination in soil, and in soil are correlated with contamination on hands before washing. This study highlights the complexity of contamination in household environments within LMICs. More, larger, studies are needed to better identify sources and exposure pathways of —and enteric pathogens generally—to identify effective interventions.

[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.

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2018-03-07
2018-06-18
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  • Received : 29 Jun 2017
  • Accepted : 27 Nov 2017

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