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Do sanitation improvements reduce fecal contamination of water, hands, food, soil and flies? Evidence from a cluster-randomized controlled trial in…

A new interesting article has been published in Environ Sci Technol. 2018 Sep 26. doi: 10.1021/acs.est.8b02988. and titled:

Do sanitation improvements reduce fecal contamination of water, hands, food, soil and flies? Evidence from a cluster-randomized controlled trial in…

Authors of this article are:
Ercumen A Pickering A Kwong LH Mertens A Arnold BF Benjamin-Chung J Hubbard AE Alam M Sen D Islam S Khalil MMR Kullmann C Chase C Ahmed R Parvez SM Unicomb L Rahman M Ram P Clasen TF Luby SP Colford JM.

A summary of the article is shown below:
Sanitation improvements have had limited effectiveness in reducing the spread of fecal pathogens into the environment. We conducted environmental measurements within a randomized controlled trial in Bangladesh that implemented individual and combined water treatment, sanitation, handwashing (WSH) and nutrition interventions (WASH Benefits, NCT01590095). Following approximately 4 months of intervention, we enrolled households in the trial’s control, sanitation and combined WSH arms to assess whether sanitation improvements, alone and coupled with water treatment and handwashing, reduce fecal contamination in the domestic environment. We quantified fecal indicator bacteria in samples of drinking and ambient waters, child hands, food given to young children, courtyard soil and flies. In the WSH arm, E. coli prevalence in stored drinking water was reduced by 62% (prevalence ratio=0.38 (0.32, 0.44)) and E. coli concentration by 1-log (log10 = -0.88 (-1.01, -0.75)). The interventions did not reduce E. coli along other sampled pathways. Ambient contamination remained high among intervention households. Potential reasons include non-community-level sanitation coverage, child open defecation, animal fecal sources or naturalized E. coli in the environment. Future studies should explore potential threshold effects of different levels of community sanitation coverage on environmental contamination.

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