Assessment of Fecal Exposure Pathways in Low-Income Urban Neighborhoods in Accra, Ghana: Rationale, Design, Methods, and Key Findings of the SaniPath Study.
Assessment of Fecal Exposure Pathways in Low-Income Urban Neighborhoods in Accra, Ghana: Rationale, Design, Methods, and Key Findings of the SaniPath Study.
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DOI：
10.4269/ajtmh.16-0508
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发表时间：
2017-10
期刊：
影响因子：
--
通讯作者：
Moe CL
中科院分区：
文献类型：
--
作者：
Robb K;Null C;Teunis P;Yakubu H;Armah G;Moe CL
快速城市化导致低收入国家出现城市卫生危机。低收入城市社区的居民往往卫生基础设施和服务较差，可能会通过一系列途径频繁暴露于粪便污染。在这些复杂和高度污染的环境中，几乎没有数据可以优先考虑减少粪便污染的战略，在规划城市卫生投资时很少考虑公共卫生优先事项。SaniPath研究通过表征粪便污染暴露途径来满足这一需求。在加纳阿克拉的四个社区的公共和私人领域进行了为期16个月的深入的跨学科接触评估。环境样本的微生物分析和行为数据收集技术被用来量化环境中的粪便污染，并描述与暴露于粪便污染相关的成人和儿童的行为。收集环境样本（n = 1，855），并分析粪便指示物和肠道病原体。对800名受访者进行了家庭调查，并对幼儿进行了500多小时的结构化观察。大约25%的环境样本是结合结构化观察收集的（n = 441个样本）。研究结果强调了公共和私人领域以及食品供应中普遍存在且通常水平很高的粪便污染。家庭中幼儿的主要粪便接触途径是通过食用未煮熟的农产品。SaniPath研究提供了关于低收入城市环境中粪便污染暴露的关键信息，并最终为减少这些公共卫生风险的投资和政策提供信息。
Rapid urbanization has contributed to an urban sanitation crisis in low-income countries. Residents in low-income, urban neighborhoods often have poor sanitation infrastructure and services and may experience frequent exposure to fecal contamination through a range of pathways. There are little data to prioritize strategies to decrease exposure to fecal contamination in these complex and highly contaminated environments, and public health priorities are rarely considered when planning urban sanitation investments. The SaniPath Study addresses this need by characterizing pathways of exposure to fecal contamination. Over a 16 month period, an in-depth, interdisciplinary exposure assessment was conducted in both public and private domains of four neighborhoods in Accra, Ghana. Microbiological analyses of environmental samples and behavioral data collection techniques were used to quantify fecal contamination in the environment and characterize the behaviors of adults and children associated with exposure to fecal contamination. Environmental samples (n = 1,855) were collected and analyzed for fecal indicators and enteric pathogens. A household survey with 800 respondents and over 500 hours of structured observation of young children were conducted. Approximately 25% of environmental samples were collected in conjunction with structured observations (n = 441 samples). The results of the study highlight widespread and often high levels of fecal contamination in both public and private domains and the food supply. The dominant fecal exposure pathway for young children in the household was through consumption of uncooked produce. The SaniPath Study provides critical information on exposure to fecal contamination in low-income, urban environments and ultimately can inform investments and policies to reduce these public health risks.
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影响因子：
11.8
作者：
Acosta, Angel Mendez;Chavez, Cesar Banda;Shrestha, Sanjaya Kumar
通讯作者：
Shrestha, Sanjaya Kumar
影响因子：
3.7
作者：
Douglas, Ian;Alam, Kurshid;Campbell, Jack
通讯作者：
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影响因子：
--
作者：
ARMAH, GE;MINGLE, JAA;NKRUMAH, FK
通讯作者：
NKRUMAH, FK
对城市卫生干预措施的受控，前后试验，以减少儿童肠道感染：莫桑比克的马普托卫生研究方案（Mapsan）研究。
影响因子：
2.9
作者：
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通讯作者：
Schmidt WP
影响因子：
3.7
作者：
Antwi-Agyei P;Cairncross S;Peasey A;Price V;Bruce J;Baker K;Moe C;Ampofo J;Armah G;Ensink J
通讯作者：
Ensink J