Can individual and integrated water, sanitation, and handwashing interventions reduce fecal contamination in the household environment? Evidence from the WASH Benefits cluster-randomized trial in rural Kenya
Can individual and integrated water, sanitation, and handwashing interventions reduce fecal contamination in the household environment? Evidence from the WASH Benefits cluster-randomized trial in rural Kenya
Abstract Combined water, sanitation, and handwashing (WSH) interventions have the potential to reduce fecal pathogens along more transmission pathways than single interventions alone. We measured Escherichia coli levels in 3909 drinking water samples, 2691 child hand rinses, and 2422 toy ball rinses collected from households enrolled in a two-year cluster-randomized controlled trial evaluating single and combined WSH interventions. Water treatment alone reduced E. coli in drinking water, while a combined WSH intervention improved water quality by the same magnitude but did not affect levels of fecal indicator bacteria on child hands or toy balls. The failure of the WSH interventions to reduce E. coli along important child exposure pathways is consistent with the lack of a protective effect from the interventions on child diarrhea or child growth during the trial. Our results have important implications for WSH program design; the sanitation and handwashing interventions implemented in this trial should not be expected to reduce child exposure to fecal contamination in other similar settings.
Clasen Thomas、Pickering Amy J.、Arnold Charles D.、Null Clair、Swarthout Jenna、Arnold Benjamin F.、Wolfe Marlene、Rao Gouthami、Lin Audrie、Dentz Holly N.、Mboya John、Ram Pavani K.、Colford John M. Jr.、Stewart Christine P.、Mureithi MaryAnne
Emory UniversityCivil and Environmental Engineering, Tufts UniversityUniversity of CaliforniaMathematica Policy InstituteCivil and Environmental Engineering, Tufts UniversityUniversity of CaliforniaCivil and Environmental Engineering, Tufts UniversityInnovations for Poverty ActionUniversity of CaliforniaInnovations for Poverty ActionInnovations for Poverty ActionUniversity at BuffaloUniversity of CaliforniaUniversity of CaliforniaInnovations for Poverty Action
预防医学环境科学基础理论微生物学
Clasen Thomas,Pickering Amy J.,Arnold Charles D.,Null Clair,Swarthout Jenna,Arnold Benjamin F.,Wolfe Marlene,Rao Gouthami,Lin Audrie,Dentz Holly N.,Mboya John,Ram Pavani K.,Colford John M. Jr.,Stewart Christine P.,Mureithi MaryAnne.Can individual and integrated water, sanitation, and handwashing interventions reduce fecal contamination in the household environment? Evidence from the WASH Benefits cluster-randomized trial in rural Kenya[EB/OL].(2025-03-28)[2025-05-10].https://www.biorxiv.org/content/10.1101/731992.点此复制
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