Identifying Potential Determinants of Faecal Contamination on Domestic Floors in Three Settings in Rural Kenya: A Mixed Methods Analysis

Observational evidence suggests that household floors may be an important domain for the transmission of enteric and parasitic infections. However, little work has been done to investigate how household floors can become contaminated with human and animal faeces. This study uses a mixed methods approach to postulate the proximal and distal determinants of household floor contamination with faeces in groups of rural villages in 3 counties in Kenya (Bungoma, Kwale and Narok). Quantitative data was collected through a household census and analysed descriptively and using mixed effects logistic regression models. Qualitative data was collected through unstructured observations of daily routines and in-depth interviews. These data were analysed thematically with case memos produced for routine activities that were hypothesised to be determinants of floor contamination. Possible proximal determinants of floor contamination included; (1) animal contact with floors; (2) child faeces disposal, and; (3) floor cleaning routines. Distal determinants are suggested to be rooted in the socioeconomic, environmental, and cultural context in which households were located and included; (1) the type and number of animals owned by households; (2) presence/absence of dedicated shelters for housing animals at night, which impacted whether sleeping or cooking areas were exposed to animals; (3) Accessibility of inside spaces to poultry and other roaming animals; (4) ownership of an improved floor; (5) ability of animals to access neighbours compounds; (6) seasonal changes in weather. These results will be of use in identifying the contexts in which faecal contamination of domestic floors may be contributing towards transmission of enteric and parasitic infections and in designing effective interventions to prevent this exposure.

Assessing the Occurrence of Host-Specific Faecal Indicator Markers in Water Systems as a Function of Water, Sanitation and Hygiene Practices: A Case Study in Rural Communities of Vhembe District Municipality, South Africa

In settings where humans and animals closely coexist, the introduction of faecal material into unprotected water sources significantly increases the risk of contracting diarrhoeal and zoonotic waterborne diseases. The data were gathered from a survey conducted through interviews at randomly sampled villages; additionally, water samples were collected in randomly selected households and their associated feeder catchments. Molecular techniques were used, specifically qPCR, to run host-specific Bacteroides microbial source tracking (MST) assays for human, cattle, pig, chicken and dog faecal contamination. Unexpectedly, the qPCR assays revealed dogs to be the most prevalent (40.65%) depositor of faecal matter in unprotected surface water, followed by humans (40.63%); this finding was contradictory to survey findings indicating cattle as the leading source. At the household level, dogs (16.67%) and chickens (15.28%) played prominent roles, as was expected. Reflecting on some of the basic daily practices in households, nearly 89.00% of the population was found to store water due to erratic supply, in contrast to 93.23% using an improved water source. Additionally, a significant association was found between water, sanitation and hygiene (WASH) variables and the occurrence of MST markers after performing a bivariate linear regression. However, the inconsistency between the MST results and household surveys suggests pervasive sanitation issues, even in households without domesticated animals.

Salmonella spp., Escherichia coli and Enterobacteriaceae Control at a Pig Abattoir: Are We Missing Lairage Time Effect, Pig Skin, and Internal Carcass Surface Contamination?

To provide meat safety and consumer protection, appropriate hygiene control measures at an abattoir are required. This study aimed to evaluate the influence of visual fecal contamination level (VFCL) and lairage time (LT) on pig skin (PS) and external (ECS) and internal (ICS) carcass surfaces. The presence of Enterobacteriaceae, Escherichia coli (E. coli) and Salmonella in PS, ECS, and ICS were evaluated. A total of 300 paired samples were collected from 100 pigs. Results underlined the importance of the skin (Enterobacteriaceae: 3.27 ± 0.68 log CFU/cm2; E. coli: 3.15 ± 0.63 log CFU/cm2; Salmonella: 21% of samples) as a direct or indirect source of carcass contamination. Although VFCL revealed no significant effect (p > 0.05), the increase of LT had a significant impact (p < 0.001) on Enterobacteriaceae and E. coli levels across all analysed surfaces, and Salmonella presence on ICS (p < 0.01), demanding attention to LT. Also, the ICS showed a higher level of these bacteria compared to ECS. These results highlight the need of food business operators to consider ICS as an alternative area to sample for Salmonella, as a criterion for process hygiene based on EC Regulation No. 2073/2005, and as a potential contamination source to be integrated in the hazard analysis critical control point (HACCP) plans.

Hand hygiene and water quality assessment in schools of Muthanna province, Southern Iraq

INTRODUCTION

The severe drought and prolonged heat waves in Iraq have adversely affected the water quality supplied to public facilities. Schools are among the most affected facilities by water scarcity. This work aims to evaluate the level of students' hand hygiene, and the quality of municipal (MW) and drinking water (DW) in some schools of Al-Muthanna Province, Iraq.

METHODOLOGY

Between October 2021 and June 2022, a total of 324 water samples from 162 schools and 2,430 hand swabs (HSs) from 1,620 students (1,080 males and 540 females) were collected. Some physicochemical standards of water were assessed besides investigating faecal contamination in water and students' hands using Escherichia coli as an indicator.

RESULTS

All MW samples were faecally contaminated with poor standards of pH, turbidity, total dissolved solids, color, and chlorine. Despite the good physicochemical standards of all DW samples, E. coli was observed in 12% of samples. Hand hygiene levels dropped by 2.5-fold within a few hours after school entry compared to early-morning levels (before school entry). Male students were 1.5- and 1.7-fold more prone to hand contamination than female students either inside or outside school, respectively. An increasing chlorine tolerance by E. coli was observed in water samples with turbidity > 5 NTU and pH > 8.

CONCLUSIONS

The students' hand hygiene level decreases within a few hours of entering school, particularly among male students. Residual-free chlorine < 0.5 mg/L with high turbidity and alkalinity in water is insufficient for 100% prevention of E. coli contamination.

Bivalve Shellfish Safety in Portugal: Variability of Faecal Levels, Metal Contaminants and Marine Biotoxins during the Last Decade (2011-2020)

Bivalves are a high-value product whose production has markedly increased, reaching 9863 tonnes in Portugal in 2021. Bivalves' habitats-lagoons, estuaries and coastal waters-are exposed to biological and anthropogenic contaminants, which can bioaccumulate in these organisms and pose a significant public health risk. The need to obtain a safe product for human consumption led to the implementation of standardised hygiene regulations for harvesting and marketing bivalve molluscs, resulting in routine monitoring of bivalve production areas for microbial quality, metal contaminants, and marine biotoxins. While excessive levels of biotoxins and metal contamination lead to temporary harvesting bans, high faecal contamination leads to area reclassification and impose post-harvest treatments. In this study, the seasonal and temporal variability of these parameters were analysed using historical data generated by the monitoring programme during the last decade. Moreover, the impact of the monitoring program on bivalve harvesting from 2011 to 2020 was assessed. This program presented a considerable improvement over time, with an increase in the sampling effort and the overall program representativeness. Finally, contamination risk, revising control measures, and defining recommendations for risk mitigation measures are given in the light of ten years' monitoring.

Endotoxin as a Marker for Water Quality

BACKGROUND

Water quality testing is vital to protect human health. Current testing relies mainly on culture-based detection of faecal indicator organisms such as Escherichia coli (E.coli). However, bacterial cultures are a slow process, taking 24-48 h and requiring specialised laboratories and trained personnel. Access to such laboratories is often sparse in developing countries and there are many fatalities deriving from poor water quality. Endotoxin is a molecular component of Gram-negative bacterial cell walls and can be used to detect their presence in drinking water.

METHOD

The current study used a novel assay (BacterisK) to rapidly detect endotoxin in various water samples and correlate the results with E. coli content measured by culture methods. The data generated by the BacterisK assay are presented as an 'endotoxin risk' (ER).

RESULTS

The ER values correlate with E. coli and thus endotoxin can be used as a marker of faecal contamination in water. Moreover, the BacterisK assay provides data in near real-time and can be used in situ allowing water quality testing at different spatial and temporal locations.

CONCLUSION

We suggest that BacterisK can be used as a convenient risk assessment tool to assess water quality where results are required quickly or access to laboratories is lacking.

Identifying Sources of Faecal Contamination in a Small Urban Stream Catchment: A Multiparametric Approach

Small urban streams discharging in the proximity of bathing waters may significantly contribute to the deterioration of water quality, yet their impact may be overlooked. This study focuses on the Elm Park stream in the city of Dublin that is subject to faecal contamination by unidentified sources. The aim of the study was to identify a minimum number of “sentinel” sampling stations in an urban catchment that would provide the maximum amount of information regarding faecal pollution in the catchment. Thus, high-resolution sampling within the catchment was carried out over the course of 1 year at 11 stations. Faecal indicator bacteria were enumerated and microbial source tracking (MST) was employed to evaluate human pollution. In addition, ammonium, total oxidised nitrogen, and phosphorus levels were monitored to determine if these correlated with faecal indicator and the HF183 MST marker. In addition, the effect of severe weather events on water quality was assessed using automated sampling at one of the identified “sentinel” stations during baseflow and high flow conditions over a 24-h period. Our results show that this urban stream is at times highly contaminated by point source faecal pollution and that human faecal pollution is pervasive in the catchment. Correlations between ammonium concentrations and faecal indicator bacteria (FIB) as well as the human MST marker were observed during the study. Cluster analysis identified four “sentinel” stations that provide sufficient information on faecal pollution in the stream, thus reducing the geographical complexity of the catchment. Furthermore, ammonium levels strongly correlated with FIB and the human HF183 MST marker under high flow conditions at key “sentinel” stations. This work demonstrates the effectiveness of pairing MST, faecal indicators, and ammonium monitoring to identify “sentinel” stations that could be more rapidly assessed using real-time ammonium readouts to assess remediation efforts.

Child hand contamination is associated with subsequent pediatric diarrhea in rural Democratic Republic of the Congo (REDUCE Program)

OBJECTIVE

The Reducing Enteropathy, Undernutrition, and Contamination in the Environment (REDUCE) program focuses on identifying exposure pathways to faecal pathogens for young children in the Democratic Republic of the Congo (DRC) and on developing scalable interventions to reduce faecal contamination from these pathways.

METHODS

A prospective cohort study of 690 participants was conducted to investigate the association between hand, food, and environmental faecal contamination and diarrhoeal disease prevalence among young children in Walungu Territory, South Kivu, DRC. A total of 1923 hand rinse, soil, food, object, surface, stored water and water source samples were collected during unannounced spot checks after baseline enrolment and analysed for Escherichia coli. Caregiver reports of diarrhoea were obtained from children < 5 years at a 6-month follow-up.

RESULTS

E.coli was detected in 73% of child and caregiver hand-rinse samples, 69% of soil samples from child play spaces, 54% of child food samples, 38% of objects and surfaces children were observed putting in their mouths, 74% of stored water samples, and 40% of source water samples. Children < 5 years with E. coli on their hands had significantly higher odds of diarrhoea at the 6-month follow-up (odds ratio: 2.03 (95% confidence interval: 1.05, 3.92)).

CONCLUSION

The cohort study findings from the REDUCE program have shown that child hand contamination is associated with diarrhoeal disease in rural DRC, and that there is high faecal contamination in child plays spaces and food. These findings provide evidence demonstrating the urgent need to provide clean play spaces for young children and interventions targeting hand hygiene to reduce paediatric exposure to faecal pathogens.

Antibiotic resistance patterns of Pseudomonas spp. isolated from faecal wastes in the environment and contaminated surface water

The Pseudomonas genus, which includes environmental and pathogenic species, is known to present antibiotic resistances, and can receive resistance genes from multi-resistant enteric bacteria released into the environment via faecal rejects. This study was aimed to investigate the resistome of Pseudomonas populations that have been in contact with these faecal bacteria. Thus, faecal discharges originating from human or cattle were sampled (from 12 points and two sampling campaigns) and 41 Pseudomonas species identified (316 isolates studied). The resistance phenotype to 25 antibiotics was determined in all isolates, and we propose a specific antibiotic resistance pattern for 14 species (from 2 to 9 resistances). None showed resistance to aminoglycosides, tetracycline, or polymyxins. Four species carried a very low number of resistances, with none to β-lactams. Interestingly, we observed the absence of the transcriptional activator soxR gene in these four species. No plasmid transfer was highlighted by conjugation assays, and a few class 1 but no class 2 integrons were detected in strains that may have received resistance genes from Enterobacteria. These results imply that the contribution of the Pseudomonas genus to the resistome of an ecosystem first depends on the structure of the Pseudomonas populations, as they may have very different resistance profiles.

Detection of canine parvovirus types 2b and 2c in canine faecal samples contaminating urban thoroughfares in Brazil

Canine parvovirus type 2 (CPV-2) is a highly contagious virus that causes acute gastroenteritis in dogs all over the world. Because of its stability in the environment, CPV-2 can remain infective for a long time, especially if protected in organic matter. To demonstrate CPV-2's potential as an environmental hazard for nonimmunized susceptible hosts, we investigated 50 faecal samples collected from public areas in a municipality of Paraná state, Brazil. Seven samples tested positive for CPV by a PCR assay targeting the partial VP2 gene, with three strains being confirmed as CPV-2b variant and one as CPV-2c variant by sequence analysis. These findings were supported by phylogenetic analysis, and the species identity of faecal samples source was confirmed by canine mitochondrial DNA amplification and sequencing. Our results demonstrate the presence of CPV in canine faeces contaminating urban thoroughfares and reinforce the importance of environmental control to reduce the potential exposure risks to susceptible hosts.

Assessing Risk of E. coli Resuspension from Intertidal Estuarine Sediments: Implications for Water Quality

Estuarine sediments are a reservoir for faecal bacteria, such as E. coli, where they reside at greater concentrations and for longer periods than in the overlying water. Faecal bacteria in sediments do not usually pose significant risk to human health until resuspended into the water column, where transmission routes to humans are facilitated. The erosion resistance and corresponding E. coli loading of intertidal estuarine sediments was monitored in two Scottish estuaries to identify sediments that posed a risk of resuspending large amounts of E. coli. In addition, models were constructed in an attempt to identify sediment characteristics leading to higher erosion resistance. Sediments that exhibited low erosion resistance and a high E. coli loading occurred in the upper- and mid-reaches of the estuaries where sediments had higher organic content and smaller particle sizes, and arose predominantly during winter and autumn, with some incidences during summer. Models using sediment characteristics explained 57.2% and 35.7% of sediment shear strength and surface stability variance respectively, with organic matter content and season being important factors for both. However large proportions of the variance remained unexplained. Sediments that posed a risk of resuspending high amounts of faecal bacteria could be characterised by season and sediment type, and this should be considered in the future modelling of bathing water quality.

Groundwater use and diarrhoea in urban Nepal: novel application of a geostatistical interpolation technique linking environmental and epidemiologic survey data

Background

Groundwater is a common domestic water source in developing countries, but is persistently contaminated with enteropathogens. However, studies on determinants of diarrhoea have predominantly focused on piped water. This study examines the relationship between groundwater microbial quality and household diarrhoea occurrence (HDO).

Methods

Considering it as a proxy of enteropathogens, this study analysed Escherichia coli concentrations in groundwater wells. Ordinary kriging, a geostatistical technique in geographic information systems, was used to interpolate the E. coli concentration to survey points that had secondary survey data (n=942). The relationship between E. coli and HDO using simple and multivariate statistical analyses in SPSS was analysed.

Results

A total of 77% of households used groundwater. One-third of households were without piped-water access (PWA), and these households were significantly more likely to use groundwater than those with PWA. Of the 87 households that reported HDO, 77% were groundwater users. Of the groundwater users, the households with HDO consumed groundwater with significantly higher E. coli concentrations than the households without HDO. Of the households without PWA, the increase in the E. coli concentration increased the odds of HDO (adjusted odds ratio=3.15; 95% CI=1.07-9.22).

Conclusion

It is suggested that the groundwater microbial quality is a risk factor for HDO and illustrates this by an application of an interpolation technique relevant for developing countries.

Statistical Analysis of Bathing Water Quality in Puglia Region (Italy)

Geostatistic analysis was applied to the dataset from multi-year monitoring, in the Apulian marine-coastal zone (Mediterranean Sea, Italy), on the presence and abundance of intestinal Enterococci and Escherichia coli, microbiological indicators of faecal contamination at the sea. The same faecal contamination can be considered as the main cause of pollution phenomenon under current Italian and European regulations for the bathing waters (Italian Government Decree 116/2008, European Directive 2006/7/CE). The main objective of the study is to verify, taking into the account the anthropic pressures acting on the coastal zone, the efficiency of the Apulian regional monitoring plan currently in force for the assessment of bathing waters quality, with a view to a hypothetical reduction of sample collection points.

Chemical and Microbial Quality of Groundwater in Siloam Village, Implications to Human Health and Sources of Contamination

Due to inaccessibility of potable water, rural communities drill boreholes within their homesteads despite vulnerability to groundwater contamination and associated health risks. This study assessed the quality of groundwater, identified potential sources of contamination and potential human health risks in Siloam Village, South Africa. Statistical difference between similar water quality parameters at different sites was determined at a significance level (α) of 0.05. Water quality parameters with serious potential health effects on human beings were correlated with selected water quality parameters to understand the nature of correlation and possible sources of contamination. Fluorides and nitrates had excessively high concentrations associated with tooth damage and pronounced skeletal fluorosis, and methaemoglobinaemia in infants and mucous membrane irritation in adults, respectively. There were statistically significant differences between means of most water quality parameters. Contrasting correlation of fluoride with calcium and pH indicated the need to further identify local sources and fluoride control mechanisms. Correlation of nitrate with chloride mostly indicated that faecal contamination is the potential source of high nitrates in groundwater. This requires further verification. Presence of total coliforms and E. coli in most boreholes indicated potential presence of faecal contamination. The need to educate borehole owners' on possible strategies to minimise groundwater pollution was identified.

Comparison of an alcohol-based hand sanitation product with a traditional chlorhexidine hand scrub technique for hand hygiene preparation in an equine hospital

AIMS

To investigate the efficacy of an alcohol gel-based hand antisepsis protocol compared with a traditional chlorhexidine-based protocol under conditions of routine clinical contamination, and following heavy faecal contamination.

METHODS

Twelve adult participants were recruited and on four separate days completed a hand sanitation protocol using a chlorhexidine scrub or an alcohol-based gel, with hands that were grossly clean but contaminated or with faecal contamination. Bacterial samples were obtained from participants' hands before sanitation, immediately after and then 2 hours later. All samples were cultured on blood and MacConkey agar and bacterial colonies counted after 48 hours.

RESULTS

for clean contaminated hands, the percentage reduction in bacterial colonies on blood agar immediately after hand sanitation was similar for both protocols (p=0.3), but was greater for the alcohol gel than chlorhexidine after 2 hours (p=0.005). For hands with faecal contamination, the percentage reduction in bacterial colonies on blood agar was similar for both protocols immediately and 2 hours after sanitation (p>0.2), but positive cultures were obtained on blood agar from samples collected after both protocols, for almost all participants.

CONCLUSIONS

The results indicate equivalent efficacy of the alcohol-based gel and the pre-surgical chlorhexidine protocol.

CLINICAL RELEVANCE

The alcohol-based gel protocol is an effective hand asepsis technique for grossly clean contaminated hands and those following faecal contamination, with comparable efficacy to chlorhexidine based scrub.

Investigation on the temporal variation and source tracking of faecal bacteria in a forest dominated watershed (Comox Lake), British Columbia, Canada

AIMS

The aims of this study were to investigate the temporal variation in Escherichia coli density and its sources at the drinking water intake of Comox Lake for a period of 3 years (2011-2013).

METHODS AND RESULTS

Density of E. coli was assessed by standard membrane filtration method. Source tracking of E. coli were done by using BOX-A1R-based rep-PCR DNA fingerprinting method. Over the years, the mean E. coli density ranged from nondetectable to 9·8 CFU 100 ml(-1) . The density of E. coli in each of the years did not show any significant difference (P > 0·05); however, a comparatively higher density was observed during the fall. Wildlife was (64·28%, 153/238) identified as the major contributing source of E. coli, followed by human (18·06%, 43/238) and unknown sources (17·64%, 42/238). Although the sources were varied by year and season, over all, the predominant contributing sources were black bear, human, unknown, elk, horse and gull.

CONCLUSIONS

The findings of this investigation identified the multiple animal sources contributing faecal bacteria into the drinking water intake of Comox Lake and their varying temporal occurrence.

SIGNIFICANCE AND IMPACT OF THE STUDY

The results of this study can reliably inform the authorities about the most vulnerable period (season) of faecal bacterial loading and their potential sources in the lake for improving risk assessment and pollution mitigation.

Microbial quality of water in rural households of Ethiopia: implications for milk safety and public health

Waterborne pathogenic agents affect the health of people either by direct consumption of contaminated water or by its indirect use in food production and/or processing. Studies on the microbiological quality of water in rural areas of Ethiopia are still limited, especially at the household level. The aim of the present study was to assess the microbial quality of water from different sources in rural households in two districts of the Ethiopian Rift Valley area. The correlation between E. coli counts in water and milk was also investigated. In total, 233 water samples (126 collected in dry and 107 in wet season) and 53 milk samples (19 from raw milk and 36 from processed milk products) were analyzed for E. coli contamination. The overall prevalence of E. coli in water samples was 54.9% (n = 233). In most of the analyzed samples, a higher prevalence of E. coli was recorded during the wet compared to the dry season. The highest load of E. coli was detected in water samples from dugouts. The quality of raw milk and traditionally-processed milk products showed variations between districts, and the traditionally-processed milk products were found to contain higher E. coli loads than raw milk. The correlation between the E. coli counts in water and milk only showed a weak but positive relationship (r = 0.1). Taking E. coli as a proxy for water quality, the microbiological quality of water consumed in the study area was found to be very poor, posing a potential food safety and health risk to the rural communities.

Microbial contamination of groundwater at small community water supplies in Finland

The raw water quality and associations between the factors considered as threats to water safety were studied in 20 groundwater supplies in central Finland in 2002-2004. Faecal contaminations indicated by the appearance of Escherichia coli or intestinal enterococci were present in five small community water supplies, all these managed by local water cooperatives. Elevated concentrations of nutrients in raw water were linked with the presence of faecal bacteria. The presence of on-site technical hazards to water safety, such as inadequate well construction and maintenance enabling surface water to enter into the well and the insufficient depth of protective soil layers above the groundwater table, showed the vulnerability of the quality of groundwater used for drinking purposes. To minimize the risk of waterborne illnesses, the vulnerable water supplies need to be identified and appropriate prevention measures such as disinfection should be applied.

A study on the transmission of Oesophagostomum dentatum and Hyostrongylus rubidus among outdoor reared pigs in Denmark

This study was carried out to obtain basic information on the transmission of Oesophagostomum dentatum and Hyostrongylus rubidus in outdoor reared pigs in Denmark. Eighteen 10 weeks old worm-free pigs were allocated into 3 groups of 6 pigs each. In May, all pigs were turned out on the same parasitologically naive pasture, and after 2 weeks the pigs in groups 2 and 3 were experimentally infected with 10,800 O. dentatum and 8,700 H. rubidus infective larvae, respectively. Pigs in group 1 served as non-infected controls. All pigs were reared together on the experimental pasture for further 134 days until slaughter in October. Strongyle egg counts, differentiation of infective larvae at species level, serum pepsinogen, and herbage larval infectivity were monitored at regular intervals throughout. Both strongyle species established in the originally parasite-free pigs (group 1) and cross infections were established in group 2 and 3. The pigs were exposed to steadily increasing herbage infectivity of both species of strongyles. At the end of the experiment, geometric mean worm burdens of O. dentatum in groups 1, 2 and 3 were 1202, 6136 and 1431 respectively, the burden in group 2 being significantly higher (p < 0.05) than that of the 2 other groups. The geometric mean worm burdens of H. rubidus in groups 1, 2 and 3 were 4907, 3679 and 5246 respectively, showing no significant differences between groups.