A localized sanitation status index as a proxy for fecal contamination in urban Maputo, Mozambique

Sanitary surveys are used in low- and middle-income countries to assess water, sanitation, and hygiene conditions, but have rarely been compared with direct measures of environmental fecal contamination. We conducted a cross-sectional assessment of sanitary conditions and E. coli counts in soils and...

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Bibliographic Details
Published in:PloS one 2019-10, Vol.14 (10), p.e0224333
Main Authors: Capone, Drew, Adriano, Zaida, Berendes, David, Cumming, Oliver, Dreibelbis, Robert, Holcomb, David A, Knee, Jackie, Ross, Ian, Brown, Joe
Format: Article
Language:English
Subjects:
Analysis
Biology and Life Sciences
Cities - statistics & numerical data
Clinical trials
Contamination
Courtyards
Disease control
Disease transmission
E coli
Ecology and Environmental Sciences
Engineering
Environmental engineering
Escherichia coli - isolation & purification
Fecal coliforms
Feces
Feces - microbiology
Health aspects
Health hazards
Households
Hygiene
Income
Low income groups
Mathematical analysis
Medicine and Health Sciences
Mozambique
Neighborhoods
Physical Sciences
Polls & surveys
Public health
Reliability analysis
Research and Analysis Methods
Risk factors
Sanitation
Sanitation - statistics & numerical data
Sediment pollution
Soil contamination
Soil pollution
Soils
Surveys and Questionnaires
Sustainable development
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Summary:Sanitary surveys are used in low- and middle-income countries to assess water, sanitation, and hygiene conditions, but have rarely been compared with direct measures of environmental fecal contamination. We conducted a cross-sectional assessment of sanitary conditions and E. coli counts in soils and on surfaces of compounds (household clusters) in low-income neighborhoods of Maputo, Mozambique. We adapted the World Bank's Urban Sanitation Status Index to implement a sanitary survey tool specifically for compounds: a Localized Sanitation Status Index (LSSI) ranging from zero (poor sanitary conditions) to one (better sanitary conditions) calculated from 20 variables that characterized local sanitary conditions. We measured the variation in the LSSI with E. coli counts in soil (nine locations/compound) and surface swabs (seven locations/compound) in 80 compounds to assess reliability. Multivariable regression indicated that a ten-percentage point increase in LSSI was associated with 0.05 (95% CI: 0.00, 0.11) log10 fewer E. coli/dry gram in courtyard soil. Overall, the LSSI may be associated with fecal contamination in compound soil; however, the differences detected may not be meaningful in terms of public health hazards.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0224333