Search Results (3)

Sharing facilities with other households offers the most realistic opportunity for access to sanitation for many households in low-income settings. However, questions remain about the safety of shared toilets, including those shared at the household level. This study sought to compare the usage and microbial safety of household-level shared and unshared toilets in a Ghanaian rural district to investigate any association between their microbial safety and sharing status. A semi-structured questionnaire was used to collect data on the user characteristics of the sampled toilets, while common contact surfaces (door handles and toilet seats) were assessed for faecal contamination following standard swab sampling and analytical protocols. The results of the study indicate that sharing toilets affords about 90% more household-level access to sanitation as compared to single-household toilets. Toilet sharing mostly occurred between two households, with a maximum user population of 14 per toilet. Generally, there was a high prevalence of faecal contamination on the door handles and seats of both shared and unshared toilets, but this had no association with the sharing status of the toilets. The median concentration of Escherichia coli (E. coli) on the door handles and seats of shared toilets was 34.3 × 10⁵ and 103.2 × 10⁵ CFU/mL, respectively, as compared to 54.7 × 10⁵ and 125.0 × 10⁵ CFU/mL, respectively, on unshared toilets. In conclusion, the sharing of toilets at the household level nearly doubles access to sanitation at home without necessarily exposing the users to a higher risk of faecal–oral disease transmission. Full article

Good sanitation and clean water are basic human rights yet they remain elusive to many rural communities in Sub-Saharan Africa (SSA). We carried out a cross sectional study to examine the impact of a four-year intervention aimed at improving access to water and sanitation and reducing waterborne disease, especially diarrhea in children under five years old. The study was carried out in April and May 2015 in Busangi, Chela and Ntobo wards of Kahama District of Tanzania. The interventions included education campaigns and improved water supply, and sanitation. The percentage of households (HHs) with access to water within 30 min increased from 19.2 to 48.9 and 17.6 to 27.3 in the wet and dry seasons, respectively. The percentage of HHs with hand washing facilities at the latrine increased from 0% to 13.2%. However, the incidence of diarrhea among children under five years increased over the intervention period, RR 2.91 95% CI 2.71–3.11, p < 0.0001. Availability of water alone may not influence the incidence of waterborne diseases. Factors such as water storage and usage, safe excreta disposal and other hygiene practices are critical for interventions negating the spread of water borne diseases. A model that articulates the extent to which these factors are helpful for such interventions should be explored. Full article

Methods to assess household excreta disposal practices are critical for informing public health outcomes of efforts to improve sanitation in developing countries. We present a new metric, the Safe San Index (SSI), to quantify the hygienic safety of a household’s defecation and human feces disposal practices in India, where behavioral outcomes from on-going public expenditures to construct household sanitation facilities and eliminate open defecation are poorly measured. We define hygienic safety of feces disposal as capture in a hygienic sanitation facility. The SSI consists of 15 self-report items and two sub-scales, Latrine Use Frequency and Seven-Day Open Defecation Rate. Households are scored on a standardized scale from 0 (no defecation safely captured) to 100 (all defecation safely captured). We present results of a pilot study in Odisha, India to apply the Index to assess excreta disposal behaviors among rural households and evaluate the reliability and validity of the Index for estimating the rate of correct and consistent sanitation facility usage of household with an improved latrine. Full article