Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
Int J Hyg Environ Health. 2020 May;226:113480. doi: 10.1016/j.ijheh.2020.113480. Epub 2020 Feb 18.
Safe fecal sludge management (FSM) - the hygienic emptying, transport, and treatment for reuse or disposal of fecal sludge - is an essential part of safely managed sanitation, especially in towns and cities in low- and middle-income countries with limited sewer coverage. The need for safe and affordable FSM services has become more acute as cities grow and densify. Hygienic pit-emptying uses equipment that limits direct human exposure with fecal sludge and hygienic transport conveys fecal sludge offsite for treatment. We evaluated whether a program of on-site sanitation infrastructure upgrades and FSM capacity development in urban Maputo, Mozambique resulted in more hygienic pit-emptying and safe transportation of fecal sludge. We compared reported emptying practices among multi-household compounds receiving sanitation upgrades with control compounds, both from the Maputo Sanitation (MapSan) trial at 24-36 months after the intervention. Intervention compounds (comprising 1-40 households, median = 3) received a subsidized pour-flush latrine to septic tank system that replaced an existing shared latrine; control compounds continued using existing shared latrines. We surveyed compound residents and analyzed available municipal data on FSM in the city. Due to the recent construction of the intervention, emptying was more frequent in control compounds: 5.6% (15/270) of intervention compounds and 30% (74/247) of controls had emptied their on-site sanitation system in the previous year. Among those compounds which had emptied a sanitation facility in the previous year, intervention compounds were 3.8 (95% CI: 1.4, 10) times more likely to have to done so hygienically. Results suggest that the construction of subsidized pour-flush sanitation systems increased hygienic emptying of fecal sludge in this setting. Further gains in hygienic emptying in urban Maputo may be limited by affordability and physical accessibility.
安全粪便污泥管理（FSM）-卫生清空、运输和处理粪便污泥以重复使用或处置-是安全管理卫生的重要组成部分，特别是在低中收入国家中，这些国家的城镇和城市的污水覆盖范围有限。随着城市的发展和人口密度的增加，对安全和负担得起的 FSM 服务的需求变得更加迫切。卫生坑排空使用限制人与粪便污泥直接接触的设备，并将卫生运输粪便污泥运离现场进行处理。我们评估了莫桑比克马普托市的现场卫生基础设施升级和 FSM 能力发展计划是否导致更卫生的坑排空和安全运输粪便污泥。我们比较了接受卫生升级的多户化合物与对照化合物之间的报告排空做法，这些化合物均来自 Maputo Sanitation (MapSan) 试验，干预后 24-36 个月进行了比较。干预化合物（由 1-40 户家庭组成，中位数= 3 户）获得了补贴的冲洗式厕所到化粪池系统，取代了现有的共用厕所；对照化合物继续使用现有的共用厕所。我们调查了化合物居民，并分析了城市中 FSM 的可用市政数据。由于干预措施最近才进行，因此在对照化合物中排空更为频繁：5.6%（270 个中的 15 个）的干预化合物和 30%（247 个中的 74 个）的对照化合物在过去一年中排空了现场卫生系统。在过去一年中排空卫生设施的那些化合物中，干预化合物更有可能以卫生方式进行排空，比例为 3.8（95%CI：1.4，10）。结果表明，在这种情况下，补贴冲洗式卫生系统的建设增加了粪便污泥的卫生排空。马普托市城市地区卫生排空的进一步增加可能受到经济承受能力和实际可达性的限制。
