Department of Environmental Sciences and Engineering, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States of America.
Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30329, United States of America.
Environ Sci Technol. 2021 Jul 20;55(14):9989-10000. doi: 10.1021/acs.est.1c02168. Epub 2021 Jul 8.
Environmental fecal contamination is common in many low-income cities, contributing to a high burden of enteric infections and associated negative sequelae. To evaluate the impact of a shared onsite sanitation intervention in Maputo, Mozambique on enteric pathogens in the domestic environment, we collected 179 soil samples at shared latrine entrances from intervention (n = 49) and control (n = 51) compounds during baseline (preintervention) and after 24 months (postintervention) as part of the Maputo Sanitation Trial. We tested soils for the presence of nucleic acids associated with 18 enteric pathogens using a multiplex reverse transcription qPCR platform. We detected at least one pathogen-associated gene target in 91% (163/179) of soils and a median of 3 (IQR = 1, 5) pathogens. Using a difference-in-difference analysis and adjusting for compound population, visibly wet soil, sun exposure, wealth, temperature, animal presence, and visible feces, we estimate the intervention reduced the probability of detecting ≥1 pathogen gene by 15% (adjusted prevalence ratio, aPR = 0.85; 95% CI: 0.70, 1.0) and the total number of pathogens by 35% (aPR = 0.65; 0.44, 0.95) in soil 24 months following the intervention. These results suggest that the intervention reduced the presence of some fecal contamination in the domestic environment, but pathogen detection remained prevalent 24 months following the introduction of new latrines.
环境粪便污染在许多低收入城市很常见，导致肠道感染负担沉重，并伴有相关的不良后果。为了评估莫桑比克马普托市共享现场卫生干预措施对家庭环境中肠道病原体的影响，我们在基线（干预前）和 24 个月（干预后）期间从干预（n=49）和对照（n=51）化合物的共享厕所入口处收集了 179 个土壤样本，作为马普托卫生试验的一部分。我们使用多重逆转录 qPCR 平台检测土壤中与 18 种肠道病原体相关的核酸。我们在 91%（163/179）的土壤中检测到至少一种病原体相关基因靶标，中位数为 3（IQR=1，5）种病原体。使用差异-差异分析并调整化合物人口、明显湿土、阳光照射、财富、温度、动物存在和可见粪便，我们估计干预措施使 24 个月后检测到≥1 种病原体基因的概率降低了 15%（调整后的流行率比，aPR=0.85；95%CI：0.70，1.0），土壤中病原体总数降低了 35%（aPR=0.65；0.44，0.95）。这些结果表明，干预措施减少了家庭环境中一些粪便污染的存在，但在引入新厕所 24 个月后，病原体的检测仍然普遍存在。
