Ballard April M, Corozo Angulo Betty, Laramee Nicholas, Pace Gallagher Jayden, Haardörfer Regine, Freeman Matthew C, Trostle James, Eisenberg Joseph N S, Lee Gwenyth O, Levy Karen, Caruso Bethany A
Department of Population Health Sciences, Georgia State University School of Public Health, Atlanta, Georgia, United States of America.
Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, United States of America.
PLOS Glob Public Health. 2024 Sep 18;4(9):e0003604. doi: 10.1371/journal.pgph.0003604. eCollection 2024.
Exposure to animal feces and associated enteric pathogens poses significant risks to child health. However, public health strategies to mitigate enteric infections among children largely aim to reduce exposure to human feces, overlooking transmission pathways related to animal feces. In this study we examine if and how children are exposed to enteric pathogens in animal feces in northwestern coastal Ecuador. We conducted qualitative interviews with mothers of children aged 10-18 months that owned (n = 32) and did not own (n = 26) animals in urban and rural communities. Using thematic analysis, we identified community, household, and child behavioral factors that influence exposure. We also compared child exposure by household animal ownership. Our findings revealed myriad opportunities for young children to be exposed to enteric pathogens in many locations and from multiple animal sources, regardless of household animal ownership. Animal feces management practices (AFM) used by mothers, such as rinsing feces into ditches and throwing feces into surrounding areas, may increase environmental contamination outside their homes and in their communities. Unsafe AFM practices were similar to unsafe child feces management practices reported in other studies, including practices related to defecation location, feces removal and disposal, environmental contamination cleaning, and handwashing. Findings suggest that animal feces may contaminate the environment along similar pathways as human feces. Identification and incorporation of safe AFM practices, similar to those developed for child feces management, would 1) mitigate child exposure to enteric pathogens by reducing animal feces contamination in domestic and public spaces; and 2) enable an integrated approach to address enteric pathogen exposure pathways related to animal and child feces.
接触动物粪便及相关肠道病原体对儿童健康构成重大风险。然而，减轻儿童肠道感染的公共卫生策略主要旨在减少接触人类粪便，却忽视了与动物粪便相关的传播途径。在本研究中，我们调查了厄瓜多尔西北沿海地区儿童是否以及如何接触动物粪便中的肠道病原体。我们对城市和农村社区中拥有（n = 32）和未拥有（n = 26）动物的10 - 18个月大儿童的母亲进行了定性访谈。通过主题分析，我们确定了影响接触的社区、家庭和儿童行为因素。我们还比较了不同家庭动物拥有情况对儿童接触的影响。我们的研究结果表明，无论家庭是否拥有动物，幼儿在许多地点都有大量机会接触多种动物来源的肠道病原体。母亲们采用的动物粪便管理做法（AFM），如将粪便冲进沟渠和扔到周围地区，可能会增加家庭外部和社区环境的污染。不安全的AFM做法与其他研究中报告的不安全儿童粪便管理做法相似，包括与排便地点、粪便清除和处理、环境污染清洁以及洗手相关的做法。研究结果表明，动物粪便可能会通过与人类粪便相似的途径污染环境。识别并纳入类似于为儿童粪便管理制定的安全AFM做法，将：1）通过减少家庭和公共场所的动物粪便污染来减轻儿童接触肠道病原体的风险；2）实现一种综合方法来解决与动物和儿童粪便相关的肠道病原体接触途径问题。
