Holcomb David A, Knee Jackie, Adriano Zaida, Capone Drew, Cumming Oliver, Kowalsky Erin, Nalá Rassul, Viegas Edna, Stewart Jill R, Brown Joe
Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States.
Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom.
Environ Health (Wash). 2025 Apr 11;3(7):757-767. doi: 10.1021/envhealth.4c00283. eCollection 2025 Jul 18.
Environmental exposure to enteric pathogens is generally assessed using fecal indicators but relationships between markers of fecal contamination and actual exposure to enteric pathogens remain poorly characterized. We investigated whether and two human fecal markers (HF183 and Mnif) in urban Mozambican household soil and drinking water were associated with detection of eight bacteria, three viruses, and three protozoa measured by multiplex reverse-transcription PCR and soil transmitted helminths assessed by microscopy in stool samples from children. We used mixed-effects logistic regression with marginal standardization to obtain a pooled estimate of the overall indicator-pathogen relationship while simultaneously estimating pathogen-specific associations that accounted for assessing multiple pathogens per sample. At least one pathogen was detected in 88% (169/192) of stool samples from children. Increasing drinking water gene concentration was associated with higher prevalence, while human HF183 in drinking water was weakly associated with lower prevalence of the most common pathogens but was infrequently detected. No fecal marker in the soil was clearly associated with any pathogen. We did not find evidence to support human markers as reliable indicators of enteric pathogen carriage in a high-prevalence domestic setting and recommend targeting enteric pathogens directly.
通常使用粪便指标来评估环境中肠道病原体的暴露情况，但粪便污染标志物与实际肠道病原体暴露之间的关系仍未得到充分描述。我们调查了莫桑比克城市家庭土壤和饮用水中的 以及两种人类粪便标志物（HF183 和 Mnif）是否与通过多重逆转录聚合酶链反应检测的八种细菌、三种病毒和三种原生动物以及通过显微镜检查评估的儿童粪便样本中的土壤传播蠕虫有关。我们使用具有边际标准化的混合效应逻辑回归来获得总体指标与病原体关系的汇总估计，同时估计考虑到每个样本评估多种病原体的病原体特异性关联。在 88%（169/192）的儿童粪便样本中检测到至少一种病原体。饮用水中 基因浓度的增加与 患病率较高相关，而饮用水中的人类 HF183 与最常见病原体的较低患病率弱相关，但很少被检测到。土壤中的粪便标志物与任何病原体均无明显关联。我们没有找到证据支持在高流行率的家庭环境中人类标志物作为肠道病原体携带的可靠指标，并建议直接针对肠道病原体。
