Tazin Sumaiya, Islam Mahfuza, Pickering Amy J, Kwong Laura H, Mertens Andrew, Niven Caitlin, Arnold Benjamin F, Hubbard Alan E, Alam Mahfuja, Sen Debashis, Islam Sharmin, Rahman Mahbubur, Unicomb Leanne, Luby Stephen P, Colford John M, Benjamin-Chung Jade, Ercumen Ayse
Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC, USA.
Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA.
Int J Hyg Environ Health. 2025 Aug;269:114641. doi: 10.1016/j.ijheh.2025.114641. Epub 2025 Jul 29.
Soil floors are common in low-income countries and can harbor contamination from fecal waste. Soil/dust ingestion from floors or indirectly via hands, water and food can contribute to children's ingestion of fecal organisms. We assessed if finished (e.g., concrete) floors are associated with lower E. coli contamination in the domestic environment in rural Bangladesh.
We collected samples from 1864 households over 3.5 years, including stored drinking water, child and caregiver hand rinses, courtyard soil, food, and flies (n = 24,118 samples), and enumerated E. coli using IDEXX Quanti-Tray/2000.
Controlling for socio-demographics, water/sanitation status, and animal ownership, households with finished floors had slightly lower log10-transformed E. coli counts (Δlog10 = -0.10 (-0.20, 0.00)) and prevalence (prevalence ratio [PR] = 0.90 (0.83, 0.98)) on child hands than households with soil floors; floor material was not associated with contamination levels in other sample types. In subgroup analyses, finished floors were associated with lower E. coli on child hands following heavy rainfall (Δlog10 = -0.23 (-0.39, -0.07)), above-median temperature (Δlog10 = -0.18 (-0.30, -0.06)), and in households with more domestic animals (Δlog10 = -0.16 (-0.32, -0.01)). Finished floors were also associated with slightly lower contamination of stored water following heavy rainfall (PR = 0.89 (0.81, 0.99)) and above-median temperature (PR = 0.91 (0.84, 0.98)), and lower contamination of stored food following higher rainfall and temperature but the associations for food were not statistically significant.
Measures to control enteric infections in low-income countries should test flooring improvements to reduce exposure to fecal contamination.
在低收入国家，泥土地面很常见，可能会受到粪便污染。儿童通过接触地面或经手、水和食物间接摄入土壤/灰尘，可能会摄入粪便中的微生物。我们评估了在孟加拉国农村家庭环境中，铺设好的（如混凝土）地面是否与较低的大肠杆菌污染有关。
在3.5年的时间里，我们从1864户家庭中采集了样本，包括储存的饮用水、儿童和看护人的洗手水、庭院土壤、食物和苍蝇（共24118个样本），并使用IDEXX Quanti-Tray/2000对大肠杆菌进行计数。
在控制了社会人口统计学、水/卫生设施状况和家畜拥有情况后，与泥土地面的家庭相比，铺设好地面的家庭儿童手上经对数10转换后的大肠杆菌计数略低（Δlog10 = -0.10（-0.20，0.00）），患病率也较低（患病率比[PR] = 0.90（0.83，0.98））；地面材料与其他样本类型的污染水平无关。在亚组分析中，铺设好的地面与暴雨后儿童手上较低的大肠杆菌数量有关（Δlog10 = -0.23（-0.39，-0.07））、高于中位数温度时有关（Δlog10 = -0.18（-0.30，-0.06）），以及在家畜较多的家庭中有关（Δlog10 = -0.16（-0.32，-0.01））。铺设好的地面还与暴雨后储存水的污染略低有关（PR = 0.89（0.81，0.99））以及高于中位数温度时有关（PR = 0.91（0.84，0.98）），并且与降雨和温度较高时储存食物的污染较低有关，但食物方面的关联无统计学意义。
低收入国家控制肠道感染的措施应测试改善地面状况以减少粪便污染暴露。
