A Pilot Study on Integrating Videography and Environmental Microbial Sampling to Model Fecal Bacterial Exposures in Peri-Urban Tanzania
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TLDR
The study demonstrates the application and utility of video activity data to quantify exposure factors for people in low-income countries and apply these factors to understand fecal contamination exposure pathways, and preliminary data suggesting contacts with dirt and sand may be important mechanisms of hand contamination.Abstract:
Diarrheal diseases are a leading cause of under-five mortality and morbidity in sub-Saharan Africa. Quantitative exposure modeling provides opportunities to investigate the relative importance of fecal-oral transmission routes (e.g. hands, water, food) responsible for diarrheal disease. Modeling, however, requires accurate descriptions of individuals’ interactions with the environment (i.e., activity data). Such activity data are largely lacking for people in low-income settings. In the present study, we collected activity data and microbiological sampling data to develop a quantitative microbial exposure model for two female caretakers in peri-urban Tanzania. Activity data were combined with microbiological data of contacted surfaces and fomites (e.g. broom handle, soil, clothing) to develop example exposure profiles describing second-by-second estimates of fecal indicator bacteria (E. coli and enterococci) concentrations on the caretaker’s hands. The study demonstrates the application and utility of video activity data to quantify exposure factors for people in low-income countries and apply these factors to understand fecal contamination exposure pathways. This study provides both a methodological approach for the design and implementation of larger studies, and preliminary data suggesting contacts with dirt and sand may be important mechanisms of hand contamination. Increasing the scale of activity data collection and modeling to investigate individual-level exposure profiles within target populations for specific exposure scenarios would provide opportunities to identify the relative importance of fecal-oral disease transmission routes.read more
Citations
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Escherichia coli Contamination across Multiple Environmental Compartments (Soil, Hands, Drinking Water, and Handwashing Water) in Urban Harare: Correlations and Risk Factors.
Tala Navab-Daneshmand,Tala Navab-Daneshmand,Max N. D. Friedrich,Marja Gächter,Maria Camila Montealegre,Linn S. Mlambo,Tamuka Nhiwatiwa,Hans-Joachim Mosler,Timothy R. Julian +8 more
TL;DR: The complexity of E. coli contamination in household environments within LMICs is highlighted and more, larger, studies are needed to better identify sources and exposure pathways of E coli—and enteric pathogens generally—to identify effective interventions.
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Measuring Environmental Exposure to Enteric Pathogens in Low-Income Settings: Review and Recommendations of an Interdisciplinary Working Group.
Frederick G. B. Goddard,Radu Ban,Dana B. Barr,Joe Brown,Jennifer L. Cannon,John M. Colford,Joseph N. S. Eisenberg,Ayse Ercumen,Helen H. Petach,Matthew C. Freeman,Karen Levy,Stephen P. Luby,Christine L. Moe,Amy J. Pickering,Jeremy A. Sarnat,Jill R. Stewart,Evan A. Thomas,Mami Taniuchi,Thomas Clasen +18 more
TL;DR: Current and emerging approaches used to characterize enteric pathogen hazards in different environmental media as well as human interaction with those media and methods that measure human infection with enteric pathogens as a proxy for past exposure are summarized and recommended.
References
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Book
Quantitative Microbial Risk Assessment
TL;DR: This paper presents a meta-analysis of 120 databases relating to Microbial Agents and Their Transmission and their Transmission and the Dose-Response Assessment that were generated during the preparation of this study.
Journal ArticleDOI
Child undernutrition, tropical enteropathy, toilets, and handwashing
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TL;DR: The highest bacteral transfer rates from fomites to the hands were seen with the hard, non‐porous surfaces, and transfer of bacteria from the fingertip to the lip is similar to that observed from hard surfaces to hands.
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