Fecal Fingerprints of Enteric Pathogen Contamination in Public Environments of Kisumu, Kenya, Associated with Human Sanitation Conditions and Domestic Animals
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Abstract
<p class="first" id="P3">Young children are infected by a diverse range of enteric
pathogens in high disease
burden settings, suggesting pathogen contamination of the environment is equally diverse.
This study aimed to characterize across- and within-neighborhood diversity in enteric
pathogen contamination of public domains in urban informal settlements of Kisumu,
Kenya, and to assess the relationship between pathogen detection patterns and human
and domestic animal sanitation conditions. Microbial contamination of soil and surface
water from 166 public sites in three Kisumu neighborhoods was measured by enterococcal
assays and quantitative reverse transcription polymerase chain reaction (qRT-PCR)
for 19 enteric pathogens. Regression was used to assess the association between observed
sanitary indicators of contamination with enterococci and pathogen presence and concentration,
and pathogen diversity. Seventeen types of pathogens were detected in Kisumu public
domains. Enteric pathogens were codetected in 33% of soil and 65% of surface water
samples. Greater pathogen diversity was associated with the presence of domestic animal
feces but not with human open defecation, deteriorating latrines, flies, or disposal
of human feces. Sanitary conditions were not associated with enterococcal bacteria,
specific pathogen concentrations, or “any pathogen”. Young children played at 40%
of observed sites. Managing domestic animal feces may be required to reduce enteric
pathogen environmental contamination in high-burden settings.
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