Faecal exposure pathways in a low-income urban area (Kenya)

This study assessed different pathways through which faecal contaminants get into human contact and the magnitude of their effects in the low-income urban neighborhood of Majengo in Meru. A descriptive cross-sectional study was conducted applying the SaniPath wiki grid sampling method in which 100 households were selected through systematic random sampling for the survey. The study employed a mixed method of data collection: preliminary assessment during which key informant interviews and transect walk were conducted and four main pathways were identified including surface water, open drain, municipal water, and soil. Each pathway was assessed in the laboratory for E. coli quantification. For instance, the sample with the highest E. coli contamination had 300·104 colony forming units (cfu) with the least in municipal water ranging between 30-300 cfu. The behavior of adults and children increasing their interaction with identified pathways was also assessed and adults were found to be interacting with surface water while children are vulnerable to open drains. Also, less than half of the population do not treat drinking water and most of the respondents only wash their hands after visiting the toilet giving little or no attention to other activities like changing diapers, playing, or preparing meals. Finally, the study concludes that open drain is the major faecal exposure pathway.