scholarly journals The Landscape of Enteric Pathogen Exposure of Young Children in Public Domains of Low-Income, Urban Kenya: The Influence of Exposure Pathway and Spatial Range of Play on Multi-Pathogen Exposure Risks

2018 ◽  
Author(s):  
Danielle Medgyesi ◽  
Daniel Sewell ◽  
Reid Senesac ◽  
Oliver Cumming ◽  
Jane Mumma ◽  
...  
Keyword(s):  
Surface Water ◽  
Young Children ◽  
Low Income ◽  
Posterior Distribution ◽  
Enteric Pathogen ◽  
Enteric Pathogens ◽  
Exposure Pathway ◽  
Public Areas ◽  
Exposure Risks ◽  
Pathogen Exposure

AbstractBackgroundYoung children are infected by a diverse variety of enteric pathogens in low-income, high-burden countries. Little is known about which conditions pose the greatest risk for enteric pathogen exposure and infection. Young children frequently play in residential public areas around their household, including areas contaminated by human and animal feces, suggesting these exposures are particularly hazardous.ObjectivesThe objective of this study was to examine how the dose of six types of common enteric pathogens, and the probability of exposure to one or multiple enteric pathogens for young children playing at public play areas in Kisumu, Kenya is influenced by the type and frequency of child play behaviors that result in ingestion of soil or surface water, as well as by spatial variability in the number of public areas children are exposed to in their neighborhood.MethodsA Bayesian framework was employed to obtain the posterior distribution of pathogen doses for a certain number of contacts. First, a multivariate random effects tobit model was used to obtain the posterior distribution of pathogen concentrations, and their interdependencies, in soil and surface water, based upon empirical data of enteric pathogen contamination in three neighborhoods of Kisumu. Then, exposure doses were estimated using behavioral contact parameters from previous studies, and contrasted under different exposure conditions.ResultsMulti-pathogen exposure of children at public play areas was common. Pathogen doses and the probability of multi-pathogen ingestion increased with: higher frequency of environmental contact, especially for surface water; larger volume of soil or water ingested; and with play at multiple sites in the neighborhood versus single site play.DiscussionChild contact with surface water and soil at public play areas in their neighborhood is an important cause of exposure to enteric pathogens in Kisumu, and behavioral, environmental, and spatial conditions are determinants of exposure.

scholarly journals Associations between enteric pathogen carriage and height-for-age, weight-for-age and weight-for-height in children under 5 years old in urban Dhaka, Bangladesh

2020 ◽  
Vol 148 ◽  
Author(s):  
David Berendes ◽  
Drew Capone ◽  
Jackie Knee ◽  
David Holcomb ◽  
Sonia Sultana ◽  
...  
Keyword(s):  
Low Income ◽  
Pathogen Detection ◽  
Controlled Trial ◽  
Prevalence Ratio ◽  
Enteric Pathogen ◽  
Enteric Pathogens ◽  
Related Factors ◽  
Environmental Interventions ◽  
Height For Age ◽  
Weight For Age

Abstract Nutritional factors and infectious agents may contribute to paediatric growth deficits in low- and middle-income countries; however, the contribution of enteric pathogens is only beginning to be understood. We analysed the stool from children <5 years old from an open cohort, cluster-randomised controlled trial of a point-of-collection water chlorinator in urban Bangladesh. We compared the presence/absence of 15 enteric pathogens detected via multiplex, molecular methods in the stool with concurrent Z-scores/Z-score cut-offs (−2 standard deviations (s.d.)) for height-for-age (HAZ/stunting), weight-for-age (WAZ/underweight) and weight-for-height (WHZ/wasting), adjusted for sociodemographic and trial-related factors, and measured caregiver-reported diarrhoea. Enteric pathogen prevalence in the stool was high (88% had ≥1 enteric pathogen, most commonly Giardia spp. (40%), Salmonella enterica (33%), enterotoxigenic E. coli (28%) and Shigella spp. (27%)) while reported 7-day diarrhoea prevalence was 6%, suggesting high subclinical infection rates. Many children were stunted (26%) or underweight (24%). Adjusted models suggested Giardia spp. detection was associated with lower HAZ (−0.22 s.d., 95% CI −0.44 to 0.00; prevalence ratio for stunting: 1.39, 95% CI 0.94–2.06) and potentially lower WAZ. No pathogens were associated with reported diarrhoea in adjusted models. Giardia spp. carriage may be associated with growth faltering, but not diarrhoea, in this and similar low-income settings. Stool-based enteric pathogen detection provides a direct indication of previous exposure that may be useful as a broader endpoint of trials of environmental interventions.

scholarly journals Environmental and behavioral exposure pathways associated with diarrhea and enteric pathogen detection in twenty-six week old urban Kenyan infants: a cross-sectional study

2021 ◽  
Author(s):  
Kelly K Baker ◽  
Jane Mumma ◽  
Sheillah Simiyu ◽  
Daniel Sewell ◽  
Kevin Tsai ◽  
...  
Keyword(s):  
Low Income ◽  
Pathogen Detection ◽  
Cross Sectional Study ◽  
Enteric Pathogen ◽  
Cow Milk ◽  
Low Income Countries ◽  
Sectional Study ◽  
Cross Sectional ◽  
Infant Exposure ◽  
Pathogen Exposure

The prevalence of enteric pathogen detection in children in low-income countries climbs rapidly between birth and 6 months of age. Few studies have tested whether improved household environmental and behavioral hygiene conditions protects infants from exposure to enteric pathogens spread via unhygienic human and animal sanitation conditions, especially during this early window of infancy. This cross-sectional study utilized enrollment survey data among households with 6 month old infants in Kisumu, Kenya participating in the Safe Start cluster-randomized controlled trial to estimate associations between household water access and treatment, animal vectors, sanitation access, hand washing practices, supplemental feeding, and flooring, with the outcomes of caregiver-reported 7-day diarrhea prevalence and sum count of different enteric viruses, bacteria, and parasites pathogens in infant stool. Then, we tested whether household environmental hygiene and behavioral practices moderated associations between infant exposure outcomes and latrine access and domestic animal co-habitation. We found that reported handwashing after handling animals and before eating were strongly associated with lower risk of caregiver-reported diarrhea, while owning and co-habitating with animals (versus no animals), living in a household with vinyl covered dirt floors (versus finished floors), and feeding infants cow milk (versus no milk) were strongly associated with pathogen detection in infants. Caregiver handwashing after child or self-defecation moderated the relationship between shared sanitation (vs private) sanitation access and infant exposure to pathogens such that handwashing had the greatest benefit for preventing pathogen exposure of infants in households with private latrines. In the absence of handwashing, access to private sanitation posed no benefits over shared latrines for protecting infants from exposure. Our evidence highlights eliminating animal co-habitation, improving flooring, improving post-defecation and food-related handwashing, and improving safety of cow milk sources and/or safe household storage of milk as interventions to prevent enteric pathogen exposure of infants less than 6 months age.

scholarly journals Detection and quantification of enteric pathogens in aerosols near open wastewater canals in cities with poor sanitation

2021 ◽  
Author(s):  
Olivia Ginn ◽  
Lucas Rocha-Melogno ◽  
Aaron Bivins ◽  
Sarah Lowry ◽  
Maria Cardelino ◽  
...  
Keyword(s):  
Low Income ◽  
Genetic Material ◽  
Enteric Pathogen ◽  
Enteric Pathogens ◽  
Low Income Countries ◽  
Enteric Infection ◽  
La Paz ◽  
Wide Range ◽  
Fecal Waste ◽  
And Control

ABSTRACTUrban sanitation infrastructure is inadequate in many low-income countries, leading to the presence of highly concentrated, uncontained fecal waste streams in densely populated areas. Combined with mechanisms of aerosolization, airborne transport of enteric microbes and their genetic material is possible in such settings but remains poorly characterized. We detected and quantified enteric pathogen-associated gene targets in aerosol samples near open wastewater canals (OWCs) or impacted surface waters and control sites in La Paz, Bolivia; Kanpur, India; and Atlanta, USA via multiplex qPCR (37 targets) and ddPCR (13 targets). We detected a wide range enteric pathogen-specific targets, some not previously reported in extramural urban aerosols, with more frequent detections of all enteric targets at higher densities in La Paz and Kanpur near OWCs. We report density estimates ranging from non-detects to 4.7 ⨯ 102 gc per m3air for targets including ST-ETEC, C. jejuni, EIEC/Shigella spp., Salmonella spp., norovirus, and Cryptosporidium spp. An estimated 25%, 76%, and 0% of samples containing positive pathogen detects were accompanied by culturable E. coli in La Paz, Kanpur, and Atlanta, respectively, suggesting potential for viability of enteric microbes at the point of sampling. Airborne transmission of enteric pathogens merits further investigation in cities with poor sanitation.Abstract FigureSYNOPSISWe detect and quantify molecular targets associated with important enteric pathogens in outdoor aerosols from cities with poor sanitation to assess the potential role of the aeromicrobiological pathway in enteric infection transmission in such settings.

scholarly journals Where Children Play: Young Child Exposure to Environmental Hazards during Play in Public Areas in a Transitioning Internally Displaced Persons Community in Haiti

2018 ◽  
Vol 15 (8) ◽  
pp. 1646 ◽  
Author(s):  
Danielle Medgyesi ◽  
John Brogan ◽  
Daniel Sewell ◽  
Jean Creve-Coeur ◽  
Laura Kwong ◽  
...  
Keyword(s):  
Young Children ◽  
Low Income ◽  
Developmental Stages ◽  
Internally Displaced Persons ◽  
Displaced Persons ◽  
Human Feces ◽  
Open Drainage ◽  
Internally Displaced ◽  
Child Exposure ◽  
Public Areas

Globally, gastrointestinal (GI) infections by enteric pathogens are the second-leading cause of morbidity and mortality in children under five years of age (≤5 years). While GI pathogen exposure in households has been rigorously examined, there is little data about young children’s exposure in public domains. Moreover, public areas in low-income settings are often used for other waste disposal practices in addition to human feces, such as trash dumping in areas near households. If young children play in public domains, they might be exposed to interrelated and highly concentrated microbial, chemical, and physical hazards. This study performed structured observations at 36 public areas in an internally displaced persons community that has transitioned into a formal settlement in Haiti. We documented how often young children played in public areas and quantified behaviors that might lead to illness and injury. Children ≤5 years played at all public sites, which included infants who played at 47% of sites. Children touched and mouthed plastic, metal and glass trash, food and other objects from the ground, ate soil (geophagia) and drank surface water. They also touched latrines, animals, animal feces and open drainage canals. Hand-to-mouth contact was one of the most common behaviors observed and the rate of contact significantly differed among developmental stages (infants: 18/h, toddlers: 11/h and young children: 9/h), providing evidence that children could ingest trace amounts of animal/human feces on hands that may contain GI pathogens. These findings demonstrate that water, sanitation and hygiene interventions could be more effective if they consider exposure risks to feces in public domains. Furthermore, this research highlights the need for waste-related interventions to address the broader set of civil conditions that create unsafe, toxic and contaminated public environments where young children play.

Nobody’s Perfect: Making sense of a parenting skills workshop through ethnographic research in a low-income neighbourhood in Santiago de Chile

2021 ◽  
pp. 026101832098398
Author(s):  
Marjorie Murray ◽  
Daniela Tapia
Keyword(s):  
Child Development ◽  
Young Children ◽  
Low Income ◽  
Ethnographic Research ◽  
Parenting Skills ◽  
Daily Lives ◽  
Making Sense ◽  
Santiago De Chile ◽  
One Year ◽  
Everyday Problems

Nadie es Perfecto (Nobody’s Perfect, or NEP) is a parenting skills workshop aimed at ‘sharing experiences and receiving guidance on everyday problems to strengthen child development’. This article explores this workshop in terms of its relationship with the daily lives of participants, based on one year of fieldwork focused on families with young children in a low-income neighbourhood in Santiago. While caregivers frame their parenting efforts as aiming to ‘hacer lo mejor posible’ (do their best) under difficult circumstances, our study found that facilitators take an anachronistic and homogenizing view of participants. Embracing a universalistic perspective of child development, they discourage participation and debate, focusing instead on providing concrete advice that limits the potential of the workshops. This article argues that by ignoring the different living situations of families in this socioeconomic context, NEP reproduces a prejudiced view of poor subjects that sees them as deficient and incapable of change.

scholarly journals Dynamic Oral Texture Properties of Selected Indigenous Complementary Porridges Used in African Communities

Foods ◽  
2019 ◽  
Vol 8 (6) ◽  
pp. 221 ◽  
Author(s):  
James Makame ◽  
Tanita Cronje ◽  
Naushad M. Emmambux ◽  
Henriette De Kock
Keyword(s):  
Young Children ◽  
Low Income ◽  
Nutrient Intake ◽  
Control Method ◽  
Protein Energy Malnutrition ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Texture Properties ◽  
Protein Energy ◽  
Infants And Young Children

Child malnutrition remains a major public health problem in low-income African communities, caused by factors including the low nutritional value of indigenous/local complementary porridges (CP) fed to infants and young children. Most African children subsist on locally available starchy foods, whose oral texture is not well-characterized in relation to their sensorimotor readiness. The sensory quality of CP affects oral processing (OP) abilities in infants and young children. Unsuitable oral texture limits nutrient intake, leading to protein-energy malnutrition. The perception of the oral texture of selected African CPs (n = 13, Maize, Sorghum, Cassava, Orange-fleshed sweet potato (OFSP), Cowpea, and Bambara) was investigated by a trained temporal-check-all-that-apply (TCATA) panel (n = 10), alongside selected commercial porridges (n = 19). A simulated OP method (Up-Down mouth movements- munching) and a control method (lateral mouth movements- normal adult-like chewing) were used. TCATA results showed that Maize, Cassava, and Sorghum porridges were initially too thick, sticky, slimy, and pasty, and also at the end not easy to swallow even at low solids content—especially by the Up-Down method. These attributes make CPs difficult to ingest for infants given their limited OP abilities, thus, leading to limited nutrient intake, and this can contribute to malnutrition. Methods to improve the texture properties of indigenous CPs are needed to optimize infant nutrient intake.

Differential calculation abilities in young children from middle- and low-income families.

1992 ◽  
Vol 28 (4) ◽  
pp. 644-653 ◽  
Author(s):  
Nancy C. Jordan ◽  
Janellen Huttenlocher ◽  
Susan C. Levine
Keyword(s):  
Young Children ◽  
Low Income ◽  
Low Income Families
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