Is there a difference in prevalence of helminths between households using ecological sanitation and those using traditional pit latrines? A latrine based cross sectional comparative study in Malawi

Save Kumwenda, Chisomo Msefula, Wilfred Kadewa, Yohane Diness, Charles Kato, Tracy Morse, Bagrey Ngwira

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

[Background] Studies have shown that households using sludge from human excreta for agriculture are at an increased risk of soil transmitted helminths. However, while use of ecological sanitation (EcoSan) latrines is increasing in most African countries including Malawi, few studies have been done to check whether use of such sludge could potentially increase the prevalence of helminthic infections among household members as a results of exposure to faecal sludge/compared to use of traditional latrines. [Methods] A cross sectional study was done targeting households using EcoSan and traditional pit latrines. Samples were collected from both types of latrines in Chikwawa (rural) and Blantyre (urban) districts. These two districts have a high number of EcoSan latrines in southern region of Malawi. 156 latrines were sampled (n=95 traditional; n=61 EcoSan), and processed following standard guidelines using modified triple floatation method. Identification of helminth ova (Ascaris lumbricoides, hookworms, Trichuris trichiura, Taenia spp and Diphyllobothrium latum) was done using standard microscopy methods. The difference between the prevalence and mean concentration of helminths between the two types of latrines was tested using Chi-Square and t-test respectively.[Results] Of the total latrines tested, 85.9% (n=134) had at least one species of helminth while 84.6% (n=132) had at least a STH, with 82.0% (n=50) in EcoSan and 86.3% (n=82) in traditional pit latrines. There was no significant difference between the prevalence of helminths in EcoSan and traditional pit latrines [χ2=0.43(1), P=0.5]. The prevalence of Ascaris lumbricoides was significantly higher in EcoSan than in traditional pit latrines [χ2=5.44(1) p=0.02] while prevalence of hookworms was significantly higher in traditional pit latrines than in EcoSan latrines [χ2=13.98(1) p<0.001]. The highest concentration of helminths per gram of faecal sludge was in traditional pit latrines [31.2 (95%CI: 19.1 to 43.2)] than in EcoSan latrines [26.4 (95%CI: 16.5 to 36.3)].[Conclusion] There was no significant difference between overall prevalence of helminths between households using EcoSan and those using traditional pit latrines. However, Ascaris lumbricoides was significantly higher in households using EcoSan latrines. EcoSan users need awareness on safe ways of handling faecal sludge in order to reduce chances of reinfection from Ascaris lumbricoides. Further research should be undertaken on household members to identify those infected and potential routes of infection to enable preventive targeting.
LanguageEnglish
Article number200
Number of pages9
JournalBMC Research Notes
Volume10
DOIs
Publication statusPublished - 9 Jun 2017

Fingerprint

Toilet Facilities
Malawi
Sanitation
Helminths
Cross-Sectional Studies
Ascaris lumbricoides
Sewage
Ancylostomatoidea
Diphyllobothrium
Trichuris
Agriculture
Taenia

Keywords

  • pit latrines
  • EcoSan
  • soil transmitted helminths
  • Ascaris lumbricoides
  • human faecal matter
  • human excreta
  • ecological sanitation
  • faecal sludge

Cite this

@article{515ccd17443c4231a48e34f3a26bdb4a,
title = "Is there a difference in prevalence of helminths between households using ecological sanitation and those using traditional pit latrines? A latrine based cross sectional comparative study in Malawi",
abstract = "[Background] Studies have shown that households using sludge from human excreta for agriculture are at an increased risk of soil transmitted helminths. However, while use of ecological sanitation (EcoSan) latrines is increasing in most African countries including Malawi, few studies have been done to check whether use of such sludge could potentially increase the prevalence of helminthic infections among household members as a results of exposure to faecal sludge/compared to use of traditional latrines. [Methods] A cross sectional study was done targeting households using EcoSan and traditional pit latrines. Samples were collected from both types of latrines in Chikwawa (rural) and Blantyre (urban) districts. These two districts have a high number of EcoSan latrines in southern region of Malawi. 156 latrines were sampled (n=95 traditional; n=61 EcoSan), and processed following standard guidelines using modified triple floatation method. Identification of helminth ova (Ascaris lumbricoides, hookworms, Trichuris trichiura, Taenia spp and Diphyllobothrium latum) was done using standard microscopy methods. The difference between the prevalence and mean concentration of helminths between the two types of latrines was tested using Chi-Square and t-test respectively.[Results] Of the total latrines tested, 85.9{\%} (n=134) had at least one species of helminth while 84.6{\%} (n=132) had at least a STH, with 82.0{\%} (n=50) in EcoSan and 86.3{\%} (n=82) in traditional pit latrines. There was no significant difference between the prevalence of helminths in EcoSan and traditional pit latrines [χ2=0.43(1), P=0.5]. The prevalence of Ascaris lumbricoides was significantly higher in EcoSan than in traditional pit latrines [χ2=5.44(1) p=0.02] while prevalence of hookworms was significantly higher in traditional pit latrines than in EcoSan latrines [χ2=13.98(1) p<0.001]. The highest concentration of helminths per gram of faecal sludge was in traditional pit latrines [31.2 (95{\%}CI: 19.1 to 43.2)] than in EcoSan latrines [26.4 (95{\%}CI: 16.5 to 36.3)].[Conclusion] There was no significant difference between overall prevalence of helminths between households using EcoSan and those using traditional pit latrines. However, Ascaris lumbricoides was significantly higher in households using EcoSan latrines. EcoSan users need awareness on safe ways of handling faecal sludge in order to reduce chances of reinfection from Ascaris lumbricoides. Further research should be undertaken on household members to identify those infected and potential routes of infection to enable preventive targeting.",
keywords = "pit latrines, EcoSan, soil transmitted helminths, Ascaris lumbricoides, human faecal matter, human excreta, ecological sanitation, faecal sludge",
author = "Save Kumwenda and Chisomo Msefula and Wilfred Kadewa and Yohane Diness and Charles Kato and Tracy Morse and Bagrey Ngwira",
year = "2017",
month = "6",
day = "9",
doi = "10.1186/s13104-017-2519-7",
language = "English",
volume = "10",
journal = "BMC Research Notes",
issn = "1756-0500",

}

Is there a difference in prevalence of helminths between households using ecological sanitation and those using traditional pit latrines? A latrine based cross sectional comparative study in Malawi. / Kumwenda, Save; Msefula, Chisomo; Kadewa, Wilfred; Diness, Yohane; Kato, Charles; Morse, Tracy; Ngwira, Bagrey.

In: BMC Research Notes, Vol. 10, 200, 09.06.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Is there a difference in prevalence of helminths between households using ecological sanitation and those using traditional pit latrines? A latrine based cross sectional comparative study in Malawi

AU - Kumwenda, Save

AU - Msefula, Chisomo

AU - Kadewa, Wilfred

AU - Diness, Yohane

AU - Kato, Charles

AU - Morse, Tracy

AU - Ngwira, Bagrey

PY - 2017/6/9

Y1 - 2017/6/9

N2 - [Background] Studies have shown that households using sludge from human excreta for agriculture are at an increased risk of soil transmitted helminths. However, while use of ecological sanitation (EcoSan) latrines is increasing in most African countries including Malawi, few studies have been done to check whether use of such sludge could potentially increase the prevalence of helminthic infections among household members as a results of exposure to faecal sludge/compared to use of traditional latrines. [Methods] A cross sectional study was done targeting households using EcoSan and traditional pit latrines. Samples were collected from both types of latrines in Chikwawa (rural) and Blantyre (urban) districts. These two districts have a high number of EcoSan latrines in southern region of Malawi. 156 latrines were sampled (n=95 traditional; n=61 EcoSan), and processed following standard guidelines using modified triple floatation method. Identification of helminth ova (Ascaris lumbricoides, hookworms, Trichuris trichiura, Taenia spp and Diphyllobothrium latum) was done using standard microscopy methods. The difference between the prevalence and mean concentration of helminths between the two types of latrines was tested using Chi-Square and t-test respectively.[Results] Of the total latrines tested, 85.9% (n=134) had at least one species of helminth while 84.6% (n=132) had at least a STH, with 82.0% (n=50) in EcoSan and 86.3% (n=82) in traditional pit latrines. There was no significant difference between the prevalence of helminths in EcoSan and traditional pit latrines [χ2=0.43(1), P=0.5]. The prevalence of Ascaris lumbricoides was significantly higher in EcoSan than in traditional pit latrines [χ2=5.44(1) p=0.02] while prevalence of hookworms was significantly higher in traditional pit latrines than in EcoSan latrines [χ2=13.98(1) p<0.001]. The highest concentration of helminths per gram of faecal sludge was in traditional pit latrines [31.2 (95%CI: 19.1 to 43.2)] than in EcoSan latrines [26.4 (95%CI: 16.5 to 36.3)].[Conclusion] There was no significant difference between overall prevalence of helminths between households using EcoSan and those using traditional pit latrines. However, Ascaris lumbricoides was significantly higher in households using EcoSan latrines. EcoSan users need awareness on safe ways of handling faecal sludge in order to reduce chances of reinfection from Ascaris lumbricoides. Further research should be undertaken on household members to identify those infected and potential routes of infection to enable preventive targeting.

AB - [Background] Studies have shown that households using sludge from human excreta for agriculture are at an increased risk of soil transmitted helminths. However, while use of ecological sanitation (EcoSan) latrines is increasing in most African countries including Malawi, few studies have been done to check whether use of such sludge could potentially increase the prevalence of helminthic infections among household members as a results of exposure to faecal sludge/compared to use of traditional latrines. [Methods] A cross sectional study was done targeting households using EcoSan and traditional pit latrines. Samples were collected from both types of latrines in Chikwawa (rural) and Blantyre (urban) districts. These two districts have a high number of EcoSan latrines in southern region of Malawi. 156 latrines were sampled (n=95 traditional; n=61 EcoSan), and processed following standard guidelines using modified triple floatation method. Identification of helminth ova (Ascaris lumbricoides, hookworms, Trichuris trichiura, Taenia spp and Diphyllobothrium latum) was done using standard microscopy methods. The difference between the prevalence and mean concentration of helminths between the two types of latrines was tested using Chi-Square and t-test respectively.[Results] Of the total latrines tested, 85.9% (n=134) had at least one species of helminth while 84.6% (n=132) had at least a STH, with 82.0% (n=50) in EcoSan and 86.3% (n=82) in traditional pit latrines. There was no significant difference between the prevalence of helminths in EcoSan and traditional pit latrines [χ2=0.43(1), P=0.5]. The prevalence of Ascaris lumbricoides was significantly higher in EcoSan than in traditional pit latrines [χ2=5.44(1) p=0.02] while prevalence of hookworms was significantly higher in traditional pit latrines than in EcoSan latrines [χ2=13.98(1) p<0.001]. The highest concentration of helminths per gram of faecal sludge was in traditional pit latrines [31.2 (95%CI: 19.1 to 43.2)] than in EcoSan latrines [26.4 (95%CI: 16.5 to 36.3)].[Conclusion] There was no significant difference between overall prevalence of helminths between households using EcoSan and those using traditional pit latrines. However, Ascaris lumbricoides was significantly higher in households using EcoSan latrines. EcoSan users need awareness on safe ways of handling faecal sludge in order to reduce chances of reinfection from Ascaris lumbricoides. Further research should be undertaken on household members to identify those infected and potential routes of infection to enable preventive targeting.

KW - pit latrines

KW - EcoSan

KW - soil transmitted helminths

KW - Ascaris lumbricoides

KW - human faecal matter

KW - human excreta

KW - ecological sanitation

KW - faecal sludge

U2 - 10.1186/s13104-017-2519-7

DO - 10.1186/s13104-017-2519-7

M3 - Article

VL - 10

JO - BMC Research Notes

T2 - BMC Research Notes

JF - BMC Research Notes

SN - 1756-0500

M1 - 200

ER -