Keeping Clean: A Qualitative Analysis of Water, Sanitation, and Hygiene Among Residents of Recreational Vehicles in Seattle, WA US.

The growing number of people living in vehicles in the urban United States in recent years makes their water, sanitation, and hygiene (WASH) an increasingly relevant public health issue. The WASH context of people living in recreational vehicles (RVs) presents unique challenges, especially as it relates to wastewater disposal. This study answers the question: How do RV residents typically manage their wastewater and meet their other WASH needs? We examined the experiences of RV residents in Seattle, Washington participating in Seattle Public Utilities' mobile pump-out program, which has offered a free, typically monthly, door-to-door RV wastewater disposal service since 2020.

Water, food, and mental well-being: Associations between drinking water source, household water and food insecurity, and mental well-being of low-income pregnant women in urban Mozambique.

Drinking water access and water and food insecurity have been linked to mental well-being, but few studies have comprehensively assessed potential pathways linking these associations. Understanding these mediation pathways is particularly important among pregnant women, as prenatal stress and poor mental well-being have been shown to negatively impact fetal development. In this study, we address this gap by analyzing the relationships between drinking water source and water and food insecurity with mental well-being amongst pregnant women living in low-income, urban neighborhoods of Beira, Mozambique.

Multiplex PCR Detection of Enteric Pathogens in a Community-based Birth Cohort in Ecuador: Comparison of xTAG-GPP and TaqMan Array Card Assays.

We compared the performance of 2 multiplex platforms, Luminex xTAG Gastrointestinal Pathogen Panel and TaqMan Array Card, against a panel of 14 enteric pathogen targets in a community-based birth cohort in Ecuador. We found high levels of agreement and similar prevalence estimates across most pathogens.

Differential Effectiveness of Water, Sanitation, and Handwashing Interventions to Reduce Child Diarrhea in Dry and Rainy Seasons: A Systematic Review and Meta-Analysis of Intervention Trials.

Background: Studies evaluating how water, sanitation, and/or handwashing (WASH) interventions in low- and middle-income countries impact diarrheal diseases have shown inconsistent results. The prevalence of enteric pathogen infections and diarrhea are highly seasonal and climate-sensitive, which could explain heterogeneous findings. Understanding how season influences the effectiveness of WASH interventions is critical for informing intervention approaches that will be resistant under the varying weather conditions that climate change will bring.

Harnessing Non-standard Nucleic Acids for Highly Sensitive Icosaplex (20-Plex) Detection of Microbial Threats for Environmental Surveillance.

Environmental surveillance and clinical diagnostics heavily rely on the polymerase chain reaction (PCR) for target detection. A growing list of microbial threats warrants new PCR-based detection methods that are highly sensitive, specific, and multiplexable. Here, we introduce a PCR-based icosaplex (20-plex) assay for detecting 18 enteropathogen and two antimicrobial resistance genes.

Environmental Exposures Associated with Enteropathogen Infection in Six-Month-Old Children Enrolled in the ECoMiD Cohort along a Rural-Urban Gradient in Northern Ecuador†.

Enteropathogens are major contributors to mortality and morbidity, particularly in settings with limited access to water, sanitation, and hygiene infrastructure. To assess transmission pathways associated with enteropathogen infection, we measured household environmental conditions and assayed 22 enteropathogens using TaqMan Array Cards in stool samples from 276 six-month-old children living in communities along a rural-urban gradient in Northern Ecuador. We utilized multivariable models, risk factor importance, and distance-based statistical methods to test factors associated with infection.

Farm-to-fork changes in poultry microbiomes and resistomes in Maputo City, Mozambique.

Unlabelled: Increasing demand for poultry has spurred poultry production in low- and middle-income countries like Mozambique. Poultry may be an important source of foodborne, antimicrobial-resistant bacteria to consumers in settings with limited water, sanitation, and hygiene infrastructure. The Chicken Exposures and Enteric Pathogens in Children Exposed through Environmental Pathways (ChEEP ChEEP) study was conducted in Maputo City, Mozambique from 2019 to 2021 to quantify enteric pathogen exposures along the supply chain for commercial and local (i.

Purchase, consumption, and ownership of chickens and chicken products among households in Maputo, Mozambique: A cross-sectional study.

Background: Chickens are an important source of animal protein, nutrition, and income in many low- and middle-income countries (LMICs). They are also a major reservoir of enteropathogens that contribute to the burden of illnesses among children. Food systems present a risk for transmission of enteropathogens from poultry to humans, but there is a lack of population-level data on the pattern of purchase, ownership, and consumption of live chickens and their products in LMICs to better characterize that risk.

Diversity and Prevalence of Helminths and Protozoa Among Pregnant Women in Tropical Ecuador: Implications for Chemotherapy.

Deworming for pregnant women using a single dose of albendazole or mebendazole is recommended by the WHO in areas where the baseline prevalence of hookworm and/or trichuriasis is >20%. However, other helminths and protozoa infecting pregnant women are not affected by these drugs and dosages. To assess the prevalence and diversity of intestinal helminth and protozoan infections, we analyzed stool samples from pregnant women recently enrolled into a birth cohort, along a rural-urban gradient in northern coastal Ecuador from 2019 to 2022.

Water, sanitation, and hygiene insecurity and disease prevention behaviors during the COVID-19 pandemic in low-income neighborhoods of Beira, Mozambique.

Background: Inadequate water, sanitation, and hygiene (WASH) are important drivers of the global burden of disease, and their impact is exacerbated during outbreaks. Directives to practice handwashing and physical distancing may be impractical for people that have limited access to WASH resources. In this study, which took place during the acute phase of the COVID-19 pandemic, we explore the relationship between control measures for global health crises and water, sanitation, and hygiene insecurity, with implications for other infectious diseases and future health emergencies.

Accumulation of microbial hazards and assessment of food hygiene associated with broiler chicken processing at open air food markets in Maputo, Mozambique.

The burden of foodborne disease due to the consumption of animal-sourced foods is substantial in low- and middle-income countries (LMICs). Open air markets, while providing fresh and affordable foods, often have unhygienic practices that may contribute to contamination during the slaughter and processing of chicken meat. This study examines whether and how the common practice of rinse water (stored water used for rinsing broiler carcasses during processing) reuse leads to accumulation of pathogens, with potential cross contamination of chicken meat.

Multiplex PCR detection of enteric pathogens in a community-based birth cohort in Ecuador: comparison of xTAG-GPP and TaqMan array card assays.

We compared the performance of two multiplex platforms, Luminex xTAG Gastrointestinal Pathogen PanelⓇ and TaqMan Array Card, against a panel of 14 enteric pathogen targets in a community-based birth cohort in Ecuador. We found high levels of agreement and similar prevalence estimates across most pathogens.

Dosimetric calibration of anatomy-specific ultra-high dose rate electron irradiation platform for preclinical FLASH radiobiology experiments.

Background: FLASH radiation therapy (RT) offers a promising avenue for the broadening of the therapeutic index. However, to leverage the full potential of FLASH in the clinical setting, an improved understanding of the biological principles involved is critical. This requires the availability of specialized equipment optimized for the delivery of conventional (CONV) and ultra-high dose rate (UHDR) irradiation for preclinical studies.

The development and validation of a survey to measure fecal-oral child exposure to zoonotic enteropathogens: The FECEZ Enteropathogens Index.

Child exposure to animal feces and associated enteropathogens contribute to a significant burden of disease in low- and middle-income countries. However, there are no standardized, validated survey-based approaches to enable accurate assessment of child exposure to zoonotic enteropathogens. We developed and validated a survey-based measure of exposure, the fecal-oral child exposure to zoonotic enteropathogens Index (the FECEZ Enteropathogens Index).

Anthroponotic and Zoonotic Hookworm DNA in an Indigenous Community in Coastal Ecuador: Potential Cross-Transmission between Dogs and Humans.

Humans can be infected with anthroponotic ( and ) and with zoonotic (, , , and ) hookworms from dogs. Anthroponotic species are usually thought not to infect dogs. We used the internal transcribed spacer-1 (ITS1) gene in a quantitative PCR to detect anthroponotic and zoonotic hookworm species in fecal samples from 54 children and 79 dogs living in an indigenous community in tropical Northwestern Ecuador.

Purchase, consumption, and ownership of chickens and chicken products among households in Maputo, Mozambique: A cross-sectional study.

Background: Chickens are an important source of animal protein, nutrition, and income in many low- and middle-income countries (LMICs). They are also a major reservoir of enteropathogens that contribute to the burden of illnesses among children. Food systems present a risk for transmission of enteropathogens from poultry to humans, but there is a lack of population-level data on the pattern of purchase, ownership, and consumption of live chickens and their products in LMICs to better characterize that risk.

Correlates of maternal depression, anxiety and functioning across an urban-rural gradient in northern Ecuador.

Maternal depression remains under characterised in many low- and middle-income countries, especially in rural settings. We aimed to describe maternal depression and anxiety symptoms in rural and urban communities in northern Ecuador and to identify socioeconomic and demographic factors associated with these symptoms. Data from 508 mothers participating in a longitudinal cohort study were included.

Why are so many enteric pathogen infections asymptomatic? Pathogen and gut microbiome characteristics associated with diarrhea symptoms and carriage of diarrheagenic in northern Ecuador.

A high proportion of enteric infections, including those caused by diarrheagenic (DEC), are asymptomatic for diarrhea. The factors responsible for the development of diarrhea symptoms, or lack thereof, remain unclear. Here, we used DEC isolate genome and whole stool microbiome data from a case-control study of diarrhea in Ecuador to examine factors associated with diarrhea symptoms accompanying DEC carriage.

Quantifying Enteropathogen Contamination along Chicken Value Chains in Maputo, Mozambique: A Multidisciplinary and Mixed-Methods Approach to Identifying High Exposure Settings.

Background: Small-scale poultry production is widespread and increasing in low- and middle-income countries (LMICs). Exposure to enteropathogens in poultry feces increases the hazard of human infection and related sequela, and the burden of disease due to enteric infection in children y in particular is substantial. Yet, the containment and management of poultry-associated fecal waste in informal settings in LMICs is largely unregulated.