Hands and Water as Vectors
of Diarrheal Pathogens
in Bagamoyo, Tanzania
- Publication date
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Abstract
Diarrheal disease is a leading cause of under-five childhood
mortality
worldwide, with at least half of these deaths occurring in sub-Saharan
Africa. Transmission of diarrheal pathogens occurs through several
exposure routes including drinking water and hands, but the relative
importance of each route is not well understood. Using molecular methods,
this study examines the relative importance of different exposure
routes by measuring enteric bacteria (pathogenic <i>Escherichia
coli</i>) and viruses (rotavirus, enterovirus, adenovirus) in
hand rinses, stored water, and source waters in Bagamoyo, Tanzania.
Viruses were most frequently found on hands, suggesting that hands
are important vectors for viral illness. The occurrence of <i>E. coli</i> virulence genes (ECVG) was equivalent across all
sample types, indicating that both water and hands are important for
bacterial pathogen transmission. Fecal indicator bacteria and turbidity
were good predictors of ECVG, whereas turbidity and human-specific <i>Bacteroidales</i> were good predictors of viruses. ECVG were
more likely found in unimproved water sources, but both ECVG and viral
genes were detected in improved water sources. ECVG were more likely
found in stored water of households with unimproved sanitation facilities.
The results provide insights into the distribution of pathogens in
Tanzanian households and offer evidence that hand-washing and improved
water management practices could alleviate viral and bacterial diarrhea