Longitudinal Effects of a Sanitation Intervention on Environmental Fecal Contamination in a Cluster-Randomized Controlled Trial in Rural Bangladesh
Jesse D. Contreras, Mahfuza Islam, Andrew Mertens, Amy J. Pickering, Laura H. Kwong, Benjamin F. Arnold, Jade Benjamin‐Chung, Alan Hubbard, Mahfuja Alam, Debashis Sen, Sharmin Islam, Mahbubur Rahman, Leanne Unicomb, Stephen P. Luby, John M. Colford, Ayşe Ercümen
Abstract
and fecal coliforms in samples of stored drinking water, child hands, mother hands, soil, and food among a random sample of households from the sanitation and control arms of the trial. Samples were collected during eight quarterly visits approximately 1-3.5 years after intervention initiation. Overall, there were no substantial differences in environmental fecal contamination between households enrolled in the sanitation and control arms. Statistically significant reductions were found in stored water and child hands after pooling across sampling rounds, but the effects were small and not consistent across rounds. In addition, we assessed potential effect modification of intervention effects by follow-up time, season, wealth, community-level latrine density and coverage, population density, and domestic animal ownership. While the intervention had statistically significant effects within some subgroups, there were no consistent patterns of effect modification. Our findings support a growing consensus that on-site latrines are insufficient to prevent fecal contamination in the rural household environment.