Logo image
Back
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
Journal article   Open access

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

Danielle Medgyesi, Daniel Sewell, Reid Senesac, Oliver Cumming, Jane Mumma and Kelly K Baker
PLoS neglected tropical diseases, Vol.13(3), pp.e0007292-e0007292
03/2019
DOI: 10.1371/journal.pntd.0007292
PMCID: PMC6453472
PMID: 30917117
url
https://doi.org/10.1371/journal.pntd.0007292View
Published (Version of record) Open Access

Abstract

Young 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. The 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. Additionally, we examine how pathogen doses and multi-pathogen exposure are modified by spatial variability in the number of public areas children are exposed to in their neighborhood. A Bayesian framework was employed to obtain the posterior distribution of pathogen doses for a certain number of contacts. First, a multivariate mixed 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. Pathogen presence and concentration in soil varied widely across local (< 25 meter radius area) and neighborhood-level scales, but pathogens were correlated among distinct surface water samples collected near to each other. Multi-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. Child 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.
 Bayes Theorem Child Child, Preschool Cross-Sectional Studies Environmental Exposure Feces - microbiology Fresh Water - microbiology Gastrointestinal Diseases - epidemiology Gastrointestinal Diseases - microbiology Gastrointestinal Microbiome - physiology Gastrointestinal Tract - microbiology Humans Infant Kenya - epidemiology Models, Statistical Poverty Residence Characteristics Soil Microbiology

Details

Metrics

14 Record Views
24 Times Cited - Web of Science
Logo image