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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

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  • Danielle Medgyesi
  • Daniel Sewell
  • Reid Senesac
  • Oliver Cumming
  • Jane Mumma
  • Kelly K Baker

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 (

Suggested Citation

  • Danielle Medgyesi & Daniel Sewell & Reid Senesac & Oliver Cumming & Jane Mumma & Kelly K Baker, 2019. "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," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 13(3), pages 1-21, March.
    • Handle: RePEc:plo:pntd00:0007292
    DOI: 10.1371/journal.pntd.0007292
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    References listed on IDEAS

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    1. Brent L. Finley & Paul K. Scott & Douglas A. Mayhall, 1994. "Development of a Standard Soil‐to‐Skin Adherence Probability Density Function for Use in Monte Carlo Analyses of Dermal Exposure," Risk Analysis, John Wiley & Sons, vol. 14(4), pages 555-569, August.
    2. Yuke Wang & Christine L. Moe & Peter F. M. Teunis, 2018. "Children Are Exposed to Fecal Contamination via Multiple Interconnected Pathways: A Network Model for Exposure Assessment," Risk Analysis, John Wiley & Sons, vol. 38(11), pages 2478-2496, November.
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    Cited by:

    1. Tracy Morse & Elizabeth Tilley & Kondwani Chidziwisano & Rossanie Malolo & Janelisa Musaya, 2020. "Health Outcomes of an Integrated Behaviour-Centred Water, Sanitation, Hygiene and Food Safety Intervention–A Randomised before and after Trial," IJERPH, MDPI, vol. 17(8), pages 1-19, April.

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