1
|
Larson A, Haver S, Hattendorf J, Salmon-Mulanovich G, Riveros M, Verastegui H, Mäusezahl D, Hartinger S. Household-level risk factors for water contamination and antimicrobial resistance in drinking water among households with children under 5 in rural San Marcos, Cajamarca, Peru. One Health 2023; 16:100482. [PMID: 36655146 PMCID: PMC9841353 DOI: 10.1016/j.onehlt.2023.100482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 12/30/2022] [Accepted: 01/02/2023] [Indexed: 01/05/2023] Open
Abstract
Household water contamination at point of use depends on human, animal and environmental factors embodying all aspects of a One Health approach. This study investigated the association between household factors, the presence of thermotolerant coliform, and the presence of antibiotic resistant bacteria in drinking water among 314 households with children under 5 in Cajamarca, Peru. This study analysed data from a baseline sampling of a randomized controlled trial, including household surveys covering household water management and factors such as household animals, as well as microbiological data from samples collected from drinking water. Data were analysed using generalized linear models. Drinking water samples collected from narrow-mouthed containers were less likely to be contaminated than samples collected from the faucet (OR = 0.55, p = 0.030) or wide mouthed containers. The presence of thermotolerant coliform was associated with owning farm birds, which increased the proportion of contamination from 42.2% to 59.1% (OR = 1.98, p = 0.017) and with animal waste observed in the kitchen area, which increased the prevalence of contamination from 51.4% to 65.6% (OR = 1.80, p = 0.024). Resistance to any antibiotic was higher among pig owners at 60%, relative to non-pig owners at 36.4% (OR = 1.97, p = 0.012) as well as households with free-roaming animals in the kitchen area at 59.6% compared to households without free-roaming animals at 39.7% (OR = 2.24, p = 0.035). Recent child antibiotic use increased the prevalence of trimethoprim-sulfamethoxazole resistance among E. coli isolates to 22.3% relative to 16.7% (OR = 3.00, p = 0.037). Overall, these findings suggest that water storage in a secure container to protect from in-home contamination is likely to be important in providing safe drinking water at point of use. In addition, transmission of thermotolerant coliform and AMR between domestic animals and human drinking water supplies is likely. Further research should explore transmission pathways and methods to support safe drinking water access in multi-species households.
Collapse
Affiliation(s)
- A.J. Larson
- Universidad Peruana Cayetano Heredia, Lima, Peru,University of Washington, Seattle, United States,Swiss Tropical and Public Health Institute, Allschwil, Switzerland,University of Basel, Basel, Switzerland
| | - S. Haver
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland,University of Basel, Basel, Switzerland
| | - J. Hattendorf
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland,University of Basel, Basel, Switzerland
| | - G. Salmon-Mulanovich
- Universidad Peruana Cayetano Heredia, Lima, Peru,Institute for Nature, Earth and Energy at the Pontificia Universidad Católica del Perú, Lima, Peru
| | - M. Riveros
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | - H. Verastegui
- Universidad Peruana Cayetano Heredia, Lima, Peru,Swiss Tropical and Public Health Institute, Allschwil, Switzerland,University of Basel, Basel, Switzerland
| | - D. Mäusezahl
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland,University of Basel, Basel, Switzerland
| | - S.M. Hartinger
- Universidad Peruana Cayetano Heredia, Lima, Peru,Swiss Tropical and Public Health Institute, Allschwil, Switzerland,University of Basel, Basel, Switzerland,Corresponding author at: Universidad Peruana Cayetano Heredia, Lima, Peru.
| |
Collapse
|
2
|
Hartinger SM, Lanata CF, Hattendorf J, Verastegui H, Gil AI, Wolf J, Mäusezahl D. Improving household air, drinking water and hygiene in rural Peru: a community-randomized-controlled trial of an integrated environmental home-based intervention package to improve child health. Int J Epidemiol 2018; 45:2089-2099. [PMID: 27818376 PMCID: PMC5841839 DOI: 10.1093/ije/dyw242] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2016] [Indexed: 12/24/2022] Open
Abstract
Background Diarrhoea and acute lower respiratory infections are leading causes of childhood morbidity and mortality, which can be prevented by simple low-cost interventions. Integrated strategies can provide additional benefits by addressing multiple health burdens simultaneously. Methods We conducted a community-randomized-controlled trial in 51 rural communities in Peru to evaluate whether an environmental home-based intervention package, consisting of improved solid-fuel stoves, kitchen sinks, solar disinfection of drinking water and hygiene promotion, reduces lower respiratory infections, diarrhoeal disease and improves growth in children younger than 36 months. The attention control group received an early child stimulation programme. Results We recorded 24 647 child-days of observation from 250 households in the intervention and 253 in the attention control group during 12-month follow-up. Mean diarrhoea incidence was 2.8 episodes per child-year in the intervention compared with 3.1 episodes in the control arm. This corresponds to a relative rate of 0.78 [95% confidence interval (CI): 0.58-1.05] for diarrhoea incidence and an odds ratio of 0.71 (95% CI: 0.47-1.06) for diarrhoea prevalence. No effects on acute lower respiratory infections or children's growth rates were observed. Conclusions Combined home-based environmental interventions slightly reduced childhood diarrhoea, but the confidence interval included unity. Effects on growth and respiratory outcomes were not observed, despite high user compliance of the interventions. The absent effect on respiratory health might be due to insufficient household air quality improvements of the improved stoves and additional time needed to achieve attitudinal and behaviour change when providing composite interventions.
Collapse
Affiliation(s)
- S M Hartinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,Instituto de Investigación Nutricional, Lima, Peru
| | - C F Lanata
- Instituto de Investigación Nutricional, Lima, Peru
| | - J Hattendorf
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - H Verastegui
- Instituto de Investigación Nutricional, Lima, Peru
| | - A I Gil
- Instituto de Investigación Nutricional, Lima, Peru
| | - J Wolf
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - D Mäusezahl
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| |
Collapse
|
4
|
Grijalva CG, Griffin MR, Edwards KM, Williams JV, Gil AI, Verastegui H, Hartinger SM, Vidal JE, Klugman KP, Lanata CF. Cohort profile: The study of respiratory pathogens in Andean children. Int J Epidemiol 2013; 43:1021-30. [PMID: 23771719 DOI: 10.1093/ije/dyt065] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We investigated respiratory pathogens in a prospective cohort study of young children living in the Peruvian Andes. In the study we assessed viral respiratory infections among young children, and explored interactions of viruses with common respiratory bacteria, especially Streptococcus pneumoniae. Through weekly household visits, data were collected on the signs and symptoms of acute respiratory illness (ARI), nasal samples were collected to test for viruses during episodes of ARI, and nasopharyngeal samples were collected on a monthly basis to monitor bacterial colonisation. We also collected data on vaccination coverage, patterns of social mixing, geographic information, and environmental and socio-demographic variables. Understanding the interaction of respiratory viruses with bacteria and its impact on the burden and severity of ARIs in rural areas of developing countries is critical to designing strategies for preventing such infections.
Collapse
Affiliation(s)
- Carlos G Grijalva
- Departments of Preventive Medicine, Vanderbilt University School of Medicine, Nashville TN, USA, Pediatrics-Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville TN, USA, Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville TN, USA, Instituto de Investigación Nutricional, Lima, Perú, Swiss Tropical and Public Health Institute, Basel, Switzerland and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USA
| | - Marie R Griffin
- Departments of Preventive Medicine, Vanderbilt University School of Medicine, Nashville TN, USA, Pediatrics-Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville TN, USA, Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville TN, USA, Instituto de Investigación Nutricional, Lima, Perú, Swiss Tropical and Public Health Institute, Basel, Switzerland and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USA
| | - Kathryn M Edwards
- Departments of Preventive Medicine, Vanderbilt University School of Medicine, Nashville TN, USA, Pediatrics-Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville TN, USA, Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville TN, USA, Instituto de Investigación Nutricional, Lima, Perú, Swiss Tropical and Public Health Institute, Basel, Switzerland and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USA
| | - John V Williams
- Departments of Preventive Medicine, Vanderbilt University School of Medicine, Nashville TN, USA, Pediatrics-Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville TN, USA, Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville TN, USA, Instituto de Investigación Nutricional, Lima, Perú, Swiss Tropical and Public Health Institute, Basel, Switzerland and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USADepartments of Preventive Medicine, Vanderbilt University School of Medicine, Nashville TN, USA, Pediatrics-Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville TN, USA, Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville TN, USA, Instituto de Investigación Nutricional, Lima, Perú, Swiss Tropical and Public Health Institute, Basel, Switzerland and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USA
| | - Ana I Gil
- Departments of Preventive Medicine, Vanderbilt University School of Medicine, Nashville TN, USA, Pediatrics-Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville TN, USA, Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville TN, USA, Instituto de Investigación Nutricional, Lima, Perú, Swiss Tropical and Public Health Institute, Basel, Switzerland and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USA
| | - Héctor Verastegui
- Departments of Preventive Medicine, Vanderbilt University School of Medicine, Nashville TN, USA, Pediatrics-Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville TN, USA, Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville TN, USA, Instituto de Investigación Nutricional, Lima, Perú, Swiss Tropical and Public Health Institute, Basel, Switzerland and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USA
| | - Stella M Hartinger
- Departments of Preventive Medicine, Vanderbilt University School of Medicine, Nashville TN, USA, Pediatrics-Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville TN, USA, Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville TN, USA, Instituto de Investigación Nutricional, Lima, Perú, Swiss Tropical and Public Health Institute, Basel, Switzerland and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USADepartments of Preventive Medicine, Vanderbilt University School of Medicine, Nashville TN, USA, Pediatrics-Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville TN, USA, Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville TN, USA, Instituto de Investigación Nutricional, Lima, Perú, Swiss Tropical and Public Health Institute, Basel, Switzerland and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USA
| | - Jorge E Vidal
- Departments of Preventive Medicine, Vanderbilt University School of Medicine, Nashville TN, USA, Pediatrics-Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville TN, USA, Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville TN, USA, Instituto de Investigación Nutricional, Lima, Perú, Swiss Tropical and Public Health Institute, Basel, Switzerland and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USA
| | - Keith P Klugman
- Departments of Preventive Medicine, Vanderbilt University School of Medicine, Nashville TN, USA, Pediatrics-Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville TN, USA, Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville TN, USA, Instituto de Investigación Nutricional, Lima, Perú, Swiss Tropical and Public Health Institute, Basel, Switzerland and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USA
| | - Claudio F Lanata
- Departments of Preventive Medicine, Vanderbilt University School of Medicine, Nashville TN, USA, Pediatrics-Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville TN, USA, Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville TN, USA, Instituto de Investigación Nutricional, Lima, Perú, Swiss Tropical and Public Health Institute, Basel, Switzerland and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USA
| |
Collapse
|