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In 2017, 55% of the global population were without safely managed sanitation services. On-site sanitation solutions, such as pit latrines, provide the majority of sanitation coverage across developing countries. Appropriate technologies are required in order to safely empty these latrines without damage to people or the environment. The design of appropriate emptying technologies can be hampered by a lack of knowledge of the mechanical properties of the waste, such as its strength. This paper will develop a calibration for a dynamic cone penetrometer to give accurate measurements of faecal sludge strength against a standard scale, rendering existing data comparable. It will be shown that the maximum shear strengths of faecal sludge found in practice are substantially greater than those previously reported; some pit latrines contain faecal sludge with strength values of 5–20 kPa at the surface, and exceeding 80 kPa at depth. Keywords: faecal sludge strength measurement dynamic cone penetrometer pit latrine

Public schools in most rural areas of South Africa depend on untreated groundwater due to unreliable water supply by the municipalities. This has the potential to cause water-related health problems to school children. Temperature, pH, and electrical conductivity (EC) were measured in situ. Chemical (fluoride, chloride, sulphate, phosphate, nitrate, magnesium, calcium, sodium, and potassium) and microbial (Escherichia coliform (E. coli), Salmonella typhimurium, and Shigella flexneri) water quality parameters were analysed in groundwater samples from 10 public schools in Vhuronga 1 to determine suitability for use. Quantitative microbial risk assessment was carried out to determine risks of infection and illness due to consumption of groundwater. Correlation analysis was used to identify potential sources of contamination. All physical and most chemical water quality parameters were within guidelines for domestic water use. A high proportion of schools had high levels of microbial organisms. Risks of infection per day were relatively low for all schools. The annual risks of infection due to E. coli and Shigella flexneri for most schools was high, with maximum values of 89.11 and 83.75%, respectively. Maximum risks of illness per year were 31.19, 30.37, and 29.31% for E. coli, Salmonella typhimurium, and Shigella flexneri, respectively. Correlation analysis indicated potential contamination of groundwater by agricultural activities, domestic waste, and faecal contamination from pit latrines. Preventive and mitigation measures to minimise such risks, including locating boreholes at safe distances from pit latrines, prevention/minimisation of pollution of groundwater from agricultural activities, and point-of-use treatment of groundwater by the schools are therefore essential.

Access to water and sanitation remain a challenge in many developing countries, especially in pro-poor urban informal settlements where socioeconomic livelihoods are generally low. The aim of this study was to characterise the water and sanitation facilities in the informal settlements of Kisumu City and to evaluate their effect on community hygiene and health. The study focussed on the five urban informal settlements of Nyalenda A, Nyalenda B, Manyatta A, Manyatta B and Obunga, and the three Peri-urban informal settlements of Kogony, Usoma and Otonglo. Using descriptive techniques, the researcher surveyed 114 water sources and all sanitation facilities within 0-15 m and 15-30 m radii of the water sources. The findings revealed dominance of shallow wells and traditional pit latrines as the primary water sources and sanitation facilities, respectively. Out of the water sources studied, 87.7% (100) were shallow wells (mean depth 1.5 m), 9.6% (11) springs and 2.6% (3) boreholes. Most of these shallow wells (83%) were within the urban informal settlements where uses range from washing and cleaning, cooking, and even drinking (13.5%), despite the majority being unprotected. The analysis of the density of sanitation facilities near the water points showed that 32.3% existed within a 15 m radius of the nearest water sources, in violation of the recommended safe distance of 30 m. With an increased density of toilets near critical water sources and other sanitary practices, public health is highly compromised.

Urban growth in low- and middle-income countries has intensified the need to expand sanitation infrastructure, especially in informal settlements. Sanitation approaches for these settings remain understudied, particularly regarding multidimensional social-ecological outcomes. Guided by a conceptual framework (developed in parallel with this study) re-envisioning sanitation as a human-derived resource system, here we characterize existing and alternative sanitation scenarios in an informal settlement in Kampala, Uganda. Combining two core research approaches (household survey analysis, process modeling), we elucidate factors associated with user satisfaction and evaluate each scenario's resource recovery potential, economic implications, and environmental impacts. We find that existing user satisfaction is associated with factors including cleaning frequency, sharing, and type of toilets, and we demonstrate that alternative sanitation systems may offer multidimensional improvements over existing latrines, drying beds, and lagoons. Transitioning to anaerobic treatment could recover energy while reducing overall net costs by 26-65% and greenhouse gas emissions by 38-59%. Alternatively, replacing pit latrines with container-based facilities greatly improves recovery potential in most cases (e.g., a 2- to 4-fold increase for nitrogen) and reduces emissions by 46-79%, although costs increase. Overall, this work illustrates how our conceptual framework can guide empirical research, offering insight into sanitation for informal settlements and more sustainable resource systems.

Access to safe water, sanitation, and hygiene (WASH) facilities is a basic necessity for human livelihood, survival, and well-being. Adequate WASH facilities provision is a critical issue to most developing countries around the world including Nigeria. Knowledge, attitudes, and practices regarding WASH are integral to effective and sustainable WASH facilities provision. This study assessed the level of knowledge, behavior, and practices towards water, sanitation, and hygiene in Kaduna state, Nigeria, with a view to ensuring sustainable WASH facilities intervention in the region. Data collection tools included spot check observation and questionnaire involving 854 participants, selected from five local government areas (LGAs): Chikun, Kajuru, Soba, Kachia, and Zango Kataf. From the results, major drinking water sources were surface waters (52.5%) and unprotected hand dug wells (44.8%); only 46.2% treated their water supply and few (16.6%) used chlorination method. Pit latrine toilets were the major (76.5%) excreta disposal means, and open defecation practices were widespread (41.4%). Level of personal and environmental hygiene understanding was fairly good in all the local government areas, and 65.4% claimed to use water and soap for washing hands after defecation. Incidence of water related diseases is generally low in the area. Despite the commendable findings in the study areas, communities are still at risk due to lack of safe water supply and poor practices of home treatment and excreta disposal. Therefore provision of WASH facilities and WASH education is fundamental for ensuring public health in the study area.

A market assessment survey was conducted to create a comprehensive baseline survey of water, sanitation, and hygiene (WASH) within the Lake Bosomtwe area. This survey provided community members the opportunity to share their needs, insight, and input into appropriate technologies for a potential demonstration farm that could help mitigate local community health issues. Interviews were conducted in the 12 villages located along the lake‘s shore. Within the last seven years, the lake has been subjected to overfishing and environmental degradation. Community members, within walking distance of the lake participated in individual interviews of a 140-question survey. Data collected were: demographics, land use, farming practices, water sanitation, personal hygiene, and participation in fishing. Spatial data were also collected for drinking water sources, pit latrines, and village centers. An initial broad spatial analysis was conducted within ArcGIS Pro of all spatial data collected, according to the SPHERE minimum humanitarian standards in water supply, sanitation, and hygiene promotion. Through this analysis, it was determined whether community pit latrines and drinking water source were seeping into the lake, potentially escalating the lake water quality problems. These sources were also evaluated to determine if they properly met each villages‘ current population size. It was determined that all current WASH sources within the Lake Bosomtwe area are inadequate. This study provided recommendations at the village and district level to help move towards sustainable access of sanitation facilities for all these villages.

There are considerable challenges to achieving the Sustainable Development Goals&rsquo, target of universal access to basic sanitation in schools. Schools require safe, clean, and sex-segregated facilities for a large number of students. Robust and affordable solutions are needed to address the economic, spatial, social, institutional, and political factors which contribute to poor sanitary conditions in informal settlements. In 2015, we undertook a randomized controlled trial to assess the feasibility of private sector sanitation delivery (PSSD) in 20 primary schools, in informal settlements of Nairobi, Kenya. Our preliminary evaluation after one year of service delivery suggested that PSSD of urine-diverting dry latrines with routine waste collection and maintenance provided a feasible, lower-cost alternative to the government standard delivery (GSD) of cistern-flush toilets or ventilated improved pit latrines. We conducted a mixed-methods follow-up study to assess sanitation delivery over 3&ndash, 4 years and investigate prevailing drivers and barriers that may influence the scalability of PSSD. The conditions of newly constructed and rehabilitated GSD facilities diminished quickly, reverting to the conditions of existing facilities, indicating lower sustainability compared to sanitation delivered from the private sector. Barriers in financial aspects related to the ongoing implementation of PSSD emerged, particularly among public schools, and few were able to pay for continued service. Our study demonstrates that the engagement of the private sector may lead to improvements in affordable, safely managed sanitation for schools and their students. Yet, to reach a sustained scale, additional guidance is needed on how to develop these partnerships, streamline procurement and contracting processes, and incorporate appropriate financing mechanisms.

Tiger Toilets use a worm-based ecosystem to degrade human waste and have recently been demonstrated as a cost-effective innovation in on-site sanitation. The benefits over traditional pit latrines include slower fill rate, fewer odours, and safer emptying. However, a question remains around how to measure the rate of accumulation of vermi-compost and predict the fill rate into the future. In this study, fifteen Tiger Toilets of varying installation ages in the villages of Jejuri, Bhalgudi and Walhe/Adachiwadi, in Maharashtra province, India were investigated to determine the rate of filling. A laser measure was used to define cross-sections of the depth to vermi-compost layers within the Tiger Toilet digesters. Bench-scale column tests were used to estimate liquid infiltration rates from the digesters into the surrounding soils. Changes over time in the interior digester conditions were photographed and a video camera was installed in selected digesters to confirm and observe the worm activity in situ under red light. Calculated fill rates of the Tiger Toilets were significantly lower compared to estimated fill rates of traditional pit latrines of a similar size and usage rate. The infiltration of the liquid fraction of the waste into the surrounding soil was observed to be a key factor in filling.

Pit latrines are promoted in resource-limited settings, but unpleasant odours may deter their use. In this study, latrines in rural Ethiopia were randomized to the addition of cooking ash, the addition of boiling water or neither. Study staff ranked odour on a 6-point scale before and approximately 24 h after intervention. Following intervention, odour grades were on average 0.2 points lower (95% confidence interval [CI] 0.7 lower to 0.3 higher) in ash-treated latrines and 0.4 points lower (95% CI 0.9 lower to 0.1 higher) in boiled water–treated latrines, although the difference between the three groups was not statistically significant (p = 0.21). Larger studies might detect a smaller difference.

Menstrual blood is not just a physical substance; it is laden with symbolism and often powerfully stigmatised. It is important to understand local perceptions and attitudes towards menstrual blood, as well as the preferred practices of menstruating women, in order to design appropriate sanitation and solid waste systems to support menstruation. Failure to take account of socio-cultural factors can jeopardise the effectiveness of such infrastructure. This study, conducted in Blantyre, Malawi, is a qualitative socio-cultural examination of how women manage and view menstruation. Thirty nine interviews, conducted with individuals and with small groups of friends, were carried out with thirty one women using pit latrines, flush toilets, and urine-diverting dry toilets in early 2019. Menstruation in Blantyre was found to be shrouded in secrecy because it was viewed as 'dirty', and therefore remained concealed. There was widespread anxiety about menstrual blood being used in ufiti (witchcraft), which affected how women used and disposed of their menstrual absorbents. At the same time, menstrual blood was also viewed as a powerful healing substance with uses in traditional medicine. The type of infrastructure required by women to support their menstruation depended on the type of menstrual absorbent used. Those using reusable cloth generally preferred a private bathroom with discreet drainage, whilst those using disposable pads needed a discreet and convenient disposal system. Increased preference for disposable pads over reusable cloth (particularly for younger women in education or employment) suggested that menstrual waste profiles of urban areas may be changing. Understanding these changing needs will be crucial for planning effective, sustainable waste disposal and sanitation infrastructure.

Subjective responses of satisfaction with basic services delivery is an indicator of service delivery performance. This study provides an overview of the status of basic service delivery and determines the factors associated with service delivery satisfaction within informal settlements targeted for upgrading in South Africa. A multinomial logistic regression was used to analyze the relationship between satisfaction with basic services of water, sanitation, refuse and electricity with several predictors including individual factors, household factors, community factors and service-related factors. The most common source of drinking water, toilet facility and refuse disposal method were communal tap (55%) pit latrine (53%) and local authorities (34%), respectively. Approximately 52% of the respondents in the study reported not having access to electricity. Results also show that satisfaction in basic services delivery varies and is influenced by service-related factors. Interventions targeted at improving the quality of basic service provided are essential to meet the targets set out in the sustainable development goals.

Most people in rural areas in South Africa (SA) rely on untreated drinking groundwater sources and pit latrine sanitations. A minimum basic sanitation facility should enable safe and appropriate removal of human waste, and although pit latrines provide this, they are still contamination concerns. Pit latrine sludge in SA is mostly emptied and disposed off-site as waste or buried in-situ. Despite having knowledge of potential sludge benefits, most communities in SA are reluctant to use it. This research captured social perceptions regarding latrine sludge management in Monontsha village in the Free State Province of SA through key informant interviews and questionnaires. A key informant interview and questionnaire was done in Monontsha, SA. Eighty participants, representing 5% of all households, were selected. Water samples from four boreholes and four rivers were analyzed for faecal coliforms and E.coli bacteria. On average, five people in a household were sharing a pit latrine. Eighty-three percent disposed filled pit latrines while 17% resorted to closing the filled latrines. Outbreaks of diarrhoea (69%) and cholera (14%) were common. Sixty percent were willing to use treated faecal sludge in agriculture. The binary logistic regression model indicated that predictor variables significantly (p ˂ 0.05) described water quality, faecal sludge management, sludge application in agriculture and biochar adaption. Most drinking water sources in the study had detections ˂ 1 CFU/100 mL. It is therefore imperative to use both qualitative surveys and analytical data. Awareness can go a long way to motivate individuals to adopt to a new change.

This study reports the findings of a large-scale, multiple-arm, cluster-randomized control study carried out in rural Punjab, India, to assess the impact of a flagship sanitation program of the Government of India. The program, the Clean India Mission for Villages, was implemented between October 2014 and October 2019 and aimed to encourage the construction of toilets, eliminate the practice of open defecation, and improve the awareness and practice of good hygiene across rural India. It utilized a combination of behavioral change campaigns, centered on the community-led total sanitation approach, and financial incentives for eligible households. The study also evaluates the incremental effects of intensive hygiene awareness campaigns in selected schools and follow-up initiatives in selected communities. The study finds that the coverage of “safely managed” toilets among households without toilets increased by 6.8–10.4 percentage points across various intervention arms, compared with a control group. Open defecation was reduced by 7.3–7.8 percentage points. The program also had significant positive impacts on hygiene awareness among adults and children, although the interventions of school campaigns and intensive follow-up were of limited additional impact.

Many developing countries lack the infrastructure needed for the treatment of fecal sludge. One limitation in implementing available treatment options is the limited availability of land in the urban areas of these countries. This paper investigated the application of process intensification as a way of reducing the land area required to dewater and sanitize pit latrine sludge from informal settlements in Blantyre City, Malawi. The intensification of the sludge treatment process was achieved by enhancing dewatering through the application of additives and by combining the dewatering and sanitization stages. Nine combinations of sludge, lime and rice husk dosages, in addition to a control, were simultaneously loaded on unplanted drying bed units to dewater for 29 days. The study found a significant reduction of 21% to 73% in the land area required to dewater and sanitize pit latrine sludge. From the study, process intensification was shown to have the potential to significantly reduce the land area required to dewater and sanitize pit latrine sludge from informal settlements in Malawi cities. This makes it an option that can be implemented close to informal settlements, despite land limitation in these areas.

Background/Purpose To assess the number of patients seen at the colorectal clinic of a low-to-middle income-country with emphasis on their social circumstances. Methods Between January 2013 and December 2018 we recorded the number of visits to colorectal clinic. From February 2019 prospective data on patients with anorectal malformations (ARMs) focusing on their social conditions (type of housing and sanitation) and HIV-exposure were collected. Results At the clinic 452 visits were recorded in 2013, 608 in 2014, 904 in 2016, 1392 in 2017, and 1968 in 2018. The ARM cohort included 100 patients: at the time of delivery the HIV status of 74 mothers was negative, positive in 21, and unknown in 5. None of the HIV-exposed patients seroconverted to HIV positive (average follow-up:39 months). Seventy-four patients live in formal settlements, 23 in informal, and 3 in unknown type. Forty-six patients have inside toilets, 39 outside flushing toilets, 10 outside pit latrines, 2 community toilets, and 3 an unknown sanitation. Conclusions The clinic work-load has increased during the past years. A significant proportion of our patients are HIV-exposed, do not live in formal houses and do not have inside toilets. Tailored strategies for a successful surgical plan and bowel management need to be implemented. Level of evidence II

This study assessed the management practices for controlling porcine cysticercosis (PC) on pig farms and in pork at the slaughter slabs in two counties (Busia and Kakamega) of Western Kenya. A total of 162 pig-rearing households at the farm level, 26 butcher owners, and 26 slaughter slab workers at the slaughter slab level were interviewed using a structured questionnaire. Data were analyzed using the “Statistical Analysis System” (SAS) programme. Results indicated that the frequent management practices used at the farm level (p<0.05) were rearing pigs under free range (69.1%), latrine ownership by households (87.7%), and use of pit latrines (72.8%) in households. At the slaughter level (p<0.05), results of the butcher owners (76.9%) and slaughter slab workers (62.5%) revealed that meat inspection was not practiced adequately in the two areas of study. The results imply that slaughtered pigs for human consumption were not adequately inspected, and thus, the study recommends for implementation of effective pig management practices at the farm level and pork meat inspection at slaughter slabs to prevent PC infections and assure food safety along the pork value chain.

Stunting is a prevalent form of child undernutrition and is associated with lifelong adverse health outcomes and loss of human capital. The Water, Sanitation, and Hygiene (WASH) Benefits (Bangladesh and Kenya) and Sanitation Hygiene Infant Nutrition Efficacy (SHINE; Zimbabwe) trials were conducted to test the independent and combined effects of improved household WASH (improved pit latrine, handwashing station not connected to a water source, point-of-use water chlorination) and improved infant and young child feeding (IYCF, complementary feeding counseling and daily small-quantity lipid nutrient supplement) on child linear growth. Together the trials enrolled >19,000 women during pregnancy and measured >15,000 of their children at 18 months (SHINE) or 24 months (WASH Benefits trials) of age. Throughout the 3 trials, the IYCF intervention increased mean length-for-age Z-score by 0.13-0.26. None of the WASH interventions had any effect on linear growth among any of the study populations. This lack of effect is most likely because the household-level elementary WASH interventions employed in the trials were not effective enough in reducing enteropathogen exposure to facilitate linear growth. Consensus papers of the trials recommend identification and implementation of "transformative WASH" - interventions that radically reduce fecal exposure - to be made available to rural low-income populations.

With the ever increasing growth in population across the nation, there is a need for proper disposal of solid waste of households. A comprehensive literature survey was conducted to study the status of sewage treatment plants (STP) in different states of India. More emphasis was laid on its status in different districts of Bihar. Existing plants are incapable of handling huge inflow of wastes through sewage pipe lines. If properly developed, STP could not only remove the problem of waste management but it will also provide financial gains. Biogas produced in most of these plants from the digesters is flared off and are not being stored, if done will certainly reduce the cost of cooking fuel. Only primary and secondary treatment of the plants is being done in most of the sewage treatment plants. If tertiary treatment is also provided, this might help in solving the problem of safe drinking water. Conventionally, these left over sludge from the digester still contains a lot of carbonaceous content which can be harnessed by converting them in the form of powders and be utilized in different gasifiers and pyrolyser to produce clean combustible gas. Several districts do not even have a single sewage treatment plant and people are forced to use pit latrines. It was found that districts like Buxar, Muzaffarpur and Bhagalpur are having very old STP which date back to 1885 AD and are insufficient to handle the load of rapidly increasing population. Government initiatives are required not only to properly manage it but also to utilize it in a more effective manner.

The presence of Escherichia coli and Staphylococcus spp. was determined on the skin, personal protective equipment, the municipal vehicle, and various surfaces at ten households in a peri-urban community (KwaZulu-Natal, South Africa) before and after manual emptying of ventilated improved pit latrines. Surface samples (n = 14) were collected using sterile wet wipes, and target bacteria were detected using standard procedures. Additionally, E. coli was enumerated in soil samples from an area of open defecation (log10 3.7 MPN/g) and areas where geophagia occurred (log10 2.7 – log10 3.3 MPN/g), using a most probable number (MPN) method. The detection frequency for the target bacteria on household surfaces (e.g., the walkway between the pit latrine and the municipal vehicle) and on municipal workers’ hands (which were frequently contaminated before pit emptying), occasionally increased after the pits were emptied, indicating that manual pit emptying might pose a potential health risk to workers and community members.

Background Latrine utilization is the actual behavior in a practice of regularly using existing latrines for safe disposal of excreta. Latrine utilization is a common problem in semi-urban areas of developing countries, including Ethiopia. Since the status of latrine utilization and associated factors among semi-urban areas of northeastern Ethiopia, including Alansha in South Wollo Zone is unknown, local data is needed in order to assess the need for planning of intervention programs for the improvement of latrine utilization to support consistent and sustained latrine utilization. This study is designed to address this knowledge gap. Methods A cross-sectional study was conducted from February to March, 2019 among 401 systematically selected households. Data were collected by trained workers using a pre-tested, structured questionnaire via face-to-face interviews and on-the-spot observations of the latrines. A systematic random sampling method was used to select participant households. Data were entered using EpiData version 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 25.0 for data cleaning and analysis. The wealth index status of participants was estimated using principal component analysis. Data were analyzed using a binary logistic regression model at 95% confidence interval (CI). From the multivariable logistic regression analysis, variables with p-value < 0.05 were taken as statistically significant and independently associated with latrine utilization. Model fitness was checked using Hosmer-Lemeshow test. Result We found that the prevalence of latrine utilization among households was 71.8% (95% CI [67.5–76.1%]) while 28.2% (95% CI [23.9–32.5%]) did not utilize latrines. About one-fifth (21.7%) of participant households were found to have a pit latrine with slab and 78.3% (311) used pit latrines without slab. The hygienic condition of the majority (82.9%) of the latrines was dirty and only 17.1% clean. Household family size from one to three persons (AOR: 3.99, 95% CI [1.20–6.24]), presence of primary or secondary school student in a house (AOR: 2.33, 95% CI [1.42–3.83]), number of years since latrine was constructed (≥ 2 years) (AOR: 1.82, 95% CI [1.12–2.95]) and a frequency of daily cleaning of the latrine (AOR: 2.19, 95% CI [1.12–4.28]) were factors significantly associated with latrine utilization. Conclusion Seven out of ten households utilized a latrine. Factors significantly associated with latrine utilization were household family size from one to three persons, presence of primary or secondary school student in the house, time since household latrine had been constructed of two or more years and daily frequency of latrine cleaning. Therefore, it is recommended that measures to promote behavioral change towards further improvement in sustainable and consistent latrine utilization should be carried out based on the evidence of the determinant factors found in this study.

Objective To describe women's experiences with subcutaneous depot medroxyprogesterone acetate (DMPA-SC) to inform scale-up of self-administered DMPA-SC. Study design We conducted a 12-month randomized controlled trial in Malawi to measure DMPA-SC continuation rates. A total of 731 women presenting at six Ministry of Health clinics or to community health workers (CHWs) in rural communities were randomized to receive DMPA-SC administered by a provider or be trained to self-inject DMPA-SC. Data collectors contacted women after the reinjection window at 3, 6 and 9 months to collect data on satisfaction and use; self-injectors were also queried about storage and disposal of DMPA-SC. We compared frequencies of injection experiences and satisfaction by study group and over time. Results Ninety-two percent of women who self-injected felt it was easy to do the first time. Women in the self-administered group primarily gave themselves the injection versus having someone else inject them; stored DMPA-SC mostly in bags, often in ways to keep the product away from others; and properly disposed of DMPA-SC in pit latrines. Women in both groups used printed calendars to remember when to get/be given their next injection. Both groups reported high satisfaction with DMPA-SC. Conclusions Women in low-resource settings can be successfully trained by public sector CHWs and clinic-based providers to self-inject and to appropriately store and dispose of DMPA-SC. DMPA-SC and self-injection are acceptable and feasible in a low-resource setting. Implications Self-administered and provider-administrated DMPA-SC should be scaled up, and the lessons learned during our trial should be applied to future scale-up efforts.

The rate of ventilation through the vent pipe of a ventilated improved pit latrine is the main technical factor that determines its efficiency in odour control aside the maintenance and cleaning practices of the users. Even though the factors affecting the ventilation rate have been well researched, they have not been previously related in a mathematical model to quantify the relative effect of the various factors on the ventilation rate. The objective of this paper is to develop such a model that could be used to optimise and predict the ventilation rate as a function of relevant design criteria and weather conditions. The ventilation rates produced by various design modifications in an experimental ventilated improved pit latrine were measured under monitored weather conditions. A linear regression model was used to assess the relative effect of the various design modifications and the elements of weather on the ventilation rate. It was found that the diameter of the vent pipe is the most important factor which accounts for 53% of variations in the ventilation rate, followed by the external wind speed, which accounts for 25% of changes in ventilation. The provision of windows in other sides of the superstructure other than the windward side leads to a reduction of 32% in the ventilation rate and accounts for 9% of the variations in the ventilation rate. A regression model developed in this study could be used to optimise and predict the ventilation rate based on a set of design criteria and meteorological data.

Rotavirus (RV) and diarrheagenic Escherichia coli are waterborne pathogens commonly causing diarrhea in children below five years old worldwide. Our study is a first step toward a loads-concentrations-risk modeling and scenario analysis framework. We analyzed current and future human RV and indicator E. Coli (EC) emissions from sanitation facilities to surface waters in Uganda using two process-based models. Emissions were estimated for the baseline year 2015 and for three scenarios in 2030 using population, excretion rates, sanitation types, and wastewater treatment. The first model is a downscaled GloWPa-Rota H1 version, producing emissions at a 1-km2 resolution. The second model is newly developed for Kampala and adds emissions from pit latrines and septic tanks excluded in the first model. The scenarios Business as Usual, Industrious, and Low Emissions reflect government prospects in sanitation coverage and wastewater treatment. For the first model, 6.14 ? 1014 RV particles d-1 and 1.31 ? 1012 EC colony-forming units (CFU) d-1 are emitted to surface waters in 2015. The RV emissions are expected to increase in 2030 by 75% for Business as Usual and 212% for Industrious and decrease by 58% in Low Emissions. Emissions from the second model are higher for Kampala than in the first model, at 3.74 ? 1014 vs. 5.95 ? 1013 RV particles d-1 and 8.18 ? 1011 vs. 1.75 ? 1011 EC CFU d-1 in 2015, most of which come from the onsite-not-contained category. Simulated emissions for Kampala show the importance of including onsite sanitation in our modeling. Our study is replicable in other locations and helps identify key emission sources, their hotspots, and the importance of wastewater treatment. The scenarios can guide future sanitation safety planning.

In a recent article an assessment of decomposition within pit latrines measured with regard to chemical oxygen demand (COD) reductions was reported on. Some fundamental concerns were raised with regard to a key assumption of the study. The alternative perspective that is presented here does not support the study's conclusion that anaerobic processes are the dominant decomposition pathway in pit latrines. Furthermore, it is argued that their analysis and some implications of their data interpretation can be viewed in a different manner.

Background Diarrhea is a major public health problem that disproportionately affects children in developing countries, including Ethiopia. Most of the diseases can be prevented through safe drinking water supply and provision of basic sanitation and hygiene. However, there is a paucity of information on childhood diarrhea related to interventions in kebeles (smallest administrative structure) where community-led total sanitation (CLTS) implemented and not implemented (non-CLTS). Thus, the aim of this study was to assess and compare the association of water supply, sanitation and hygiene interventions, and childhood diarrhea in CLTS implemented and non-implemented kebeles. Method A comparative cross-sectional study was conducted in Kersa and Omo Nada districts of Jimma Zone, Ethiopia from July 22 to August 9, 2018. Systematically selected 756 households with under-5 children were included in the study. Data were collected through interview using structured questionnaires. Water samples were collected in nonreactive borosilicate glass bottles. The binary logistic regression model was used; variables with a p value < 0.05 were considered as significantly associated with childhood diarrhea. Results The prevalence of childhood diarrhea in the past 2 weeks was 17.7% (95% CI: 13.9–21.5) in CLTS kebeles and 22.0% (95% CI: 17.8–26.2) in non-CLTS kebeles. The occurrence of childhood diarrhea, increased among children whose families did not treat drinking water at home compared to those who treated in both CLTS (AOR = 2.35; 95% CI: 1.02–05.98) and non-CLTS (AOR = 1.98; 95% CI: 0.82–4.78) kebeles. About 96% of households in CLTS and 91% of households in non-CLTS kebeles had pit latrine with and without superstructure. Children from families that used water and soap to wash their hands were 76% less likely to have diarrhea in CLTS kebeles (AOR = 0.76; 95% CI: 0.31–1.88) and 54% less likely to have diarrhea in non-CLTS kebeles (AOR = 0.54; 95% CI: 0.17–1.72) when compared to children from families who used only water. The odds of having diarrhea was 1.63 times higher among children whose families live in CLTS non-implemented kebeles compared to those children whose families live in CLTS implemented kebeles (AOR = 1.63; 95% CI: 0.98–2.68). Conclusions No significant difference was observed in the prevalence of childhood diarrhea between CLTS and non-CLTS kebeles.

This paper provides a multi-date review of trends in groundwater pollution from pit latrine sanitation structures using global, regional and South African cases. The paper focuses on three parameters which are microorganisms, nitrate and phosphorus, which are aligned with the challenge of waterborne diseases, and generally linked to poor water quality, and inadequate sanitation and hygiene. Poor sanitation and hygiene open up transmission routes for ingestion of faecal matter, which as at 2018 continue to pose risks of diarrhoea, opportunistic infections, and consequent malnutrition. These challenges currently account for approximately 1.7 million deaths annually, of which more than 90% are in developing countries, which have low sanitation coverage. While pit toilets are the generally preferred form of sanitation technology for developing countries, most provide evidence of the interconnectedness between the structures and groundwater pollution. The mechanism of pollution is generally indicated to be seepage of polluted pit latrine leachate into groundwater. This specific type of microbial and chemical routing from toilets into the environment increases the prevalence of diseases. These diseases usually result in high mortality for developing countries. Therefore, this review has highlighted the need to minimize pollution of groundwater from pit latrines, thereby contributing towards sustainable water quality management.

The Sustainable Development Goals on water and sanitation offer an opportunity for Malawi to examine new approaches to improving and sustaining rural household sanitation coverage by the year 2030. This paper assessed the impact of training rural pit latrine masons as sanitation entrepreneurs and the role of sanitation marketing. The paper used a tracer study of 76 masons from 15 districts in Malawi trained by Mzuzu University under a United Nations Children’s Fund (UNICEF) Malawi programme promoting the corbelled pit latrine design. The results from the study showed that pit latrines were being built by some masons, but that not all programme trainees had used their new knowledge. Masons were part-time and informal providers. Our results indicate a need to scale-up and train more pit latrine masons and the necessity to enhance the sanitation marketing programme component of the training. The registration of masons as sanitation providers, the identification of novel financing mechanisms appropriate for the masons and improved collaboration are also recommended.

The culture of sewage management in Lagos dates back to pit latrines (Shalanga) in precolonial Lagos; this culture gave way to bucket latrines in the wake of British colonial administration in Lago...

The limited availability of data on faecal sludge characteristics remains one of the major challenges faced by the developing countries in proper management of faecal sludge. Taking into account the limited financial resources and expertise, there is a need to come up with less resource intensive approaches for faecal sludge characterisation in these resource-constrained developing countries. Despite being used substantially in wastewater, there is a lack of evidence pointing towards the predictive modelling being used as a tool for cost-effective characterisation of faecal sludge. In this study, first order multiple linear regression models are developed as a cost-effective approach for accurate predictions of organics (biochemical oxygen demand and chemical oxygen demand) in pit latrine sludge. The predictors explored during the modelling include pH, electrical conductivity, total solids, total volatile solids, fixed solids and moisture content. The models are built using the data collected from a total of 80 latrines from informal settlements in four cities in Malawi. The results for the models show that it is possible to reliably predict the chemical oxygen demand and biochemical oxygen demand in pit latrine sludge using the electrical conductivity and total solids, the determination of which requires low levels of resources and expertise.

Leaching of nitrogen-containing compounds (e.g., ammonia, nitrate) from pit latrines and seepage tanks into groundwater may pose health risks, given that groundwater is a significant source for drinking water in many low-income countries. In this study, three communities within Kathmandu, Nepal (Manohara, Kupondole, and Lokanthali) were visited to investigate the impact of pit latrines on groundwater quality, with a focus on understanding the fate of nitrogen-containing compounds specifically. Well water samples were analyzed over two seasons (wet and dry) for their nitrogen content, dissolved oxygen (DO), chemical oxidation demand (COD), and oxidation-reduction potential (ORP), and samples collected from within the nearby pits were also analyzed to determine nitrogen content and COD. Hand dug wells were found to be more likely receptors of contamination than tube wells, as expected, with inter-well variations related to the relative redox conditions in the wells. Increased pit-emptying frequency was related to lower levels of nitrogen in the latrines and in the nearest wells, suggesting this may be an effective strategy for reducing the risks of groundwater contamination in such settings, all else being equal.

Most developing countries use existing knowledge and infrastructure for wastewater in the treatment, reuse and disposal of faecal sludge. There is need to have a clear picture of the risk faecal sludge poses in relation to wastewater if effective treatment, disposal and reuse systems are to be implemented. Little work has been done to quantify the risk faecal sludge poses in relation to wastewater in a localized setting. This study quantifies the comparative risk of faecal sludge from pit latrines in unplanned settlements in Mzuzu City and wastewater. A total 80 sludge samples were obtained from 20 pit latrines in five unplanned settlement Laboratory characterisation was performed for Organics (chemical oxygen demand and biochemical oxygen demand), nutrients (total ammonia nitrogen and total phosphorus) and pathogens (Escherichia coli and helminth eggs) were determined through laboratory analyses. Documentation review was used to get wastewater characteristics. The study found a higher risk (comparative risk >1; p < 0.0001) for organics and nutrients in pit latrine sludge as compared to wastewater. Pit latrine sludge was found not to pose significantly higher public health risk from both E. coli (comparative risk

Contamination of water from feacal sources can lead to major outbreaks of water-borne diseases when such water is consumed without proper treatment. The microbiological and physicochemical analyses of well-water sample collected near pit latrines in Oko, Oyo State, Nigeria were carried out during rainy and dry seasons. Microbiological analysis was carried out by using Most Probable Number (MPN) technique while physico-chemical parameters of the well-water samples were determined by standard procedures. Thermotolerant coliforms were present in all the well-water analysed during both seasons, while total coliform ranged from 350 to 160,000 and 110 to 160,000 MPN/100 ml in rainy and dry season respectively. Results obtained showed that seasonal changes had a significant impact on water quality and that some of the chemical, physical, biological and trace metal parameters analyzed in the samples from study locations were above the acceptable standards for portable water. Water samples from these wells were unsafe for human consumption without proper treatments. Key words: Hand dug well, thermotolerant coliform, physico-chemical parameters, Most Probable Number.

The aim of this study was to assess pit latrine samples from a peri-urban community in KwaZulu-Natal (South Africa) for the presence of multidrug-resistant (MDR) Staphylococcus spp. Standard procedures were used to isolate Staphylococcus spp. from pit latrine fecal sludge samples, with confirmation at genus level by polymerase chain reaction (PCR). Sixty-eight randomly selected pit latrine Staphylococcus spp. isolates were further characterized by using established disk diffusion procedures. An average Staphylococcus spp. count of 2.1 × 105 CFU per g fecal material was established using two randomly selected pit latrine samples. Of the 68-selected Staphylococcus spp. pit latrine isolates, 49% were identified as coagulase positive, 51% as coagulase negative and 65% (12 coagulase positive, 32 coagulase negative isolates) were categorized as MDR. The majority (66/68) of Staphylococcus spp. isolates displayed resistance to fusidic acid while only 5/68 isolates displayed resistance to chloramphenicol. The pit latrine samples analyzed in this study are a source of MDR Staphylococcus spp., highlighting the need for proper hygiene and sanitation regimes in rural communities using these facilities.

Only a small proportion of Addis Ababa is served by conventional sewerage treatment systems. Most of the city relies upon on-site sanitation, while open defecation remains a common practice, especially in slum areas. This paper provides evidence of environmental pollution related to inadequate sanitation using a range of physicochemical and fecal contamination indicators and a mix of surveys of pit latrine contents, soils and water sources. Some water sources, including deep wells, show indications of fecal contamination, and soils are widely contaminated with the parasitic worm, Ascaris lumbricoides. Analysis of pit latrine contents shows a significant reduction in the number of A. lumbricoides ova with depth, but levels of ova at even the bottom of the pit suggest the need for proper sludge treatment. Wider awareness of environmental pollution gleaned from this research is intended to inform policy makers and their prioritization of actions to improve urban sanitation.

Parallel global rise in pit-latrine sanitation and groundwater-supply provision is of concern due to the frequent spatial proximity of these activities. Study of such an area in Malawi has allowed understanding of risks posed to groundwater from the recent implementation of a typical developing-country pit-latrine sanitation policy to be gained. This has assisted the development of a risk-assessment framework approach pragmatic to regulatory-practitioner management of this issue. The framework involves water-supply and pit-latrine mapping, monitoring of key groundwater contamination indicators and surveys of possible environmental site-condition factors and culminates in an integrated statistical evaluation of these datasets to identify the significant factors controlling risks posed. Our approach usefully establishes groundwater-quality baseline conditions of a potentially emergent issue for the study area. Such baselines are foundational to future trend discernment and contaminant natural attenuation verification critical to policies globally. Attribution of borehole contamination to pit-latrine loading should involve, as illustrated, the use of the range of contamination (chemical, microbiological) tracers available recognising none are ideal and several radial and capture-zone metrics that together may provide a weight of evidence. Elevated, albeit low-concentration, nitrate correlated with some radial metrics and was tentatively suggestive of emerging latrine influences. Longer term monitoring is, however, necessary to verify that the commonly observed latrine-borehole separation distances (29–58 m), alongside statutory guidelines, do not constitute significant risk. Borehole contamination was limited and correlation with various environmental-site condition factors also limited. This was potentially ascribed to effectiveness of attenuation to date, monitoring of an emergent problem yet to manifest, or else contamination from other sources. High borehole usage and protective wall absence correlated with observed microbiological contamination incidence, but could relate to increased human/animal activity close to these poorly protected boreholes. Additional to factors assessed, a groundwater-vulnerability factor is recommended that critically relies upon improved proactive securing of underpinning data during borehole/latrine installations. On-going concerns are wide ranging, including poorly constrained pit-latrine input, difficulties in assessing in-situ plume natural attenuation and possible disposal of used motor oils to latrines.

Fecal sludge management is an emerging issue in urban sanitation. Access to sewage network is limited in Dhaka; therefore people construct septic tanks and different forms of unhygienic latrines to fulfill their basic sanitary needs. The main objective of this study was to evaluate the effectiveness of the Vacutug pit latrine exhausting technology considering the perspectives of the technical experts, operators and consumers. With increasing rapid growth, Dhaka city may reach up to 25 million people by 2025. The slum population is growing massively and with it sanitation problems. A major problem is one of sanitation facilities, especially for the urban poor but a further and equally pressing one is that of the emptying, transportation and treatment of fecal sludge from latrines. In this paper, the operational, financial and management issues surrounding Vacutug are introduced. The research focused on the experiences from three initiatives (Mirpur, Mohammadpur and Kuril in Dhaka) to gain a greater insight into key features of straight awareness related to participatory planning and community involvement in decision-making, decentralized management arrangements for operation and maintenance, application and operation of decentralized technologies; Financing arrangements and economics of decentralized initiatives.

In the past sanitation was the responsibility of Local Authorities or councils with the Department of Waste Management and Pollution Control (DWMPC). Pollution of groundwater in Botswana is currently forcing the Government of Botswana (GoB) to abandon pit latrine construction and Ventilated Improved Pit (VIP) emptying services in peri-urban areas. Currently Government has embarked on the expensive and unsustainable construction of sewer systems that require peri-urban communities to pay for connection fees. Most rural communities cannot afford these fees and since Botswana is a water scarce country, sewer connection may be costly for the country. This paper aims to review current practices, policies and challenges facing Botswana in Faecal Sludge Management (FSM). A desktop review was carried out to review policies, regulations, guidelines and strategies on waste management. A pretested questionnaire was administered among 50 randomly selected households to assess current practices in sludge management from two suburbs in Gaborone. Key informant interviews were undertaken among water and sanitation stakeholders to establish roles on waste management and faecal sludge management. Despite the disjointed efforts by stakeholders, Botswana has the potential to improve the FSM in the country. Though unsafe, FSM/pit emptying has the potential to provide income and employment to both the rural and urban poor and making it safe may have wider economic benefits.

In the period 1990-2012, the percentage for open defecation has dropped by 11% in sub-Saharan Africa which has resulted to substantial progress in access to improved sanitation facilities i.e. pit latrines, VIPs, septages and centralized sewage facilities since 1990 [figure 1]. This therefore put at ease the operations of many municipal's water resource and waste management agencies. Recent investigation confirms that the number of people defecating in the open is currently increasing in 26 of 44 countries of sub-Saharan Africa and this unsustainable practice is predicted to persist as long as there are toilets that are dysfunctional or unhygienic (WRC, 2015) in Africa. Per review conducted, the unhygienic and dysfunctional conditions of public toilets facilities are results of poor sludge management operations of which inconsistent collection of faecal sludge from toilet sites is a major part. Reported cause of inconsistent emptying of faecal sludge at sanitation sites is due to higher cost of faecal sludge management(FSM) services within urban and peri-urban settlements. FSM services comprise of three stages i.e. collection, treatment & re-use, and disposal of which the treatment stage accrue the most cost of the services. Treatment cost depends on treatment techniques applied by sanitation inspectors/operators but there is currently no definite treatment method which is the most suitable as the physico-chemical properties and environmental compliance requirements for disposal of faecal sludge is highly variable and most solutions have not been demonstrated at scale. To be precise on the key scope of study, on-site sanitation & centralized facility faecal sludge treatment techniques and management practices are deemed the core basis of study hereafter. In this paper, anaerobic-aerobic phosphorous removal process (A/O) is selected as an efficient and cost-effective centralized facility sludge treatment technique and its applied to a case study in Bujumbura municipal of Burundi. Also a simple but effective on-site sanitation management plan which is feasible in Africa communities is discussed.Read Complete Article at ijSciences: V72018011542 AND DOI: http://dx.doi.org/10.18483/ijSci.1542

We carried out a stated preference survey in Malawi to examine whether access to microfinance for sanitation would significantly increase the proportion of households upgrading to improved pit latrines or alternative improved sanitation technologies (urine diverting dry toilet, fossa alterna, pour flush). We presented a range of sanitation options at local market prices, initially without and then with a real microfinance option, to 1,300 households sampled across 27 low-income urban settlements in the two largest cities, Lilongwe and Blantyre. When we gave respondents a microfinance option, the proportion of households stating an intention to install improved and unimproved pit latrines decreased significantly, while the proportion stating an intention to upgrade to alternative improved sanitation technologies increased significantly. However, households in the lowest wealth quintile were more likely to state a preference for unimproved pit latrines, suggesting that the benefits of microfinance for sanitation may not accrue equally across wealth strata. Organisations seeking to improve access to safely managed sanitation by promoting alternative sanitation technologies would succeed if households have access to affordable alternative sanitation technologies and microfinance for sanitation. However, poorer households would need more affordable improved sanitation technologies, flexible microfinance options and possibly targeted subsidies to gain access to safely managed sanitation.

Nelson Owoicho/Water Aid Sanitation workers such as Iliyasu Abbas (pictured), a pit latrine and septic tank emptier in Nigeria’s Kano state, have been largely forgotten during the covid-19 pandemic, despite risking their lives every day to provide a service essential …

The ongoing Toilet Revolution in China offers an opportunity to improve sanitation in rural areas by introducing new approaches, such as urine source separation, that can contribute to achieving SDG6. However, few studies have systematically assessed the social acceptability of managing human excreta collected in new sanitation systems. Therefore, in this study we performed face-to-face interviews with 414 local residents from 13 villages across three provinces in western China, to analyze the current situation and attitudes to possible changes in the rural sanitation service chain. We found that the sanitation chain was predominantly pit latrine-based, with 86.2% of households surveyed collecting their excreta in a simple pit, 82% manually emptying their pits, and 80.2% reusing excreta in agriculture without adequate pre-treatment. A majority (72%) of the households had a generally positive attitude to production of human excreta-derived fertilizer, but only 24% agreed that urine and feces should be collected separately. Multivariate logistic regression indicated that three factors (level of education, number of permanent household residents, perceived social acceptability) significantly influenced respondents' attitudes to reuse of excreta, although only perceived social acceptability had a high strength of association. Overall, our survey revealed that rural households often misuse toilet systems, fail to comply with government-specified sanitation guidelines, have low awareness of alternative solutions, and are over-reliant on the government to fix problems in the service chain. Thus while new sanitation technologies should be developed and implemented, information campaigns that encourage rural households to manage their excreta safely are also important., Graphical abstract Unlabelled Image, Highlights • Face-to-face interviews were performed at 414 rural households in western China. • Both status and attitude towards the rural sanitation service chain were evaluated. • Poor hygiene practices are ubiquitous across the service chain, posing health risk. • Perceived social acceptability correlated with positive attitude to excreta reuse. • Awareness campaigns can positively influence sanitation management.

In unplanned urban settlements, where onsite sanitation systems are the norm, desludging of faecal sludge (FS) containments is a necessity because of the lack of land space to enable new construction. Poorly designed toilet facilities however may jeopardize the progress towards attainment of safely managed sanitation. This study examined FS characteristics and containment design and their effect on safe desludging with a case of two selected unplanned settlements of Dar es Salaam, Tanzania. The analysis focused on design features for the strength of the containment, access to the containment, and desludging characteristics of the FS. The Desludgeability potential of FS was determined on basis of flow behaviour explained in terms of moisture content and volatile solids. Research results showed that partially lined pits, lack of containment access holes and solid wastes are design and usage features which negatively affect containment strength and potential for safe desludging. The analysis further found that, only 54.8% of containments studied have FS that can be desludged by either mechanized or hand pumps. Pour flush toilets and septic tanks indicated a slightly higher potential for safe desludging compared to traditional pit latrines, however, the difference is not statistically significant (P = 0.180). Thus, safe desludging is a problem across all types of containments. To enhance safe desludging in Dar es Salaam, three key design features and usage ought to be urgently addressed: first, a requirement to ensure that all pits are fully lined inside, second, the mandatory presence of an access hole for FS desludging and third, limitations on solid waste entering the pits.

The importance of access to safe drinking water and improved sanitation facilities have by and large driven the global water, sanitation and hygiene agenda. However, a large segment of the global population, particularly in developing countries remain without access. Botswana has made significant strides towards improving access to safe drinking water and improved sanitation, but there have been observations in certain low-income neighbourhoods in Gaborone and Francistown that some households lacked access to such services. Furthermore, the coping strategies used by households to mitigate lack of access to drinking water and sanitation services were unclear. This study established barriers to household accessing drinking water and waterborne sanitation in urban neighbourhoods of Botswana and determined coping strategies employed by households without access. It is a cross-sectional survey of two neighbourhoods of Old Naledi (Gaborone) and Monarch North (Francistown). A semi-structured questionnaire was used to interview household respondents that were purposively selected. It was found that land tenure with its different manifestations is the primary barrier to access to safe drinking water and waterborne sanitation services. Households who lacked access to drinking water mainly fetched water from their neighbours and contributed to the water bill, while those without access to waterborne sanitation used pit latrines as their sanitation option. The study recommends that in order to facilitate drinking water and waterborne sanitation access it is important that the socio-economic conditions of potential beneficiaries are understood at a low level of aggregation such as a household to enable household-specific policy interventions.

Classifications for onsite sanitation in terms of facility type (septic tanks, pit latrines) exist, but connecting these facilities to the wider sanitation value chain via improved containment, emptying, and collection has not been well explored. Using existing Joint Monitoring Programme facility classifications and secondary data on piped water access, a Service Typology was developed to classify and quantify the primary emptying service needs of household level onsite sanitation facilities. Facilities in six Sustainable Development Goal (SDG) regions were classified as Emptiable (faecal sludge can be removed either via Mechanized or Non-Mechanized means) or Unemptiable. Of the 722 million household level sanitation facilities assessed in these regions, 32% were found to be emptiable via Mechanized means, 50% via Non-Mechanized means and 18% were found to be Unemptiable pits. The volume (by number of facilities) and density (as a proportion of the full population) of each service type were estimated by SDG region and by country. Results from this study provide background data on the role of emptying sanitation facilities in achieving SDG6, and can be incorporated into investment priorities, policy framing, technology development, infrastructure development, and targeted behaviour change strategies., Graphical abstract Image 1, Highlights • First study to quantify the service needs for 772 M onsite sanitation facilities. • 32% of facilities are emptied via Mechanized means using pumps or vacuum trucks. • 50% of facilities are manually emptied via Non-Mechanized means. • 18% of facilities are unimproved and Unemptiable due to their poor quality. • Service innovation for dry, improved onsite facilities identified as priority need.