Risk of Intestinal Parasitic Infections in People with Exposures to Wastewater

Risk of Intestinal Parasitic Infections in People with Different Exposures to Wastewater and Fecal Sludge in Kampala, Uganda: A Cross-Sectional Study

Background

There are health risks associated with wastewater and fecal sludge management and use, but little is known about the magnitude, particularly in rapidly growing urban settings of low- and middle-income countries. We assessed the point-prevalence and risk factors of intestinal parasite infections in people with different exposures to wastewater and fecal sludge in Kampala, Uganda.

Conclusions/Significance

Urban farmers are particularly vulnerable to infections with soil-transmitted helminths,  S . mansoni , and intestinal protozoa. Hence, our findings call for public health protection measures for urban farmers and marginalized communities, going hand-in-hand with integrated sanitation safety planning at city level.

Author Summary

Urban wastewater and fecal sludge use is of growing importance all over the world. However, unsafe management and inappropriate use might exacerbate the transmission of infectious diseases, including those caused by intestinal protozoa (e.g., amebiasis and giardiasis) and parasitic worms (e.g., soil-transmitted helminthiasis and schistosomiasis). People living and working in densely populated and rapidly transforming cities in Africa and Asia are especially vulnerable.

We conducted a cross-sectional survey and assessed people’s risk of intestinal parasitic infections due to exposure to wastewater and fecal sludge management and use in Kampala, the capital of Uganda. We collected data on the prevalence, intensity, and risk factors of infections with parasitic worms and intestinal protozoa among slum dwellers, urban farmers, and workers maintaining the sanitation system. We found high infection prevalence of Schistosoma mansoni  and soil-transmitted helminths in urban farmers and slum dwellers after adjusting for age, sex, and educational attainment. Our data suggest that urban farmers are especially vulnerable to infections with intestinal parasites, which may play an important role in the transmission through contamination of their living and working environments. In view of our results, the control of schistosomiasis and soil-transmitted helminthiasis should be accelerated in Kampala.

Source: PLOS

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Taxonomy

• Wastewater Use
• Public Health
• Sludge Management