Molecular characterization and serotyping of enteric pathogens for validation of "peepoo" sanitization along handling chain at urban informal settlement, Kenya
An estimated 40% of the world's population has no asses to proper sanitation, resulting in a contaminated environment from which enteric diseases are spread. Infectious diarrhoea has been shown to cause an estimated 2.2 million deaths per year accounting for more deaths than AIDS, malaria and measles combined. At the same time human excreta, which to a large extent end up in water bodies via wastewater and surface runoff, contain millions of tons of fertiliser equivalent to 20-30% of what the global fertiliser industry produces annually. Such misuse of plant nutrients from human excreta is currently a neglected aspect of health in relation to sanitation. This study aims at assessing the applicability of "Peepoo" as single use personal toilet for human excreta sanitization and reuse as safe fertilizer thus preventing dissemination of pathogens to the environment, and increase agricultural yields. This study will be validating the sanitisation function of "Peepoo" when used in an informal settlement by measuring selected pathogens and parameters related to sanitization. The research will be conducted within an initial launch project (ILP) in Kibera under Peepoople Kenya Limited. A cross sectional study will be conducted to sample schools enrolled in the project working site of Gatwekera village in Kibera. Two hundred and ten samples will be randomly selected, thirty from seven schools and submitted for laboratory analysis to establish the baseline information for all the test parameters. Peepoo bags with urea will be distributed to the same enrolled schools during the second week of study and used Peepoo collected on daily basis for incubation and analysis. Temperature inside the incubation bags will be monitored during storage throughout the incubation period. The analysis of faecal material will be conducted with standard microbiological methods. This analysis will relate faecal pathogen concentration at the start with the sanitisation level in the end of handling chain, it will also provide disease prevalence data and allow assessment of the sanitisation process of the Peepoo relating it to pH, temperature and ammonia concentration parameters. The analysis will be repeated during the dry and wet seasons to catch seasonal variations in faeces and in environmental parameters such as temperature and humidity. Bacteria pathogens, gastrointestinal virus, protozoa and helminths; (Salmonella spp, Escherichia coli, Campylobacter, Rota virus, Cryptosporidium spp and helminth eggs) will be used to assess microbiological risk in the Peepoo handling and reuse chain. Susceptibility patterns of isolated pathogens including; Salmonella spp, Escherichia coli will be determined. Specific primers will be designed to carry out multiplex peR for detection of resistant genes as well as serotype and genetic fingerprinting to distinguish between different strains of isolates recovered along the peepoo handling chain to source tracking relationship patterns among strains. The data collected will undergo multivariate analysis to derive a model that will simulate sanitisation in the Peepoo. The results from the study will be used to optimize the Peepoo product as a hygienic toileting alternative thus recommending a model to be used for continuous monitoring of the safe use of Peepoo as fertilizer.