Cookie tracking notice
Are we allowed to crumble with cookies and anonymous tracking?

We use cookies on our website. Some of them are essential for the operation of the site (so called session cookies), while others help us to improve this site and the user experience (tracking cookies). We use the application Matomo and the external service etracker to analyze your behavior on our website anonymously. Because we value your privacy, we are here with asking your permission to use the following technologies. You can change your settings any time via this link or the menu item in footer menu. For more information visit our Data Policy

Sanitation Trial in Maputo, Mozambique (MAPSAN)

2015 - 2018 • London School of Hygiene and Tropical Medicine LSHTM

Purpose

Supporting the generation of new knowledge on the health impacts of urban sanitation

Activities

The combination of a high faecal-related disease burden and inadequate infrastructure suggests that investment in expanding sanitation access in densely populated urban slums can yield important public health gains. No rigorous, controlled intervention studies have evaluated the health effects of decentralised (non-piped) sanitation in an informal urban setting, despite the role that such technologies will likely play in scaling up access.

Methods. We have designed a controlled, before-and-after (CBA) trial to estimate the health impacts of an urban sanitation intervention in informal neighbourhoods of Maputo, Mozambique, including an assessment of whether exposures and health outcomes vary by localised population density. The intervention consists of private pour-flush latrines (to septic tank) shared by multiple households in compounds or household clusters. We will measure objective health outcomes in approximately 1100 children (550 children with household access to interventions, 550 matched controls using existing shared private latrines in poor sanitary conditions), at 2 time points: immediately before the intervention and at follow-up after 12 months of latrine use.

Primary outcome. We define our primary outcome as combined prevalence of the following enteric infections in stool samples from children: Campylobacter; Clostridium difficile, Toxin A/B; Es. coli O157; ETEC LT/ST; Shiga-like toxin producing Es. coli (STEC) stx1/stx2; Salmonella; Shigella; V. cholerae; Yersinia enterocolitica; Giardia; Cryptosporidium; and Entamoeba histolytica. These and other enteric infections are increasingly thought to be related to environmental enteric dysfunction (EED) and stunting. Additionally, we will detect viral pathogens adenovirus 40/41, Norovirus GI/GII, and Rotavirus A, though we have excluded viral infections from the primary outcome definition.

Secondary outcome measures include soil-transmitted helminth (STH) reinfection (A. lumbricoides, T. trichiura, and hookworm by Kato-Katz and qPCR) in children following baseline deworming and prevalence of reported diarrhoeal disease (7-day recall). Tertiary outcomes include biomarkers for EED including neopterin, α-antitrypsin, and myeloperoxidase in stools; anthropometric measures to compute height-for-age Z-scores and other measures of growth in children; and salivary IGF-1.

Countries of activity

Location of main activity

Objectives

We seek to answer two primary study questions:

Question 1: Can urban, onsite, shared sanitation reduce risk of enteric infections in children?

Question 2: Do enteric infection risks and the effects of urban sanitation vary by localised population density?

Further information

We are using exposure assessment, faecal source tracking, and microbial transmission modelling to examine whether and how routes of exposure for diarrhoeagenic pathogens and STHs change following introduction of effective sanitation.

Ethics Study protocols have been reviewed and approved by human subjects review boards at the London School of Hygiene and Tropical Medicine, the Georgia Institute of Technology, the University of North Carolina at Chapel Hill, and the Ministry of Health, Republic of Mozambique.
Trial registration number NCT02362932

This project includes sanitation interventions in Maputo, in order to preserve the validity of the embedded trial.

Filter tags

Behaviour change Bill & Melinda Gates Foundation Health and hygiene Specific to one or several countries Sub-Saharan Africa University, education or research institution Urban informal settlements (slums)

Links


Uploaded by:
danijela milosevic (milli)

Share this page on    


Follow us on    

SuSanA Partners  currently 400 partners

Show all partners »

Networks Circle

 

Latest SuSanA Blog Articles

  • 26-03-2024Alice Brandt ,Mascha Kaddori:
    Let’s get wild: Water, sanitation and hygiene at the human-wildlife interface »
  • 21-03-2024Tabeer Riaz:
    Empowering Young Women Water Professionals in South Asia: Leading the Wave of Change »
  • 12-03-2024Beauty Mkoba:
    Unlocking the potential of African Women in STEM through mentorship »
  • 08-03-2024Gloria Mariga :
    Mentorship empowers African women to lead environmental stewardship »
  • 05-03-2024Josphine Gaicugi:
    Achieving access to adequate and equitable sanitation for all is no mean feat »
  • 01-02-2024Sanitation for Millions:
    Toilets Making the Grade® school competition – A Competition where all Participants are Winners »
  • 24-01-2024Anne Fetscher,Jörg Felmeden:
    The sustainable use of tap water (in Germany) and the power of education. An Interview with Dr.-Ing. Jörg Felmeden »

SuSanA Blog »

SuSanA newsletter

Stay informed about the activities of SuSanA and its partners. The SuSanA newsletter is sent out around four times per year. It contains information about news, events, new partners, projects, discussions and publications of the SuSanA network.

Subscribe to newsletter »

 


close  

 

Resources and publications

Our library has more than 3,000 publications, factsheets, presentations, drawings etc. from many different organisations. It continues to grow thanks to the contributions from our partners.

Add item to library »

The three links below take you to special groups of items in the library for more convenient access:

Projects

The project database contains nearly 400 sanitation projects of many different organizations dealing with research, implementation, advocacy, capacity development etc. Advanced filtering functions and a global map are also available. Information on how and why this database was created is here.

People working for SuSanA partners can add their own projects through their partner profile page. You might need your SuSanA login upgraded for this purpose. Please contact us if you would like to add a project.


Trainings, conference and events materials

Missed important conferences or courses? Catch up by using their materials for self study. These materials have been kindly provided by SuSanA partners.

Shit flow diagrams, excreta flow diagrams (298 SFDs worldwide)

Shit flow diagrams (SFDs) help to visualize excreta management in urban settings. Access SFDs and more through the SFD Portal.

Emersan eCompendium

Humanitarian Sanitation Hub

Sanitation Workers Knowledge and Learning Hub

 


close  

 

Discussion forum

Share knowledge, exchange experiences, discuss challenges, make announcements, ask questions and more. Hint: Your discussion forum login is the same as your SuSanA login. More about the forum's philosophy »


Integrated content

We are hosting content from some other communities of practice and information-sharing portals. This section also provides a link to SuSanA's Sanitation Wikipedia initiative.

Suggest content to add »

SuSanA partners

Not yet a SuSanA partner? Show your organisation's support to SuSanA's vision and engage in  knowledge sharing by becoming partners.

Apply to become a partner »


Individual membership

Register as an individual member of SuSanA free of charge. As a member you can interact with thousands of sanitation enthusiasts on the discussion forum.  You can also get engaged in one of our 13 working groups and our regional chapters. Our FAQs explain the benefits further.

By getting a SuSanA login you can fully participate in the SuSanA community!

Register as a member

Login


Forgot your password?
Forgot your username?

 


close