Open Defecation Sites, Unmet Sanitation Needs, and Potential Sanitary Risks in Atlanta, Georgia, 2017-2018

American Journal of Public Health
Drew CaponeJoe Brown

Abstract

To survey the spatial distribution and enteric pathogen profile of discarded human feces in the city of Atlanta, Georgia. After defining priority search areas in central Atlanta, we conducted 5 searches of open defecation sites totaling 15 hours during the period from October 2017 to January 2018. We collected fresh stools for analysis via multiplex reverse-transcription polymerase chain reaction to identify presence of 15 common parasitic, bacterial, and viral enteric pathogens. We identified and mapped 39 open defecation sites containing 118 presumptive human stools; 23% of the 26 collected fresh stools tested positive for 1 or more pathogens. An estimated 12% of stools were positive for enterotoxigenic Escherichia coli, 7.7% for Giardia spp., 3.8% for norovirus, and 3.8% for Salmonella spp. The majority (92%) of identified open defecation sites were within 400 meters of a shelter or soup kitchen. Though this study was constrained by a small sample size, results suggest that open defecation in Atlanta is common and may pose risks to public health. Public Health Implications. Open defecation may pose health risks to people experiencing homelessness and the general public.

References

Oct 8, 1999·Emerging Infectious Diseases·P S MeadR V Tauxe
Aug 8, 2015·Critical Reviews in Environmental Science and Technology·C RoseE Cartmell
Jun 21, 2016·Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre·Manuel John AlbertWassim Chehadeh
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Dec 7, 2017·The New England Journal of Medicine·Margot Kushel

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Citations

Aug 21, 2020·American Journal of Public Health·Drew CaponeJoe Brown
Mar 7, 2021·International Journal of Environmental Research and Public Health·Mounah Abdel-SamadDavid Sleet
Jan 30, 2021·Acta Microbiologica Et Immunologica Hungarica·Tran Duc Anh LyPhilippe Gautret

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