London School of Hygiene & Tropical Medicine, Faculty of Infectious Tropical Diseases, Disease Control Department, London, United Kingdom; Georgia Institute of Technology, School of Civil and Environmental Engineering, Atlanta, United States
Trent Sumner
Georgia Institute of Technology, School of Civil and Environmental Engineering, Atlanta, United States
Zaida Adriano
WE Consult ltd, Maputo, Mozambique
Claire Anderson
Georgia Institute of Technology, School of Civil and Environmental Engineering, Atlanta, United States
Farran Bush
Georgia Institute of Technology, School of Chemical and Biomolecular Engineering, Atlanta, United States
Georgia Institute of Technology, School of Civil and Environmental Engineering, Atlanta, United States; University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, United States
University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, United States; University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Environmental Sciences and Engineering, Chapel Hill, United States
Pete Kolsky
University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, United States
Amy MacDougall
London School of Hygiene & Tropical Medicine, Faculty of Epidemiology and Population Health, Department of Medical Statistics, London, United Kingdom
Evgeniya Molotkova
Georgia Institute of Technology, School of Biological Sciences, Atlanta, United States
Judite Monteiro Braga
Instituto Nacional de Saúde, Maputo, Mozambique
Celina Russo
Georgia Institute of Technology, School of Civil and Environmental Engineering, Atlanta, United States
Wolf Peter Schmidt
London School of Hygiene & Tropical Medicine, Faculty of Infectious Tropical Diseases, Disease Control Department, London, United Kingdom
Georgia Institute of Technology, School of Civil and Environmental Engineering, Atlanta, United States; University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, United States
We conducted a controlled before-and-after trial to evaluate the impact of an onsite urban sanitation intervention on the prevalence of enteric infection, soil transmitted helminth re-infection, and diarrhea among children in Maputo, Mozambique. A non-governmental organization replaced existing poor-quality latrines with pour-flush toilets with septic tanks serving household clusters. We enrolled children aged 1–48 months at baseline and measured outcomes before and 12 and 24 months after the intervention, with concurrent measurement among children in a comparable control arm. Despite nearly exclusive use, we found no evidence that intervention affected the prevalence of any measured outcome after 12 or 24 months of exposure. Among children born into study sites after intervention, we observed a reduced prevalence of Trichuris and Shigella infection relative to the same age group at baseline (<2 years old). Protection from birth may be important to reduce exposure to and infection with enteric pathogens in this setting.
