Are there seasonal variations in faecal contamination of exposure pathways? An assessment in a low-income settlement in Uganda

Sanitation infrastructure are not able to cope with the increasing population in low-income countries, which leaves populations exposed to faecal contamination from multiple pathways. This study evaluated public health risk (using SaniPath) in a low-income community during the dry season, to identify the dominant exposure pathways, and compare this data to existing data for the rainy season, questioning the assumption that risk of faecal contamination is higher in the rainy season. SaniPath was used to collect and assess exposure and environmental data, and to generate risk profiles for each pathway. In the dry season the highest exposure frequency was for bathing and street food, exposure frequency generally increased, and seasonal variation was found in five pathways. The highest hazards in the dry season were through contact with drains, soil, and street food. Seasonal variation was found in the contamination of open drains and street food, with higher levels of Escherichia coli (E. coli) in the dry season. Open drains were identified as the most dominant risk pathway in both seasons, but risk was higher in the dry season. This highlights the complex nature of seasonal variation of faecal risk, and questions the assumption that risk is higher in the rainy season