Speaker: Dr. Christine Moe


SaniPath Co-Founder and Emory University Professor, Dr. Christine Moe, presented during the Center for Science and Environment (CSE) Webinar on the SaniPath Tool and how it is used to examine exposure to faecal contamination in urban, residential environments. The presentation covers: why exposure assessments are useful and the information they provide; an overview of the objectives and methods of the SaniPath Tool; key findings from Dhaka, Bangladesh; and how results can inform municipal and national policies and programming.

SaniPath presentation for CSE webinar-7
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Rethinking WASH indicators to understand and address environmental contamination and improve child growth


Speakers: Christine Moe, Suraja Raj, Habib Yakubu


Growing evidence is reinforcing that to ensure healthy growth and development, infants and young children (IYC) need to be far less exposed to feces in their environment. Even in the absence of diarrhea, fecal contamination affects nutrient absorption and IYC resilience to fight infections. However, several powerful randomized studies conclude that traditional WASH interventions aren’t effective to protect IYC and promote growth, and recommendations suggest we must move toward ‘Transformational WASH’.


The WASH, Nutrition & Child Growth Webinar series is an opportunity to discuss how the wealth of new research focusing on the impacts of harmful environmental pathogens can be applied in order to deliver more effective multi-sectoral WASH programming. PRO-WASH, USAID WASHPaLS and the Clean, Fed and Nurtured Coalition invite you to the third, and final installment in the series on May 26th at 9.00 am EST that will focus on rethinking WASH, program indicators in order to understand and address environmental contamination and improve child growth. Presentations will be given by representatives from the SaniPath team, at the Center for Global Safe WASH at Emory University.


Access Webinar Presentation Here
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American Society of Tropical Medicine and Hygiene 2019

November 20-24, 2019


Wolfgang Mairinger, Yuke Wang, Suraja Raj, Habib Yakubu, Casey Siesel, Jamie Green, Sarah Durry, Christine Moe

Emory University, Atlanta, GA, United States


The SaniPath exposure assessment tool compares risks of exposure to fecal contamination in urban environments across multiple exposure pathways. The tool has been deployed in 39 neighborhoods in 8 cities: Accra, Ghana, Vellore, India; Maputo, Mozambique; Siem Reap, Cambodia; Dhaka, Bangladesh; Atlanta, United States; Lusaka, Zambia; and Kampala, Uganda. Ten exposure pathways were investigated (open drains, ocean water, surface water, floodwater, public latrines, soil, bathing water, raw produce, drinking water, and street food) through behavior surveys and environmental sample analyses. Exposure was expressed as monthly dose (average amount of fecal contamination ingested as measured by E. coli colony-forming units [CFU]) and the percent of population exposed to fecal contamination for each pathway. Magnitude of fecal contamination, frequency of exposure behavior, and estimated fecal exposures were compared across pathways, neighborhoods and cities. The most common dominant exposure pathways for adults were raw produce, open drains, and street food and for children were open drains, produce, and floodwater. For produce, the dose was usually very high (>106 CFU/ month), and a large percent of the population was exposed (>80%). For street food, average E. coli concentration ranged from 101.3 CFU/serving in one neighborhood in Lusaka, Zambia to 105.5 CFU/serving in one neighborhood in Dhaka, Bangladesh. Exposure to open drains resulted in high doses (>104 CFU/month), but the population exposed varied (5%-92%) even within the same city. Exposure to fecal contamination via floodwater, usually affected a high percent of population (>80%) but had variable doses (102.5-1010 CFU/month). Both dose and percent of population exposed varied for public latrines and municipal piped water. This information can help city governments choose effective interventions to reduce the risk of exposure to fecal contamination. Widespread risks from contaminated produce and street food within and across cities underscore the link between excreta management and food safety and need for global action.