Exposure to animal and human feces in the household environment is associated with diarrheal diseases in young children. The objective of this study was to identify exposure pathways to fecal pathogens for young children that are significant contributors to diarrheal disease to allow for targeted water, sanitation, and hygiene (WASH) interventions on these pathways. The WASHmobilePreventative Intervention for Cholera for 7 Days prospective cohort study was conducted in urban Bukavu, South Kivu province, Democratic Republic of the Congo. The cohort study of 794 children under 5years of age included monthly diarrhea surveillance and unannounced spot checks to assess WASH behaviors and conditions over a 12-month period. Caregiver report of child mouthing of fomites was also obtained during monthly visits. The presence of animals in the child's sleeping space (odds ratio (OR): 1.87; 95% confidence interval (CI): 1.14, 3.08), unimproved sanitation (OR: 2.27; 95% CI 1.19, 4.33), and consumption of food outside the household (OR: 1.88; 95% CI 1.16, 3.06) were significantly associated with diarrhea during the subsequent month.Chickens [OR: 3.38; 95% CI: 2.05, 5.59) and cats [OR 3.9; 95% CI: 1.46, 10.46] in the child's sleeping space was also associated with significantly higher odds of diarrhea in the subsequent month. These results demonstrate the need for WASH interventions targeted at reducing child contact with animal feces in the indoorhousehold environment and improved sanitation, to reduce exposure to fecal pathogens for susceptible pediatric populations.

Extraintestinal pathogenic Escherichia coli (ExPEC) are a leading cause of human bloodstream infections (BSIs) in sub-Saharan Africa, yet few studies have characterized African strains implicated in BSI or explored their potential reservoirs. We enrolled febrile patients at 2 hospitals in Moshi, Tanzania, 2007-2019, and performed blood cultures. Whole-genome sequencing was conducted on E. coli originating from the bloodstream to characterize sequence types (STs), serotypes, and theoretical coverage of a 9-valent ExPEC polysaccharide conjugate vaccine (ExPEC9V). Separately, we evaluated 601 E. coli whole-genome sequences from humans, animals, and environmental sources in nearby communities. We assessed genetic relatedness between bloodstream and community isolates based on single-nucleotide polymorphisms and allele differences. Of 3046 participants receiving blood culture, 48 (0.2%) had BSI yielding 48 E. coli isolates. The median (range) age of participants with E. coli BSI was 40.7 (0.3-89.0) years, and 32 (68.1%) were female. We identified 16 STs including ST131 (n = 16, 33.3%), ST73 (n = 10, 20.8%), and ST69 (n = 6, 12.5%) and 19 O groups including O25 (n = 13, 27.1%), O6 (n = 10, 20.3%), O17 (n = 4, 8.3%), and O18 (n = 4, 8.3%). Theoretical coverage for an ExPEC9V was 72.9%. None of the bloodstream and community E. coli pairs were closely related. We found a high diversity of STs among E. coli human bloodstream isolates in Tanzania. Despite this diversity, we observed that an EXPEC9V in development would provide good coverage. Reservoir-attribution studies at finer spatial and temporal scales may better identify transmission networks and reservoirs of ExPECs.

Interrupted water supplies contribute to water insecurity, water quality risks, diarrhea, and stress; other risks (acute respiratory infections (ARIs), antibiotic use, antimicrobial resistance) remain unquantified. We assessed associations between water interruptions and various outcomes. Among 237 households in Malawi, we conducted a cross-sectional questionnaire and tested drinking water for generic and cefotaxime-resistant Escherichia coli (CREC). Water interruptions in the past month were reported by 32.5% of households; interruptions were unpredictable and more common in piped supplies. Households with interruptions were 3-5 times more likely to be water-insecure, skip laundry and handwashing after handling animal feces (p-values < 0.05). Most water samples came from storage, and 65.7% harbored E. coli and 8.4% harbored CREC; households with vs without interruptions had similar fecal contamination. Children <5 years experiencing interruptions had increased caregiver-defined diarrhea (prevalence ratio [PR] = 1.85, 1.02-3.37) and ARI with fever (PR = 1.98, 1.09-3.57). Rare (1-2/month) interruptions were associated with diarrhea and antibiotic use; frequent (≥3/month) or long (above-median duration) interruptions with ARI. Frequent or short interruptions were associated with stress. Our findings highlight respiratory risks from water interruptions and suggest that interruption frequency and duration may influence enteric vs respiratory pathogen transmission through distinct mechanisms. Prospective studies should validate these associations and evaluate mitigation strategies.

Leprosy-related stigma has a profound impact on affected individuals and their communities. Embedded within the MetLep trial of adjunctive metformin for multibacillary leprosy, we explored knowledge and perceptions of leprosy in endemic communities in Sulawesi, Indonesia. We conducted a mixed-methods cross-sectional study using interview-administered questionnaires and qualitative methods. Quantitative data were collected using the ‘NLR Perception Toolkit’, including a knowledge-questionnaire, the EMIC-Community Stigma Scale (EMIC-CCS) and the Social Distance Scale (SDS). Semi-structured interviews (SSIs) and focus group discussions (FGDs) were conducted to gain in-depth insights into perceived stigma, fears related to leprosy, care-seeking behaviour and access to healthcare. Quantitative data were analyzed using descriptive and multivariate analyses, while qualitative data were analyzed using inductive coding and content analysis. A total of 402 participants completed the questionnaires: 75 affected by leprosy (18.7%), 126 close contacts (31.3%), 150 community members (37.3%), and 51 healthcare workers (12.7%). Most participants were female (75.6%), with a median age of 42.0 years (IQR 32.3-52.0). Twenty-five individuals participated in SSIs and FGDs. Mean knowledge-score was low (3.0; SD 2.0; range 0–9), particularly regarding leprosy symptoms, cause, and transmission. Misconceptions included hereditary transmission and transmission through animal feces, sexual contact, or intercourse during menstruation. Mean EMIC-CSS and SDS scores were 11.2 (7.1; 0–28) and 8.7 (4.1; 0–21), respectively, with the highest stigma levels among community members. Qualitative findings revealed that care seeking experiences and perceived stigma were complex and context specific. Leprosy was locally referred to as “kandala”, a term with negative socio-cultural connotations, and was often associated with witchcraft, sinful behavior, and moral transgression. Persons affected by leprosy reported community rejection, social exclusion, and avoidance of physical contact. Institutional stigma persisted within national leprosy programs. Addressing leprosy stigma requires context-specific, stigma-sensitive educational and public health interventions, supported by sustained political commitment and adequate funding.

Barley is more extensively and more rapidly fermentable than maize, thus it is supposed to increase digestive disorders in ruminants. However, the effect of cereal type on animal performance and digestion may vary with processing degree. In the present experiment, the effect of dry-rolling or grinding barley and maize, as the main cereals in a concentrate containing a high proportion of starch with different rates of fermentation, on intensively reared beef cattle performance, diet digestibility, and feed intake amount and pattern, was studied. Thirty-six 3-month-old male calves were allocated to one of four diets consisting of barley straw (BS) and a concentrate with 60% cereals (barley and maize in proportions 75:25 or 25:75) presented dry-rolled or ground through a 3.5 mm sieve. The experimental period was divided into two phases of 10 weeks each: from start to 277 ± 3.6 kg live weight (LW; Growing), and from 289 ± 3.8 kg LW to slaughter (399 ± 4.6 kg; Finishing). For the Growing phase, there were no differences (p &gt; 0.10) between the majority cereal in the concentrates, nor between their processing methods, in the daily intake of concentrate and BS, and in the animals’ final LW. With respect to Finishing, the interaction between cereal type and processing was significant (p &lt; 0.05) for concentrate daily intake. As a result, animals consuming ground barley ate less concentrate than those fed rolled barley, whereas there were no differences between processing methods for animals fed maize-based diets. Animals consuming ground-barley concentrates consumed significantly more straw than those fed on dry-rolled-barley concentrates (p &lt; 0.05 for Growing and p &lt; 0.01 for Finishing) during the first four hours after feeding. No such differences appeared in animals consuming maize-based concentrates. Starch digestibility was higher in animals fed ground cereals vs. dry-rolled cereals during the Growing phase (p = 0.048), whereas NDF digestibility was also higher (p = 0.008) in animals fed ground cereals during the Finishing phase. The faeces from animals fed on rolled-maize concentrates showed a higher concentration of purine bases than the faeces of animals fed on rolled-barley concentrates (p = 0.016), although there were no differences for the ground cereals. Overall, the results reported indicated that replacing maize with barley in diets for feedlot beef cattle did not affect average daily gain, intake of straw or concentrate, or feed conversion ratios (total or considering just the concentrate); hence the inclusion of either cereal in greater proportions should be based on their market price and on the final cost of the compound feed (which may include different ingredients). The processing method of the cereals (grinding or dry-rolling) also had no influence on the above-mentioned variables, so the selection of the method should be based on their relative cost, exclusively in terms of feed efficiency.

Large scale biomonitoring of glyphosate and AMPA by analysis of human and animal feces and comparison with urine.

Aim: Foodborne non-typhoidal Salmonella (NTS) infections are a major global health issue, frequently linked to animal source foods. However, there is limited data on NTS prevalence, distribution, and serotype diversity in common animal products and related food in Ghana. This study investigated the prevalence and serotype diversity of NTS in animal source foods, ready-to-eat (RTE) food, and animal fecal samples across six districts in the Greater Accra Region of Ghana. Methods: A total of 696 samples were randomly collected from selected markets across the districts. These included unprocessed animal products: beef (16), chicken (21), eggs (185), and raw cow milk (40). Additionally, 50 samples of RTE street foods and 36 samples of locally produced soft cheese (“wagashie”) were obtained from vendors. Fecal samples consisted of chicken droppings (70) and pig feces (138), which were purposively collected from 11 poultry farms and two pig slaughter facilities in the region. Furthermore, 140 pork samples were purposively collected from the slaughter facilities. Standard microbiological methods, including pre-enrichment, selective enrichment, and plating on selective media, were used for Salmonella species isolation, with identification confirmed by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Serotyping followed the White-Kauffman Le-Minor classification scheme. Results: Overall, 26 Salmonella isolates were recovered (3.7%). Prevalence was significantly higher in animal source foods (5.71%; 25/438) compared to fecal samples (0.4%; 1/208) (p = 0.0026). Salmonella contamination was highest in raw pork (13.6%), followed by “wagashie” (5.5%) and raw milk (5%). Nine distinct serotypes were identified. Among them, Salmonella Typhimurium was the most prevalent, accounting for 40.9%, followed by Salmonella Kaapstad at 13.6%. Additionally, pork samples contained seven of these serotypes. Conclusions: These findings highlight a potential risk posed by NTS in commonly consumed animal source foods in Greater Accra and emphasize the need for targeted interventions to control contamination, particularly in pork products.

The most common causes of respiratory diseases in wild hedgehogs are the lungworms Crenosoma striatum and Capillaria aerophila, which can lead to life-threatening pneumonia. The aim of the current study was (A) to assess the prevalence of common lungworm infections in northern white-breasted hedgehogs (Erinaceus roumanicus) in Greece and (B) to identify an efficient and easy to administer treatment option. (A) Fifty-six hedgehogs were admitted to a Greek wildlife rehabilitation center and included in the present study. Fecal tests were performed using the flotation method (ZnSO4 33.2%) combined with the Baermann technique. In total, 49 hedgehogs excreted Crenosoma spp. larvae (87.5%), and 27 of them were also infected with Capillaria spp. (48.2%). One of them died, and the necropsy and lung histopathology confirmed the diagnosis of crenosomosis. (B) Fourteen animals with mixed infections were treated using NexGard® Combo (esafoxolaner, eprinomectin, praziquantel) administered orally at a dose rate of 0.2 mL/kg body weight, once. On days 10 and 14 post-treatment, no parasitic elements were detected in the feces of the infected animals. All the animals had gained weight by day 14, and their biochemical parameters were normal. It was concluded that this combination given orally was safe and successful against hedgehog respiratory nematodes.

IntroductionEscherichia marmotae is one of the Escherichia cryptic clades that were first isolated from animal feces and environmental waters and has recently emerged as an organism of concern due to its presence in human infections. Although E. marmotae cannot be distinguished from E. coli by standard clinical tests, its 10% pairwise genomic difference from E. coli led us to investigate other phenotypic differences that may be present.MethodsBioinformatic software was used to identify the E. marmotae pan-genome, antimicrobial and virulence genes, and sequences of genes for motility, biofilm formation, and other phenotypic characteristics. Environmental and clinical isolates of E. marmotae were analyzed for antimicrobial sensitivity, and for temperature effects on motility, growth, and biofilm formation, in comparison to E. coli. RT-PCR analyzed associated changes in gene expression.ResultsThe E. marmotae genome consists of >75% core genes, and has many accessory genes, including plasmids and antimicrobial resistance genes. E. marmotae is resistant to erythromycin. E. marmotae had all genes needed for complete flagellar gene assembly, and phenotypically was motile at 28°C, and much less motile at 37°C. More biofilm formation was observed at 28°C than at 37°C. The expression of motility genes motA and fliA decreased at 37°C in E. marmotae compared to E. coli.ConclusionThese temperature-sensitive traits may support environmental persistence and adaptations that may facilitate E. marmotae to cause human disease.

Carbapenem-resistant Pseudomonas aeruginosa (CRPA) poses a significant threat to human health, with animal feces serving as an important reservoir of antibiotic-resistant bacteria and potentially CRPA. However, data on the prevalence and characteristics of CRPA in animals are still lacking. The pathogenic potential of CRPA from animals is also poorly understood. This study investigated the prevalence of CRPA in animals in China, along with the virulence potential and phylogenetic relationships of CRPA from animals and humans. The detection rate of CRPA among the 867 animal samples was 5.07%. Notably, multi-drug resistance was observed in 62% of the 50 animal-derived CRPA, significantly higher than the 23 clinical CRPA isolates in this study (p < 0.05). Furthermore, 20% of the CRPA isolates from animals showed resistance to colistin. Mutations in the oprD gene, rather than carbapenemases, were identified as the primary cause of carbapenem resistance. Phylogeographic analysis revealed that PA isolates were disseminated across 47 countries, and the sequence types (STs) exhibited significant diversity. Furthermore, a higher detection rate of animal-derived CRPA simultaneously carrying multiple virulence factors was observed, surpassing the rate in clinical CRPA. Galleria mellonella assays further confirmed that the CRPA from animals and humans exhibited greater pathogenicity than the hypervirulent Klebsiella pneumonia 18,622. Phylogenetic analysis further revealed that the animal hypervirulent CRPA had only a few SNPs with clinical PA from various countries, including our clinical CRPA, indicating the potential of clonal transmission of CRPA between animals and humans. Our findings reveal that animals could be an important reservoir of hypervirulent CRPA and highlight the potential for zoonotic transmission to humans. The emergence of hypervirulent CRPA in animal feces highlights the significance of developing control measures in animal farming environments from a "One Health" perspective.

Bacteroidota, a diverse phylum of bacteria, includes classes whose members are increasingly recognized for their significant contributions to host health, particularly through their antimicrobial properties. This study investigates the functional diversity of 42 new Bacteroidia and Sphingobacteriia strains enriched and identified from diverse hosts, including mouse ceca and human stool samples. Using 16S rRNA gene sequencing, we phylogenetically characterized the strains of the genera Bacteroides, Phocaeicola, and Sphingobacterium and assessed their functional properties related to potential beneficial functions. The strains were evaluated concerning their ability to inhibit biofilm formation of the World Health Organization-declared clinically significant pathogens, including Gram-positive Staphylococcus aureus and Staphylococcus epidermidis, Gram-negative Klebsiella oxytoca and Pseudomonas aeruginosa, and the eukaryotic yeast Candida albicans. Additionally, we investigated bile salt hydrolase and quorum-quenching (QQ) activities of the strains, as these functions contribute to microbial community interactions and host–microbe dynamics. Our findings demonstrate that all examined Bacteroidota strains consistently exhibit a capacity to inhibit biofilm formation but to different extents. Furthermore, 14 strains showed QQ activity, and 39 bile salt hydrolase activity, indicating functional diversity among the isolates. High biofilm inhibition as well as QQ activity against both autoinducers, AHL and AI-2, were predominantly observed in Bacteroides caecimuris and Bacteroides muris. These traits suggest that such strains may play important roles in shaping microbial communities and interfering with pathogens and their communication. Overall, this study provides valuable insights into strain-specific functions that could support future microbiome-based strategies for pathogen control and host health modulation.

Sewage, animal feces, heavy metals, pathogenic microbes,and otherpollutants can contaminate floodwater. Fresh vegetables that havebeen submerged in floodwater or that might have been exposed to contaminatedwater are not safe to consume. Pollutants may enter plant tissuesin addition to being on the outside of fruits and vegetables. In theautumn of 2024, there were great floods in central Bosnia and Herzegovina.The aim of this study was to determine the effect of floods on heavymetals and microbe content in the soil and plant tissue. Twenty-onesamples of soil and sludge were prepared by extraction with aqua regiaand EDTA, for the measurement of pseudo-total and available amountsof metals. Samples of chard were taken from flooded areas and fromareas outside of floods (controls). The chard samples were dividedinto roots, stems, and leaves. The quantity of nine heavy metals (Cu,Zn, Ni, Co, Pb, Cd, Fe, Cr, and Mn) was measured by means of AtomicAbsorption Spectroscopy with flame atomization (FAAS). Statisticalevaluation included descriptive statistics (maximum, minimum, andaverage), principal component analysis (PCA), correlations, bioaccumulationfactor, and translocation factor. The total bacterial count was determinedusing R2A agar, while the Most Probable Number method was appliedfor quantifying total coliforms and spore-forming bacteria. The CNanalyzer measured the total content of C and N. The average concentrationsof metals followed the sequence Cd < Co < Cr < Cu < Ni< Zn < Pb < Mn < Fe. The sludge had the highest averagecontent of Pb, Fe, Cu, and Zn. Soil samples showed high backgroundconcentrations of Pb and Cd, and in some cases, concentrations werehigher than permissible amounts. In plants, the highest concentrationsof heavy metals were found in roots and leaves. Zn, Mn, and Co hadpositive (root/shoot) translocation factors in all cases. The highesttotal bacterial count, exceeding log 11, was observed in three soilsamples. In contrast, two samples of sludge exhibited a significantlylower bacterial abundance, falling below log 6. Chard showed highability to accumulate Cu, Zn, Ni, Fe, Mn, and Co. In some cases, chardhas amounts of Cd higher than permissible, but it is not a consequenceof flooding. Although high concentrations of lead are found in thesoil samples, it is mostly kept within the root system.

Seedlings are particularly vulnerable to herbivory because their defenses are underdeveloped and their capacity to tolerate damage is limited. However, how seedlings cope with such threats remains poorly understood. Animal feces may provide important chemical cues that influence plant responses to herbivory. We examined whether the presence of isopod feces affects the herbivory of Japanese plantain (Plantago asiatica) seedlings in the field. Laboratory experiments were also conducted to test the effects of herbivore feces on P. asiatica germination. Bioactive compounds in the feces that regulate seed germination were extracted and identified. The field experiments indicated that the presence of isopod feces induces seed germination on rainy days (when isopod activity is low), reduces herbivory, and triples the survival rate of P. asiatica seedlings. In the laboratory, feces from isopods that had recently fed on P. asiatica leaves suppressed seed germination. However, germination resumed after simulated rain washed them away. Chemical analyses revealed that trehalose and abscisic acid are the active compounds responsible for germination suppression. These findings demonstrate that the detection of chemical cues in animal feces by seeds alters their germination timing accordingly, thereby increasing their chances of survival in environments with high herbivore densities.

ABSTRACT Mato Grosso State, Brazil, is the main producing region of native farmed round fish. This study aimed to investigate the occurrence of Salmonella spp. in fish farms located in the Pantanal and Cerrado biomes, across eight municipalities, focusing on the hybrid species tambatinga ( Colossoma macropomum × Piaractus brachypomus ); to analyze possible multicausal associations contributing to contamination during the fish farming phase; to characterize the circulating serotypes; and to assess the antimicrobial resistance profiles. A total of 184 samples were tested for Salmonella spp. following protocols from the International Organization for Standardization (ISO) and confirmed by polymerase chain reaction (PCR). Salmonella spp. was detected in 88% (22/25) of the fish farms and in 31.5% (58/184) of the samples. Contamination was confirmed in fish farms from all eight municipalities investigated, reinforcing the widespread circulation of the pathogen. Among the positive samples, 60.3% were from fish, with viscera showing the highest detection rate, while sediment/soil, pond water, and animal feces were the most frequent environmental sources. Serotyping revealed 10 distinct serotypes, with S . Saintpaul and S . Newport predominant, alongside S . Reading, S . Abaetetuba, and other less common serotypes of epidemiological relevance. The associations between environmental and management factors contributed to 57% of the explained variance in Salmonella spp. occurrence, and contamination was significantly higher during the dry season. Resistance was most frequent against azithromycin (44%) and sulfonamides (38%), although no multidrug‐resistant strains were identified. The high occurrence of Salmonella spp. during the fish farming phase demonstrates that associated factors contribute to contamination and the persistence of strains with resistance profiles from the early production stages. These findings highlight weaknesses in on‐farm biosecurity that must be addressed, while joint actions with good manufacturing practices in processing plants are also needed to mitigate risks. The circulation of diverse and epidemiologically relevant serotypes emphasizes the need for integrated surveillance under a One Health perspective in Brazilian aquaculture.

Assessment of vermicompost compositions containing cattle, sheep, and poultry manures for contamination risk of microgreens by foodborne pathogens.

Knowledge, attitudes, and practices of women related to human and animal feces management in Ethiopia: Evidence for strengthening water, sanitation, and hygiene (WaSH) initiatives

Wildlife is greatly impacted by the presence of microplastics in the environment, which has become a global concern. In order to clarify their possible effects on ecosystem health, this study examines the frequency of microplastics in the feces of wild animals. Indian Elephants (Elephas maximus indicus), sambar Deer (Rusa unicolor), Gaurs (Bos gaurus), and Rabbits (Lepus nigricollis) were the main subjects of this investigation. In Tamil Nadu's Coimbatore district, we gathered wild animal excrement from the buffer zones of the Western Ghats range. Twelve animal feces samples included 127 Micro Plastic Particles (MPs) in total. A trinocular microscope was used for qualitative investigation, which showed that MPs came in a variety of colors and forms. Transparent (46 particles) was the most commonly detected color, followed by white (30), blue (15), red (6), light blue (4), brown (3), and pink (3). Fibers (70), pieces (36), and sheets (21) were among the MP shapes that were detected. To determine the kinds of polymeric components contained in the particles, FT-IR analysis was performed using Origin software. Correlations between the overall number of MPS in various animal samples and their colors and shapes were examined using SPSS software

Background:Early childhood growth, a key indicator of child well-being, is shaped by both the prenatal and postnatal environment. To understand where and when environmental factors influence growth most, we analyzed size at birth, postnatal growth trajectories, and associations with environmental factors across a rural-urban gradient in the ECoMiD longitudinal birth cohort.Methods and Findings:Between 2021–2022, pregnant women were enrolled from four sites in northwest coastal Ecuador (urban city, intermediate town, rural villages connected by road, rural villages connected by river) and children were visited shortly after birth and quarterly thereafter for 24 months. We selected exposure variables using UNICEF’s Conceptual Framework on Maternal and Child Malnutrition, including demographics, maternal characteristics, household infrastructure, and environmental factors. We used multivariable linear models and generalized estimating equations to analyze associations between exposures and length-for-gestational-age Z-score (LGAZ) and postnatal change in 3-month length-for-age Z-score (3-month ΔLAZ) and explored effect measure modification by site and child age (0–6 versus 7–24 months). Among 401 children, LGAZ was higher among children born to taller mothers, in households with higher food security, and in the rural river site. However, the postnatal growth of children in rural river sites faltered most rapidly, particularly after six months, resulting in 51% of children stunted (LAZ < −2 SD) at 24 months, compared to urban (8%), intermediate (14%), rural road (5%). Over the 0–24 month postnatal period, 3-month ΔLAZ was negatively associated with children who were male, from poorer households, had shorter mothers, and had greater exposure to animals and animal feces. Other associations, including with season, hygiene characteristics, and maternal demographics, varied by age and site.Conclusions:These findings show that environmental conditions influenced postnatal linear growth more strongly, compared to prenatal growth, which was associated with maternal anthropometry and nutrition. Community context strongly influenced growth only after age six months and modified associations with environmental conditions, suggesting that interventions targeting child growth faltering after six months may be important for certain populations.

Soil can harbor enteropathogens and antimicrobial-resistant organisms from domestic animals. We enrolled 49 households with young children (28 soil floors and 21 concrete floors) in Bangladesh and recorded animal ownership/management. Staff swabbed the floor of children's sleeping area and collected floor dust and child hand rinses. We used IDEXX QuantiTray/2000 with and without cefotaxime supplementation to enumerate cefotaxime-resistant and generic E. coli. Soil floors had 40 times more dust than concrete (8.0 vs 0.2 g/m2, p-value = 0.005). We detected E. coli on 100% of soil vs 86% of concrete floors and cefotaxime-resistant E. coli on 89% of soil vs 43% of concrete floors (p-values <0.05). Cefotaxime-resistant E. coli prevalence on floors increased with animal cohabitation: 36% in compounds without animals, 79% in compounds with animals, and 100% if animals stayed indoors overnight or if floors had animal feces; associations were strongest for chickens. Compounds with soil floors and animals had the highest contamination; those with concrete floors and no animals had the lowest. In multivariable models, generic and cefotaxime-resistant E. coli counts were 1.5-2 log higher on soil floors; counts on floors and child hands were 0.17-0.24 log higher for every 10 chickens owned (p-values <0.05). Efforts to mitigate infections and antimicrobial resistance in low-income countries should test flooring improvements and hygienic animal management.

Child malnutrition remains a global health priority, particularly in regions burdened by inadequate environmental sanitation. This narrative review aims to examine the relationship between environmental sanitation and child nutritional outcomes, focusing on children under five in low and middle income countries. A systematic literature search was conducted using PubMed, Scopus, and Google Scholar, incorporating predefined keywords and Boolean operators to identify empirical and theoretical studies published between 2010 and 2024. The findings reveal that improved sanitation facilities, handwashing behaviors, and water treatment are consistently associated with better child growth indicators, including reduced stunting and wasting. Diarrheal diseases and environmental enteric dysfunction are identified as key mediators in this relationship. Exposure to animal feces and poor waste management further exacerbate the risks. Socioeconomic and cultural factors, such as poverty and traditional beliefs, also influence sanitation practices and nutritional outcomes. Integrated interventions that combine WASH improvements with nutrition education and community led initiatives demonstrate significant potential to address child malnutrition holistically. This review underscores the urgent need for multisectoral policies and context specific research that address both environmental and behavioral determinants of malnutrition. Improving sanitation practices should be considered a central pillar in strategies aimed at enhancing child health outcomes globally.