Details:

Alternative Title:
Trop Med Int Health
Personal Author:
Prentice-Mott, Graeme ; Odhiambo, Aloyce ; Conners, Erin E. ; Mwaki, Alex ; Blackstock, Anna J. ; ... More +
Prentice-Mott, Graeme ; Odhiambo, Aloyce ; Conners, Erin E. ; Mwaki, Alex ; Blackstock, Anna J. ; Oremo, Jared ; Akelo, Oscar ; Eleveld, Alie ; Quick, Robert ; Murphy, Jennifer ; Berendes, David M. Less -
Description:
Objectives:

Innovations to improve public sanitation facilities, especially in healthcare facilities (HCFs) in low-income countries, are limited. SaTo pans represent novel, largely untested, modifications to reduce odor and flies and improve acceptability of HCF sanitation facilities. We conducted a pilot project to evaluate acceptability, cleanliness, flies, and odor within latrines in 37 HCFs in Kisumu, Kenya, randomized into intervention (SaTo pan modifications) and control arms by sub-county and HCF level.

Methods:

At baseline (pre-intervention) and endline (>3 months after completion of SaTo pan installations in latrines in intervention HCFs), we surveyed users, cleaners, and in-charges, observed odor and cleanliness, and assessed flies using fly tape. Unadjusted difference-in-difference analysis compared changes from baseline to endline in patient-reported acceptability and observed latrine conditions between intervention and control HCFs. A secondary assessment compared patient-reported acceptability following use of SaTo pan versus non-SaTo pan latrines within intervention HCFs.

Results:

Patient-reported acceptability of latrines was higher following the intervention (baseline: 87%, endline: 96%, p = 0.05). However, patient-reported acceptability was also high in the control arm (79%, 86%, p = 0.34), and the between-arm difference-in-difference was not significant. Enumerator-observed odor declined in intervention latrines (32% to 14%) compared with controls (36% to 51%, difference-in-difference ratio: 0.32, 95% confidence interval: 0.12, 0.84), but changes in flies, puddling of urine, and visible feces did not differ between arms. In the secondary assessment, fewer intervention than control latrines had patient-reported flies (0% v 26%) and odor (18% v 50%), and reported satisfaction was greater. Most cleaners reported dropholes and floors were easier to clean in intervention vs. controls; limited challenges with water for flushing were reported.

Conclusions:

Our results suggest SaTo pans may be acceptable by cleaners and users and reduce odor in HCF sanitation facilities, though challenges exist and further evaluation with larger sample sizes is needed.


Keywords:
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Animals Delivery Of Health Care Diptera Healthcare Facilities Humans Kenya Latrine Pilot Projects Public Health Sanitation Sato Pan Technology Toilet Facilities Water, Sanitation, Hygiene (WASH)
Source:
Trop Med Int Health. 28(12):881-889
Pubmed ID:
37940633
Pubmed Central ID:
PMC10886420
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHSUnited States/
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:0ca189ba6430fa5cb167214a682be9fd2aeb85b1f4d6588a5fdeb7a31a5864be
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