Elucidating Pathways of Fecal Transmission: Evidence from Bangladesh - Laura Kwong, PhD Candidate, CEE

Abstract: Nearly 500,000 children die from diarrhea each year and many more suffer the effects of asymptomatic infections. The highest burden is among children under 5 years old in low-income countries. Decades of household interventions in water, sanitation, and hygiene have had mixed results, often with little long-term effect. Are interventions failing to tackle primary pathways of fecal-oral transmission that can result in disease?

This dissertation seeks to understand the relative contribution of multiple pathways of fecal transmission. I examine how young children come into contact with their environment, from the objects that they put into their mouths to surfaces that they touch and where they spend their time. I then combine this information with data on the concentration of fecal matter in different environmental reservoirs to estimate a child’s ingestion of fecal matter and the assess the primary pathways of fecal transmission. Taking a child’s perspective to understand fecal-oral transmission, this work suggests pathways of intervention that deserve further attention in the effort to reduce sickness and death from diarrhea and other fecal-oral diseases.