{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:39:56Z","timestamp":1787319596152,"version":"build-2736575974"},"reference-count":61,"publisher":"Wiley","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Consortium for Advanced Research Training in Africa"},{"name":"Southern African Consortium for Research Excellence"},{"name":"Scotland Chikwawa Health Initiative"},{"name":"University of Malawi"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Environmental and Public Health"],"published-print":{"date-parts":[[2017]]},"abstract":"<jats:p>\n                    Use of Ecological Sanitation (EcoSan) sludge is becoming popular due to increasing price of organic fertilizers in Malawi; however, there is little evidence on the associated risks. Quantitative microbiological risk assessment (QMRA) was done to determine health risks associated with use of EcoSan. Pathogens considered included\n                    <jats:italic>Escherichia coli (E. coli)<\/jats:italic>\n                    ,\n                    <jats:italic>Salmonella,<\/jats:italic>\n                    and soil transmitted helminths (STHs). Exponential and Beta Poisson models were used to estimate the risk from helminthic and bacterial pathogens, respectively. Main exposure pathways were through poor storage of sludge, contamination of foods during drying, walking barefoot on the ground contaminated with sludge, pit emptying without protection, and application of sludge in the fields. Estimated annual risk for\n                    <jats:italic>Ascaris lumbricoides, Taenia, and<\/jats:italic>\n                    hookworms was approximately over 5.6 \u00d7 10\n                    <jats:sup>\u22121<\/jats:sup>\n                    for both Fossa Alternas (FAs) and Urine Diverting Dry Toilet (UDDTs). Risk from\n                    <jats:italic>E. coli<\/jats:italic>\n                    and\n                    <jats:italic>Salmonella<\/jats:italic>\n                    was 8.9 \u00d7 10\n                    <jats:sup>\u22122<\/jats:sup>\n                    and above. The risks were higher than WHO acceptable risk for use of faecal sludge in crops of 10\n                    <jats:sup>\u22124<\/jats:sup>\n                    infections per year. Promoters and users of EcoSan latrines need to consider advocating for strict guidelines to reduce the risk.\n                  <\/jats:p>","DOI":"10.1155\/2017\/3931802","type":"journal-article","created":{"date-parts":[[2017,11,8]],"date-time":"2017-11-08T18:31:29Z","timestamp":1510165889000},"page":"1-13","source":"Crossref","is-referenced-by-count":20,"title":["Estimating the Health Risk Associated with the Use of Ecological Sanitation Toilets in Malawi"],"prefix":"10.1155","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3329-5875","authenticated-orcid":true,"given":"Save","family":"Kumwenda","sequence":"first","affiliation":[{"name":"College of Medicine, University of Malawi, P\/Bag 360, Chichiri, Blantyre 3, Malawi"},{"name":"The Polytechnic, University of Malawi, P\/Bag 303, Chichiri, Blantyre 3, Malawi"},{"name":"Sanitation and Hygiene Applied Research for Equity (SHARE), London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chisomo","family":"Msefula","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Malawi, P\/Bag 360, Chichiri, Blantyre 3, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfred","family":"Kadewa","sequence":"additional","affiliation":[{"name":"Lilongwe University of Agriculture and Natural Resources, P.O. 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