{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T07:25:44Z","timestamp":1780989944991,"version":"3.54.1"},"reference-count":28,"publisher":"IWA Publishing","issue":"8","license":[{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Eawag, The Swiss Federal Institute of Aquatic Science and Technology,  Environmental Microbiology Unit, Pathogens and Human Health Group"}],"content-domain":{"domain":["iwaponline.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Escherichia coli (E. coli) pathotypes, particularly enteropathogenic and enterotoxigenic strains, are among the leading causes of moderate-to-severe diarrhea in low- and middle-income countries (LMICs). These pathogens are commonly transmitted through environmental media such as contaminated water, soil, and hands, often due to poor sanitation and hygiene. In this first phase of an ongoing longitudinal study, we conducted a cross-sectional assessment of E. coli contamination across multiple environmental compartments in 41 rural households in Daro Lebu Woreda, West Hararghe Zone, Eastern Ethiopia. Environmental samples were collected from drinking water, indoor and outdoor soil, and hand rinses of children under two and their mothers or caregivers to quantify E. coli levels and explore associations between contamination and household-level risk factors. From the data we collected, the source and risk factors for E. coli contamination are not readily apparent. These findings underscore the complexity of fecal contamination pathways in rural settings and highlight the need for integrated, multi-pathway interventions. Improving household hygiene behaviors, ensuring safe water storage, and upgrading sanitation infrastructure could significantly reduce exposure to enteric pathogens. Further large-scale and longitudinal studies are essential to better understand contamination dynamics and inform transformative WASH (Water, Sanitation, and Hygiene) interventions.<\/jats:p>","DOI":"10.2166\/wh.2025.050","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T12:31:32Z","timestamp":1753101092000},"page":"940-951","update-policy":"https:\/\/doi.org\/10.2166\/iwapcrossmarkpolicypage","source":"Crossref","is-referenced-by-count":1,"title":["Assessment of <i>Escherichia coli<\/i> contamination risk across different environmental media in rural Ethiopia"],"prefix":"10.2166","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4501-963X","authenticated-orcid":false,"given":"Alazar Negash","family":"Horecha","sequence":"first","affiliation":[{"name":"1 Department of Water and Health, Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4255-6264","authenticated-orcid":false,"given":"Seblework","family":"Mekonen","sequence":"additional","affiliation":[{"name":"1 Department of Water and Health, Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"945","published-online":{"date-parts":[[2025,7,21]]},"reference":[{"key":"2025091706561443800_JWH-D-25-00050C1","doi-asserted-by":"crossref","first-page":"2511","DOI":"10.1186\/s12889-024-20067-x","article-title":"Prevalence and epidemiological distribution of indicators of pathogenic bacteria in households drinking water in Ethiopia: a systematic review and meta-analysis","volume":"24","year":"2024","journal-title":"BMC Public Health"},{"key":"2025091706561443800_JWH-D-25-00050C2","doi-asserted-by":"crossref","first-page":"655","DOI":"10.2166\/wh.2019.224","article-title":"Do domestic animals contribute to bacterial contamination of infant transmission pathways? Formative evidence from Ethiopia","volume":"17","year":"2019","journal-title":"Journal of Water and Health"},{"key":"2025091706561443800_JWH-D-25-00050C3","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1021\/acsenvironau.2c00039","article-title":"Hands are frequently contaminated with fecal bacteria and enteric pathogens globally: a systematic review and meta-analysis","volume":"3","year":"2023","journal-title":"ACS Environmental Au"},{"key":"2025091706561443800_JWH-D-25-00050C4","first-page":"1","article-title":"Risk factors for childhood stunting in 137 developing countries: a comparative risk assessment analysis at global, regional, and country levels","volume":"13","year":"2016","journal-title":"PLoS Medicine"},{"key":"2025091706561443800_JWH-D-25-00050C5","unstructured":"Daro Lebu Woreda Agriculture Office (2023) Woreda Annual Report. Mechara: Woreda Administration Office."},{"key":"2025091706561443800_JWH-D-25-00050C6","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/j.ijheh.2018.03.005","article-title":"Pathogens transmitted in animal feces in low- and middle-income countries","volume":"221","year":"2018","journal-title":"International Journal of Hygiene and Environmental Health"},{"key":"2025091706561443800_JWH-D-25-00050C7","unstructured":"FAO (2017) Africa Sustainable Livestock 2050: Ethiopia Country Brief, Rome: FAO, pp. 1\u20135."},{"key":"2025091706561443800_JWH-D-25-00050C8","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.ajic.2016.06.035","article-title":"Handwashing, but how? Microbial effectiveness of existing handwashing practices in high-density suburbs of Harare, Zimbabwe","volume":"45","year":"2017","journal-title":"American Journal of Infection Control"},{"key":"2025091706561443800_JWH-D-25-00050C9","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/S0140-6736(07)60032-4","article-title":"Developmental potential in the first 5 years for children in developing countries","volume":"369","year":"2007","journal-title":"Lancet"},{"key":"2025091706561443800_JWH-D-25-00050C10","doi-asserted-by":"crossref","first-page":"102","DOI":"10.5005\/jp-journals-11002-0056","article-title":"Pathophysiology of enteropathogenic Escherichia coli-induced diarrhea","volume":"2","year":"2023","journal-title":"Newborn"},{"key":"2025091706561443800_JWH-D-25-00050C11","doi-asserted-by":"crossref","first-page":"129","DOI":"10.2166\/h2oj.2021.095","article-title":"Water, sanitation, and hygiene (WASH) in healthcare facilities of 14 low- and middle-income countries: to what extent is WASH implemented and what are the \u2018drivers\u2019 of improvement in their service levels?","volume":"4","year":"2021","journal-title":"H2Open Journal"},{"key":"2025091706561443800_JWH-D-25-00050C12","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1542\/pir.36.4.167","article-title":"Escherichia coli infections","volume":"36","year":"2015","journal-title":"Pediatrics in Review"},{"key":"2025091706561443800_JWH-D-25-00050C13","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1017\/S136898001500227X","article-title":"How consistent are associations between stunting and child development? Evidence from a meta-analysis of associations between stunting and multidimensional child development in fifteen low- and middle-income countries","volume":"19","year":"2016","journal-title":"Public Health Nutrition"},{"key":"2025091706561443800_JWH-D-25-00050C14","first-page":"e00704","article-title":"High genomic diversity and heterogenous origins of pathogenic and antibiotic-resistant Escherichia coli in household settings represent a challenge to reducing transmission in low-income settings","volume":"5","year":"2020","journal-title":"mSphere"},{"key":"2025091706561443800_JWH-D-25-00050C15","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1186\/s12916-022-02677-7","article-title":"Genomic epidemiology of Escherichia coli: antimicrobial resistance through a one health lens in sympatric humans, livestock and peri-domestic wildlife in Nairobi, Kenya","volume":"20","year":"2022","journal-title":"BMC Medicine"},{"key":"2025091706561443800_JWH-D-25-00050C16","doi-asserted-by":"crossref","first-page":"e0245910","DOI":"10.1371\/journal.pone.0245910","article-title":"The utility of Escherichia coli as a contamination indicator for rural drinking water: evidence from whole genome sequencing","volume":"16","year":"2021","journal-title":"PLoS ONE"},{"key":"2025091706561443800_JWH-D-25-00050C17","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1186\/s12879-024-09793-0","article-title":"Diarrhoeagenic Escherichia coli associated with childhood diarrhoea in Osun state, Nigeria","volume":"24","year":"2024","journal-title":"BMC Infectious Diseases"},{"key":"2025091706561443800_JWH-D-25-00050C18","doi-asserted-by":"crossref","first-page":"e0222355","DOI":"10.1371\/journal.pone.0222355","article-title":"Microbiological contamination of young children's hands in rural Bangladesh: associations with child age and observed hand cleanliness as proxy","volume":"14","year":"2019","journal-title":"PLoS ONE"},{"key":"2025091706561443800_JWH-D-25-00050C19","doi-asserted-by":"crossref","first-page":"5501","DOI":"10.2147\/IDR.S425728","article-title":"Trends in antibiotic resistance patterns and burden of Escherichia coli infections in young children: a retrospective cross-sectional study in Shenzhen, China from 2014 to 2018","volume":"16","year":"2023","journal-title":"Infection and Drug Resistance"},{"key":"2025091706561443800_JWH-D-25-00050C20","doi-asserted-by":"crossref","first-page":"11537","DOI":"10.1021\/acs.est.7b02811","article-title":"Exposure to animal feces and human health: a systematic review and proposed research priorities","volume":"51","year":"2017","journal-title":"Environmental Science & Technology"},{"key":"2025091706561443800_JWH-D-25-00050C21","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.2166\/wh.2023.174","article-title":"E. coli contamination of drinking water sources in rural and urban settings: an analysis of 38 nationally representative household surveys (2014\u20132021)","volume":"21","year":"2023","journal-title":"Journal of Water and Health"},{"key":"2025091706561443800_JWH-D-25-00050C22","doi-asserted-by":"crossref","first-page":"e0135676","DOI":"10.1371\/journal.pone.0135676","article-title":"The impact of water, sanitation and hygiene interventions to control cholera: a systematic review","volume":"10","year":"2015","journal-title":"PLoS ONE"},{"key":"2025091706561443800_JWH-D-25-00050C23","doi-asserted-by":"crossref","first-page":"e255","DOI":"10.1016\/S2214-109X(18)30045-7","article-title":"Global disability-adjusted life-year estimates of long-term health burden and undernutrition attributable to diarrhoeal diseases in children younger than 5 years","volume":"6","year":"2018","journal-title":"The Lancet Global Health"},{"key":"2025091706561443800_JWH-D-25-00050C24","unstructured":"UNICEF & WHO (2022) Joint Child Malnutrition Estimates. New York: UNICEF & WHO."},{"key":"2025091706561443800_JWH-D-25-00050C25","unstructured":"Wagner\n            E. G.\n          , LanoixJ. N. & World Health Organization (1958) Excreta Disposal for Rural Areas and Small Communities\/Edmund G. Wagner, J. N. Lanoix. World Health Organization Monograph Series; No. 39. Geneva: World Health Organization."},{"key":"2025091706561443800_JWH-D-25-00050C26","unstructured":"WHO & UNICEF (2023) Progress on Household Drinking Water, Sanitation and Hygiene 2000\u20132022: Special Focus on Gender. 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