{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T03:53:33Z","timestamp":1782878013731,"version":"3.54.5"},"reference-count":70,"publisher":"IWA Publishing","issue":"6","license":[{"start":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:00:00Z","timestamp":1781308800000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["iwaponline.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Conceptual diagram linking faecal contamination in pour-flush latrines to pathogen exposure through hands, anal cleansing water containers, and footwears, with risk of faecal-oral, urinary tract, and soil-transmitted helminths infection.<\/jats:p>\n                  <jats:p>Microbial contamination from faeces to hands after latrine usage significantly increases the transmission risks of faecal\u2013oral infections. This is further exacerbated in regions using water-based anal cleansing and without adequate handwashing facilities. In Nepal, understanding latrine surface contamination is crucial as diseases such as typhoid and cholera are endemic, and 36% of the population lacks access to basic handwashing facilities. This study aims to assess latrine usage behaviours and faecal contamination levels (Escherichia coli) on frequently contacted household latrine surfaces of Ichchhakamana Rural Municipality, Chitwan. It includes analysis of the National Water, Sanitation, and Hygiene survey (n = 628) and latrine swab samples (n = 91) from eight latrines. E. coli densities on latrine surfaces were significantly associated with flush types, latrine location, and visible moisture and dirt. Households reporting diarrhoea had significantly higher E. coli on latrine surfaces (2.6 \u00d7 102 CFU\/25 cm2) than those without (12.3 CFU\/25 cm2) (p &amp;lt; 0.001), suggesting a possible diarrhoeal transmission pathway. It also highlights the potential risk of urinary tract infections, specifically for women from faecally contaminated anal cleansing water. Despite having improved sanitation infrastructures, findings emphasise the need for context-appropriate interventions that prioritise latrine cleanliness and safe hygiene to reduce pathogen transmission from latrines.<\/jats:p>","DOI":"10.2166\/wh.2026.136","type":"journal-article","created":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T16:05:38Z","timestamp":1781453138000},"page":"709-728","update-policy":"https:\/\/doi.org\/10.2166\/iwapcrossmarkpolicypage","source":"Crossref","is-referenced-by-count":0,"title":["Latrine surface contamination and hygiene practices in rural Nepal: implications for diarrhoeal diseases and urinary tract infections"],"prefix":"10.2166","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6388-6644","authenticated-orcid":false,"given":"Sabita","family":"Adhikari","sequence":"first","affiliation":[{"name":"a School of Civil Engineering, The University of Sydney, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6073-8646","authenticated-orcid":false,"given":"Erin C.","family":"Hunter","sequence":"additional","affiliation":[{"name":"b Department of Public Health Sciences, College of Behavioural, Social and Health Sciences, Clemson University, Clemson, South Carolina, USA"},{"name":"c School of Public Health, The University of Sydney, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4961-5933","authenticated-orcid":false,"given":"Giri","family":"Khatri","sequence":"additional","affiliation":[{"name":"d Water, Sanitation and Hygiene Program, Viva con Agua, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4497-6155","authenticated-orcid":false,"given":"Jack van de","family":"Vossenberg","sequence":"additional","affiliation":[{"name":"e Water Supply, Sanitation and Environmental Engineering Department, IHE Delft Institute of Water Education, Delft, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0520-7564","authenticated-orcid":false,"given":"Jacqueline","family":"Thomas","sequence":"additional","affiliation":[{"name":"a School of Civil Engineering, The University of Sydney, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"945","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"issue":"1","key":"key-10.2166\/wh.2026.136-1","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s12560-023-09580-1","article-title":"Transmission of viruses from restroom use: a quantitative microbial risk assessment","volume":"16","author":"Abney","year":"2024","journal-title":"Food and Environmental Virology"},{"issue":"3","key":"key-10.2166\/wh.2026.136-2","first-page":"387","article-title":"Prevalence and risk factors of gastrointestinal parasites in the Chepangs in Nepal","volume":"67","author":"Adhikari","year":"2021","journal-title":"Annals of Parasitology."},{"key":"key-10.2166\/wh.2026.136-3","doi-asserted-by":"crossref","first-page":"114261","DOI":"10.1016\/j.ijheh.2023.114261","article-title":"A review of latrine front-end characteristics associated with microbial infection risk; 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