{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:13:51Z","timestamp":1785428031020,"version":"3.56.0"},"reference-count":62,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014515","name":"CARTA","doi-asserted-by":"publisher","award":["19-57145"],"award-info":[{"award-number":["19-57145"]}],"id":[{"id":"10.13039\/100014515","id-type":"DOI","asserted-by":"publisher"}]},{"award":["19-57145"],"award-info":[{"award-number":["19-57145"]}],"id":[{"id":"https:\/\/ror.org\/01qv4nh82","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Reuse of human excreta and derivatives is becoming a common practice in areas with agricultural predominance. While in situ treated faeces through ecological sanitation (Ecosan), known as \u201cfaecal by-products\u201d are being used to sustain soil nutrients and improve on-site sanitation, the concern remains about the health risks related to the survival of pathogens in these by-products in the community of farmers. This study assessed the survival of faecal pathogens and estimated microbial risks associated with the use of Ecosan faecal by-products in agriculture. The quantitative microbial risks assessment (QMRA) framework was used to estimate the risks posed by each faecal pathogen in solid and semi-solid faecal by-products under the probabilistic model of Monte Carlo simulation. Ascaris lumbricoides (6.5 eggs\/gr), Taenia species (0.3 egg\/gr), Schistosoma species (9.3 cercariae\/gr), Entamoeba species (4.4 cysts\/gr), and Escherichia coli (451 Cfu\/gr) were detected in semi-solid faecal products. Exposure scenarios were observed throughout four critical points: vault faecal by-products removal\/unloading, transport, collection, and application of faecal by-products in the gardens. Due to the presence of eggs and cysts, an estimated annual risk of infections was found in semi-solid faecal by-products with Schistosoma species (88%) and Ascaris lumbricoides (90%). Both concentrations were above World Health organisation (WHO) standards of associated infective risks of 0\u201310% of helminths in faecal sludge applied in the gardens. The users of faecal by-products, particularly farmers are exposed not only to high concentrations of helminth eggs but also to protozoa and bacteria with infective risks of Entamoeba species (99%) and E. coli species (62%). A stepwise implementation of faecal pathogens die-off during treatment of faecal by-products in compliance with the WHO\u2019s 2018 guidelines can prevent the use of unsanitary faecal by-products. According to these findings, the proper control of intestinal protozoa and soil-transmitted helminths (STHs) should be enforced through personal protective measures in Burera district, Rwanda.<\/jats:p>","DOI":"10.3390\/ijerph23060816","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:52:11Z","timestamp":1782453131000},"page":"816","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Faecal Pathogen Survival and Risks of Use of Ecological Sanitation By-Products in Burera District, Rwanda: A Quantitative Microbial Risks Assessment"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2817-2926","authenticated-orcid":false,"given":"Celestin","family":"Banamwana","sequence":"first","affiliation":[{"name":"Department of Environmental Health, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 3286, Rwanda"},{"name":"The Emerging and Re-Emerging of Infectious Diseases (TERID) Research Hub, College of Veterinary Medicine, Animal Resources and Bio-Security, Makerere University, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3262-3918","authenticated-orcid":false,"given":"David","family":"Musoke","sequence":"additional","affiliation":[{"name":"Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4870-6251","authenticated-orcid":false,"given":"Theoneste","family":"Ntakirutimana","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, College of Medicine and Health Sciences, University of Rwanda, Kigali P.O. Box 3286, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4410-8027","authenticated-orcid":false,"given":"Esther","family":"Buregyeya","sequence":"additional","affiliation":[{"name":"Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8289-2844","authenticated-orcid":false,"given":"John","family":"Ssempebwa","sequence":"additional","affiliation":[{"name":"Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8680-543X","authenticated-orcid":false,"given":"Gakenia Wamuyu","family":"Maina","sequence":"additional","affiliation":[{"name":"Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3160-6657","authenticated-orcid":false,"given":"Charles Drago","family":"Kato","sequence":"additional","affiliation":[{"name":"The Emerging and Re-Emerging of Infectious Diseases (TERID) Research Hub, College of Veterinary Medicine, Animal Resources and Bio-Security, Makerere University, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5432-6407","authenticated-orcid":false,"given":"Lordrick","family":"Alinaitwe","sequence":"additional","affiliation":[{"name":"The Emerging and Re-Emerging of Infectious Diseases (TERID) Research Hub, College of Veterinary Medicine, Animal Resources and Bio-Security, Makerere University, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6552-9392","authenticated-orcid":false,"given":"Patrick Albert","family":"Ipola","sequence":"additional","affiliation":[{"name":"The Emerging and Re-Emerging of Infectious Diseases (TERID) Research Hub, College of Veterinary Medicine, Animal Resources and Bio-Security, Makerere University, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7085-8780","authenticated-orcid":false,"given":"Nazarius Mbona","family":"Tumwesigye","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"ref_1","unstructured":"Fuhrimann, S. (2017). Health Risk Assessment Along Wastewater Recovery and Reuse Systems in Kampala, Uganda and Hanoi, Vietnam. [Ph.D. Thesis, Faculty of Science, University of Basel]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/S2095-3119(13)60407-4","article-title":"Use of Human Excreta as Manure in Rural China","volume":"13","author":"Liu","year":"2014","journal-title":"J. Integr. 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