ArticleThe Science of the total environment2020
Child feces management practices and fecal contamination: A cross-sectional study in rural Odisha, India.
Article in The Science of the total environment, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Association between water, sanitation, and hygiene (WASH) practices and childhood stunting in low- and middle-income countries: a systematic review and meta-analysis.BMC public health · 2026Pooled it
- Does owning improved latrine facilities enhance the safe disposal of child feces in Africa? a systematic review and meta-analysis.PloS one · 2024Pooled it
- Improved Child Feces Management Mediates Reductions in Childhood Diarrhea from an On-Site Sanitation Intervention: Causal Mediation Analysis of a Cluster-Randomized Trial in Rural Bangladesh.Journal of epidemiology and global health · 2024Trial
- Effect of a behavior change and hardware intervention on safe child feces management practices in rural Odisha, India: a cluster-randomized controlled trial.BMC public health · 2024Trial
- Assessing sustained uptake of latrine and child feces management interventions: Extended follow-up of a cluster-randomized controlled trial in rural Bangladesh 1-3.5 years after intervention initiation.International journal of hygiene and environmental health · 2023Trial
- Antimicrobial-resistantmedRxiv : the preprint server for health sciences · 2026Article
- Socio-Demographic and Household Environmental Conditions Associated With Prevalence of Diarrheal Disease in Burao, Somaliland.Environmental health insights · 2026Article
- Factors associated with rural-urban safe disposal of children stools in Ghana.BMC research notes · 2024Article
- Multilevel factors drive child exposure to enteric pathogens in animal feces: A qualitative study in northwestern coastal Ecuador.PLOS global public health · 2024Article
- Using intersectionality to study gender and antimicrobial resistance in low- and middle-income countries.Health policy and planning · 2023Article
- A comparative pilot study on Gram-negative bacteria contaminating the hands of children living in urban and rural areas of Indonesia versus Germany - A suitable monitoring strategy for diarrhea risk assessment?Frontiers in microbiology · 2023Article
- PersistentEnvironmental science & technology · 2022Article
- Formative Research Using Settings and Motives to Explore Child Faeces Disposal and Management in Rural Solomon Islands.International journal of environmental research and public health · 2022Article
- Global practices, geographic variation, and determinants of child feces disposal in 42 low- and middle-income countries: An analysis of standardized cross-sectional national surveys from 2016 - 2020.International journal of hygiene and environmental health · 2022Article
- Study design and rationale for a cluster randomized trial of a safe child feces management intervention in rural Odisha, India.BMC public health · 2022Article
- Formative Research to Design a Child-Friendly Latrine in Bangladesh.International journal of environmental research and public health · 2021Article
- Impacts of an Urban Sanitation Intervention on Fecal Indicators and the Prevalence of Human Fecal Contamination in Mozambique.Environmental science & technology · 2021Article
- Article
- No Child's Play: Under-five Child Feces Management in a Rural Area of Bengaluru Urban District, India.Indian journal of community medicine : official publication of Indian Association of Preventive & Social MedicineArticle
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
Safe child feces management (CFM) is likely critical for reducing exposure to fecal pathogens in and around the home, but the effectiveness of different CFM practices in reducing fecal contamination is not well understood. We conducted a cross-sectional study of households with children <6 years in rural Odisha, India, using household surveys (188 households), environmental sample analysis (373 samples for 80 child defecation events), and unstructured observation (33 households) to characterize practices and measure fecal contamination resulting from CFM-related practices, including defecation, feces handling and disposal, defecation area or tool cleaning, anal cleansing, and handwashing. For environmental sampling, we developed a sampling strategy that involved collecting samples at the time and place of child defecation to capture activity-level fecal contamination for CFM practices. Defecating on the floor or ground, which was practiced by 63.7% of children <6 years, was found to increase E. coli contamination on finished floors (p < 0.001) or earthen ground surfaces (p = 0.008) after feces were removed, even if paper was laid down prior to defecation. Use of unsafe tools (e.g., paper, plastic bag, straw/hay) to pick up child feces increased E. coli contamination on caregiver hands after feces handling (p < 0.0001), whereas the use of safe tools (e.g., potty, hoe, scoop) did not increase hand contamination. Points of contamination from cleaning CFM hardware and anal cleansing were also identified. The most common disposal location for feces of children <6 years was to throw feces into an open field (41.6%), with only 32.3% disposed in a latrine. Several households owned scoops or potties, but use was low and we identified shortcomings of these CFM tools and proposed alternative interventions that may be more effective. Overall, our results demonstrate the need for CFM interventions that move beyond focusing solely on feces disposal to address CFM as a holistic set of practices.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.