ASSESSMENT OF THE OCCURENCE OF VIABLE HELMINTHES OVA IN FAECAL SLUDGE AND PIT DESLUDGING PRACTICES IN NAKURU COUNTY, KENYA

ABSTRACT
The use of pit latrines, their eventual fill up and need to desludge them expose humans and the environment to diseases associated with untreated excreta. Based on this, a study was done in Nakuru County to assess prescence of viable parasitic helminthes ova in faecal sludge and pit desludging and disposal practices used. Thirty five pit latrines were sampled and the prescence of parasitic helminthes ova determined at varius pit depths. Pit desludging and disposal practices was also analysed from a sample of 28 practitioners to determine their health safety level. One way analysis of variance (ANOVA) was used to determine significant differences in the occurrence of via ble helminthes ova in relation to pit depth. Where significant differences were found, Post Hoc tests (fisher‟s exact and Tukey) were done to establish the exact depths at which the significant differences occurred. Descriptive statistics were used to describe desludging practices in relation to occupational health challenges amongst those involved and in relation to environmental and public health. Results indicate that among the 128 samples collected, 23% (n=30) were found to bear viable helminthes ova. The ova identified belonged to seven species of helminthes, ie; Ascaris lumbricoides, Trichuris trichiura, Schistosoma haematobium, schistosoma mansoni, Taenia sp, Enterobius vermicularies and Necator americanus. A significant difference in the occurrence of total viable helminthes ova versus pit latrine depth was established. This meant that some depths had higher concentration of helminthes ova than others. A significant difference in the occurrence of viable Ascaris ova versus pit depth was also established meaning that some depths were higher in the concentration of Ascaris ova than others. Ascaris was the most dominant and persistent helminthes parasite in pit latrine faecal sludge suggesting that pit latrine sludge was still infective upon exposure to exhausters and the public. The fact that faecal sludge mixes up during desludging implies that there is a possibility of exposure from all the different species of helminthic parasites identified regardless of the depth from which one is emptying from. Proper handling, disposal and occupational safety by those desludging pit latrines should be ensured to prevent infections from the various hazards identified.

CHAPTER ONE
INTRODUCTION
Background information
Use of pit latrines is one of the most common forms of sanitation worldwide despite the fact that approximately 2.6 billion people do not have access to even this basic sanitation facility. Some of the places with the lowest sanitation coverage include Southern Asia and Sub-Saharan Africa of which Kenya is included where two-thirds of the population lack access to improved sanitation facilities (JMP, 2014). The World Health Organization (WHO) estimates show that 80 percent of all sicknesses and diseases are caused by polluted water, unavailability of water and inadequate sanitation (WEDC 1992). Improper disposal of faecal sludge lead to contamination of water sources which is the main way in which water borne diseases are transmitted. The disposal of faecal sludge inappropriately can be considered as a point source of faecal pollution in water and therefore a major environmental health hazard.

Pit latrines are commonly used in developing countries since they have several advantages over other forms of sanitation. Some of these advantages include; simple construction of the facility, low costs in construction and mantainance compared to other forms of sanitation and their acceptability by different communities globally. However, they have limitations that include bad smell, harbouring of flies, and their rapid fill up,that create problem of desludging and disposal of this faeacal sludge. This could easily cause public health risks and the possible contamination of underground and surface water sources. The fact that every pit latrine will eventually fill up and require emptying poses a health hazard. The speed with which pit latrines fill up depends on a number of factors which include; the number of users per day, amount of excreta produced per person per day and the rate of decomposition of excreta. Poor degradation in most pits result in building up of noxious and potentially hazardous material that must eventually be removed at a significant cost and risk to human and environmental health.

In urban areas, space is often a limiting factor when one decides to relocate a filled up pit latrine and thus opt to empty the pit instead. It is this increased demand for pit latrine emptying and disposal practices that forms the need to find safe methods of emptying and disposing of faecal sludge in terms of regulations and methods to be used. Unsafe emptying and disposal of faecal sludge from pit latrines poses a number of health risks that call for the need to identify appropriate technologies and policies in order to safeguard human and environmental health. Human infection with pathogens from the sludge may occur during emptying of faecal sludge where improper desludging procedures are used. Spillage of excreta during pit emptying and transportation may lead to contamination of surrounding ground and surface water that may eventually be consumed by humans.

Statement of the problem
Use of pit latrines is a common sanitation practice especially in developing countries, this results in concentration of faecal pathogens in these pit latrines that can easily infect other people when these latrines are emptied. Emptying of pit latrines is becoming a common practice especially in urban areas due to limited space for putting up new pit latrines to replace the filled ones. The pathogens present in faecal sludge in these latrines may infect people emptying them or those who may be in contact with the sludge at their disposal points. This calls for the need to understand the existence of pathogens in the faecal sludge and the sludge emptying practices to minimize the exposure of the public and the people exhausting the sludge to health risks associated with these pathogens. Though there is documentation on survival of pathogens in faecal sludge, little is known on the occurences of pathogens at different depths in a pit latrine.

Very few studies have been done to investigate the prevalence of pathogens in faecal sludge in Kenya and the types of pit latrine emptying practices. Nakuru municipality is an appropriate study area because of its rapid urban expansion with large parts of the urban and peri urban areas not served with a sewerage system. They rely on pit latrines and therefore faecal waste emptying and disposal is increasingly being practiced due to lack of space for new pit latrine construction.

Objectives of the study
Broad objective
To assess the disludging practices and the occurrence of viable helminthes ova in pit latrine faecal sludge in Nakuru County, Kenya.

Specific objectives
1) Assess the practices of faecal sludge emptying, transport and disposal practices I Nakuru County.

2) Assess how sludge handling practices are likely to impact on public, environmental and occupational health exposure in Nakuru County.

3) Identify the parasitic helminthes species present in faecal sludge in Nakuru County.

4) Determine the presence of viable helminthes ova in faecal sludge in pit latrines and their survival at different depths in Nakuru County.

Research questions
1) What are the sludge emptying, transport and disposal practices in Nakuru County

2) How is faecal handling practices likely to impact on public, environmental and occupational health exposure in Nakuru County?

3) Which species of helminthes are found in faecal sludge within Nakuru County?

4) Are there viable helminthes ova in faecal sludge at different pit latrine depths within Nakuru County?

Justification
The provision of basic sanitation to all remains a necessary and urgent task in Kenya. The government of Kenya is committed to reducing the back log in sanitation services, and more so through the recently decentralized government where counties have been mandated to act on water and sanitation affairs at the county level. The constitution of Kenya and vision 2030 are some of the policy instruments geared towards improved sanitation in Kenya. This is of significance since according to Water Sanitation Program, it is estimated that poor sanitation costs Kenya an equivalent to U.S $324 million each year. This sum is equivalent to U.S $ 8 per person per year or 0.9% of the national GDP. Majority of Kenyans use pit latrines as their main mode of faecal waste disposal and eventually the pit would need to be emptied especially in urban and Peri urban areas where space is a limiting factor.

The completion of a pit latrine infrastructure does not necessarily mean that enough sanitary conditions are guaranteed, unless it is accompanied by other essential services like proper use, excreta emptying, transport, treatment and disposal to ensure proper and sustainable sanitation. Inadequate information regarding pit emptying and disposal of faecal waste may hinder progress on sanitation programs in Kenya and specifically in Nakuru County and more so those involved in pit latrine emptying and disposal. Knowledge base on the above mentioned aspects will go a long way in ensuring that occupational safety and health of the workers involved in desludging and disposal of faecal sludge is upheld by those responsible through awareness creation.

Documenting the occurrence of viable helminthic ova at different depths in a pit latrine creates a knowledge base and a challenge for further research to come up with better technologies on pit latrine desludging and treatment that would ensure the containment of such parasites during pit desludging and disposal. The data generated from this study would thus be beneficial to key local, national and international actors and institutions involved formally or informally with the provision of adequate sanitation in line with SDGs, vision 2030, OSHA 2007 and the Constitution of Kenya on the need for adequate environmental, public and occupational health and safety as well as sanitation for all. Nakuru County has various sanitation policies but are not clear on how to handle faecal sludge while desludging, transporting and disposing. Proper enforcement on the available policies and laws on sanitation is also lacking.

Scope of the study
This study was part of a larger research project “scientific understanding of pit latrine processes in Nakuru County, Kenya. The study covered the aspects of sanitation in Nakuru County and especially on desludging and disposal practices of pit latrine contents, biodegradability of pit latrine contents and viability of helminthic ova in relation to pit depth among selected pit latrines in selected locations (Kaptembwa, Free area, Hilton, Njokerio and Jowatho) in relation to health and management of these sanitation systems. Data from the local players in the desludging and disposal of faecal sludge such as the County Government of Nakuru and those involved with exhausting was collected to identify the different methods of desludging and how the faecal sludge is disposed of thereafter and in relation to occupational, environmental and public health exposure.

The analysis of faecal sludge to establish the presence of viable helminthic parasites at different depths within pit vaults was done to establish if there are significant differences in their occurence. Sampling of faecal sludge was done by use of modified calibrated sampler.

Assumptions and limitations
The successful accomplishment of this study was based on the following assumptions and limitations;

1. There would be cooperation from all stakeholders involved, especially those involved in desludging and disposal of faecal waste.

2. That solid waste will not prevent the penetration of the sampler

3. Information given by the desludgers was correct to the best of their knowledge.

4. The pedestal hole would be wide enough for the sampler to pass through.

Definition of terms
Environmental sanitation - This refers to the interventions to reduce people‟s exposure to diseases by providing a clean environment in which to live. It is a measure to break the cycle of diseases and includes the hygienic management and or disposal of human excreta and the control of disease vectors.

Improved sanitation - The availability and use of a pit latrine (simple, VIP,) pour flush latrine, or a connection to a public sewer or a septic tank.

Basic sanitation - This refers to the management of human excreta at household level as used to describe the MDG target on sanitation.

Hygiene - This is the practice of keeping one self and the surrounding environment clean.

Adequate sanitation - Refers to one that provides privacy and separates human excreta from human contact

Onsite sanitation - Refers to the sanitation technologies where the human excreta are disposed permanently on site e.g. ventilated improved pit latrines or septic tank systems with soak away of pit waste.

Desludging – refers to the removal of faecal sludge from a pit latrine vault

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Item Type: Kenyan Material  |  Attribute: 52 pages  |  Chapters: 1-5
Format: MS Word  |  Price: KSh900  |  Delivery: Within 30Mins.
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