Population density, sanitation, and health in urban Maputo: the MapSan Trial

The rapid trend towards urbanization in lower- and middle-income countries over the past half-century has significant implications for economic development, health, and the environment. There is an opportunity to understand how decentralized sanitation may affect environmental exposures and children’s health in dense, informal settlements of Sub-Saharan Africa, where pervasive contamination by fecal-associated microorganisms, including several pathogens, exists.

Led jointly by the London School of Hygiene and Tropical Medicine and Georgia Institute of Technology, this project aims to assess the impact of sanitation on a variety of health indicators such as incidence of diarrhea, soil-transmitted helminth infection, and anthropometric measurements, especially among children under five. Researchers from The Water Institute at UNC will design the MapSan Trial, a controlled before-and-after (CBA) study of shared sanitation in urban Maputo, Mozambique. The study evaluates a large-scale, shared sanitary latrine intervention in low-income communities and estimates the impact of sanitary latrine provision on the prevalence of enteric pathogens and environmental exposure to fecal microbes. Participating neighborhoods span a wide range of population densities in order to assess the effect of population density on the relationship between safe sanitation and children’s health. Dr. Stewart leads the analysis of environmental exposures. Researchers will translate the findings to inform policy decisions.

Results from this project could inform efforts to alleviate the burdens of fecal-related disease and environmental exposure to fecal contamination in similar informal, low-income settlements in Sub-Saharan Africa.

Water Institute Researchers and Staff

Jamie Bartram– Co-Principal Investigator
Pete Kolsky – Co-Principal Investigator
Jill Stewart– Co-Principal Investigator
Kaida Liang – Technical Advisor
David Holcomb – Graduate Research Assistant

The U.S. Agency for International Development administers the U.S. foreign assistance program providing economic and humanitarian assistance in more than 80 countries.