title: Association between intestinal parasitic infections and type of sanitation system in rural El Salvador.
abstract: OBJECTIVE
  To identify demographic, behavioural and environmental determinants of intestinal parasitic infection, evaluate the impact of a variety of dry sanitation systems on intestinal parasitic infection, and evaluate the safety of using stored biosolids in agriculture in order to guide future sanitation interventions in rural areas of El Salvador.
  
  
  METHODS
  Interviews were conducted with 109 households in eight communities where double-vaulted and solar urine-diverting desiccating latrines, pit latrines or no latrines were used. Faecal samples from 499 individuals were tested for enteric helminths and protozoa.
  
  
  RESULTS
  Users of solar desiccating latrines had the lowest prevalence of enteric parasite infection. Double-vault, urine-diverting desiccating latrines effectively reduced the transmission of some pathogens, but may not achieve the conditions sufficient for the complete destruction of the more environmentally persistent pathogens, Ascaris lumbricoides and Trichuris trichiura. Contact with inadequately treated latrine biosolids was associated with an increased risk of Ascaris infection.
  
  
  CONCLUSIONS
  Solar latrines were associated with the overall lowest prevalence of enteric parasitic infections. Members of households where latrine biosolids were used in agriculture had a higher prevalence of infection than those where biosolids were buried. We therefore recommend the promotion of solar latrines in rural areas of El Salvador over other dry sanitation systems, and recommend that stored biosolids not be used in agriculture.
authors.affiliation: Hubert Department of Global Health, Emory University, Rollins School of Public Health, Atlanta, GA, USA.
authors.forename: Lana F
authors.initials: LF
authors.lastname: Corrales
authors.forename: Ricardo
authors.initials: R
authors.lastname: Izurieta
authors.forename: Christine L
authors.initials: CL
authors.lastname: Moe
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D004544:El Salvador / Q000453:epidemiology; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data; D014038:Toilet Facilities