Researcher of the Month: Dr Amber Barnes

Our Researcher of the Month for June is Dr Amber Barnes, postdoctoral research associate at Duke University. Amber is the first author of a recent SHARE study on domestic animal ownership and household water contamination in peri-urban Kenya. Here, she tells us about her background, the key findings from this work and implications for future research and practice.

What is your background?
Growing up in a small, rural town exposed me to the importance of the human-animal relationship. After an undergraduate degree from Western Illinois University, I found myself drawn to public health and later global health. My graduate studies at the University of North Florida during my MPH and later at the University of Florida for my PhD solidified my passion for studying the epidemiology of zoonotic disease within populations reliant upon domestic animals for food, income, and cultural identity. For my dissertation, I was able to work with Oliver Cumming and SHARE to complete my research surrounding zoonotic WASH challenges and risk factors among peri-urban Kenyan households. This spring I completed a postdoctoral research associate position with Duke University’s One Health program investigating the prevalence of zoonotic enteric parasites in humans, animals and the environment across Mongolia. As of fall 2018, I will be a visiting instructor at the University of North Florida where I will continue my research into WASH factors and zoonoses.

How did this study come about?
My doctoral advisor Dr. Richard Rheingans at the University of Florida and Oliver Cumming from the London School of Hygiene and Tropical Medicine were co-investigators on a larger study to examine water, sanitation and hygiene inequities, household economic and social characteristics and environmental conditions as they relate to child health in Kisumu, Kenya supported by the SHARE Research Consortium through the UK Department for International Development. I realized that their project was lacking questions related to the role domestic animals may play in household WASH-related disease risks. Graciously, they allowed me to explore this area for my dissertation research by creating household survey questions related to animal contact and ownership, collecting observational data on domestic animal and animal waste presence at the participating households, sampling animal stool from the living spaces for future analysis of zoonotic enteric pathogens, and comparing this data to household water, sanitation, and hygiene factors including rates of fecal contamination among household drinking water samples.

What were the main findings from your study?
Despite almost all study households having access to an improved water source, the vast majority (67%) of household drinking water samples were contaminated with the fecal indicator bacteria enterococci, as demonstrated by laboratory analysis by colleagues from the International Centre for Diarrhoeal Disease Research, Bangladesh and Great Lakes University, Kisumu. This indicates that contamination is occurring after water retrieval but before consumption, likely somewhere inside the home. Although we have typically associated household drinking water contamination with traditional WASH factors such as access to improved water or water treatment, access to improved sanitation, and hand-washing behaviors, none of these components were related to our study households’ drinking water pollution. However, animal factors such as household ownership of a domestic animal or the observational recording of animal waste in the household’s living space were significantly associated with drinking water contamination. Therefore, we can postulate that at least some household drinking water contamination is due to contact with animals or animal waste inside or nearby the home.

Was there anything surprising or unexpected you found from the study?
Although I had theorized that close contact between household/community members and domestic animals would create multiple opportunities for zoonotic disease exposure and the potential transmission of fecal contaminants to food and water, it was still very surprising to see that among our study population, animal contact factors were more closely associated with the household drinking water contamination rates in comparison to the traditional WASH factors.

What further research is still needed on this topic?
The results of this study demonstrate the need for further research on the impact of domestic animals, drinking water contamination and zoonoses inside the home. I believe that future WASH studies should incorporate the question of how animals may be contributing to water and food contamination and overall household disease risks.

How might the findings of this study have implications for policy and/or practice?
Although access to safe WASH behaviors have proven critical to helping to prevent diarrheal and enteric diseases around the world, they often overlook the contribution of animals and animal waste within the household setting. I strongly encourage future WASH interventions and studies to incorporate zoonotic education and messages to create a more well-rounded curriculum to address the multiple disease risks faced in the home.