Environmental faecal contamination and associated health risks along multiple exposure pathways in Yatta Sub-County, Machakos County, Kenya.

Access to safe drinking water and sanitation is a fundamental human right. However, in many regions, particularly in low- and middle-income countries, the prevalence of faecal contamination of water poses health risks. In Kenya, a substantial portion of the population relies on unimproved water sources that are susceptible to faecal contamination from various environmental pathways, including open drains, surface water, and inadequate sanitation facilities. The SaniPath study framework provided a robust approach for assessing faecal exposure pathways by examining the behaviors and environmental factors contributing to contamination and was used in Yatta Sub-County, Machakos County. The study revealed significant faecal contamination across various environmental pathways. The highest E. coli concentrations were found in raw produce (4.09 Log₁₀ CFU/mL) and public latrines (3.87 Log₁₀ CFU/mL), suggesting a serious public health risks associated with these exposure routes. Adults and children frequently encountered contaminated water and food. The reliance on contaminated drinking water sources (mean concentration of 3.11 Log₁₀ CFU/mL) and high usage of public latrines underscore the necessity for urgent improvements in sanitation infrastructure and hygiene practices to mitigate possible health risks associated with faecal contamination.