Human, animal and environmental health are becoming increasingly interconnected particularly in resource constrained settings. An estimated 1 billion people worldwide live in informal settlements, generally characterised by their lack of access to basic services such as clean water, sanitation and health services. Consequently, enteric diseases are a significant public health concern in these low-income, high-density settings. Non-diarrhoeal pathogens such as helminths also contribute to the disease burden and malnutrition. This interconnectedness of humans, animals, and their environment requires a holistic One Health approach to understand pathogen carriage, survival and transmission pathways.
The Revitalising Informal Settlements and their Environments (RISE) programme is a transdisciplinary research program and randomized controlled trial in urban informal settlements of Fiji and Indonesia. To assess the extent of enteropathogen abundance within informal settlements, methods that can monitor several genera in a range of sample types are needed. TaqMan array card (TAC) technology represents one approach that has been successfully applied for the identification and semi-quantitation of enteric pathogens from human and environmental samples (water, soil, animal faeces). The RISE project teams have analysed over 1000 samples, representing one full program year (2019-2020) to start to understand seasonal variation across human, animal, and environments.
The results revealed notable differences in pathogen presence and abundance between Indonesia and Fiji. In Fijian samples, a total of 30 microbes overlapped between humans, animals, and environments, while in Indonesia, only 15 were observed, with distinct pathways of contamination (such as human-water and animal-soil) identified. This high degree of cross-connectivity in Fiji indicates that constant faecal contamination and close contact between humans, animals, and their environment may result in a consistent cycle of illness beyond anticipated seasonal trends. This study highlights the importance of establishing baseline pathogen data, within a One Health framework, before implementing targeted mitigation strategies such as those applied in water and sanitation programs.