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Achieving safely managed sanitation (SMS) in rural areas has spurred innovation in toilet designs that provide on-site treatment of fecal sludge (FS), including the development of International Development Enterprise (iDE)’s alternating dual-pit latrine upgrade (ADP). ADPs treat FS by inactivating pathogens using storage treatment with lime; however, ADPs’ reduction in pathogenicity (and thus their associated public health benefit) has not yet been described in real-world pits at scale. We thus enumerate the fecal indicator bacteria Escherichia coli (E. coli) and fecal coliforms in 147 pits after two years of storage treatment with lime and compare detected concentrations to relevant standards. E. coli and fecal coliform concentrations indicated a risk to human health in 31% and 42% of sampled pits, respectively. Regression models described relationships between fecal indicator bacteria concentrations and measured factors (e.g., sludge pH, temperature) but did not reveal any meaningful associations. High rates of pit ineligibility also indicate that many ADPs are not operated as recommended. Results indicate a one-in-three chance that a household emptying their own pit would be exposed to health hazards and call into question the effectiveness of the standard two-year storage treatment in real-world applications. To improve rural SMS, various evidence-based recommendations are made.

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在农村地区实现安全管理卫生设施 (SMS) 刺激了厕所设计的创新，提供粪便污泥 (FS) 的现场处理，包括开发国际发展企业 (iDE) 的交替双坑厕所升级 (ADP) 。ADP 通过使用石灰进行储存处理来灭活病原体来治疗 FS；然而，ADP 致病性的降低（以及由此带来的相关公共卫生益处）尚未在现实​​世界中大规模描述。因此，我们对147个窖池经过石灰储存处理两年后的粪便指示菌大肠杆菌（ E. coli ）和粪大肠菌群进行了计数，并将检测到的浓度与相关标准进行了比较。大肠杆菌和粪便大肠菌浓度分别表明 31% 和 42% 的采样坑对人类健康构成风险。回归模型描述了粪便指示菌浓度和测量因素（例如污泥 pH 值、温度）之间的关系，但没有揭示任何有意义的关联。高比例的矿坑不合格率也表明许多 ADP 没有按照建议进行操作。结果表明，清空自家坑的家庭有三分之一的机会面临健康危害，并让人质疑标准两年储存处理在实际应用中的有效性。为了改善农村短信服务，提出了各种基于证据的建议。