ABSTRACT Three-panel summary linking household and environmental conditions, emptying methods, and predictors of unsafe emptying. Unsafe practices are associated with lower education, larger household size, prior overflow, and proximity to water sources. Unsafe pit-latrine emptying remains a major challenge in faecal sludge management in peri-urban areas of low- and middle-income countries due to inadequate infrastructure and weak regulation. This study assessed pit-latrine emptying practices, disposal routes, operator safety, and their association with sanitation-related illness in a peri-urban community in Ghana. A cross-sectional mixed-methods design was used, comprising a household survey of 375 households, interviews with ten pit-emptying operators, and field observations. Although mechanized vacuum trucks were commonly used, 79.7% of emptying events resulted in open environmental disposal. Multivariable analysis showed that unsafe emptying was significantly associated with lower educational attainment (odds ratio = 3.61), larger household size (odds ratio = 1.38), proximity to a water source within 100 m (odds ratio = 2.44), and a history of pit overflow (odds ratio = 4.19). Most operators lacked formal training, and consistent use of personal protective equipment was limited. Households practicing unsafe emptying had higher odds of reporting diarrhoeal illness (odds ratio = 3.21). These findings highlight persistent failures in faecal sludge management and the need for stronger regulation, safer disposal options, and improved oversight of pit-emptying services.
Manu et al. (Mon,) studied this question.