The impact of shared sanitation facilities on diarrheal diseases with and without an environmental reservoir: a modeling study.

Epidemiological studies have identified an increased risk of diarrheal diseases associated with using shared sanitation facilities. We hypothesized that this might be related to differences in transmission routes of pathogens. We proposed a mathematical model of two fictitious pathogens, one transmitted with an environmental reservoir and one without. We assumed that individuals susceptible to one pathogen are not susceptible to the other, and therefore, decoupled the two models. We initialized the model with 99% individuals being susceptible. We sampled the parameter space using Latin Hypercube Sampling. We simulated 10,000 parameter sets. We varied the effective shared sanitation coverage (the product of latrine coverage and users' compliance). Our results show that, in our hypothetical scenario, across all levels of effective coverage of shared sanitation, the median final cumulative incidence of diarrheal disease was higher than that of zero coverage. Our simulation findings suggest that increasing effective coverage of shared sanitation may have limited benefits against diarrhea-causing pathogens with an environmental reservoir and may lack benefit against diarrhea-causing pathogens without an environmental reservoir given increased human contacts if latrines are poorly maintained.

CAHOST: An Excel Workbook for Facilitating the Johnson-Neyman Technique for Two-Way Interactions in Multiple Regression.

When using multiple regression, researchers frequently wish to explore how the relationship between two variables is moderated by another variable; this is termed an interaction. Historically, two approaches have been used to probe interactions: the pick-a-point approach and the Johnson-Neyman (JN) technique. The pick-a-point approach has limitations that can be avoided using the JN technique. Currently, the software available for implementing the JN technique and creating corresponding figures lacks several desirable features-most notably, ease of use and figure quality. To fill this gap in the literature, we offer a free Microsoft Excel 2013 workbook, CAHOST (a concatenation of the first two letters of the authors' last names), that allows the user to seamlessly create publication-ready figures of the results of the JN technique.