Quality improvements and reduction of disease risk for low-resource shared sanitation facilities require cleanliness assessment approaches that are both rigorous and practical. Using Adenosine Triphosphate (ATP) bioluminescence testing, we assessed contamination on high-touch (HT) surfaces (inner door handles) at 32 shared toilet sites in Kisumu, Kenya. In public toilets, contamination was lowest after cleaning and disinfection (C&D) with 0.5% chlorine solution (adjusted difference in mean log₁₀ Relative Light Units per 100 cm² (aDiff): −1.61; CI: −2.43, −0.59), followed by C&D with 0.1% chlorine solution (aDiff: −1.16; CI: −1.77, −0.55). ATP levels were not associated with overall observable toilet cleanliness and had poor agreement with visually assessed HT surface cleanliness. Our findings demonstrate the utility of this field-feasible method for detecting the impact of recent C&D in low-resource shared toilets, a novel setting for ATP cleanliness testing, while also highlighting the importance of using effective C&D procedures and addressing HT surfaces within cleaning protocols.

资源匮乏的共享卫生设施的质量提高和疾病风险的降低需要严格且实用的清洁度评估方法。我们利用三磷酸腺苷 (ATP) 生物发光测试，评估了肯尼亚基苏木 32 个共用厕所点的高接触 (HT) 表面（内门把手）的污染情况。在公共厕所中，使用 0.5% 氯溶液清洁和消毒 (C&D) 后污染最低（每 100 cm ²平均对数₁₀相对光单位的调整差值 (aDiff)：-1.61；CI：-2.43，-0.59），其次是通过 C&D 使用 0.1% 氯溶液进行测定（aDiff：-1.16；CI：-1.77，-0.55）。 ATP 水平与整体可观察到的厕所清洁度无关，并且与目视评估的 HT 表面清洁度的一致性较差。我们的研究结果证明了这种现场可行的方法可用于检测近期 C&D 对资源匮乏的共享厕所的影响，这是 ATP 清洁度测试的一种新颖设置，同时还强调了使用有效的 C&D 程序和在清洁协议中解决 HT 表面问题的重要性。