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.

提高资源匮乏的共享卫生设施的质量并降低疾病风险需要既严格又实用的清洁度评估方法。使用三磷酸腺苷 （ATP） 生物发光测试，我们评估了肯尼亚基苏木 32 个共用厕所地点的高接触 （HT） 表面（内门把手）的污染。在公共厕所中，使用 0.5% 氯溶液进行清洁和消毒 （C&D） 后污染最低（调整后每₁₀₀ cm² 10 相对光单位 （aDiff） 的平均值差异：-1.61;CI： -2.43， -0.59），其次是含0.1%氯溶液的C&D （aDiff： -1.16;CI：-1.77、-0.55）。ATP 水平与整体可观察到的马桶清洁度无关，并且与目视评估的 HT 表面清洁度的一致性差。我们的研究结果证明了这种现场可行的方法在检测低资源共享厕所中近期C&D的影响的实用性，这是一种新的ATP清洁度测试环境，同时也强调了使用有效的C&D程序和在清洁协议中处理HT表面的重要性。