In the world, Hygiene has been a major issue since antiquity as evidenced by the mobilization of the international community for its promotion [1]. Lack of hygiene is the basis of manual pathologies such as gastro pathologies-intestinal which constitute a real public health problem worldwide [1].

In sub-Saharan Africa, gastrointestinal pathologies also represent a major public health problem mainly in environments with poor hygienic conditions [2]. Today, it is estimated at more than 2.5 billion people worldwide, including 550 million in sub-Saharan Africa who do not have minimum hygiene conditions, according to the recent report of the joint WHO/UNICEF program on water, Hygiene and Sanitation (EHA) [3] [4] [5]. Human health risks are undoubtedly the most serious and widespread problem. Each year, around 3.5 million people die from manual diseases, especially in developing countries [6] [7]. The organization of several forums on Water, Hygiene and Sanitation (WASH) (Marrakech in 1997, The Hague in 2000, Kyoto in 2003, Mexico in 2006 and Senegal in 2012) testifies to the magnitude of this problem in developing countries [8]. In these countries, poor hygiene and a lack of basic sanitation are the foundations of these numerous manual pathologies [3] [4] [9] [10]. The latter are themselves the causes of absenteeism from school and work, and therefore from a low level of education and significant economic and income losses across a developing country [3] [11]. They represent a huge burden for these countries [12] [13]. Indeed, the physical environment and the degree of cleanliness of WAH works have an impact on the health and well-being of learners. In the event that this environment does not have acceptable sanitation and hygiene conditions such as hand washing facilities and toilets in good condition, the diseases develop and spread quickly. It becomes a high-risk space for the latter by accentuating their vulnerability to manual illnesses, especially gastrointestinal [14]. However, the provision of hygiene and sanitation facilities could reduce these manual diseases by almost 90% [15] [16] [17].

In Côte d’Ivoire, the level of hygiene and sanitation is still low despite the establishment of a policy to improve the living conditions and well-being of the populations [18].

This low level of hygiene recorded among students at the Félix Houphouët-Boigny University of Côte d’Ivoire [19] [20] and the promiscuity observed led to a study whose objective was to determine the microbial ecology of the germs present in the sanitary surfaces of university toilets. We thought it appropriate to assess microbial germs by emphasizing those capable of transmitting gastrointestinal infections in the sanitary toilets of students and staff of the Félix Houphouët-Boigny University.

The study was carried out in the toilets of students and staff at the Félix Houphouët-Boigny University in Cocody (Abidjan, Côte d’Ivoire). It is located between 5˚20 and 5˚38 north latitude and 3˚58 and 3˚59 west longitude (Figure 1). It is the main University of Côte d’Ivoire. To date, it has received more than 60,000 students [21].

This study highlighted the presence of total coliforms, Escherichia spp and Salmonella spp at the Félix Houphouët-Boigny university. The overall proportions are 21.27% for Escherichia spp, and 1.17% for Salmonella spp at the level of the staff toilets. On the other hand, the overall proportions are 51.51% for Escherichia spp, and 4.54% for Salmonella spp at the level of the staff toilets. However, the absence of Pseudomonas spp has been reported.

The results showed that the university environment of toilets has potentially pathogenic microorganisms. These results are corroborated with the studies of Rutala and collaborators on the one hand, and of Weber and collaborators on the other hand. Indeed, according to these authors, the human environment is largely contaminated by specifically environmental microorganisms [22] [23]. This contamination varies qualitatively and quantitatively over time. They also demonstrated that the capacity to create an infection results from a combination of factors associating the level of expression of the virulence factors of the microorganism, its quantity or its concentration, the mode of contamination and the receptivity of the host.

The contact surfaces of the hands in the toilets presented a bacterial flora in particular enterobacteria. These results are in agreement with that of Munoz and collaborators who have demonstrated the presence of bacteria at the contact surfaces of door handles in a university health center [24].

According to our results, the microbial flora detected at our study site consists of the genera Escherichia and Salmonella. It should be noted that this flora found on surfaces depends on several factors such as human activity which leads to an intake of microorganisms. Without effective bio-cleaning, the survival of these microorganisms on surfaces can be very prolonged. Escherichia spp bacteria can survive for 1.5 hours to 16 months on dry, inert surfaces [25]. In addition to the quality of the bio-cleaning, surface contamination depends on many factors linked to the microorganism: its life on an inert support (which varies depending on the material, temperature, drying), its adhesion to the surface, its ability to produce a biofilm and its ability to withstand adverse conditions [26] [27].

In our study, the genus Escherichia occupied the first place of enterobacteria. This abundance could be explained by their predominance in the optional aerobic-anaerobic flora of the digestive tract in humans and in many animal species on the one hand, and on the other hand by their undemanding living conditions [28] [29]. It has been noted that Escherichia spp is responsible for the most common in especially nosocomial infections and is much less resistant to desiccation [27] [30]. The absence of the genus Pseudomonas could be due to the method of analysis which is likely to be poorly suited to these. The microorganisms of human origin or specifically environmental present in the environment belong to opportunistic species and to pathogenic species for humans. It should be noted that most infections linked to environmental contamination are still poorly documented, with the exception of those linked to some microorganisms of environmental origin [31] [32] [33].

Controlled epidemiological studies show an association between infection and exposure to a contaminated environment is still rare [34] [35] [36] [37].

The most contaminated sites were the toilet seats, the push buttons and the tap heads and taps. This situation is linked to the fact that these materials are frequently exposed to faeces. This observation is confirmed by Marty [38]. For this author, this significant colonization of sites constitutes a real risk of manual transmission of bacilli which can be the source of infection [28]. In order to reduce this manual transmission to the handles of hygienist authors like Séguier in Strasbourg, proposed the use of ULNA door handles.

Concerning isolated bacteria, a high proportion of Gram-negative bacilli is noted.

The presence of Escherichia spp coli, a witness to faecal contamination confirms poor hygiene in our university structure. If these germs present themselves as opportunistic agents for the sick, the strains of Salmonella spp isolated in the present study constitute a major infectious risk for the students and the staff of the Félix Houphouët-Boigny University because they are specific pathogenic bacteria.

The limits of this study could be located in the analysis of samples. This analysis focused more on classical microbiology. High proportions of bacteria could be obtained if one had to use culture media more specific to germs.

The genera Escherichia spp and Salmonella spp are bacteria present on the contact surfaces of university surfaces of student toilets. The most abundant proportions were obtained in the area of student toilets (Escherichia spp: 51.51% and Salmonella spp: 4.54%). The most contaminated areas in order of abundance are toilet seats, push buttons; toilet tap heads and door handles. The presence of enterobacteria in the sanitary surfaces of the toilets of the Félix Houphouët-Boigny University represents a health risk for the university population. We recommend installing hand hygiene devices and regular cleaning of WASH sanitary facilities to limit the risk of faecal-oral contamination. The identification of the species of germs found and their resistance to different antibiotics will be the next step of the study.

Our thanks go to the heads of the training and research units, the heads of the cleaning service staff and the cleaning service staff of the Félix Houphouët-Boigny University. We also thank the managers and the technicians of central and veterinary laboratory of Bingerville (LCVB) in particular Mr ELOI ADJE and Mrs Traore Mariana épse AKE.

The authors declare no conflicts of interest regarding the publication of this paper.

N’gbesso, N.J.-P., Félicité, B., N’guessan, O.N.A.N., Serge, M., Arra, J.L.A. and Ahoua, A.A.C. (2020) Prevention of Gastrointestinal Pathologies: Comparative Study of the Microbial Flora of the Sanitary Surfaces of the Toilets of Students and Staff of the Félix Houphouët-Boigny University. Open Journal of Medical Microbiology, 10, 129-138. https://doi.org/10.4236/ojmm.2020.103011