Household wastewater and excreta management practices and their health and environmental impacts in Ebolowa Cameroon

In secondary cities of sub-Saharan Africa such as Ebolowa (Cameroon), inadequate wastewater and excreta management poses serious public health and environmental challenges. This study assessed household sanitation practices and their health, economic, and environmental impacts through a cross-sectional survey conducted in 2023 across eight urban districts, involving 2,293 households. Data were collected using questionnaires, field observations, and health records, and analyzed with chi-square tests and logistic regression (p < 0.05). Results revealed widespread use of traditional pit latrines and uncontrolled wastewater disposal into pits, drains, or streets, leading to environmental contamination. Sanitation-related diseases, particularly malaria, typhoid, and amebiasis, were prevalent, especially among children under five, with monthly healthcare costs averaging 25,000–30,000 FCFA. The study underscores major infrastructure and governance gaps and advocates community-based, resource-oriented sanitation solutions to improve urban health sustainability.