Better understanding of how household and community sanitation affects child exposure to fecal contamination and diarrheal pathogens could improve the design of sanitation interventions in low-income urban communities. This project includes a case-control study to assess observable household and community sanitation characteristics as risk factors for child clinical diarrhea cases. It also includes an in-depth microbial sampling component to measure environmental fecal contamination among households with varying sanitation service levels.