Abstract
BackgroundAccess to potable water is grossly inadequate in Douala-Cameroon. The situation is worse in slum areas, compelling inhabitants to obtain water from sources of doubtful quality. This has contributed to frequent outbreaks of water-borne diseases particularly cholera, which results in severe morbidity and mortality. Shallow wells are a major source of water in these areas. We analyzed the influence of some factors on the bacteriological quality of well water in Bepanda and New Bell, cholera endemic localities in Douala to generate data that would serve as basis for strengthening of water and health policies.MethodsQuestionnaires were administered to inhabitants of study sites to appraise their hygiene and sanitation practices, and level of awareness of waterborne diseases. The bacteriological quality of water was determined by investigating bacterial indicators of water quality. Relationship between well characteristics and bacteriological quality of water was determined using χ2 test. The Kendall tau_b nonparametric correlation was used to measure the strength of association between well characteristics and bacteriological parameters. Statistics were discussed at 95% confidence level. Antibiotic susceptibility of isolates was investigated by the Kirby-Bauer and broth dilution techniques. Multidrug resistant species were tested for extended β-lactamase production potential.ResultsInhabitants demonstrated adequate knowledge of waterborne diseases but employed inappropriate method (table salt) for well disinfection. Well construction and location violated guidelines. Indicator bacterial counts greatly exceeded the WHO guidelines. Variation in bacteriologic parameters between sites was not significant (P > 0.05) since well characteristics and hygiene and sanitary practices were similar. Differences in bacteriologic quality with respect to state of well, and presence of molded casing and lid, and height of casing were not significant (P > 0.05). Well distance from sanitary structure negatively correlated with bacteriological characteristics indicating it could be a major contributory factor to poor water quality. Bacteria isolated were predominantly enteric organisms. Ciprofloxacin was the most active agent. Extended β-lactamase producers were detected among Salmonella species, Citrobacter fruendii and E. coli.ConclusionPoor well location, construction, and hygiene and sanitary practices were among the factors affecting water quality. There is an urgent need for education of inhabitants on effective water disinfection strategies and for regular monitoring of wells.
Highlights
IntroductionThe situation is worse in slum areas, compelling inhabitants to obtain water from sources of doubtful quality
Access to potable water is grossly inadequate in Douala-Cameroon
Douala has an average rainfall of 2900 mm per year with an equatorial climate of two seasons: the dry season which begins in November and ends in April, with January and February being the hottest months [14], and the rainy season begins from April to October, with August and September having the highest rainfall
Summary
The situation is worse in slum areas, compelling inhabitants to obtain water from sources of doubtful quality This has contributed to frequent outbreaks of water-borne diseases cholera, which results in severe morbidity and mortality. Many countries of the world are investing enormous resources to meet the growing demand for good quality water, the supply of potable water is still a great challenge in developing countries where urbanization, industrialization and rapid population growth in the context of limited financial resources has placed a burden on water resources [1] In these countries, lack or inadequate supply of potable water in addition to absence of basic sanitary and hygiene practices has resulted in increased morbidity and mortality from waterborne diseases among children less than 5 years old [2]. Overcrowding, poor hygiene and sanitation have subjected water in these wells to contamination with pathogenic organisms making them a potential source of health hazard
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