Abstract
Information about the quality of rural drinking water sources can be used to manage their safety and mitigate risks to health. Sanitary surveys, which are observational checklists to assess hazards present at water sources, are simpler to conduct than microbial tests. We assessed whether sanitary survey results were associated with measured indicator bacteria levels in rural drinking water sources in Kisii Central, Kenya. Overall, thermotolerant coliform (TTC) levels were high: all of the samples from the 20 tested dug wells, almost all (95%) of the samples from the 25 tested springs, and 61% of the samples from the 16 tested rainwater harvesting systems were contaminated with TTC. There were no significant associations between TTC levels and overall sanitary survey scores or their individual components. Contamination by TTC was associated with source type (dug wells and springs were more contaminated than rainwater systems). While sanitary surveys cannot be substituted for microbial water quality results in this context, they could be used to identify potential hazards and contribute to a comprehensive risk management approach.
Highlights
In sub-Saharan Africa, unsafe drinking water was estimated to cause more than 200,000 deaths in 2012 [1]
A study in Amuria District, Uganda, found that the water source type was a better predictor of fecal contamination than sanitary scores; boreholes had the best microbiological water quality, followed by open dug wells, protected springs, and, surface water, but there was only
While we found that sanitary surveys were not a substitute for microbial water quality testing results in this context, they did identify many faults in the water sources, in sources considered by communities to be protected
Summary
In sub-Saharan Africa, unsafe drinking water was estimated to cause more than 200,000 deaths in 2012 [1]. Water quality testing is expensive and complicated: collecting and testing water samples requires labor, equipment, consumables, transportation, and training [5,6,7]. Given the large amount of resources required for testing water quality, there is a need to improve its cost-effectiveness. Sanitary surveys can be completed quickly and require no special equipment, making them less expensive and easier to implement than microbiological testing [6,8]. Previous research on whether risks assessed through sanitary surveys correspond to measured water quality has produced mixed results and focused primarily on solely groundwater sources. A study in Amuria District, Uganda, found that the water source type was a better predictor of fecal contamination than sanitary scores (the sum of hazards present in the sanitary survey); boreholes had the best microbiological water quality, followed by open dug wells, protected springs, and, surface water, but there was only
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