Drinking Water Quality As A Risk Factor of Stunting : A Systematic Review

ABSTRACK Background: Water represents an absolute medium to human life and other living things. However, water can also be the best media of diseases to spread. Therefore, before consumed, water has to be processed drinking to eliminate or degrade impure materials up to the safest level. As water becomes more problematic these days, it attracts the attention of drinking water refill depots to. Furthermore, dringking water that produce is not yet legalized and standardized in terms of its process. This research to know determine factors related to bacteriological quality of drinking water product drinking water refill in Semarang City. Methods :This research was an Explanatory Research. Using observation with a cross sectional approach. Samples are determined with standard error of 10% from 49 depots divided proportionally towards the spreading of depots throughout Semarang city. The variables used are a parameter of the bacteriologic number of coliform, E_Coli germs. Data analysis using Test correlation of kontingensi chi-square to know relation between variable. Results: The result of this research shows the relation to the variables using Chi-square test, it is shown that the condition of standard water and the condition of Bacteria of refill drinking water are C = 0,494, p = 0,0001, consequently Ho rejects it. Correlation test of instrument condition and the bacteriologic quality of refill drinking water showed that when C = 0,178, p = 0,447, Ho accepts it. While correlation test of processing of drinking water and the bacteriologic quality of refill drinking water showed that when C = 0,346, p = 0,035, Ho rejects it. Correlation test of hygienic officer of depot and the bacteriologic quality of refill drinking water shows that when C = 0,263, p = 0,162, so Ho accepts it. And correlation test of DAMIU sanitation and the bacteriologic quality of refill drinking water showed that C = 0,512, p = 0,0001, so Ho rejects it. Conclusions : All depots have not yet met the requirements of producing standard water as requested by Department of Health. The hygienic behavior of workers is still poor. The bacteriologic quality of refill drinking water based on the result of lab. test indicates that 34 samples ( 69,4%) have fulfilled the requirements of standard drinking water but the rest have not yet reached the minimum standard of drinking water. This matter is caused by the standard water which is used, the procedure of processing and the environmental condition of depot. Keyword; drinking water, refill depots, bacteriology quality

Diarrhoeal diseases kill an estimated 2.5 million people each year, the majority being children under 5 years (Kosek et al. 2003). An estimated 4 billion cases annually account for 5.7% of the global burden of disease and place diarrhoeal disease as the third highest cause of morbidity and sixth highest cause of mortality (Pruess et al. 2002). Among children under 5 years in developing countries, diarrhoeal disease accounts for 21% of all deaths (Parashar et al. 2003). By inhibiting normal consumption of foods and adsorption of nutrients, diarrhoeal diseases are also an important cause of malnutrition, leading to impaired physical growth and cognitive development (Guerrant et al. 1999), reduced resistance to infection (Baqui et al. 1993) and potentially long-term gastrointestinal disorders (Schneider et al. 1978). Infectious agents associated with diarrhoeal disease are transmitted chiefly through the faecal-oral route (Byers et al. 2001). A wide variety of bacterial, viral and protozoan pathogens excreted in the faeces of humans and animals are known to cause diarrhoea. Many of these are potentially waterborne – transmitted through the ingestion of contaminated water (Leclerc et al. 2002). Accordingly, a number of interventions have been developed to treat water. These include (i) physical removal of pathogens (e.g. filtration, adsorption and sedimentation); (ii) chemical treatment (e.g. assisted sedimentation, chemical disinfection and ion exchange); or (iii) heat and ultra violet (UV) radiation. Because of the risk of recontamination (Clasen & Bastable 2003), interventions to improve water quality also include steps to maintain the microbiological quality of safe drinking water, such as piped distribution, residual disinfection and improved storage. These efforts are expected to receive additional priority as a result of the United Nation’s commitment to reduce by one-half of the 1.5 billion people without sustainable access to improved water, one of the United Nation’s Millennium Development Goals (United Nations 2000), and by the World Health Organization’s steps to accelerate the health gains of safe water to the remaining population by improved treatment and storage of water at the household level (Sobsey 2002). Health authorities generally accept that safe water plays an important role in preventing outbreaks of diarrhoeal disease (Hunter 1997). Accordingly, the most widely accepted standard for water quality allows no detectable level of harmful pathogens at the point of distribution (WHO 1993). However, in those settings in which diarrhoeal disease is endemic, much of the epidemiological evidence for increased health benefits following improvements in the quality of drinking water has been equivocal (Esrey & Habicht 1986; Lindskog et al. 1987; Cairncross 1989). As many of these same waterborne pathogens are also transmitted via ingestion of contaminated food and other beverages, by person-to-person contact, and by direct or indirect contact with infected faeces, improvements in water quality alone may not necessarily interrupt transmission (Briscoe 1984). As a result of this variety of risk factors, interventions for the prevention of diarrhoeal disease not only include enhanced water quality but also steps to (i) improve the proper disposal of human faeces (sanitation), (ii) increase the quantity and improve access to water (water supply), and (iii) promote hand washing and other hygiene practices within domestic and community settings (hygiene). As in the case of studies of water quality, there is a wide range in the reported measure of effect on diarrhoea morbidity of each of these other environmental interventions (Esrey et al. 1985). Even more fundamentally, there are also questions about the methods and validity of studies designed to assess the health impact of such interventions (Briscoe et al. 1986; Imo State Evaluation Team 1989). As part of a larger evaluation of interventions for the control of diarrhoeal disease (Feachem et al. 1983), Esrey et al. (1985) reviewed 67 studies to determine the health impact from improvements in water supplies and excreta disposal facilities (Esrey et al. 1985). The median reduction in diarrhoeal morbidity from improved water quality was 16% (range 0–90%). This compared with 22% for Tropical Medicine and International Health

The ever-growing population of India, along with the increasing competition for water for productive uses in different sectors – especially irrigated agriculture and related local water systems and drainage – poses a challenge in an effort to improve water quality and sanitation. In rural and peri-urban settings, where agriculture is one of the main sources of livelihood, the type of water use in irrigated agriculture has complex interactions with drinking water and sanitation. In particular, the multi-purpose character of irrigation and drainage infrastructure creates several interlinks between water, sanitation (WATSAN) and agriculture and there is a competition for water quantity between domestic water use and irrigated agriculture. This study looks at the determinants of the microbiological quality of stored drinking water among households residing in areas where communities use different types of irrigation water. The study used multiple tube fermentation method 'Most Probable Number' (MPN) technique, a WHO recommended technique, to identify thermotolerant fecal coliforms and E. coli in water in the laboratory (WHO 1993). Overall, we found that the microbiological water quality was poor. The stored water generally had very high levels of Escherichia coli (E. coli) contamination, 80% of the households had water in storage that could not be considered potable as per the World Health Organization (WHO) standards, and 73% of the households were using a contaminated water source. The quality of household storage water was largely unaffected by the major household socioeconomic characteristics, such as wealth, education level or social status. Households using surface water for irrigation had poor drinking water quality, even after controlling for hygiene, behavioral and community variables. Drinking water quality was positively impacted by proper storage and water treatment practices, such as reverse osmosis. Hygiene and sanitation indicators had mixed impacts on the quality of drinking water, and the impacts were largely driven by hygiene behavior rather than infrastructures. Community open defaecation and high village-household density deteriorates household storage water quality.

The ever-growing population of India, along with the increasing competition for water for productive uses in different sectors – especially irrigated agriculture and related local water systems and drainage – poses a challenge in an effort to improve water quality and sanitation. In rural and peri-urban settings, where agriculture is one of the main sources of livelihood, the type of water use in irrigated agriculture has complex interactions with drinking water and sanitation. In particular, the multi-purpose character of irrigation and drainage infrastructure creates several interlinks between water, sanitation (WATSAN) and agriculture and there is a competition for water quantity between domestic water use and irrigated agriculture. This study looks at the determinants of the microbiological quality of stored drinking water among households residing in areas where communities use different types of irrigation water. The study used multiple tube fermentation method ‘Most Probable Number (MPN) technique, a WHO recommended technique, to identify thermotolerant fecal coliforms and E. coli in water in the laboratory (WHO 1993). Overall, we found that the microbiological water quality was poor. The stored water generally had very high levels of Escherichia coli (E. coli) contamination, 80% of the households had water in storage that could not be considered potable as per the World Health Organization (WHO) standards, and 73% of the households were using a contaminated water source. The quality of household storage water was largely unaffected by the major household socioeconomic characteristics, such as wealth, education level or social status. Households using surface water for irrigation had poor drinking water quality, even after controlling for hygiene, behavioral and community variables. Drinking water quality was positively impacted by proper storage and water treatment practices, such as reverse osmosis. Hygiene and sanitation indicators had mixed impacts on the quality of drinking water, and the impacts were largely driven by hygiene behavior rather than infrastructures. Community open defaecation and high village-household density deteriorates household storage water quality.

the bacteriological quality of drinking water plays a critical role in preventing waterborne diseases. In Ghana, there is water scarcity and many communities depend on contaminated water sources for their domestic use. This study aimed to assess the bacteriological quality of household drinking water in both cholera endemic and non-endemic areas in Greater Accra Region. a community-based cross-sectional comparative survey in cholera endemic and non-endemic communities was conducted. A total of 480 drinking water samples were collected. The membrane filtration technique was used for the quantification of coliform counts and Vibrio counts. The bacteria were further identified and characterized. The Kruskal Wallis rank test was used to determine any significant variations in the means of the log-transformed bacteria counts among specific factor variables. drinking water samples were contaminated with coliform counts exceeding the zero colony-forming units per 100 ml standard in most communities across cholera endemic and non-endemic areas. Vibrio counts were detected in all household water stored in vessels. Further characterization identified predominantly Klebsiella pneumonia and Escherichia coli. The coliform contamination levels were significantly higher in water stored in vessels compared to water directly obtained from the source. The contamination levels were generally higher during the wet season than the dry season. the household's stored drinking water and direct water sources were highly contaminated with coliform bacteria, posing a significant risk for the transmission of pathogenic waterborne diseases. Therefore, the need to implement an effective water treatment strategy to improve the quality of drinking water.

Sunstainable development principles suggest that health effects are associated with the result of complex issues affecting air, soil and water. In some areas in Indonesia, such as South Kalimantan province, water quality has been a problem due to both natural environmental hazards and anthropogenic activities. One of the water borne diseases which results as a sign of permanent damage to health is dental decay. Teeth also can provide an excellent record of nutritional status and environmental exposure.The Indonesian Basic Health Research Survey (2008) showed that the prevalence of dental decay was extremely high (83. 6 %). In addition, only 40 % of the people have access to a good quality source of drinking water and much of the drinking water quality was poor (58. 6 %). Tooth decay is a multi-factorial disease, related to socio-behavioural risk: unhealthy diet, poor oral hygiene, individual susceptibility; hereditary factors, and environmental risk factors. The aims of this research are to study the association between drinking water quality and the severity of dental caries in school children as well as investigate the associated environmental risk factors from the perspective of sustainable development principles. In this dissertation, quantitative & Qualitative methods are employed in a cross sectional study, with oral health examinations of 600 school children in 2 age group, 6 and 12 years old, of 300 children each.Study location covered 20 villages, 3 districts, in South Kalimantan Province, Indonesia. Interviewers investigated social risk factors. Drinking water samples were collected from 20 villages and tested through the laboratory analyses. To strengthen the evidence of the environmental exposure, a dental analysis using Laser Ablation Inductively Couple Plasma Mass Spectrometry (LA-ICP-MS) examined trace elements in selected 30 exfoliated deciduous teeth from the sample of 600 children. The study shows the prevalence of tooth decay is 99,7%; on average there are 11 decayed, exfoliated or filled deciduous teeth per person. This finding exceeding the target of oral global health set by WHO is of 50%, and no more than 7 tooth decay. Laboratory findings showed that 30 % of drinking water is outside the normal pH range of 6.5-8.5. Then, 95 % of fluoride concentration is below the optimum level (0.7 ppm) to prevent dental caries. In certain areas, manganese concentration exceeds the safety level of 0.4 ppm. Bivariate analysis showed significant correlations (p<0.05); the more acidic water, the lower the fluoride, the higher the dental caries. Manganese is positively associated with dental caries in deciduous teeth. The potential resource of manganese in this study found is the study site close to mining area. Turbidity and colour shows significant association with permanent teeth decay. Multivariate analysis shows covariate factors positively associated with tooth decay are oral hygiene index and consumption of sweet food, and inversely associated with consumption of milk and fruit. The result of mass Spectrometry through LA-ICP-MS shows that an individual has a unique pattern resulting from different concentration of trace elements in the tooth. Bivariate analysis showed significant (p<0.05) but moderate correlations between the dental caries index and concentrations of tin, mercury and uranium in dentine and inversely with copper in enamel. Concentration of fluoride in water is inversely correlated with selenium, tin, cerium, and lead in enamel, selenium and lanthanum in dentine and positively associated with, samarium, erbium in dentine. Water pH is positively correlated with arsenic and uranium in enamel and with samarium in dentine, and inversely with selenium in enamel and dentine. Socio-behavioural patterns vary among the school children in different villages. The findings support views of people that they have tooth decay due to poor quality water and that many teenagers failed the health examination of Army School entry test, in large part due to teeth decay. Hence, tooth decay also reflects poor environmental conditions and has consequences for future socio-political life, education and employment. A potential approach using local wisdom and applying religious approach in innovative methods in oral health promotion was also identified. Identification of trace elements in the teeth of schoolchildren was undertaken in order to associate levels with caries experience and the quality of local drinking water in communities with distinctive environmental conditions. Tooth decay in school children is highly prevalent and related to poor drinking water quality in certain areas. This needs to be taken into account as a potential indicator of general environmental problems. Interventions are not only treatment of cases and minimizing human exposures but also integrated action from sectors that generate environmental health threats. Environmental risk factors need to be taken into account as the subject of oral health promotion in preventing the high incidence of dental caries in school children.

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p&gt;&lt;em&gt;Unhealthy housing conditions will hurt human health, one of which is ARI. Based on data from the Stabat Health Center, ARI is among the top 10 diseases. Based on 2019 data, there were 1572 cases; the increase in cases occurred from 2020 to 1692, with 206 cases in Sidomulyo Village. Moreover, the physical condition of the houses in Sidomulyo still needs to meet the requirements of a healthy home. Based on the Basic Health Research (Riskesdas) report, the prevalence of stunting in Indonesia increased from 2016 to 2018, namely 27.5% in 2016, 29.6% in 2017, and 30.8% in 2018 (Riskesdas, 2018). Factors causing stunting are divided into direct causal factors and indirect causal factors. This study aimed to determine the relationship between household drinking water quality and the incidence of stunting in children aged 6-59. Observational research with a case-control design on children aged 6-59 months in the Talun Kenas Health Center Area, Deli Serdang Regency. The sampling technique was carried out by consecutive sampling with a total sample of 42 subjects in each group. Stunting was categorized based on TB/U score &amp;lt; -2 SD according to KEPMENKES RI anthropometric standard table. Drinking water quality was tested using a sanitarian kit—bivariate analysis using the Chi-Square test by looking at the Odds Ratio (OR). The results of the bivariate analysis show that the quality of household drinking water is associated with stunting in children aged 6-59 months (p=0.004; OR=4.144), meaning that the quality of drinking water that does not meet the requirements increases the incidence of stunting in children aged 6-59 months. This study concludes a significant relationship between the quality of household drinking water and the incidence of stunting in children aged 6-59 months.&lt;/em&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;

Background. Implementation of the Federal Clean Water Project within the National Housing and Urban Environment Project was based on the results of numerous health studies conducted within the framework of functioning of the interdepartmental system of public health monitoring and introduction of the risk-based approach into sanitary and epidemiological surveillance. In this regard, there was a need to develop a comprehensive approach to securing safety of drinking and recreational water use and assessing efficiency of implemented solutions. Objective. To assess efficiency of implementation of a system approach to ensuring safety of public drinking and recreational water use on the example of the Voronezh Region. Materials and methods. The study included laboratory testing of water quality in places of recreational water usage, drinking water quality assessment followed by a health risk assessment, a comprehensive evaluation of the extent of sanitary and epidemiological problems in drinking water supply systems, an online questionnaire-based survey of regional residents on tap water quality, a correlation analysis to establish the relationship between population health and water quality, and experimental studies to assess migration of organic compounds from polymer containers into bottled drinking water. Results. Challenges of recreational water use are associated with poor quality of surface water in terms of chemical (ammonium ion, nitrates, phosphates, and biochemical oxygen demand) and microbiological water quality parameters. Priority indices of drinking water quality in centralized water supply systems include the contents of nitrates, fluorine, boron, and iron, which are unacceptable in terms of non-carcinogenic risk (HQ &gt; 1). In disadvantaged areas, water quality in centralized drinking water supply systems is considered “extremely poor”. The online survey demonstrated that the majority of the population (30.7 %) prefers to use water filter jugs to treat tap water. We observed significant correlations between the quality of tap and surface waters and disease incidence rates in the population. We also obtained new data on migration of organic compounds from polymer containers intended for drinking water storage and bottling in case of storage temperature excursions. Conclusion. Our findings served as the basis for the proposed algorithm of implementing a system approach to securing safety of recreational and drinking water use and for evaluating the effectiveness of implemented solutions.

Research on the Drinking Water in Tartu in the Late 19th Century The 19th century witnessed positive developments in the maintenance of cities. Various medical and healthcare factors had a role in this, including the understanding of drinking water as a relevant component of applied hygiene. Discussions on the quality of water turned vehement after the nature of infectious diseases was explained, i.e., it was proved that they are caused and transmitted by different microorganisms. The presence of bacteria in water and the need for clean drinking water arising from it was still, however, not immediately unequivocal. The approach to cholera is an example of a model situation, where different theories collided. At the turn of the century there were two theories on the spread of the aforementioned infectious disease that also reached Tartu: the drinking water theory (created by Robert Koch) and the so-called groundwater level theory (Max v. Pettenkofer). The first predicated that the disease spreads in drinking water via disease agents. The other theory considered that the existence of certain favourable geological circumstances is relevant. Both theories fitted the scientific context of their times, i.e., they had strengths and weaknesses. Against the backdrop of the concern for the quality of drinking water, academics got involved in the discussion in Tartu as well. The research performed by Bernhard Korber, professor of hygiene at the University of Tartu, and his students persuaded the school of science here to support the drinking water theory. This was the right direction. Korber was socially active, which, in its turn, helped to shape the environment of Tartu in view of health care, including improving the quality of drinking water.

To ensure safe and quality drinking water for residents of rural settlements who use their own wells, boreholes, and natural sources for domestic water supply, a comprehensive approach to evaluating the quality of underground drinking water using geographic information system (GIS) technologies is necessary. The purpose of the study was to assess the quality of drinking water sources of noncentralized water supply in rural settlements of the united territorial communities (UTCs) of Zhytomyr district and to create geoinformation models based on the research results. The following research methods were used during the research: analytical, field, laboratory, statistical, calculation, and cartographic. The research was conducted in 129 settlements of 12 UTCs of Zhytomyr district, where drinking water samples were collected from noncentralized water supply sources for further analysis in the Measurement Laboratory of Polissia National University, and the creation of geoinformation models using the ArcGIS Pro software package. It has been proven that the average pH level in none of the studied settlements exceeded the norm. The average nitrate concentration in the drinking water from noncentralized water sources exceeded the norm by 1.4–3.5 times, specifically in the water of the Pulyny, Cherniakhiv, Vilshanka, Volytsia, and Oliivka communities, exceeding the maximum acceptable concentration (MAC) limit by more than two times. Only in rural settlements in the Liubar community was the average iron content found to be above the norm by more than 1.9 times. Overall, it was established that the calculated value of the overall water quality class in the Zhytomyr district was 2.03, which is determined as “good,” clean water of acceptable quality. The best water quality was found in the Vilshanka, Cherniakhiv, and Stanyshivka communities, with a quality class range of 1.85–1.93, while the worst water quality was recorded in the Oliivka, Teterivka, and Liubar communities, with a quality class range of 2.13–2.31. It was determined that the highest contribution to the overall water quality was made by nitrate and iron content. The obtained research results and models based on them can be used by local governments of the studied communities to inform the population about the quality of drinking water and to develop a plan for improving the state of drinking water supply with the aim of increasing the level of environmental safety of drinking water.

Physicochemical quality of drinking and hot waters in Finnish buildings originated from groundwater or surface water plants

Biological effect-based monitoring is essential for predicting or alerting to a possible deterioration in drinking water quality. In the present study, a reporter gene assay based on oxidative stress-mediated Pgst-4::GFP induction in the Caenorhabditis elegans strain VP596 (VP596 assay) was assessed for its applicability in evaluating drinking water safety and quality. This assay was used to measure the oxidative stress response in VP596 worms exposed to six ubiquitous components (As3+, Al3+, F-, NO3--N, CHCl3, and residual chlorine) in drinking water, eight mixtures of these six components designed through orthogonal design, ninety-six unconcentrated water samples from source to tap water in two supply systems, and organic extracts (OEs) of twenty-five selected water samples. Pgst-4::GFP fluorescence was not induced by Al3+, F-, NO3--N, and CHCl3, and was significantly enhanced by As3+ and residual chlorine only at concentrations higher than their respective drinking water guideline levels. Pgst-4::GFP induction was not detected in any of the six-component mixtures. Induction of Pgst-4::GFP was observed in 9.4% (3/32) of the source water samples but not in the drinking water samples. However, a notable induction effect was revealed in the three OEs of drinking water, with a relative enrichment factor of 200. These results suggest that the VP596 assay has limited utility for screening drinking water safety by testing unconcentrated water samples; however, it offers a supplemental in vivo tool for prioritizing water samples for an enhanced quality assessment, monitoring pollutant removal performance by drinking water treatment plants, and evaluating water quality in water supplies.

BackgroundEpidemiological evidence has shown that poor drinking water quality can lead to dyslipidemia, which might be associated with cognitive decline or lower domain‐specific cognitive function in older adults. Given the prevalence of water pollution, dyslipidemia, and dementia in China, it is important to examine the association between drinking water quality and cognitive function in older Chinese and to identify the direct and indirect effects of drinking water quality and dyslipidemia on their cognitive function.MethodPrimary data for the study were selected from China Health and Retirement Longitudinal Study (CHARLS, 2015) and 4,951 respondents aged 60 and above were included. Data on drinking water quality were selected from the 2015 prefectural water quality data from the Institute of Public and Environment Affairs in China. Mixed effects models were conducted to assess the associations of cognitive function with drinking water quality and dyslipidemia. The mediation effects of dyslipidemia were examined by path analyses.ResultExposure to high quality drinking water was significantly associated with higher scores in mental status, episodic memory, and global cognition (β = 0.34, p &lt; 0.001 for mental status; β = 0.24, p &lt; 0.05 for episodic memory; β = 0.58, p &lt; 0.01 for global cognition). Respondents who reported dyslipidemia diagnosis had higher scores in the three composite measures of cognitive function (β = 0.39, p &lt; 0.001 for mental status; β = 0.27 p &lt; 0.05 for episodic memory; β = 0.66, p &lt; 0.001 for global cognition). An elevated blood triglycerides was only associated with higher scores in mental status (β = 0.21, p &lt; 0.05). Self‐reported dyslipidemia diagnosis was a suppressor, which increased the magnitude of the direct effect of drinking water quality on mental status, episodic memory, and global cognition.ConclusionDrinking water quality was associated with cognitive function in older Chinese and the relationship was independent of natural or socioeconomic variations in neighborhood environments. Improving drinking water quality could be a potential public health effort to delay the onset of cognitive impairment and prevent the dementia pandemic in older people.

The health troubles due to poor drinking water quality are huge. The impact of increasing developmental activities, pollution and over-exploitation are altering the distribution of safe water. Besides this, the non-uniform distribution of rainfall due to changing climatic conditions aggravated the trouble. Both point and non-point sources of pollution affect the drinking water quality dominantly. The lack of education and awareness among community people and students about the drinking water quality are also key issues for health problems due to the consumption of contaminated water. Therefore, the knowledge of drinking water quality including health hygiene and sanitation aspects among students and community people is an urgent need. The present paper highlights the need of education about water quality, significant scientific information about the selected drinking water quality parameters, reasons of water quality deterioration, its health impacts etc.

This paper simultaneously explores temporal changes in drinking water quality and practices in peri-urban Peru. A mixed methodology approach was used, which included a household survey (n= 96) and analysis of water samples taken at source (n= 33 2006, n= 64 2007) and from households (n= 51 2006, n= 91 2007), during both the dry (2006) and rainy season (2007). Variations in practices were found, the most important being the type of water being used, but these changes were found to be contextual and linked to the termination of municipal piped water to the community, rather than seasonal. Seasonal changes in quality of ground water sources were found, but the change in the quality of the major water sources used for drinking and cooking were again not seasonal. A relationship between drinking water practices and quality was identified, due to household contamination of water, which was linked to perceived quality of source. Although the results from this study do not establish any link between seasonal drinking water quality and practices, evidence supporting the general hypothesis of this work was uncovered.