Abstract

This study seeks to improve the QMRA of drinking water sources in the context of developing countries. Existing QMRA dose–response models were modified to use data generated from the developing country environment and scenarios. The modified model assessed drinking water borehole supplies in Afikpo North Local Government Area, Nigeria. Water samples were taken every three days from July 2019 to December 2019. They were assessed for concentrations of E. coli, Salmonella spp, Shigella spp, Campylobacter, Giardia lamblia and Cryptosporidium parvum. Other input parameters to the modified model were obtained in the study environment through survey instruments; they include per capita water consumption per day, % exposed population, % vulnerable population and pathogen strike rate. The daily mean risk of infection was determined to be 0.236, standard deviation, 0.056, while the daily mean risk of diarrhea was 0.039, standard deviation, 0.016. The predicted mean diarrhea risk values showed a positive correlations (C = 0.74) with the observed diarrhea disease prevalence rate among the study communities. Mean values of diarrhea risk obtained using the modified model were compared with those obtained using formulations adopted by some recent studies that used existing QMRA models in the developing countries. The mean risk values were further compared with values obtained by using other existing QMRA dose–response models/parameters. The study found no statistical significant difference in the predicted risk of diarrhea of the two types of models. The modification is intended to facilitate a better interest on and the acceptability of QMRA in the developing countries.

Highlights

  • Water is an inevitable necessity of life

  • Since 1855, when John Snow scientifically established the link between cholera epidemic and microorganism (Vibrio cholera) in a drinking water source in England, many other microorganisms continue to be associated to other waterborne disease outbreaks across the world

  • More than 62% of the sampled population used water boreholes as a source of drinking water, but approximately 58% do not subject the water to any form of treatment before direct consumption (Table 4)

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Summary

Introduction

Water is an inevitable necessity of life. Access to sufficient quantity and quality of water is required for the maintenance of health and other human activities. Since 1855, when John Snow scientifically established the link between cholera epidemic and microorganism (Vibrio cholera) in a drinking water source in England, many other microorganisms continue to be associated to other waterborne disease outbreaks across the world. A major consequence of using or consuming water contaminated by microorganisms is high prevalence of gastro-intestinal diseases, leading to high morbidity and mortality globally. The prevalence of gastro-intestinal diseases claims more than 2.2 million people annually, mostly in developing counties (WHO 2020a). According to the World Health Organization [WHO] (2020b), Global Health Observatory (GHO) data for 2016, diarrhea disease, commonly caused by gastro-intestinal infections, ranks 9th among the 10 leading causes of death globally. Diarrhea can be caused by inadequate sanitation, poor hygiene, contaminated food or unsafe drinking water. It is estimated that contaminated drinking water alone causes 485,000 diarrheal deaths annually (WHO 2019)

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