Abstract
Packaged drinking water (PW) sold in bottles and plastic bags/sachets is widely consumed in low- and middle-income countries (LMICs), and many urban users in sub-Saharan Africa (SSA) rely on packaged sachet water (PSW) as their primary source of water for consumption. However, few rigorous studies have investigated PSW quality in SSA, and none have compared PSW to stored household water for consumption (HWC). A clearer understanding of PSW quality in the context of alternative sources is needed to inform policy and regulation. As elsewhere in SSA, PSW is widely consumed in Sierra Leone, but government oversight is nearly nonexistent. This study examined the microbiological and chemical quality of a representative sample of PSW products in Freetown, Sierra Leone at packaged water manufacturing facilities (PWMFs) and at points of sale (POSs). Samples of HWC were also analyzed for comparison. The study did not find evidence of serious chemical contamination among the parameters studied. However, 19% of 45 PSW products sampled at the PWMF contained detectable Escherichia coli (EC), although only two samples exceeded 10 CFU/100 mL. Concentrations of total coliforms (TC) in PSW (but not EC) increased along the supply chain. Samples of HWC from 60 households in Freetown were significantly more likely to contain EC and TC than PSW at the point of production (p<0.01), and had significantly higher concentrations of both bacterial indicators (p<0.01). These results highlight the need for additional PSW regulation and surveillance, while demonstrating the need to prioritize the safety of HWC. At present, PSW may be the least unsafe option for many households.
Highlights
Access to safe drinking water is critical to human health and development [1]
For the purpose of calculating log Escherichia coli (EC) and total coliforms (TC) concentrations, values of 0.5 CFU/100 ml were substituted for those samples in which no CFUs were detected
While packaged sachet water (PSW) samples at the points of sale (POSs) were collected in duplicate, the results of the first replicate POS sample were always used for hypothesis-testing and quantitative comparisons
Summary
Access to safe drinking water is critical to human health and development [1]. Efforts to ensure access to safe drinking water have historically focused on communal drinking water sources and piped supplies. The scale of PW consumption is substantial: in 2011, documented global bottled water (BW) sales exceeded 225 billion liters [2]. While statistics on sales of packaged sachet water (PSW, drinking water packaged in sealed plastic sleeves, typically 500-mL) are more difficult to obtain, consumption is increasing rapidly—especially in LMICs [3]. According to the 2011 Multiple Indicator Cluster Survey for Ghana, 18.3% of households listed PSW as their main source of water for consumption, 5.4% of rural households and 32.2% of urban households [4]. A recent study in a peri-urban area of Accra found that 47% of respondents listed PSW as their primary source of water for consumption [5]. The volumes of PSW consumed are often substantial relative to total daily drinking water consumption: a study of 137 PW users in Ibadan, Nigeria found that 58% consumed between two and four 500-mL sachets per day, while 28% consumed more than four sachets per day [6]
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