Abstract
As in many low- and middle-income countries around the world, thousands of local communities in Southeast Asia rely on river water to sustain their livelihoods. However, poor water quality threatens the health of both humans and ecosystems. The aim of this review was to examine the available literature to investigate how health outcomes in Malaysia have been studied and reported as directly attributable to human infections from river water. Computer-aided searches from 10 electronic databases were undertaken, with searches limited to the English language and publication dates since January 2010. The literature search revealed that the predominant river water infections identified in Malaysia were bacterial (coliforms,Salmonellaspp., typhoid, leptospirosis, melioidosis), viral (including dengue, hepatitis, enterovirus), parasitic infections including amoebiasis, giardiasis and cryptosporidiosis, helminth infections,Blastocystisinfections and sarcocystosis. No studies were found that have attempted to evaluate the impact of water related infection on human health longitudinally. Moreover, the possibility of integrated water governance systems that could reduce infection and improve water quality, particularly for marginalized groups have not been discussed or studied. Several cross-sectional studies identified infections at a point in time, but large longitudinal data sets of water infection parameters and how they influence human health outcomes have not been reported. Using Malaysia as a demonstration case study, we suggest a number of recommendations based on using a systems approach to tackle the challenges involved in data collection and integration, which is central to the understanding, strategic planning and management of water-borne infections.
Highlights
In Southeast Asia (SEA), thousands of local communities rely on river water for sustainable livelihoods; this may be through operating fisheries, coastal farming or tourism
Most water pollution in Malaysia is caused by human activities such as surface water pollution from point sources such as industrial effluents, leachate from unsanitary landfills, substandard sewage effluents and pollution at non-point sources from pesticides and herbicides used in agriculture activities
This review focuses on understanding the prevalence and the impact of infections on humans related to water in various parts of Malaysia in the last 10 years
Summary
In Southeast Asia (SEA), thousands of local communities rely on river water for sustainable livelihoods; this may be through operating fisheries, coastal farming or tourism These economic activities form an important water-food nexus, which has driven regional socioeconomic development for more than 40 years (Blancas and El-Hifnawi, 2014; Pangare et al, 2014). Global burden of disease assessments over the last 25 years have allowed the influence of water accessibility, sanitation and hygiene (WASH) practices on health outcomes to be estimated (Prüss-Ustün et al, 2014). They are commonly reported in the context of communicable diseases such as diarrhoeal illnesses, nematode infections, lymphatic filariasis, trachoma, schistosomiasis, malaria and dengue (Prüss-Ustün et al, 2014; Troeger et al, 2017). The burden of disease at the country level is often by inference and association with water sources, such as river water, rather than a well-documented pathway from exposure at the river to disease development
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