Abstract
Unsafe drinking water is a leading cause of child morbidity, especially among young children in low‐income settings. Safe water consumption requires high‐quality water available at its source and at point of use. We examined the quality of drinking water at point of collection and point of use in 796 households in three provinces, in Cambodia. Microbiological testing for coliform and Escherichia coli contamination was conducted for samples collected. Bivariable analysis and multivariable logistic regression were used to examine associations between various factors and the deterioration in water quality (increase in the risk according coliform or E. coli concentration) between point of collection and point of use. Contamination with both coliforms and E. coli was higher at point of use than at point of collection, with contamination at point of collection to account for 76.6% (coliforms) and 46.3% (E. coli). Results suggest that child drinking water represents a considerable pathway for the ingestion of pathogens, in Cambodia. Area of residence, seasonality, type of water source, and water chlorination were associated with coliform concentration between the point of collection and point of use, whereas only seasonality was associated with E. coli contamination (OR = 1.46; 95% CI [1.05, 2.02]). Children living in rural settings were two times more likely to drink water with a deteriorating coliform concentration between the two‐time points than children living in urban settings (OR = 2.00; 95% CI [1.22, 3.30]). The increase in coliform and E. coli concentrations between point of collection and point of use indicates that water contamination mostly occurs within the household. Strengthening national legislation on water quality standards and promoting safe water management at the household are needed.
Highlights
This study examines the quality of household drinking water intended for consumption by children under 5 years to better understand the extent of Cambodian children's exposure to contaminated water
Our research aims to build on existing data on main household drinking water sources (National Institute of Statistics et al, 2015) and their quality (Ministry of Rural Development & World Health Organization [WHO], 2013; WHO, 2015) in Cambodia, by (a) providing a greater age‐specific focus aligned with the nutrition‐ sensitive WASH approach proposed by Cumming and Cairncross (2016) and (b) providing a more detailed analysis of microbiological
Plate counts were assessed for E. coli and coliforms, and results were interpreted according to WHO guidelines for drinking water with the following classifications: (a) acceptable if coliform or E. coli counts were equal to 0 CFU/100 ml; (b) low risk if counts were 1–10 CFU/100 ml; (c) intermediate risk for 11–100 CFU/100 ml; and (d) high risk if counts were above 100 CFU/100 ml (WHO, 2011)
Summary
The main aim of the project is to offer feedback to the Cambodian government on the national health system and health interventions by monitoring children's health and development in selected districts of several provinces. The main objective of the project was to collect health and nutrition monitoring data during 3 years in selected districts in three provinces
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