Water, Sanitation and Hygienic (WASH) risk factors that promote cholera outbreaks in Nairobi County

Abstract

BACKGROUND 
 Cholera is still a significant worldwide threat to global public health as it leads to about 100,000 deaths every year. It is a diarrheal water and foodborne disease with its person-to-person transmission resulting from limited sanitation access, poor hygiene, and inadequate water supply, which often leads to outbreaks. This study sought to examine Water, Sanitation and Hygienic (WASH) risk factors that promote cholera outbreaks in Nairobi County 
 METHODOLOGY 
 A cross-sectional descriptive research design was used in this study. The target population included 2,154,726 residents of Nairobi County aged 18 years and above. Slovin's Formula was used in the study to estimate the sample size. The study adopted stratified random sampling in the selection of 399 respondents from the target population. Primary datasets were collected using questionnaires and key informant interviews. The data from the questionnaires were analysed using descriptive and inferential statistics. Descriptive statistics such as percentages and frequencies were used to study the trends and WASH factors related to cholera outbreaks. Inferential statistics included Chi-square (X2), which was used to analyze the relationship between variables. 
 RESULTS 
 The study established that the top five WASH challenges associated with the spread of Cholera disease included lack of enough water supply (76%); poor personal hygiene (54%); poor wastewater management (54%); poor community hygiene and sanitation (55%); and poorly maintained sewage facilities in the residential areas (44%). Communal water challenges included irregular supply of water (77%) and limited access to safe drinking water in most of the households (58%), lack of tap water in households (44%), unhygienic water vending facilities (57%) and supply of poorly treated water (38%). 
 CONCLUSION 
 The main risk factors related to Water, Sanitation and Hygiene practices (WASH) in areas reporting cholera outbreaks in Nairobi County were lack of adequate water supply, poor personal hygiene, poor wastewater management, poorly maintained sewage facilities, and poor culture of community hygiene and sanitation. Inadequate water supply, unregulated water vendors and water kiosks made water contamination likely.