Household Water Quality Research Articles

Prediction of Child Health by Household Density and Asset-Based Indices in Impoverished Indigenous Villages in Rural Panamá

Chronic infection over a 16-month period and stunting of preschool children were compared between more spatially dense versus dispersed households in rural Panamá. Chronic protozoan infection was associated with higher household density, lower household wealth index, poor household water quality, yard defecation, and the practice of not washing hands with soap before eating. Models for chronic diarrhea confirmed the importance of household wealth, water quality, sanitation, and hygiene practices. Furthermore, chronic protozoan infection was an important predictor for low height-for-age, along with low household wealth index scores, but not household density. Thus, despite better access to health related infrastructure in the more densely populated households, chronic protozoan infection was more common, and was associated with higher rates of child stunting, compared with more dispersed households.

Assessing and managing fluorosis risk in children and adults in rural Madhya Pradesh, India

This paper presents the application of quantitative chemical risk assessment for assessing and managing fluorosis in 19 schools and 6 villages in Madhya Pradesh, India. A longitudinal study was undertaken with a baseline survey in 2005 and an endline in 2007. Household surveys, water quality and food analysis were undertaken to measure the impact of an Integrated Fluorosis Mitigation programme that included water and nutritional interventions. The baseline survey indicated a maximum fluoride content of 7.8 mg/l in food and 3.7 mg/l in water, equating to a maximum fluoride uptake of 4.8 and 3.7 mg/l in food and water respectively. Mean (actual) daily intake of fluoride for all exposure routes was 0.4 mg/kg of combined adult and child body weight. Intake of fluoride through food was more than 40% of total intake. Calculated guideline values for age groups <18 years and >18 years were 1.7 and 1.9 mg/l respectively. Using WHO methodology, the Guideline Value would be 1.7 mg/l. Fluoride dilution was implemented to reduce the fluoride content to below this level. The endline survey indicated reduction in the prevalence of grade 1 fluorosis of 86%, of grade 2 of 77%, of grade 4 of 60% in all children examined.

Spring Cleaning: Rural Water Impacts, Valuation, and Property Rights Institutions*

Using a randomized evaluation in Kenya, we measure health impacts of spring protection, an investment that improves source water quality. We also estimate households' valuation of spring protection and simulate the welfare impacts of alternatives to the current system of common property rights in water, which limits incentives for private investment. Spring infrastructure investments reduce fecal contamination by 66%, but household water quality improves less, due to recontamination. Child diarrhea falls by one quarter. Travel-cost based revealed preference estimates of households' valuations are much smaller than both stated preference valuations and health planners' valuations, and are consistent with models in which the demand for health is highly income elastic. We estimate that private property norms would generate little additional investment while imposing large static costs due to above-marginal-cost pricing, private property would function better at higher income levels or under water scarcity, and alternative institutions could yield Pareto improvements.

A Study Of Socio-Cultural Factors, Water Quality And Diarrhea In Bangalore

The study was aimed to find the socio--cultural factors in relation to acute diarrhea andbacteriological quality of water in households with diarrhea and time trend of diarrhea. 150 houses in each of the two areas, one supplied by bore well and the other by Bangalore Water Supply and Sewage Board[BWSSB] water selected by modified cluster sampling. Weekly morbidity details were collected and water samples assessed from diarrhea reported houses. The study revealed an incidence rate of diarrheal diseases of 3.2%. It was also noted that children less than 5 years showed an incidence of 38.89% and 57.14% in bore well and piped water supply areas respectively. Peak incidence of diarrhea was observed in the month of November. From our study it was inferred that the practices such as washing vessel, hygienic transportation, storage and drawing of water, and pretreatment of drinking water among the individuals with morbidities in the two areas were considerably different. Thus the study recommends improved water quality at point of use along with promotion of better water handling during collection, storage and treatment can produce better health outcomes.

Source to point of use drinking water changes and knowledge, attitude and practices in Katsina State, Northern Nigeria

In many Sub-Saharan countries such as Nigeria, inadequate access to safe drinking water is a serious problem with 37% in the region and 58% of rural Nigeria using unimproved sources. The global challenge to measuring household water quality as a determinant of safety is further compounded in Nigeria by the possibility of deterioration from source to point of use. This is associated with the use of decentralised water supply systems in rural areas which are not fully reticulated to the household taps, creating a need for an integrated water quality monitoring system. As an initial step towards establishing the system in the north west and north central zones of Nigeria, The Katsina State Rural Water and Sanitation Agency, responsible for ensuring access to safe water and adequate sanitation to about 6 million people carried out a three pronged study with the support of UNICEF Nigeria. Part 1 was an assessment of the legislative and policy framework, institutional arrangements and capacity for drinking water quality monitoring through desk top reviews and Key Informant Interviews (KII) to ascertain the institutional capacity requirements for developing the water quality monitoring system. Part II was a water quality study in 700 households of 23 communities in four local government areas. The objectives were to assess the safety of drinking water, compare the safety at source and household level and assess the possible contributory role of end users’ Knowledge Attitudes and Practices. These were achieved through water analysis, household water quality tracking, KII and questionnaires. Part III was the production of a visual documentary as an advocacy tool to increase awareness of the policy makers of the linkages between source management, treatment and end user water quality. The results indicate that except for pH, conductivity and manganese, the improved water sources were safe at source. However there was a deterioration in water quality between source and point of use in 18%, 12.5%, 27% and 50% of hand pump fitted boreholes, motorised boreholes, hand dug wells and streams respectively. Although no statistical correlation could be drawn between water management practices and water quality deterioration, the survey of the study households gave an indication of the possible contributory role of their knowledge, attitudes and practices to water contamination after provision. Some of the potential water related sources of contamination were poor source protection and location, use of unimproved water source and poor knowledge and practice of household water treatment methods, poor hand washing practices in terms of percentage that wash hands and use soap. Consequently 34 WASH departments have been created at the local government level towards establishment of a community based monitoring system and piloting has begun in Kaita local government area.

Improved Filtration Technology for Pathogen Reduction in Rural Water Supplies

Intermittent bio-sand filtration (BSF) is a low-cost process for improving water quality in rural households. This study addresses its two drawbacks: flow limitations requiring excessive waiting, and inadequate purification when high flows are imposed. Two modifications were examined: increasing the sand’s effective size, and adding zero-valent iron (ZVI) into the media as a disinfectant. After 65 days, percent reductions in total coliform, fecal coliform, and fecal streptococci averaged 98.9% for traditional BSF and 99% for the improved BSF. Both modifications showed statistically significant improvements. Increased sand size and ZVI addition can counter the drawbacks of traditional BSF.

Local population and regional environmental drivers of cholera in Bangladesh

BackgroundRegional environmental factors have been shown to be related to cholera. Previous work in Bangladesh found that temporal patterns of cholera are positively related to satellite-derived environmental variables including ocean chlorophyll concentration (OCC).MethodsThis paper investigates whether local socio-economic status (SES) modifies the effect of regional environmental forces. The study area is Matlab, Bangladesh, an area of approximately 200,000 people with an active health and demographic surveillance system. Study data include (1) spatially-referenced demographic and socio-economic characteristics of the population; (2) satellite-derived variables for sea surface temperature (SST), sea surface height (SSH), and OCC; and (3) laboratory confirmed cholera case data for the entire population. Relationships between cholera, the environmental variables, and SES are measured using generalized estimating equations with a logit link function. Additionally two separate seasonal models are built because there are two annual cholera epidemics, one pre-monsoon, and one post-monsoon.ResultsSES has a significant impact on cholera occurrence: the higher the SES score, the lower the occurrence of cholera. There is a significant negative association between cholera incidence and SSH during the pre-monsoon period but not for the post-monsoon period. OCC is positively associated with cholera during the pre-monsoon period but not for the post-monsoon period. SST is not related to cholera incidence.ConclusionsOverall, it appears cholera is influenced by regional environmental variables during the pre-monsoon period and by local-level variables (e.g., water and sanitation) during the post-monsoon period. In both pre- and post-monsoon seasons, SES significantly influences these patterns, likely because it is a proxy for poor water quality and sanitation in poorer households.

Evaluating a composite cartridge for small system drinking water treatment

A pilot-scale evaluation was conducted at the U.S. Environmental Protection Agency (EPA) Test & Evaluation (T&E) Facility in Cincinnati, Ohio, on a multi-layer, cartridge-based system that combines physical filtration with carbon adsorption and ultraviolet (UV) light disinfection to serve as a home-base water treatment security device against accidental or intentional contaminant events. The system was challenged with different levels of turbidity, a number of biological contaminants including Bacillus subtilis, Escherichia coli, MS2 bacteriophage and Polystyrene Latex (PSL) beads as a surrogate for Cryptosporidium and a number of chemical contaminants including super-chlorination, methyl tertiary butyl ether (MTBE), water chlorination disinfection byproducts (DBPs) and diazinon. The results demonstrated that the performance of the system varies as a function of the specific contaminant or surrogate. The overall performance indicated the potential of the system to improve the quality and safety of household water and to serve as an additional treatment barrier in circumstances where there is little or no treatment or where the quality of treated water may have deteriorated during distribution. The results also demonstrated that B. subtilis spore can serve as a more conservative surrogate for Cryptosporidium than PSL beads.

Pilot Study of Household Drinking Water Quality in Remote Rural Communities, Baja California Sur, Mexico

ISEE-0641 Background and Objectives: The infant mortality rate in Mexico is still four times higher than in the US, with rates even double the Mexican average among rural and indigenous communities. Water related illnesses are a leading cause of infant death in these rural areas. The objective of this pilot study was an assessment of water quality and usage pattern in remote rural households in Baja California Sur as basis for the development of a participatory community based intervention module. Methods: Microbial water quality was assessed in 192 households located in remote rural communities lacking access to a piped water system. Samples were taken from the main water source and the storage container. Screening for arsenic was conducted in 415 water sources in the same rural area. Sampling and testing was conducted by a trained research team, involving measurements of E.coli, arsenic, salinity, turbidity using field kits; water sources were geocoded. Information on usage pattern and contextual factors was recorded. Results: The family water sources included shallow open wells, springs, or standing water in dry river beds, with 41.1% testing positive for E.coli. Drinking water measured in the main storage container (n = 102), tested positive for E.coli in 42%; 24.4% of tested sources had values >10 μg/L of arsenic. Parameters were identified supporting the development of a culturally targeted participatory intervention module to be implemented. Conclusions: Although worldwide the water related Millennium Development Goal is likely to be achieved in many countries, there are within country disparities that may disproportionally affect rural and indigenous communities. Our pilot findings in Baja California Sur, Mexico, underscore the need for the development and implementation of culturally appropriate household based, user friendly and integrative water intervention approaches where there continues to be no access to piped water, aiming at the reduction of environmental health disparities.

Field Evaluation of Long-Term Performance and Use of Biosand Filters in Posoltega, Nicaragua

Abstract An evaluation was conducted in 2007 on biosand filters that were installed in Posoltega, Nicaragua in 1999 and 2004.The objectives were to characterize the condition and use of filters eight and three years after installation, determine filter performance of those filters still in use, and identify determinants of successful long-term use and performance. Methods consisted of household identification, user questionnaires, and water quality testing. Of the 234 filters installed, only 24 were found to still be in use. Average log reductions were 1.73 (98%) for total coliforms, 1.36 (96%) for Escherichia Coli, and 0.91 (88%) for turbidity. Statistically significant effects were detected for the magnitude of the contamination of source water, the peak hydraulic loading rate, and the standing depth of water over the filter media. Questionnaire results indicated user training on filter maintenance could improve the peak hydraulic loading rate and hence filter performance. The low rate of sustained use (10%) is an indication of failed implementation, and is attributable to structural failure, particularly cracking of the concrete filters from 2004. Nonetheless, this evaluation demonstrated the biosand filter technology to be robust since those filters still in use were performing as expected three and eight years postimplementation.

Drivers of Water Quality Variability in Northern Coastal Ecuador

Microbiological safety of water is commonly measured using indicator organisms, but the spatiotemporal variability of these indicators can make interpretation of data difficult. Here, we systematically explore the variability in Escherichia coil concentrations in surface source and household drinking water in a rural Ecuadorian village over one year. We observed more variability in water quality on an hourly basis (up to 2.4 log difference) than on a daily (2.2 log difference) or weekly basis (up to 1.8 log difference). E. coli counts were higher in the wet season than in the dry season for source (0.42 log difference, p < 0.0001) and household (0.11 log difference, p = 0.077) samples. In the wet season, a 1 cm increase in weekly rainfall was associated with a 3% decrease (p = 0.006) in E. coli counts in source samples and a 6% decrease (p = 0.012) in household samples. Each additional person in the river when source samples were collected was associated with a 4% increase (p = 0.026) in E. coil counts in the wet season. Factors affecting household water quality included rainfall, water source, and covering the container. The variability can be understood as a combination of environmental (e.g., seasonal and soil processes) and other drivers (e.g., human river use, water practices, and sanitation), each working at different time scales.

Avoidance Measures and Household Perceptions of Water Quality in Uganda

ABSTRACT The importance that households place on reducing health risks from drinking water can guide policies intended to enhance safety. Self-reported household water quality opinions and avoidance measures used by households in Kampala, Uganda, to manage health risks were analyzed. The paper is based on survey data collected from four divisions in Kampala district and analyzed using binary logit model. Survey results indicate that the majority of the respondents boil water to manage potential health risks. On the other hand, logit results confirmed the existence of strong relationships between household characteristics, opinions on water quality, and the use of avoidance measures.

Local Drinking Water Filters Reduce Diarrheal Disease in Cambodia: A Randomized, Controlled Trial of the Ceramic Water Purifier

A randomized, controlled intervention trial of two household-scale drinking water filters was conducted in a rural village in Cambodia. After collecting four weeks of baseline data on household water quality, diarrheal disease, and other data related to water use and handling practices, households were randomly assigned to one of three groups of 60 households: those receiving a ceramic water purifier (CWP), those receiving a second filter employing an iron-rich ceramic (CWP-Fe), and a control group receiving no intervention. Households were followed for 18 weeks post-baseline with biweekly follow-up. Households using either filter reported significantly less diarrheal disease during the study compared with a control group of households without filters as indicated by longitudinal prevalence ratios CWP: 0.51 (95% confidence interval [CI]: 0.41-0.63); CWP-Fe: 0.58 (95% CI: 0.47-0.71), an effect that was observed in all age groups and both sexes after controlling for clustering within households and within individuals over time.

Environmental health in slum communities : analysis of household water quality in four slum communities in the City of Bhuj, India

Abstract. The main focus of this study is on water quality in four slum communities in the City of Bhuj, India. In order to determine key variables affecting water quality in surveyed households, the interrelation between household water quality, environmental services, and demographic, social and financial factors was examined. The data used in this study draws on a household survey and the analysis of water samples collected within the targeted slum communities. As faecal contamination of drinking water is a major health risk in small-community supplies, water samples were tested for E.coli bacteria using the membrane-filter method. In a next step, the efficiency of three water treatment methods – filtration through cloth, chlorination and solar disinfection – was tested. Considering various factors, solar disinfection is identified to be the most appropriate method for households in most slum areas. The analysis shows that the water supply and sanitation situation of a household has an effect on that household’s drinking water quality. Personal endeavours to protect family members from disease can be greatly supported by the provision of safe drinking water, adequate sanitation facilities and wastewater removal systems to every household. Furthermore, it appears that most slum dwellers are not aware of the interdependent relation between environmental health and their personal health conditions. It is therefore argued that awareness raising measures in this area can also be an effective means of supporting personal endeavours to improve household financial situations.

Point of Use Household Drinking Water Filtration: A Practical, Effective Solution for Providing Sustained Access to Safe Drinking Water in the Developing World

The lack of safe water creates a tremendous burden of diarrheal disease and other debilitating, life-threatening illnesses for people in the developing world. Point-of-use (POU) water treatment technology has emerged as an approach that empowers people and communities without access to safe water to improve water quality by treating it in the home. Several POU technologies are available, but, except for boiling, none have achieved sustained, large-scale use. Sustained use is essential if household water treatment technology (HWT) is to provide continued protection, but it is difficult to achieve. The most effective, widely promoted and used POU HWTs are critically examined according to specified criteria for performance and sustainability. Ceramic and biosand household water filters are identified as most effective according to the evaluation criteria applied and as having the greatest potential to become widely used and sustainable for improving household water quality to reduce waterborne disease and death.

Community and household determinants of water quality in coastal Ghana

Associations between water sources, socio-demographic characteristics and household drinking water quality are described in a representative sample of six coastal districts of Ghana's Central Region. Thirty-six enumeration areas (EAs) were randomly chosen from a representative survey of 90 EAs in rural, semi-urban and urban residence strata. In each EA, 24 households were randomly chosen for water quality sampling and socio-demographic interview. Escherichia coli per 100 ml H2O was quantified using the IDEXX Colilert system and multi-stage regression models estimated cross-sectional associations between water sources, sanitation and socio-demographic factors. Almost three quarters, 74%, of the households have > 2 E. coli /100 ml H2O. Tap water has significantly lower E. coli levels compared with surface or rainwater and well water had the highest levels. Households with a water closet toilet have significantly lower E. coli compared with those using pit latrines or no toilets. Household size is positively associated, and a possessions index is negatively associated, with E. coli. Variations in community and household socio-demographic and behavioural factors are key determinants of drinking water quality. These factors should be included in planning health education associated with investments in water systems.

Determinants of persistent underweight among children, aged 6-35 months, after huge economic development and improvements in health services in Oman.

Over the last decades, health indicators have witnessed major improvements in the Sultanate of Oman. This study was aimed at factors associated with underweight among children in four regions of Oman, as, in 1998, underweight was prevalent among 17.9% of children aged less than five years. A case-control study was conducted in 2002: 190 cases were 6-35-month old children with weight-for-age < -2 z-scores. Controls were individually matched by village of residence, sex, and age. The questionnaire included anthropometry of children, child-feeding practices, morbidity, anthropometry of mothers, parity, birth-spacing, and socioeconomic characteristics. Conditional logistic regression was used for analyses. Birth-weight of < 2,500 g was strongly associated with underweight and also were height of mother, low level of education of mother, bad quality of water in households, diarrhoea of children in the last two weeks, and regular use of infant formula. Factors, such as birth-weight, height of mother, supply of safe water in household, and care for mothers and children were the determinants of persistent underweight after huge economic development and improvements in health services. Further research is also needed to investigate further specific determinants of low birth-weight in the Omani context and try to disentangle emaciation and determinants of linear growth retardation.

FACTORS ASSOCIATED WITH E. COLI CONTAMINATION OF HOUSEHOLD DRINKING WATER AMONG TSUNAMI AND EARTHQUAKE SURVIVORS, INDONESIA

The December 2004 tsunami in Sumatra, Indonesia, destroyed drinking water infrastructure, placing over 500,000 displaced persons at increased risk of waterborne disease. In June 2005, we assessed the relationship of water handling behaviors to household water quality in three districts: Aceh Besar, Simeulue, and Nias. We surveyed 1,127 households from 21 communities and tested stored drinking water. Factors associated with a reduced likelihood of having contaminated stored drinking water included obtaining water from improved sources (Aceh Besar, adjusted odds ratio (aOR) 0.41, P < 0.01; Simeulue, aOR 0.48, P = 0.02), using chlorine solution (Simeulue, aOR 0.41, P < 0.01), and having free chlorine in stored water (Aceh Besar, aOR 0.42, P < 0.01; Nias, aOR 0.28, P < 0.01). Reported boiling, even among those who could describe correct practice, was not associated with improved water quality. Water source improvement and household water chlorination appear to be useful strategies to improve household stored drinking water quality in post-disaster situations.

A Little Knowledge…: Household Water Quality Investment in the Annapolis Valley

A household drinking water and sewage management survey in Nova Scotia's Annapolis Valley suggests that ability to interpret water quality information (proxied by education) strongly affects behavior. Higher education reduces the likelihood of households treating drinking water, but may increase the amount of water treated by households choosing to do so. Septic maintenance may impact water quality, but evidence for jointness in treatment and maintenance choice is absent. Further, increased education weakly reduces septic maintenance. Results suggest that more information about septic source threats to drinking water may induce households to choose more water treatment and less septic maintenance. Information campaigns alone are therefore unlikely to significantly reduce septic source pollution. Une enquête sur la gestion de l'eau potable et des eaux usées menée auprès des ménages de la vallée d'Annapolis en Nouvelle‐Écosse autorise à penser que la capacité d'interpréter l'information sur la qualité de l'eau (déterminée par la variable ≪éducation≫) influence fortement le comportement. Le fait de posséder une éducation supérieure diminue la probabilité que des ménages à traiter l'eau potable, mais peut augmenter la quantité d'eau traitée par ceux qui choisissent de le faire. L'entretien des fosses septiques peut avoir un impact sur la qualité de l'eau, mais il n'existe pas de preuve sur le choix combiné de traiter et d'entretenir. De plus, un niveau d'éducation élevé diminue faiblement le choix d'entretenir les fosses septiques. Les résultats laissent supposer que davantage d'information sur les menaces que représentent les eaux usées pour l'eau potable peut persuader les ménages à choisir davantage de traiter l'eau et à moins entretenir les fosses septiques. Il est donc peu probable que les campagnes d'information seules réussissent à faire diminuer considérablement la pollution provenant des fosses septiques.

Development and implementation of water safety plans for small water supplies in Bangladesh: benefits and lessons learned

Water safety plans (WSPs) are promoted by the WHO as the most effective means of securing drinking water safety. To date most experience with WSPs has been within utility supplies, primarily in developed countries. There has been little documented experience of applying WSPs to small community-managed systems, particularly in developing countries. This paper presents a case study from Bangladesh describing how WSPs can be developed and implemented for small systems. Model WSPs were developed through consultation with key water sector practitioners in the country. Simplified tools were developed to translate the formal WSPs into a format that was meaningful and accessible for communities to use. A series of pilot projects were implemented by Non-Governmental Organisations (NGOs) across the country covering all major water supplies. The results show that WSPs can be developed and implemented for small community managed water supplies and improve the sanitary condition and water quality of water sources. Hygiene behaviour improved and household water quality showed a significant reduction in contamination. Chlorination was found to be important for some technologies, thus increasing the costs of water supply and raising important problems with respect to transfer to the communities. Simple tools for community monitoring were found to be effective in supporting better water safety management.