Household Water Storage Research Articles

Porphyrinoid macrocycles as potential photosensitizers for photodynamic inhibition of biofilm formation in household water storage systems

AbstractThe issue of biofilm formation by microorganisms in household water storage systems is a problem that lowers the efficiency of disinfectants. Antimicrobial photodynamic inactivation (aPDI) is a potential alternative to the current water disinfection methods. It employs a photosensitizer agent that inactivates microbes by absorbing light of a specific wavelength in the presence of molecular oxygen. Although aPDI has been proven in literature to have a wide spectrum of action, effective against resistant microbes and biofilms, it has not been approved for real-life applications yet. Therefore, there is an ongoing search for ideal photosensitizers that can produce sufficient reactive oxygen species for efficient inactivation of microbes and disruption of biofilms in household water storage systems. This review summarises the developments that have been made so far with porphyrin-, expanded porphyrin-, corrole-, and boron dipyrromethene-based photosensitizers. First, the issues with the current water disinfection methods are described, and then aPDI is also described as a possible alternative to the current methods. Emphasis is put on the antimicrobial activities and the solid support materials that the porphyrinoid family members have been incorporated into for potential application in the disinfection of household water and limitation of biofilm formation in water storage systems.

Determinants of adoption of household water treatment in Haiti using two analysis methods: logistic regression and machine learning.

Household water treatment (HWT) is recommended when safe drinking water is limited. To understand determinants of HWT adoption, we conducted a cross-sectional survey with 650 households across different regions in Haiti. Data were collected on 71 demographic and psychosocial factors and 2 outcomes (self-reported and confirmed HWT use). Data were transformed into 169 possible determinants of adoption across nine categories. We assessed determinants using logistic regression and, as machine learning methods are increasingly used, random forest analyses. Overall, 376 (58%) respondents self-reported treating or purchasing water, and 123 (19%) respondents had residual chlorine in stored household water. Both logistic regression and machine learning analyses had high accuracy (area under the receiver operating characteristic curve (AUC): 0.77-0.82), and the strongest determinants in models were in the demographics and socioeconomics, risk belief, and WASH practice categories. Determinants that can be influenced inform HWT promotion in Haiti. It is recommended to increase access to HWT products, provide cash and education on water treatment to emergency-impacted populations, and focus future surveys on known determinants of adoption. We found both regression and machine learning methods need informed, thoughtful, and trained analysts to ensure meaningful results and discuss the benefits/drawbacks of analysis methods herein.

Occurrence and Mitigation of Bacterial Regrowth in Stored Household Water in Eastern Coastal Madagascar

In communities where people lack on-demand, safely managed drinking water, stored household water often becomes contaminated by fecal bacteria, regardless of the source-water quality. The objectives of this paper are to assess and control bacterial contamination in stored household water in Toamasina, a rapidly urbanizing city in eastern coastal Madagascar. We collected samples of source water and stored household water from 10 representative households that use different water sources and different storage strategies, and we analyzed the samples for several fecal indicator bacteria. We also tested three methods that residents of Toamasina could realistically employ for cleaning their household water storage vessels, assessing the effect of the cleaning methods on measured bacterial levels in the water. Consistent with the previous literature, we found that concentrations of total coliforms in stored household water were significantly higher than in the corresponding source water (p < 0.05). In 100% of households that stored their water in 20 L polyethylene jerrycans (n = 4), biofilms on the walls of the jerrycan harbored total coliforms and Enterococcus. The use of a closed storage container was, on its own, not found to provide a meaningful protective effect against bacterial regrowth; to be protective, closed storage containers must be combined with high-quality source water and/or with adequate cleaning to prevent biofilm formation. A dilute solution of sodium hypochlorite, known locally as Sûr’Eau or Manadio Rano, was both the most effective and the least expensive method for cleaning household water storage containers. We conclude that regular and effective cleaning of storage containers is an essential component of safe water storage. Because household storage of collected water is common in many low- and middle-income countries, these results are important towards the worldwide achievement of the United Nations’ Sustainable Development Goal 6.

Physicochemical and Microbial Quality of Drinking Water at Gorkha, Nepal

To assess the drinking water quality of Bhimsen Thapa Rural Municipality-6, situated in Gorkha district of Nepal, the physicochemical parameters like pH, electrical conductivity, total hardness, ammonia, and nitrate content were investigated using standard procedures. Likewise, for microbiological parameter coliform presence and absence was analyzed. A total of 37 samples were collected from four sampling stations ( the water source, water reservoir, point of collection, and household water storage) in the last week of November 2022 using simple random sampling for tap water and stratified random sampling for household water storage. When comparing the results with the National Drinking Water Quality Standards (NDWQS), 2005 and World Health Organization (WHO), 2004 guidelines, it was observed that most of the physiochemical parameters were within the standards. Based on the microbiological parameter, in most of the water samples during the study coliforms were detected indicating potential health hazards. Therefore, the findings suggest that water from these sources can be considered safe for drinking only after undergoing purification treatment. Urgent attention from relevant authorities is imperative to implement treatment measures for drinking water to ensure its safety before consumption.

Identifying predictors of E. coli in rural household water in sub-Saharan Africa using elimination regression.

Exposure to fecally contaminated drinking water contributes to the global disease burden, especially in sub-Saharan Africa (SSA). We used cross-sectional data and elimination regression analysis to examine factors influencing E. coli contamination in household drinking water samples from 4,499 rural households in nine countries in SSA (Malawi, Mozambique, and Zambia in Southern Africa; Ghana, Mali, and Niger in Western Africa; and Kenya, Rwanda, and Tanzania in Eastern Africa). The proportion of household water samples containing E. coli was 71%, ranging from 45% (Malawi) to 89% (Tanzania). Pooled and multi-country predictive logistic regression models showed that using an unimproved-type water source, the absence of a community water committee, and domestic animal ownership were significantly associated with household drinking water contamination. Household water treatment and storage practices, sanitation and hygiene practices, and payment for drinking water were not significantly associated with E. coli contamination in any model. The season was a significant predictor of E. coli in the pooled model; samples collected in the rainy season were 2.3 [2.0, 2.7] times as likely to be contaminated with E. coli. Practitioners and policymakers should prioritize implementing piped on-plot water services, establishing effective local water source management structures, and incorporating animal husbandry practices into water, sanitation, and hygiene interventions.

Physico-Chemical and Bacteriological Quality of Household Drinking Water from Source to Point of Use in Akewu Community in Ibadan, Oyo State, Southwest, Nigeria

Poor household water storage is one of the major factors contributing to contamination of drinking water in Nigeria. Studies have shown that sizes of containers opening can affect water quality, but little has been documented on comparative effect of storage containers with different opening sizes in improving drinking water quality in Ibadan. This study was designed to assess the effect of different storage containers on household drinking water quality in selected communities in Ibadan. A quasi-experimental design was adopted. Four communities in Ibadan North Local Government namely; Akewu using protected springs as household drinking water sources were purposively selected. Forty-four households (11 from each community) were selected and randomly assigned to four treatment groups; those with Covered Buckets with Taps (CBT), Covered Buckets without Tap (CB), Covered Kegs with Taps (CKT) and Covered Kegs without Tap (CK). Prior to introducing the treatment containers, water samples were collected from their Regular Storage Containers (RSC) and springs for physicochemical and bacteriological analysis using standard methods. Participants were thereafter encouraged to store drinking water in the treatment containers provided for them. Water samples were later collected from CBT, CB, CKT and CK containers twice daily for 3 alternate days over two weeks for bacteriological analysis. In addition, oldest female of selected households were interviewed using a pre-tested semi-structured questionnaire to elicit information on their socio-demographic characteristics, storage container cleaning and handwashing practices. Results of physicochemical and bacteriological findings were compared with Standard Organisation of Nigeria (SON) guidelines. Data were analysed using descriptive statistics, t- test and ANOVA at p=0.05. At baseline, mean pH values of water samples from the springs and RSC were 6.4±0.6 and 7.1±0.7 respectively compared with 6.5-8.5 limits recommended by SON. Mean chloride concentration of springs (14.3±7.4mg/l) and RSC (19.3±10.0 mg/l) samples were below 250mg/l limit recommended by SON. Mean Total Coliform Count (TCC) of the springs in the four communities was 18.0±4.0 and mean TCC of RSC was 12.7±4.9 which exceeded the SON standard of 10MPN/100ml. Five percent of water samples from RSC had mean E.coli count of 100/100ml compared with SON guidelines of 0/100ml. The mean TCC after introducing CB, CBT, CK and CKT in all the communities were 10.0±4.0, 8.5±4.2, 6.9±2.8 and 7.3±3.7 respectively (p<0.05). No E.coli was found in the samples collected from the treatment storage containers. The percentage difference of coliform count in water from springs and RSC was 29.4% while percentage difference from RSC and CB, CBT, CK and CKT were 21.5%, 33.2%, 45.5% and 42.5% respectively. Mean age of the 44 respondents interviewed was 37.9±10.7years. Seventy-three percent washed their hands with only water after defecation and 95.0% stored water for cooking and drinking in the same container. Sixty-eight percent cleaned their containers weekly while 32.0% cleaned twice weekly.

Evaluation of a participatory citizen approach to monitor microbial water quality of self-supply in urban Indonesia

ABSTRACT A participatory citizen approach was established to monitor microbial water quality in household self-supply in Bekasi, Indonesia, and evaluated using a conceptual framework for context analysis, process evaluation and impact assessment (CPI). Households tested their self-supplied water for Escherichia coli presence every two weeks for six months, accompanied by pre- and post-monitoring surveys. The approach provided reliable water quality results, and increased awareness of water quality; however, nearly half of the households dropped out of the monitoring and increased awareness did not translate into actions that improved water quality within the study period. Contamination rates ranged from 11% to 70% at source and from 15% to 44% at point-of-use. Household-led testing could fulfil an important monitoring role in self-supply contexts, however it may have little impact on the drinking water safety unless accompanied by support to improve source protection and strengthen household water treatment and storage practices.

Access to water, sanitation and hygiene (WASH) services and drinking water contamination risk levels in households of Bishoftu Town, Ethiopia: A cross-sectional study.

Access to safe drinking water, sanitation, and hygiene is a fundamental human right and essential to control infectious diseases. However, many countries, including Ethiopia, do not have adequate data to report on basic water, sanitation, and hygiene (WASH) services. Although contaminated drinking water spreads diseases like cholera, diarrhea, typhoid, and dysentery, studies on drinking water contamination risk levels in households are limited in Ethiopia. Therefore, closing this gap needs investigation. A community-based cross-sectional study was conducted. A total of 5350 households were included. A systematic, simple random sampling technique was used to select the participants. The information was gathered through in-person interviews using a standardized questionnaire. Furthermore, 1070 drinking water samples were collected from household water storage. This investigation revealed that 9.8%, 83.9%, and 4.9% of households used limited, basic, and safely managed drinking water services, respectively. Besides, 10.2%, 15.7% and 59.3% of households used safely managed, basic and limited sanitation services, respectively. Yet, 10.6% and 4.2% of households used unimproved sanitation facilities and open defecation practices. Also, 40.5% and 19.4% of households used limited and basic hygiene services. On the other hand, 40.1% of households lacked functional handwashing facilities. In this study, 12.1%, 26.3%, and 42% of households' drinking water samples were positive for Escherichia coli, fecal coliforms, and total coliforms, respectively. Also, 5.1% and 4.5% of households' drinking water samples had very high and high contamination risk levels for E. coli, respectively. We found that 2.5% and 11.5% of households and water distributors had unacceptable fluoride concentrations, respectively. The majority of households in Bishoftu town lack access to safely managed sanitation, drinking water, and basic hygiene services. Many households' water samples had very high and high health risk levels. Hence, the government and partner organizations should implement water and sanitation safety plans.

Water quality in rural Greenland - acceptability and safety

The low proportion of households with piped drinking water in Greenlandic settlements – and elsewhere in the Arctic, leads to improvised methods of household water storage and water saving practices that could present a risk for public health.This interview-based study investigated the perceptions of safety and acceptability of the water supply in rural Greenlandic households. The bacterial quality of the water distributed by the public supply before and after storage in the homes, of alternative water sourced from nature by the users themselves, and of shared handwash basins used in un-piped homes, was analyzed.The treated water distributed by the rural Greenlandic water supply was acceptable to most users, although half of them expressed concerns about its quality, and distrusted the state of the infrastructure delivering piped water. For drinking, most respondents preferred untreated water from nature, but a majority used mainly piped water for practical reasons of access. The microbial quality of the public water supply met legislative requirements in most cases, but was found to deteriorate during both distribution to some taps, and storage in the homes, which constitutes a challenge to the reliable provision of safe water to users. Water from alternative sources showed slightly higher heterotrophic plate counts (HPC) than piped water, but no Escherichia coli. As for washbasins, they were found to have high levels of contamination in all three bacterial parameters investigated (HPC, coliforms and E. coli), indicating a possible transmission route for pathogens.In conclusion, while the quality of treated water was overall good at distribution, the water saving and storage practices developed to compensate for the lack of piping may threaten public health. Alternative water sources are culturally important and trusted by users, although the possible impact of changes in climate and land use on the reliability of their quality is unknown.

Determinants of consistency of use of household water filters in emergencies: Insights from a protracted drought in Northern Kenya

The consistent use of household water treatment and storage (HWTS) technologies is necessary for human health. However, most HWTS options are designed for typical household use as opposed to emergency contexts, where use is less consistent. To investigate ways to improve the consistency of HWTS use in emergencies, we conducted in-person surveys with 108 households in northern Kenya and comparatively analyzed factors that influenced the use of household filters during a protracted drought. Findings showed that about 50% of respondents used their filter consistently over the course of the study. The main limitation to usability was that none of the filters were well-suited for the indoor living environment of the survey respondents. The factors associated with consistency of use varied by filter design. For one-bucket filters, consistent use was associated with ease of assembly, reported availability of spare parts, and peer approval of HWTS use. For two-bucket filters, consistent use was best explained by the certainty regarding when the filter was functioning or not. We suggest that filter manufacturers should reduce the number of parts to mitigate assembly difficulties and should develop flexible filter designs to improve compatibility across households in terms of space and height requirements. Those disseminating filters during protracted emergencies should conduct user training on the assembly and disassembly of unfamiliar filters and ensure affordable access to necessary replacement parts. Finally, to improve consistency of use of new types of filters, implementers should assess the peer approval of these HTWS options among the target population.

Reduced Diarrhea Prevalence and Improvements in Handwashing with Soap and Stored Drinking Water Quality Associated with Diarrheal Disease Awareness Measured by Interactive Voice Response Messages in the CHoBI7 Mobile Health Program.

The Cholera-Hospital-Based-Intervention-for-7-Days (CHoBI7) mobile health program promotes water, sanitation, and hygiene (WASH) behaviors through interactive voice response (IVR), voice, and text messages to reduce diarrheal diseases in Bangladesh. The objective of this study was to investigate the relationship between responses to CHoBI7 WASH IVR quiz messages and subsequent diarrhea and WASH behaviors. Fourteen CHoBI7 IVR quiz messages on handwashing with soap and treatment of stored water were sent to 517 households with 1,777 participants during the 12-month program period. IVR message responses were classified as correct answer, incorrect answer, no response (did not press 1 or 2), and failed (did not answer the phone). Diarrhea prevalence was assessed through self-reported monthly clinical surveillance visits. Handwashing with soap was assessed by a 5-hour structured observation, and stored water quality was defined by Escherichia coli concentration. Households that responded correctly to a CHoBI7 IVR quiz message had significantly lower odds of diarrhea for all age groups (adults and children) at the subsequent visit 1 month later (odds ratio [OR], 0.73; 95% CI, 0.54-0.98), and significantly greater odds of handwashing with soap after stool-related events (OR, 2.48; 95% CI, 1.12-5.49) and E. coli levels < 100 colony forming units (CFU)/100 mL (World Health Organization high-risk cutoff) in the stored household water (OR, 2.04; 95% CI, 1.25-3.33) compared with households that did not answer CHoBI7 IVR quiz calls. Correct responses to CHoBI7 IVR quizzes were associated with decreased diarrhea prevalence and improved stored drinking water quality and handwashing with soap behaviors at the subsequent visits. These findings suggest engagement in the CHoBI7 mobile health (mHealth) program and awareness of diarrheal disease prevention can reduce diarrhea and facilitate changes in WASH behaviors.

Household water storage containers: Aedes aegypti larval breeding site and high risk of transmission of arboviruses in Abidjan, Côte d'Ivoire

Dengue 3 epidemic was declared in Abidjan in 2018. Vector control was directed towards management of breeding sites to reduce proliferation of mosquitoes. Thus, characterization was carried out through larval prospecting in 100 households in six communes of Abidjan in February and August (large and small dry season) of 2018, before and after mosquito control. 3,809 larval breeding sites were inventoried, including 2,289 before and 1,520 after (p-value &gt; 0.05). 76% of sites (2,909), consisted of water storage (1,380) and abandoned containers (1,529). These two categories were most abundant in households (p-value &lt;0.0001). Greatest number of storage containers were observed in Attécoubé (n = 312) and Abobo (n = 296). Abandoned containers were abundant in Port-Bouet (n = 416). Number of abandoned containers was reduced from 1,016 before to 513 after operation (p-value &lt; 0.01). However, water storage containers have increased slightly. It went from 686 before operation to 694 after. Positive storage containers (255) were also the most numerous (53%). Their proportions were 151 (41%) and 104 (55%) before and after mosquito control. They were very productive in Aedes aegypti. Household water storage containers could lead to reconstitution, maintenance of mosquitoes and increased risk of arboviruses spread in Abidjan.

Domestic water supply in rural Greenland – sufficiency, affordability and accessibility

ABSTRACT Global efforts are still under way to ensure sustainable development goal 6 of providing enough clean water to sustain public health in many regions, and especially in the Arctic where the remoteness of communities and the harsh climate make water provision especially challenging. This study aimed to examine the sufficiency, accessibility, and affordability of water supplies in rural Greenland. The state of the water supply was investigated using quantitative data on infrastructure and demographics. Qualitative data on water-related practices and perceptions were collected through fieldwork and interviews in a selection of settlements. Generally, the supply of drinking water was found to be sufficient and affordable for most. However, access was severely constrained by the lack of piping to rural homes (20% were piped). The daily water consumption of residents from un-piped households was between 13 and 23 L/d/cap, i.e. within the basic access level according to WHO, which is in theory not sufficient to sustain public health. Several health risks could be caused by the low daily consumption in un-piped homes, and water saving practices induced by it – i.e. the use of shared handwashing basins, and household water storage, which could lead to degradation of water quality at the point-of-use.

Evaluating the costs and components of a territory-wide household water storage and treatment program in the US Virgin Islands

AbstractAmong island communities, water security and access continue to be a critical issue. In the US Virgin Islands (USVI), 90% of households are capable of collecting roof-harvested rainwater, whereas less than 25% of households are connected to a municipal water system serviced by desalination plants. Rainwater collection leaves the household in charge of managing and treating their own water. Therefore, understanding current barriers to accessing water treatment technologies and the costs of a water storage and treatment program at scale are critical in developing a territory-wide program. In this study, we evaluate (1) household-level barriers to accessing water treatment technologies, (2) a cost breakdown of a UV water treatment pilot program, and (3) potential estimates of program costs at a territory-wide scale. The results suggest that for households, key barriers include knowledge of the problem or solution and capital and installation costs. From the programmatic cost evaluation, the water treatment technology and water testing services were the most expensive. However, given key adjustments, a territory-wide program is estimated to cost $30.4 M covering 50% of households. These data can be used by a coalition of stakeholders in allocating financial and managerial responsibility for a territory-wide water storage and treatment program in USVI.

Biofilm-responsive encapsulated-phage coating for autonomous biofouling mitigation in water storage systems

Biofilms in water storage systems may harbor pathogens that threaten public health. Chemical disinfectants are marginally effective in eradicating biofilms due to limited penetration, and often generate harmful disinfection byproducts. To enhance biofouling mitigation in household water storage tanks, we encapsulated bacteriophages (phages) in chitosan crosslinked with tri-polyphosphate and 3-glycidoxypropyltrimethoxysilane. Phages served as self-propagating green biocides that exclusively infect bacteria. This pH-responsive encapsulation (244 ± 11 nm) enabled autonomous release of phages in response to acidic pH associated with biofilms (corroborated by confocal microscopy with pH-indicator dye SNARF-4F), but otherwise remained stable in pH-neutral tap water for one month. Encapsulated phages instantly bind to plasma-treated plastic and fiberglass surfaces, providing a facile coating method that protects surfaces highly vulnerable to biofouling. Biofilm formation assays were conducted in tap water amended with 200 mg/L glucose to accelerate growth and attachment of Pseudomonas aeruginosa, an opportunistic pathogen commonly associated with biofilms in drinking water distribution and storage systems. Biofilms formation on plastic surfaces coated with encapsulated phages decreased to only 6.7 ± 0.2% (on a biomass basis) relative to the uncoated controls. Likewise, biofilm surface area coverage (4.8 ± 0.2 log CFU/mm2) and live/dead fluorescence ratio (1.80) were also lower than the controls (6.6 ± 0.2 log CFU/mm2 and live/dead ratio of 11.05). Overall, this study offers proof-of-concept of a chemical-free, easily implementable approach to control problematic biofilm-dwelling bacteria and highlights benefits of this bottom-up biofouling control approach that obviates the challenge of poor biofilm penetration by biocides.

Bacteriological Quality of Bottled Drinking Water and Municipal Tap Water in Northeastern Ethiopia

Objective: Water-borne diseases cause high morbidity and mortality in developing countries, like Ethiopia. Diarrheal disease and typhoid are one of the top five diseases that cause significant public health burden and economic cost in Dessie city. Thus, monitoring the quality of drinking water is crucial to prevent waterborne disease. This study aimed to determine the bacteriological quality of bottled drinking water and municipal tap water in Northeastern Ethiopia for proper planning, monitoring, and intervention purpose.Methods: A laboratory-based cross-sectional study was conducted on 248 municipal tap water samples from point of collection (MTPOC), 248 water samples from a household water storage container (HHSC), 38 bottled water samples before packaging from manufacturing facilities (BPMF), and 38 bottle water samples from point of sale (POS) in Dessie city between March 15 to May 15, 2021. Water samples were collected by trained data collectors using a standard sampling protocol. Data were entered into Microsoft Excel and exported to SPSS version 25.0 for data cleaning and analysis. The commonest microbiological parameters, total coliforms (TC) and Escherichia coli (E. coli) were tested using the standard procedure. One-way ANOVA was used to compare the mean log concentration of E. coli and TC between sampling points and the Tukey post hoc test was also computed to identify statistically significant differences among sample types. The 95% confidence interval [CI] and p &amp;lt; 0.05 were taken as statistically significant.Results: About 15.8 and 36.8% of the samples from BPMF and 26.3 and 55.3% of samples from POS were positive for E. coli and TC respectively while 47.2 and 65.7% of water sample from MTPOC and 48.8 and 98.8% of samples from HHSC were positive for E. coli and TC respectively. The mean log concentration of E. coli from the sample of MTPOC was significantly higher than BPMF. Similarly, water samples from HHSC had significantly higher E. coli and TC concentrations than BPMF and POS. Water samples from HHSC had also a significantly higher prevalence of log concentrations of TC than MTPOC.Conclusion: Most values were beyond maximum tolerable limits recommended by World Health Organization (WHO). Thus, good water handling practices and water quality monitoring are essential to prevent bacteriological contamination.

Co-Existence of Free-Living Amoebae and Potential Human Pathogenic Bacteria Isolated from Rural Household Water Storage Containers.

Simple SummaryIn many households in rural communities, water needed for drinking and cooking is fetched from rivers, fountains, or boreholes shared by the community. The water is then stored in various storage containers for several days without treatment and exposed to several conditions that could potentially contaminate the water and cause diseases. If the storage containers are not regularly and properly cleaned, biofilms can form inside the containers. Several microorganisms can be found inside the biofilm that can potentially cause diseases in humans. One such group of organisms is called free-living amoebae, which graze on the bacteria found inside the biofilm. Several of these potentially harmful bacteria have adapted and can survive inside these free-living amoebae and potentially cause diseases when ingested by humans.This study investigated the co-existence of potential human pathogenic bacteria and free-living amoebae in samples collected from stored water in rural households in South Africa using borehole water as a primary water source. Over a period of 5 months, a total of 398 stored water and 392 biofilm samples were collected and assessed. Free-living amoebae were identified microscopically in 92.0% of the water samples and 89.8% of the biofilm samples. A further molecular identification using 18S rRNA sequencing identified Vermamoeba vermiformis, Entamoeba spp., Stenamoeba spp., Flamella spp., and Acanthamoeba spp. including Acanthamoeba genotype T4, which is known to be potentially harmful to humans. Targeted potential pathogenic bacteria were isolated from the water samples using standard culture methods and identified using 16S rRNA sequencing. Mycobacterium spp., Pseudomonas spp., Enterobacter spp., and other emerging opportunistic pathogens such as Stenotrophomonas maltophilia were identified. The results showed the importance of further studies to assess the health risk of free-living amoebae and potential human pathogenic bacteria to people living in rural communities who have no other option than to store water in their homes due to water shortages.

Narrative Review of Primary Preventive Interventions against Water-Borne Diseases: Scientific Evidence of Health-EDRM in Contexts with Inadequate Safe Drinking Water.

Waterborne diseases account for 1.5 million deaths a year globally, particularly affecting children in low-income households in subtropical areas. It is one of the most enduring and economically devastating biological hazards in our society today. The World Health Organization Health Emergency and Disaster Risk Management (health-EDRM) Framework highlights the importance of primary prevention against biological hazards across all levels of society. The framework encourages multi-sectoral coordination and lessons sharing for community risk resilience. A narrative review, conducted in March 2021, identified 88 English-language articles published between January 2000 and March 2021 examining water, sanitation, and hygiene primary prevention interventions against waterborne diseases in resource-poor settings. The literature identified eight main interventions implemented at personal, household and community levels. The strength of evidence, the enabling factors, barriers, co-benefits, and alternative measures were reviewed for each intervention. There is an array of evidence available across each intervention, with strong evidence supporting the effectiveness of water treatment and safe household water storage. Studies show that at personal and household levels, interventions are effective when applied together. Furthermore, water and waste management will have a compounding impact on vector-borne diseases. Mitigation against waterborne diseases require coordinated, multi-sectoral governance, such as building sanitation infrastructure and streamlined waste management. The review showed research gaps relating to evidence-based alternative interventions for resource-poor settings and showed discrepancies in definitions of various interventions amongst research institutions, creating challenges in the direct comparison of results across studies.

Adapting a safe water storage container to improve household stored water quality in rural Burkina Faso: a cluster randomized trial

AbstractSafe water storage protects household drinking water from microbial contamination, maintaining water quality and preventing diarrhea and other water-borne diseases. However, achieving high adoption and sustained use of safe storage is challenging. Systematic adaptation can address these challenges by improving contextual fit while retaining core functionality to protect water quality. We applied Plan-Do-Study-Act (PDSA) cycles to systematically adapt a safe water storage container (SWSC) intervention for implementation in rural Burkina Faso. This study describes the adaptation process and the impacts of the SWSC on Escherichia coli contamination in household stored water in a cluster-randomized trial with 49 intervention villages (274 households) and 50 no-intervention control villages (290 households). SWSC adoption among intervention households was high (88.9%). The intervention achieved approximately a 0.4 log reduction in E. coli contamination. Intervention impact was likely moderated by differential changes in improved source use across intervention and control households. Safe storage improves water quality when used consistently. PDSA frameworks can guide the adaptation of safe storage interventions to optimize adoption and sustained use in new contexts while preserving core functions that protect water quality.

Integrated disease management: arboviral infections and waterborne diarrhoea.

Water-related diseases such as diarrhoeal diseases from viral, bacterial and parasitic organisms and Aedes-borne arboviral diseases are major global health problems. We believe that these two disease groups share common risk factors, namely inadequate household water management, poor sanitation and solid waste management. Where water provision is inadequate, water storage is essential. Aedes mosquitoes commonly breed in household water storage containers, which can hold water contaminated with enteric disease-causing organisms. Microbiological contamination of water between source and point-of-use is a major cause of reduced drinking-water quality. Inadequate sanitation and solid waste management increase not only risk of water contamination, but also the availability of mosquito larval habitats. In this article we discuss integrated interventions that interrupt mosquito breeding while also providing sanitary environments and clean water. Specific interventions include improving storage container design, placement and maintenance and scaling up access to piped water. Vector control can be integrated into sanitation projects that target sewers and drains to avoid accumulation of stagnant water. Better management of garbage and solid waste can reduce the availability of mosquito habitats while improving human living conditions. Our proposed integration of disease interventions is consistent with strategies promoted in several global health frameworks, such as the sustainable development goals, the global vector control response, behavioural change, and water, sanitation and hygiene initiatives. Future research should address how interventions targeting water, sanitation, hygiene and community waste disposal also benefit Aedes-borne disease control. The projected effects of climate change mean that integrated management and control strategies will become increasingly important.