Unimproved Water Sources Research Articles

Scabies and its associated factors among under 15 years children in Wadila district, Northern Ethiopia, 2019.

Introductionscabies is a contagious ectoparasite of the skin. It is caused by the mite Sarcoptes scabiei var. hominis that causes a pruritic skin eruption. It was estimated that more than 300 million cases of scabies occur worldwide every year. It remains one of the commonest skin diseases seen in developing countries including Ethiopia. Therefore, the main aim of this study is to determine scabies prevalence and its associated factors among less than 15 years children in Wadila district, Northern Ethiopia.Methodscommunity based cross-sectional study was conducted on 583 participants from January 30th to February 28th 2019. Multistage sampling technique was used and data were collected using pre-tested interviewer administered questionnaire. SPSS version 23.0 was used for analysis and bivariable logistic regression was computed and variables having p < 0.25 was modelled in multi-variable logistic regression to control confounders. The level of statistical significance was set at p < 0.05.Resultsthe prevalence of scabies infestation was 23.8% in Wadila district. Not using of soap when taking shower [AOR=2.93 (95% CI:1.72-5.00)], using unimproved water source [AOR=1.82 (95% CI:1.04-3.16)], sharing clothes from scabies cases [AOR=10.10 (95% CI: 3.37-30.23)], uncleaning of the house every day [AOR=2.28 (95% CI: 1.32-3.95)], presence of pet animals at home [AOR= 3.01(95% CI: 1.66-5.45)] and went to epidemic areas of scabies [AOR= 4.09 (95% CI: 2.37-7.06) were predictors of scabies infestation.Conclusionthere was higher prevalence of scabies infestation in Wadila district. Therefore, special attention should be given to under 15 years children.

Prevalence and antimicrobial susceptibility patterns of Salmonella and Shigella isolates among children aged below five years with diarrhea attending Robe General Hospital and Goba Referral Hospital, South East Ethiopia

BackgroundDiarrheal diseases are responsible for high level of morbidity and mortality, particularly in children below 5 years. Salmonella and Shigella spp. are pathogenic microbes responsible for the major diarrheal associated mortality. The purpose of this study was to determine the prevalence, factors associated with Salmonella and Shigella isolates infections and their antimicrobial susceptibility patterns among diarrheic children aged below 5 years attending BRGH and GRH, Ethiopia.MethodsA health institution based cross-sectional study was conducted from April to July 2016. One stool samples was collected from 422 diarrheic children under the ages of five and were cultured on to Hektoen Enteric (HE) and Salmonella-Shigella agar. Isolation identification of the Salmonella and Shigella isolates were conducted using standard bacteriological methods. Antibiotic susceptibility was done by Kirby–Bauer disk diffusion method. The isolates were defined as multidrug resistant if it was resistant to two or more antimicrobial agents. Descriptive statistics were employed and logistic regression models were constructed to determine factors associated with Shigella/Salmonella prevalence.ResultsThe prevalence of Salmonella and Shigella isolates were 6.9 and 4.3%, respectively. Children aged between 1 to 3 years were significantly associated with Salmonella infection [AOR = 19.08, 95% CI (2.68–135.86)]. The odd of prevalence of Salmonella/Shigella isolates was significantly associated with absence of latrine, absence of hand washing after latrine, and in unimmunized children in adjusted odd ratio. Unimproved water sources and hand washing before meal had also higher odd of prevalence although the difference was not significant. All Salmonella and Shigella isolates were resistant to amoxicillin (100%). In addition, all Shigella isolates were completely resistant to chloramphenicol, and tetracycline, and were multidrug resistant. However, all Salmonella and Shigella isolates were susceptible to ciprofloxacin and ceftriaxone.ConclusionThere was a relatively low prevalence of Salmonella and Shigella species in the study areas and were significantly associated with lack of personal hygiene and environmental sanitation. There were also higher drug resistance and multidrug resistant pattern. Personal hygiene and environmental sanitation, including access to latrine and supply of safe drinking water are suggested. Checking susceptibilities of Shigella and Salmonella isolates causing diarrhea is also suggested.

The role of drinking water source, sanitation, and solid waste management in reducing childhood stunting in Indonesia

Indonesia still bears a significant public health problem of stunting among under-5 (U-5) children. Environmental factors have been demonstrated to be associated with stunting as indirect causes. However, the extent to which the environmental factors determine the stunting burden in rural Indonesia is stil underexplored. Hence, this study investigates environmental factors that determine stunting among U-5 children in the rural areas of Indonesia. We employed data from the Indonesia Family Life Survey 2014/2015 (IFLS5) and selected a sample size of 2,571 children under five years of age residing in rural areas. We performed a multivariable logistic regression analysis and estimated the “population attributable fraction” (PAF) of drinking water, sanitation, and garbage collection on stunting. The results suggest that unimproved drinking water source and improper garbage collection correspond with higher odds of child stunting. Inadequate sanitation facility, however, was not found to be significantly influencing the odds of stunting. Moreover, household wealth is protective of risk of stunting. Furthermore, the PAF analysis demonstrated that 21.58% of the stunting burden among U-5 children residing in rural areas are preventable by providing access to an improved drinking water source and better household solid waste management to prevent repeated infections.

Water Source Preferences and Water Quality Perceptions among Women in the Eastern Region, Ghana: A Grounded Theory Study.

Residents in the Eastern Region, Ghana with access to improved water sources (e.g., boreholes and covered wells) often choose to collect water from unimproved sources (e.g., rivers and uncovered wells). To assess why, we conducted two field studies to coincide with Ghana’s rainy and dry seasons. During the rainy season, we conducted semi-structured in-depth interviews among a convenience sample of 26 women in four rural communities (including one woman in the dry season). We asked each participant about their attitudes and perceptions of water sources. During the dry season, we observed four women for ≤4 days each to provide context for water collection and water source choice. We used a grounded theory approach considering the multiple household water sources and uses approach to identify three themes informing water source choice: collection of and access to water, water quality perception, and the dynamic interaction of these. Women selected water sources based on multiple factors, including season, accessibility, religious/spiritual messaging, community messaging (e.g., health risks), and ease-of-use (e.g., physical burden). Gender and power dynamics created structural barriers that affected the use of unimproved water sources. A larger role for women in water management and supply decision-making could advance population health goals.

Estimating access to drinking water supply in Farta district rural community, Amhara Region, North Central Ethiopia, 2017: a community based cross-sectional study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Water is an essential for lives and development. Ethiopia is endowed with enormous water resources potential but access to water is limited. An uneven spatial distribution of water sources and drinking water demand is big challenge. Therefore objectives of this study were to estimate access for water supply among household of Farta district, Ethiopia.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A community based cross-sectional study design was employed in 758 households of Farta district. Interview and observational check lists were used to collect data. Systematic sampling technique was used to select households. Data was analyzed using SPSS version 20 software. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The community has access to improved water supply which was estimated to be 57.1%. The rest 42.9% of the households used unimproved water sources from other unprotected sources like unprotected dug well and river. Nearly the third quartile (74.5%) of the households had access to water within a distance of 1.5 km or less from dwelling. Majority (86%) of households had no access to water within a time of 30 minutes or less. Nearly 92.3% of the households used less than 20 liters per capita per day.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; There was a significant gap in accessing water supply for the community within 1.5 km in the district. Nearly half of households used protected well water sources. The per capita water consumption of the households were extremely low. Hence local administrator should expand protected well in all members. The community participation should be encouraged to prepare and maintain the water sources.&lt;/p&gt;

Age-specific risk factors for child anaemia in Myanmar: Analysis from the Demographic and Health Survey 2015-2016.

Anaemia is prevalent among preschool-aged children in Myanmar, but few epidemiological studies of anaemia at the national level were reported. Using data from the Myanmar Demographic and Health Survey 2015-2016, we examined risk factors for anaemia at household, maternal, and individual levels for children aged 6-23months (n=1,133) and 24-59months (n=2,393) separately. Survey design and sampling weights were adjusted for in multivariate regression analyses. The prevalence of anaemia was 77.2% in children aged 6-23months and 50.8% in those aged 24-59months. Living in geographic zones other than the hilly zone was associated with a higher odds of anaemia in both age groups (OR=1.86-2.51 [95% lower limit>1.0]). Maternal anaemia predicted child anaemia in a dose-response manner in both groups (6-23months of age, OR=2.01, 95% CI [1.38, 2.92; mild] and OR=2.41, 95% CI [1.12, 5.19; moderate]; and 24-59months of age, OR=1.42, 95% CI [1.12, 1.81; mild] and OR=2.92, 95% CI [1.91,4.46; moderate]). A maternal age of 14-24years (ref: 25-34years, OR=1.67, 95% CI [1.06, 2.64]) and maternal tolerant attitude to domestic violence (OR=1.61, 95% CI [1.13, 2.31]) predicted anaemia in children aged 6-23months only. Younger child age (OR=0.97, 95% CI [0.96, 0.98]), stunting (OR=1.35, 95% CI [1.08, 1.69]) and using unimproved drinking water sources (OR=1.38, 95% CI [1.10, 1.75]) were associated with anaemia in children aged 24-59months. Consideration of age-specific risks factors for child anaemia will help in planning anaemia control programmes in Myanmar.

Prevalence and risk factors of Strongyloides stercoralis infection among Orang Asli schoolchildren: new insights into the epidemiology, transmission and diagnosis of strongyloidiasis in Malaysia.

This cross-sectional study aimed to determine the prevalence and risk factors of S. stercoralis infection among 1142 Orang Asli primary schoolchildren in six different states of Peninsular Malaysia. Fecal samples were examined using direct smear, formalin-ether sedimentation (FES), agar plate culture (APC) and PCR techniques. Overall, 15.8% of the children were found to be infected with S. stercoralis. The prevalence was 0.2, 1.3, 15.2 and 13.7% by direct smear, FES, APC and PCR, respectively. Multivariate analysis showed that an age of >10 years, being male, belonging to a Proto-Malay tribe, belonging to the Senoi tribe, indiscriminate defecation, using an unimproved water source for drinking water and not wearing shoes when outside were the significant risk factors of infection among these children. In conclusion, we provide new evidence on the occurrence of S. stercoralis in Malaysia to show that there is a relatively high prevalence of infection among Orang Asli schoolchildren. Therefore, the use of specific methods for detecting S. stercoralis should be considered when screening these children for intestinal parasites. Moreover, prevention and control measures specific to S. stercoralis should be integrated into the intestinal parasitic infections control programme in Malaysia.

Unimproved water sources and open defecation are associated with active trachoma in children in internally displaced persons camps in the Darfur States of Sudan.

PurposeTo estimate the proportion of children with trachomatous inflammation—follicular (TF) and adults with trachomatous trichiasis (TT) in internally displaced persons (IDP) camps in the Darfur States of Sudan and to evaluate associated risk factors.MethodsIDP camps were identified from government census data. We conducted a subanalysis of data collected in these camps during 2014–2015 as part of surveys covering 37 districts of the Darfur States within the Global Trachoma Mapping Project. A random-effects hierarchical model was used to evaluate factors associated with TF in children or TT in adults.ResultsThirty-six IDP camps were represented in the survey data, in which 1926 children aged 1–9 y were examined, of whom 38 (8%) had TF. Poor sanitation, younger age and living in a household that purchased water from a vendor were associated with TF in children aged 1–9 y. Of 2139 individuals examined aged ≥15 y, 16 (0.7%) had TT. TT was strongly independently associated with being older and living alone.ConclusionTrachoma is found at low levels in these camps, but still at levels where intervention is needed. Disease elimination in conflict-related settings presents a unique challenge for the trachoma community, and may require an innovative approach. Understanding how best to undertake trachoma elimination interventions in these areas should be prioritized.

Dirty hands on troubled waters: Sanitation, access to water and child health in Ethiopia

AbstractIn this paper, we investigate the impact of access to drinking water sources and sanitation facilities on the incidence of diarrheal diseases among children below 5 years of age in Ethiopia using the propensity score matching technique with a polychotomous treatment variable. We find that among the water sources traditionally considered as improved, only water piped into dwelling, yard or plot leads to a large percentage point reduction in diarrhea incidence. The other water sources, generally believed as clean, are not effective in reducing diarrhea even compared with some of the unimproved water sources. We also find that some unimproved water sources and sanitation facilities are less inferior than they are believed to be. These results suggest that the traditional way of categorizing different types of improved and unimproved water sources and sanitation facilities into a dichotomous variable, “improved” or “unimproved”, could be misleading as it masks the heterogeneous effects of the water sources and the sanitation facilities.

From Administrative to Political Evaluation: Estimating Water, Sanitation, and Hygiene Indicators for Parliamentary Constituencies in India

With the launch of the Swachh Bharat Mission (SBM), India accelerated access to improved sanitation in a ‘mass movement’ emphasising people’s participation and political leadership. However, SBM continues to be implemented at the administrative unit of districts, disassociated from the political and electoral units of Parliamentary Constituencies (PC). We provide estimates of India’s 543 PCs by their performance on three important Water Sanitation and Hygiene (WASH) indicators: unsafe disposal of child stool, unimproved drinking water supply, and unimproved sanitary facilities. We used multilevel modelling to generate precision-weighted estimates of each indicator at PC-level, based on recently developed methodologies linking cluster GPS data from the National Family Health Survey (NFHS), 2016 to potential PCs. We found very high heterogeneity across PCs ranging from 0.95 per cent–95.85 per cent for unsafe stool disposal, 0.35 per cent–64.17 per cent for unimproved drinking water source, and 0.19 per cent–90.69 per cent for unimproved sanitation facility. Unsafe child stool disposal and unimproved sanitary facility were strongly correlated ( r = 0.85, Pearson and r = 0.83, Spearman). Monitoring of SBM data at the PC level will allow parliamentarians to effectively improve WASH conditions in their constituencies, while accounting for critical between-PC variability that may be obfuscated in an approach focussed on state or district means.

Effects of water and health on primary school enrolment and absenteeism in Indonesia.

Clean water provision remains a serious problem in low- and middle-income countries. In 2017, about 30% of the world population relied on unimproved water sources located outside of the dwellings. Often women and children are occupied in fetching water. This situation increases the prevalence of water-related diseases such as diarrhoea and reduces children's study time. School attendance may decrease due to the combined effects of diarrhoea and time spent on fetching water. We investigate the effects on school absenteeism and primary school enrolment in Indonesia, using a panel data set for 295 districts over the period 1994-2014. Districts with higher diarrhoea prevalence are found to have lower school enrolment (B: -0.202, sig p < 0.01) and higher school absenteeism (B: 2.334, sig p < 0.001). Districts where more households have access to private water facilities have higher school enrolment (B: 0.025, sig p < 0.01) and lower school absenteeism (B: -0.027, sig p < 0.01). More use of piped and bottled water in a district is associated with a lower diarrhoea prevalence (B: -0.004, sig p < 0.05). Policy-makers should take the benefits of improved water supply into account when making cost-benefit analyses regarding investments in water infrastructure.

Bacterial contamination of drinking water sources in rural villages of Mohale Basin, Lesotho: exposures through neighbourhood sanitation and hygiene practices

BackgroundBacterial contamination of drinking water is a major public health problem in rural areas of sub-Saharan Africa. Unimproved water sources are a major reservoir of Escherichia coli (E. coli) causing severe diarrhoea in humans. This study assessed E. coli counts in drinking water from different sources and their relationship with water source protection status and neighbourhood sanitation and hygiene practices in rural villages of Mohale Basin in Lesotho.MethodsThirty drinking water sources were purposively sampled and their water analysed for E. coli counts. The types of water sources, their protection status and neighbourhood sanitation and hygiene practices in their proximity were also assessed. E. coli counts in water samples were compared to water source protection status, neighbourhood sanitation, hygiene practices, livestock faeces and latrine proximity to water sources.ResultsE. coli counts were found in all water samples and ranged from less than 30 colony-forming units (cfu)/100 ml to 4800 cfu/100 ml in protected sources to 43,500,000 cfu/100 ml in unprotected sources. A significant association between E. coli counts in drinking water samples and lack of water source protection, high prevalence of open defecation (59%, n = 100), unhygienic practices, livestock faeces and latrine detections in proximity to water sources was found in the study (P < 0.05).ConclusionWater sources in studied villages were contaminated with faeces and posed a health risk to consumers of that water. Community-led sanitation and hygiene education and better water source protection are urgently needed.

Factors influencing household access to drinking water in Nigeria

Sustainable Development Goal 6 of the United Nations, adopted in 2015, aims at equitable access to safe and affordable drinking water for all by 2030. Attaining this goal is difficult without focusing on inequalities among regions and populations. This article explores the factors that influence household access to drinking water in Nigeria using 2013 Demographic and Health Surveys. Descriptive and inferential statistics show that about 88% of all households that used surface water are from rural areas. The Northwest and Northeast regions are home to 78% of all households that use unprotected wells. Whereas 64% of households with access to piped water into dwelling are richer and richest households, the middle-class, poorer and poorest households constitute 83.4% of surface water users. Household drinking water sources are significantly (p = 0.01) influenced by place of residence (χ2 = 8328.2), geopolitical zone (χ2 = 12042.8), education (χ2 = 5346.2), wealth index (χ2 = 16540.3), ethnicity (χ2 = 8649.9), access to electricity (χ2 = 8040.9), and gender (χ2 = 537.3). Logistic regression analysis indicates that these variables, as well as state of residency, water collection time, and number of rooms, are significant predictors of access to improved or unimproved water sources. Toilet type and household size are not significant. Based on the findings, we recommend providing public standpipes and community boreholes as interim measures and piped water eventually, household water treatment as a stop-gap measure for improving water safety, and targeted interventions in poor communities and marginalized regions.

Choice and quantity demand for improved and unimproved public water sources in rural areas: Evidence from Benin

Almost half of the world's population relies on public water sources for the daily drinking water supply. In this context, usage of improved public water sources is identified as a major contributor to good health. This research aims to identify important determinants of demand for water from improved and unimproved public water sources in rural areas. This is done by estimating choice and quantity models using a unique data set from a household survey conducted in rural areas of Benin, West Africa. The analysis identifies source and household characteristics that increase choice probability and water quantity demand for improved and unimproved public water sources. The price of water, the distance between the household and the water source, and the subjective quality of the source are relevant characteristics for the water source choice. Wealthy households and households with female heads have a higher probability to choose improved public water sources. After households have chosen a public water source, quantity demand is driven by wealth, household size and perceived taste. Price only affects water quantity demand from improved sources, while distance only affects water quantity demand from unimproved sources.

Modification of the impact of access to water on childhood diarrhoea by socioeconomic status in the Gaza Strip from 2000 to 2014: a cross-sectional study

BackgroundAccess to unsafe water is a concern in the Gaza Strip, where water supplies continue to degrade owing to regional sanctions, bombardment, and mismanagement. Our previous study found that decreased access to public water networks was associated with increased diarrhoea prevalence in children younger than 5 years in the Gaza Strip. This study examined the role of socioeconomic status as an effect modifier in this association. MethodsWe used data from five consecutive demographic health surveys and multiple indicator cluster surveys conducted by the Palestinian Central Bureau of Statistics in 2000, 2004, 2006/2007 (December, 2006, to March, 2007), 2010, and 2014. Multivariable logistic regression models were applied to pooled data with prevalence of diarrhoea as the outcome and access to water as the main exposure of interest, with adjustment for age, sex, governorate, and survey year (to adjust for the seasons or other administrative conditions, for each survey). Access to water was characterised by the type of source, namely piped, other improved (eg, public standpipe, borehole, protected dug well, protected spring, and rainwater collection), or unimproved, as defined by the WHO. We defined socioeconomic status in the analysis using maternal education, refugee status, and locality type (urban, rural, or camp). FindingsThe odds ratio (OR) of diarrhoea for children with access to unimproved water sources was higher than for those with access to piped water sources when mothers had only primary education (OR 1·35; 95% CI 1·07–1·71) than when mothers also had secondary or higher education (1·09; 0·93–1·27). The OR for children in camps was 1·32 (1·10–1·57) compared with 1·19 in urban areas (1·05–1·36). Point estimates of ORs suggested strong effect modification by refugee status, although with wider CIs for non-registered refugee children (4·95; 1·58–15·55) than for registered refugees (1·35; 1·18–1·53) or non-refugees (1·18; 1·07–1·43). InterpretationOur results suggest that, in the Gaza strip, children with lower socioeconomic status experience a greater burden of diarrhoea morbidity risk than children with higher socioeconomic status, even when using the same type of water source. Changes to policy are required to address such disproportionate burden of diarrhoea risk in the occupied Palestinian territory. FundingNone.

Consistent point-of-use water chlorination among households using unimproved water sources and treatment preference in Eastern Ethiopia

ABSTRACTA consistent and correct use of water treatment options is fundamental for health gain from point-of-use water chlorination. In Ethiopia, empirical evidence about the consistent use and preference for by end users is scarce. The current study is intended to explore these issues using Waterguard and Bishan Gari in Kersa Health and Demographic Surveillance Site, Eastern Ethiopia. Data were collected every 2 week for 4 months and analyzed using mixed effects logistic regression. Of 377 households, 31% consistently used Waterguard and Bishan Gari in all the study waves. Product use over time within a household varied based on the perception about the products and the type of products each household received. From the exit assessment, 56% of households stated a preference for Waterguard significantly different from 5.6% of households that stated a preference for Bishan Gari. An intervention for consistent use beyond their availability and accessibility to end users is needed.

Chemical and Bacteriological Control of Drinking Water from 15 Villages in Côte d'Ivoire

The High percentage of diarrhea-related child deaths in Africa is related to water, sanitation and hygiene. In Cote d'Ivoire, 20% of the population feeds on water from unimproved water sources and surface water. These waters are not taken into account in the sanitary monitoring of drinking water in the country. Thus, this study aimed to control the quality of the main drinking water sources in several Ivorian localities without a drinking water supply system. The methodological approach was to carry out a campaign to collect water samples from the main sources of drinking water supply in fifteen villages in five regions of Cote d'Ivoire: Agnebi tiassa, Gontougo, Kabadougou, Sud-comoe and Nawa. On these samples, the classical physicochemical parameters were determined by electrochemical and spectrophotometric methods. Microbiological analysis was performed by membrane filtration technique and pesticides by gas chromatography coupled with mass spectrometry. The results showed that the waters are characterized by mineralization ranging from 23.80 to 650 μScm-1, an acidic pH in 63% of cases, an high turbidity values (37% of cases), a color (30% of cases), in iron (20% of cases) and nitrites (17% of cases). All waters are contaminated by indicator germs of faecal pollution. A carbamate pesticide, terbucarb, was identified in 67% of the samples. In conclusion, the waters of the fifteen localities are of unsatisfactory quality and unfit for human consumption. Authorities should take measures to ensure the treatment, protection and continuous improvement of water quality in these areas in order to preserve population's health.

Unsafe Drinking Water Is Associated with Environmental Enteric Dysfunction and Poor Growth Outcomes in Young Children in Rural Southwestern Uganda.

.Environmental enteric dysfunction (EED), a subclinical disorder of the small intestine, and poor growth are associated with living in poor water, sanitation, and hygiene (WASH) conditions, but specific risk factors remain unclear. Nested within a birth cohort study, this study investigates relationships among water quality, EED, and growth in 385 children living in southwestern Uganda. Water quality was assessed using a portable water quality test when children were 6 months, and safe water was defined as lacking Escherichia coli contamination. Environmental enteric dysfunction was assessed using the lactulose:mannitol (L:M) test at 12–16 months. Anthropometry and covariate data were extracted from the cohort study, and associations were assessed using linear and logistic regression models. Less than half of the households (43.8%) had safe water, and safe versus unsafe water did not correlate with improved versus unimproved water source. In adjusted linear regression models, children from households with safe water had significantly lower log-transformed (ln) L:M ratios (β: −0.22, 95% confidence interval (CI): −0.44, −0.00) and significantly higher length-for-age (β: 0.29, 95% CI: 0.00, 0.58) and weight-for-age (β: 0.20, 95% CI: 0.05, 0.34) Z-scores at 12–16 months. Furthermore, in adjusted linear regression models, ln L:M ratios at 12–16 months significantly decreased with increasing length-for-age Z-scores at birth, 6 months, and 9 months (β: −0.05, 95% CI: −0.10, −0.004; β: −0.06, 95% CI: −0.11, −0.006; and β: −0.05, 95% CI: −0.09, −0.005, respectively). Overall, our data suggest that programs seeking to improve nutrition should address poor WASH conditions simultaneously, particularly related to household drinking water quality.

Effects of household drinking water choices, knowledge, practices and spatio-temporal trend on the prevalence of waterborne diseases in Enugu Urban, Nigeria

Background: The inadequacy of drinking water supply to households in Enugu Urban, Nigeria, has forced many to depend on unimproved water sources, thus, exposing them to infection by waterborne pathogens (WBP). Methods & Materials: A cross-sectional multi-stage sampling was adopted. Standard methods of stool samples examination was used to determine the prevalence of waterborne diseases. Well-structured close-ended questionnaire aided assessment of households’ drinking water choices, knowledge and practices. Retrospective records of waterborne diseases (WBD) from January, 2013 to December, 2016 were also reviewed. Results: A total of 403 samples were examined, 344 (85.4%) were infected with at least one WBP. Ordered by prevalence, nine genera of WBP were isolated: Escherichia (38.0%), Giardia (35.2%), Entamoeba (33.0%), Salmonella (19.9%), Proteus (13.2%), Shigella (9.4%), Klebsiella (7.4%), Enterobacter (5.5%) and Cryptosporidium (5.2%). Prevalence of WBP was highest in children within 0 - 5yrs (90.6%). Out of six communities, Ogui in Enugu North Local Government Area had the highest prevalence (91.5%) of WBP. Respondents who source their drinking water from “public wells” (OR = 2.487, CI95 1.296 -4.774), “borehole/vendors” (OR = 2.175, CI95 1.231–3.843), and those that have poor sanitation level (OR = 4.495, CI95 2.358–0.371) were significantly associated with increased odds of WBD (p < 0.05). Furthermore, having very good sanitation level (OR = 0.179, CI95 0.094–0.343), not storing drinking water (OR = 0.166, CI95 0.064–0.429), boiling drinking water (OR = 0.546, CI95 0.307–0.907), and always filtering drinking water (OR = 0.398, CI95 0.174–0.909) reduced the risk of WBD (p < 0.05). Analysis of retrospective records shows an increase in temporal trend from 2013-2015, with slight decrease in 2016. Conclusion: Against the background of this study, most households in Enugu Urban are vulnerable to consuming water contaminated at many points in their journey from source to mouth. This portrays the importance of adequate provision of safe drinking water, and need for appropriate “point of use” household water treatment and storage methods that will effectively curb the prevalence of WBD.

Physico-chemical quality of drinking water in the Njoro sub-county in Kenya

Abstract Njoro sub-county in Kenya suffers from constant water shortages causing the residents to rely on both improved and unimproved water sources in the area. The households in the sub-county also use different household storage containers to store drinking water in times when water is not readily available. This study was therefore undertaken to assess selective physico-chemical parameters of water used by the population for drinking purposes using standard assessment methods. A total of 372 water source samples and 162 storage container water samples were tested over a period of three months. Turbidity (0.70–273.85 NTU), iron (0.7–2.10 mg/L), fluoride (0.15–4.01 mg/L), manganese (0.01–0.37 mg/L), and nitrate (0.09–27.90 mg/L) levels in water samples were generally higher than the Kenya Bureau of Standards (KEBS) and/or the World Health Organization (WHO) water quality recommendations for safe drinkable water. The results from this study support the need for continuous monitoring and treating drinking water at the points of collection and of consumption to minimize the long-term health effects on communities consuming this water.