Water-related Diseases Research Articles

Chlorine As a Disinfectant in Water Treatment

Abstract: Disinfection of treated water is a necessary process. For this, chlorine and its products are widely used. During the treatment process, chlorine is added to drinking water as elemental chlorine, sodium hypochlorite solution or dry calcium hypochlorite. When applied to water, each of these forms “free chlorine”, which destroys pathogenic organisms. If adequate water treatment is not readily available, the impact on public health can be devastating. Worldwide, about 1.2 billion people lack access to safe drinking water, and about 2.4 billion people lack sanitation. As per WHO, 3.4 million people die from waterrelated diseases. Drinking water chlorination will remain a cornerstone of disinfection. This is because of the wide range of benefits provided by chlorine. However, alternative disinfectants including ozone and UV radiation are available, all disinfection methods have unique benefits, limitations and costs. So, an engineer has to consider all the pros and cons of a disinfectant method properly before deciding the one to adopt. Keywords: Disinfection, Gaseous Chlorination, Sodium Hypochlorite, Calcium Hypochlorite, Ultraviolet, Ozone, Chlorine dioxide

Review on Emerging Waterborne Pathogens in Africa: The Case of Cryptosporidium

Water-related diseases, particularly waterborne diseases, remain significant sources of morbidity and mortality worldwide but especially in developing countries. Emerging waterborne pathogens represent a major health risk. Cryptosporidium is one such pathogen which is globally recognized as a major cause of diarrhea in children and adults. The objective of this paper is not only to review published studies on the impact of these emerging waterborne pathogens but also to identify the various risk factors that favor their transmission. A number of envisaged and needed actions to tackle the challenge of these pathogens in Africa have also been discussed. We have searched the web of ScienceDirect, PubMed, Scopus. ISI Web of Science, SpringerLink, and Google Scholar. The first database search yielded 3099 articles. As a result, 141 studies were submitted for abstract review. A total of 68 articles were selected for full text analysis. After evaluating a considerable number of articles on this topic, the following results were obtained. A number of pathogens are likely to present public health risks, including Cryptosporidium. The contaminating potential of these pathogens is associated with a multitude of factors, such as the effects of climate change, social and behavioral aspects of local populations, water issues, geographical locations that may cause isolation, and inequalities due to lack of transparency of governments in the distribution of financial resources. We stress the need to maintain and strengthen real-time surveillance and rapid epidemiological responses to outbreaks and the emergence of new waterborne pathogens in all countries. African governments, for their part, should be aware of future risks of waterborne protozoan diseases. They must provide immediate and effective responses by establishing technical and financial mechanisms to ensure sufficient quantities of safe drinking water, sewage disposal, and hygiene for all.

Drinking water quality surveillance status for Amazonas state's 62 counties

Abstract Introduction The state of Amazonas is the largest state in Brazil and it has 62 counties, including Manaus, its capital, all of which have plenty of water resources. The control and surveillance of water quality, as well as the sewage treatment must be carried out satisfactorily in order to avoid a favorable environment for the development of pathogens that cause water related diseases. Objectives Assess the quality of the water supplied to the population of the 62 counties in the period of 2015-2019. Methods Quantitative and qualitative descriptive study, based on secondary data taken from Water Quality Surveillance Information System for Human Consumption. and analyzed from the available database at the Health Surveillance Foundation. Information was gathered on the type of collection, treatment, control, surveillance and microbiological (total coliforms and Escherichia coli). Results it was observed that 73% of the counties use underground water (well), 19% superficial (rivers) and 8% mixed combination (underground and superficial); 35% undergo chlorine treatment; less than 50%, averaging 26 counties, carry out control, surveillance and/or combined control and surveillance activities; on average: 29% have control data; 23% of surveillance and of these, 19% embody it effectively (≥ 7 months/year) and 19% of control and surveillance simultaneously. During the study, 46,670 microbiological analysis were carried out and of these 10,603 (23%) presented total coliforms and 2.265, approximately 4.9%, unsatisfactory result for human consumption due to the presence of Escherichia coli. The data demonstrate that the control and surveillance of water quality is carried out in an unsatisfactory manner, highlighting the need to strengthen the performance of the health sector and those responsible for an alternative water supply system or alternative solution in the state Amazonas. Key messages Measuring the effectiveness of surveillance actions are necessary for water quality control. Vigilance actions are important to reduce morbidity and mortality due to water transmission problems.

Study the optical properties of drinking water supply by KUKL and KVWSIP in Kathmandu Valley

The optical properties of two water supply samples Kathmandu Upatyaka Khanepani Limited (KUKL) and Kathmandu Valley Water Supply Improvement Project (KVWSIP) in the Kupondole Area, Lalitpur, Nepal show that the transmittance of light is higher for KVWSIP sample water than for KUKL. A large amount of work has been done to test the purities of KUKL and KVWSIP water supplies (chemically), but even their optical properties have not been studied. This method has no hazardous side effects or requires chemical method testing. In comparing the optical properties, the authors recommended that the public take KVWSIP water for good health and wealth rather than KUKL if they have an option.This is because KUKL is more contaminated and has more total dissolved solids (TDS) particles, while KVWSIP has fewer TDS particles. Therefore, if people take KVWSIP water in their daily life, they obtain relief from different types of water-related diseases.

Burden of water, sanitation and hygiene related diseases in India: prevalence, health care cost and effect of community level factors

ObjectivesTo study the disease burden and financial burden of water, sanitation and hygiene (WASH) related-diseases among individuals in India. MethodsThe prevalence and economic burden of WASH-related diseases was estimated using 75th Round National Sample Survey: ‘Household social consumption: Health’. A multilevel logistic regression model was used to assess the effect of community level factors in the prevalence of these diseases. ResultsThe prevalence of WASH-related diseases in India was at 5.7% of all outpatient visits and 6.9% of all hospital admissions during in 2017–18.66% of all outpatient malaria visits in rural areas were associated with restrictions in daily activities of ailing individuals. The mean out-of- pocket expenditure across all WASH-related diseases was ₹703 per outpatient visit and ₹9656 per hospital admission. The monthly OOPE on outpatient care for 74% persons with jaundice in rural areas, was greater than their monthly per capita consumption expenditure and 97% persons with malaria in urban areas faced catastrophic OOPE on outpatient care. Each hospital admission for jaundice in urban areas led to an earning loss of ₹2260. The intra-class correlation at community level from the multilevel logistic regression for diseases prevalence were 0.28 and 0.26 for outpatient and inpatient cases, indicating the role of community level factors in the variation in disease prevalence. ConclusionThere is a high prevalence, financial burden and effect of community level factors on WASH-related diseases in India. Holistic strengthening of WASH facilities is required to mitigate the avoidable burden of these diseases.

Physicochemical, bacteriological, and correlational evaluation of water obtained from boreholes and springs in a sub-urban community

Inadequate safe and portable water supply particularly in underdeveloped and developing countries has been associated with posing serious public health implications, especially as water related diseases continue to be a major health challenge in resource limited settings worldwide. Physicochemical and bacteriological parameters of borehole and spring water sources in a sub-urban community were assessed to determine their potability and correlation index. Twenty (20) water samples, 10 from boreholes and 10 from springs were randomly collected from different locations and analysed using standard microbiological and physicochemical methods. The results were compared with NIS and WHO standards for drinking water. Physicochemical parameters including; temperature, pH, turbidity, electrical conductivity, total hardness, total dissolved solid, Iron, Manganese, Zinc, Chloride, Sodium, Nitrate, Ammonium and Potassium were determined following the procedures prescribed by American Public Health Association Standard Method. Results obtained revealed that 99.3% of the analysed physicochemical parameters were within the maximum acceptable limits of NIS and WHO guidelines for drinking water except borehole iron concentration (0.52mg/L) and Manganese concentration (0.14mg/L). The total heterotrophic bacterial count (THB), total coliform count and faecal coliform count ranged from 1.6x103cfu/100ml to 4.7x103cfu/100 ml, 8.0cfu/100ml to 25cfu/ml, 0cfu/100ml to 14cfu/100ml respectively for boreholes, and 1.7x103cfu/100ml to 4.6x103cfu/100ml, 10cfu/100ml to 21cfu/100ml, 9cfu/100ml to 17cfu/100ml respectively for samples from spring water supply. Phenotypic characterization of the samples revealed the presence of certain organisms with pathogenic potentials such as Staphylococcus aureus 27.5%, followed by E. coli 19.6%, P. aeruginosa 11.8%, Klebsiella spp. 9.8%, Enterobacter spp. 7.8%, Enterococcus spp. 7.8%, Lactobacillus spp. 5.9%, Proteus spp. 3.9%, Shigella spp. 3.9% and Vibrio cholerae 2.0%. Pearson’s correlation analysis showed significantly strong positive correlation between total heterotrophic bacteria count and total coliforms (r = 0.643) and strong negative correlation between pH and total dissolved solids (r = -0.640). Other parameters such as faecal coliform, temperature, pH, turbidity, Zinc, Ammonium and Sodium shows significant correlation among variables.

THE EFFECT OF INADEQUATE ACCESS TO POTABLE WATER ON THE HEALTH OF THE PEOPLE IN THE WA MUNICIPALITY OF GHANA

Accessibility to safe drinking water is regarded as a fundamental human right since it is essential to preserving healthy livelihoods and the basic human dignity of all human beings. The study examined the effect of inadequate potable water supply on the health of the people in the Wa Municipality of Ghana. Findings of the study revealed that water related diseases are very common in the municipality due to the inadequate supply of potable water. About 55% of respondents, mentioned schistosomiasis as the top disease burden in the area. Again, the analysis of data on water provision and accessibility in the study suggested that most of the residents of the Municipality precisely 69.2% covered distances more than the standard distance of 1km stipulated by World Health Organization in search for potable water. The impacts of the time spent and distance traveled to acquire water in the Municipality were largely experienced by children and women, owing to the fact that in Ghana, water collection is considered to be the primary duty of children and women. Based on the findings the study recommends that more boreholes should be provided in the Wa Municipality to enable the residents have easy access to potable water supply. KEYWORDS: Ghana, Wa Municipality, Potable water accessibility.

WATER, ENERGY AND FOOD NEXUS INTERVENTIONS: IMPLICATIONS FOR THE ACHIEVEMENT OF THE SUSTAINABLE DEVELOPMENT GOALS IN MALAWI

Malawi faces mounting challenges in meeting the growing demand for food, water, and energy to satisfy the needs of a rapidly growing population. Relying on secondary data, the paper argues that while the existing policy initiatives have increased food production to a certain extent, the demand for water and energy has also increased, leading to degradation of the resource base, and contributing to an increase in water-related diseases. Poor sectoral coordination and institutional fragmentation have triggered the unsustainable use of resources and threatened the long-term sustainability of food, water, and energy security in the country, posing challenges to achieving the Sustainable Development Goals (SDGs) in the country. Consequently, this paper substantiates that a nexus approach can enhance understanding of the interconnectedness of the sectors and strengthen coordination among them. However, it requires a major shift in the decision-making process towards taking a holistic view, and development of institutional mechanisms to coordinate the actions of diverse actors and strengthen complementarities and synergies among the three sectors. The framework for cross-sectoral coordination and managing the nexus challenges is also suggested.

The Urban Metabolism of Waterborne Diseases: Variegated Citizenship, (Waste)Water Flows, and Climatic Variability in Maputo, Mozambique

In this article we draw on an interdisciplinary study on drinking water quality in Maputo, the capital of Mozambique, to examine the nature, scale, and politics of waterborne diseases. We show how water contamination and related diseases are discursively framed as household risks, thereby concealing the politics of uneven exposure to contaminated water and placing the burden of being healthy on individuals. In contrast, we propose that uneven geographies of waterborne diseases are best understood as the product of Maputo’s urban metabolism, in which attempts at being sanitary and healthy are caught up in relations of power, class, and variegated citizenship. Waterborne diseases are the result of complex and fragmented circulations and intersections of (waste)waters, generated by uneven urban development, heterogeneous infrastructure configurations, and everyday practices to cope with basic service deficits, in conjunction with increasing climatic variability. The latrine—from which ultimately contamination and diseases spread—is an outcome of these processes, rather than the site to be blamed. This article also advances an interdisciplinary framework for analyzing urban metabolism and deepening its explanatory potential. It serves as a demonstration of how interdisciplinary approaches might be taken forward to generate new readings of more-than-human metabolic processes at distinct temporal and spatial scales.

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.

Smart Urban Water Quality Prediction System Using Machine Learning

The World Health Organization says that every year more than 3.4 million people die as a result of water-related diseases. Quality of water serves as a powerful environmental determinant and a foundation for the prevention and control of waterborne diseases. The project aims to design a water quality prediction system using Machine learning based on the water standards suggested by BIS to prevent deaths due to water related diseases. The quality is predicted based on parameters such as pH, Temperature, TDS, Turbidity and Conductivity value. The dataset is preprocessed and split into test and training data. The data is fed into regression algorithm and been evaluated. Sensors that can measure the water parameters are also been implemented. A webpage interfaced with the Machine Learning model is created to upload sensor values and the corresponding water quality is predicted. This project can be used in urban areas to predict the quality of the drinking water thereby preventing the spread of diseases such as dysentery, typhoid and cholera due to consumption of contaminated water.

Accelerating the Provision of Safe Water Supply in Urban and Rural Areas of Indonesia

Over the past 100 years, the provision of a safe water supply to drink in Indonesia has been slowly progressed with low coverage. The majority of the population does not have access to safe water. Morbidity and mortality of water-related diseases, including diarrhea, are very high. The provision of safe water is not a technological issue but good water management that comprises content, institutional, and communication layer. This paper provided information for strategic and operational decisions to accelerate the provision of safe water services in urban and rural areas. Benchmarking good water management with the characteristics of the water supply location is required to improve the health status of the population, mainly the poor urban and rural areas with limited resources, including time and cost.

Mega festivals like MahaKumbh, a largest mass congregation, facilitated the transmission of SARS-CoV-2 to humans and endangered animals via contaminated water.

Our surrounding environment has been influenced by the COVID-19 pandemic situation. The second wave of COVID-19 in India has proven to be more devastating and aggressive than the first wave of the pandemic, which led to recognizing India as one of the world's topmost worst-hit nations considering >4000 fatalities reported in a single day in May 2021. Such “resurgence and acceleration” of COVID-19 transmission has been fuelled by the MahaKumbh festival and political mass gathering (elections rallies) events, where the COVID-19 protocols have been ignored by millions of pilgrims/followers. The present review discusses only the consequences of this year's MahaKumbh festivals, the largest religious mass gathering on earth, which was held during the COVID-19 pandemic in India, and its impact on both the spread of SARS-CoV-2 among participants and their families and its influence on the quality of the river Ganga. This article tries to give readers outside of India an overview of how much impact of any such single large gathering of any relgion in any part of the world can drive coronavirus infections and effectively commence the second/third wave outbreak with this case study. Furthermore, the religious large scale celebration are widely accepted through out the world that have played a significant role in the spread of the pandemic into remote villages and towns all over the subcontinent/world, thus affecting many areas with insufficient healthcare facilities that have been relatively spared. This review also highlights the potential risk of transmission from infected humans into the aquatic environment of the river Ganga. Besides the obvious relevance of SARS-CoV-2, a large variety of other water-related disease vectors (bacteria, viruses, and protozoa) stemming from visitors to the religious congregation were introduced into the upstream regions of the Ganga river. Their sheer number is assumed to have had a severe influence on its delicate ecosystem, including endangered mammals such as the river Dolphins. The detailed epidemiological and clinical study on transmission routes of SARS-CoV-2 is the need of the hour to understand the pathogenesis of RNA virus infection and prevent the massive spreading of such infectious respiratory diseases. An interdisciplinary approach, rooted in evidence-based efficient learning, contextual strategies, and a streamlined unified approach should be adopted to help in the development of a proactive prevention model during future MahaKumbh festival (and similar religious gatherings) instead of just “picking up the pieces” in a conventional post-event model.

Water Related Diseases in Adamawa Region, Cameroon: A Prospective and Retrospective Case Study

Water related disease is defined as any significant or widespread adverse effects on human health, such as death, disability, illness or disorders, caused directly or indirectly by the condition, or changes in the quantity or quality of any water. This crossectional and analytical study, carried out from July to December 2019 at the Ngaoundere Regional Hospital and Protestant Hospital aimed to determine the prevalence of water related diseases in the Vina Division. Retrospective data of patients records covered the period of five years (2014 to 2018) were analyzed in order to identify common water related diseases in the study area. Document review technique was adopted in this study; outpatients/inpatients registers were reviewed and information on socio-demographic characteristics of each individual patient were collected. Also, the bacteriological characterization of stool samples collected from patients was done to identify the most frequent bacteria responsible for water related disease in the area, followed by an antibacterial susceptibility testing of some isolated bacteria using standard methods. Results show that, out of 153073 patients recorded from 2014 to 2019, 63750 were clinically diagnosed for water related diseases, giving a prevalence of 41%. Overall, typhoid fever and malaria were the most prevailing water related diseases confirmed clinically with a prevalence of 43%. Parasitic infections were the least prevailing (3.7%). The study revealed that, females was more prone to water related cases than males. Bacteria were more sensitive to streptomycin and resistant to amoxicillin. This study shows that water related diseases are a major health problem in the Vina Division. Routinely monitoring of drinking water sources is recommended to the different users in order to limit the spread of water related diseases.

A systematic review of waterborne and water-related disease in animal populations of Florida from 1999-2019.

Florida's waters are a reservoir for a host of pathogens and toxins. Many of these microorganisms cause water-related diseases in people that are reportable to the Florida Department of Health. Our objective in this review was to ascertain which water-related pathogens and toxins of public health importance have been found in animal populations in Florida over the last twenty years. Nineteen databases were searched, including PubMed and Web of Science Core Collection, using keywords and search terms for the waterborne diseases, water-related vector-borne diseases, and water-based toxins reportable to the Florida Department of Health. For inclusion, peer-reviewed journal articles were to be written in English, published between January 1, 1999 and December 31, 2019, and contain primary research findings documenting at least one of the water-related pathogens or toxins of interest in an animal population within Florida during this same time frame. Of over eight thousand initial search results, 65 studies were included for final analysis. The most common animal types implicated in the diseases of interest included marine mammals, fish and shellfish, wild birds, and livestock. Toxins or pathogens most often associated with these animals included toxin-producer Karenia brevis, vibriosis, Escherichia coli, and Salmonellosis. Findings from this review elucidate the water-related disease-causing pathogens and toxins which have been reported within animal populations in recent Florida history. As most of these diseases are zoonotic, our results suggest a One Health approach is necessary to support and maintain healthy water systems throughout the state of Florida for the protection of both human and animal populations.

Exploration of the driving factors and distribution of fecal coliform in rivers under a traditional agro-pastoral economy in Kyrgyzstan, Central Asia

Fecal coliform (FC) in river water is one of the threats to human health. To explore the pollution status of FC in rivers of Kyrgyzstan, a mountainous country with traditional agro-pastoral economy, 184 water samples from the rivers of Kyrgyzstan in low and high river flow period were analyzed. Spatial autocorrelation and classical statistical methods were used to analyze the spatiotemporal distribution and driving factors of FC. The results showed that the surface water quality of Kyrgyz rivers was good, and the concentration range of FC was 0–23 MPN/100 mL. Temporally, the maximum FC concentration was 4 MPN/100 mL in low river flow period, while in the period of high river flow, the highest value reached to 23 MPN/100 mL. Spatially, the concentration of FC in high altitude areas was low, while that in the lowland areas was relatively high, which indicated that animal husbandry in high altitude areas contributed little to FC in rivers, and urban domestic sewage and agricultural activities in lowlands were the main pollution sources of FC in rivers. There was no correlation between FC and hardness, electrical conductivity (EC), pH and total organic carbon (TOC) in river water of Kyrgyzstan, and the distribution of FC in high river flow period was mainly driven by population and human modification of terrestrial systems. The results can provide a basis for the prevention and control of surface water FC pollution and related diseases in Kyrgyzstan.

Twenty years of waterborne and related disease reports in Florida, USA

Florida represents a unique challenge for preventing and responding to infectious disease associated with water. This study cataloged the prevalence of reportable waterborne and water-related disease within Florida residents over the last twenty years and identified relationships between confirmed cases by location and additional risk factors. Data was collected through FLHealthCHARTS for confirmed cases between January 1, 1999 and December 31, 2019. Case records were compiled and analyzed by year, county, pathogen name and disease category, patient age, and where the infection was acquired. During this time, 218,707 cases of water-related disease were recorded with 214,745 due to waterborne disease, 3255 cases of water-related vector-borne disease, and 707 cases caused by a water-based toxin. Children aged 0–4 and the elderly demonstrated a higher proportion of waterborne disease while 45–49 year olds had increased rates of water-based toxins and water-related vector-borne disease. Most cases were reported in the southeast region. Across the state, opportunities for water contact have led to high rates of water-related infectious disease. Public health initiatives and response efforts should target the pathogens of greatest impact for each region, largely zoonotic waterborne diseases, using a One Health approach.

Water Management Policies in Cameroon: Interference Through Technology Transfer

Water is an indispensable resource for human life and for social and economic development. But Oswaldo de Rivero (2003) notes that ninety-seven percent of all water on the planet is salty, only 3% is fresh and three-quarters of it is concentrated in inaccessible places such as the polar regions and glaciers. Therefore, only a small fraction of the earth's water is fresh and accessible in rivers, lakes and groundwater. According to international hydrological studies carried out by the United Nations and the Stockholm Environment Institute, this small fraction is declining and by 2025, two-thirds of the world's population will be affected by water shortages due to the decrease in the earth's hydraulic cycle caused by the urban population explosion. The search for a balance between population growth and vital resources such as water has a pride of place in the MDGs, which show that disparities in access to water are high, particularly in Sub-Saharan Africa, and require the pooling of all energies. In Cameroon, the resurgence of endemic water-borne diseases prompted the government to set up a drinking water supply system known as the "Scandinave Water Project." This article attempts to describe the water management policies that eventually led to the re-emergence of water-related diseases. The data for this study were collected between 2006-2009 as part of doctoral studies. This collection is still going on in other localities of the country. This reflection is based on two theoretical approaches: The sociology of knowledge, which, according to David le Breton (2004), strives to identify laws that escape agents carried away by the weight of their class habitus. Knowledge is then viewed as a conquest, an enterprise 'against,' where it is a question of forcing the agent give up a conduct whose motivation he does not know. Science then brings out the hidden, the unknowing, it is an illumination, the revelation of obscure laws of operation to those who live them. Then comes pragmatism, an empirical theory of knowledge of which Widmer (1968) is one of the representatives. The relevance of this theory is measured by its consequences on reality. Pragmatism rehabilitates knowledge as it participates in the mutual construction of the world and brings about changes. The failure of this water supply project is above all the non-involvement of the populations and the lack of communication.

Characterization of Water Quality on University Campus

Introduction: Safe drinking water is vital to all human and living organisms.
 Aim and Study Location: This study appraised untreated water within the Federal University of Petroleum Resources, Effurun (FUPRE) campus with a view to ascertaining their potability.
 Methodology: The samples were analyzed using the America Public Health Association (APHA), standard protocol
 Results: The pH indicated that the water were acidic with pH values from 3.50 ± 0.04 to 5.73 ± 0.08. Total iron exceeded the stipulated WHO limit of 0.3 mg/L in some of the locations with concentration varying from 0.232 ± 0.01 to 0.963 ± 0.04. The heavy metal load was relatively low and within regulatory limits.
 Conclusion: The study concluded that water should not be consumed without treatment due to the non-conforming parameters. In addition, waters with a non-conformance contributed by feacal coliform (E coli) or any other microbial entities should be avoided since serious health water-related diseases (cholera, typhoid, dysentery and diarrheal) may set if consumed.

Understanding the decision-making structures, roles and actions of village-level water committees in Fiji

ABSTRACT As part of a community-based project on water-related disease in Fiji, we conducted a qualitative study to assess the decision-making structures, roles and actions of village-level water committees. Village water committees played a role in the management, operation and maintenance of water and sanitation infrastructure. Reactive and proactive management approaches were both present. The water committees had clear processes in place for decision-making and membership and were influenced by social and cultural norms. Men dominated water committee membership, roles and decision-making. Knowledge about governance structures and processes can be used to strengthen systems for water committees to effectively manage water access and security.