Paired water samples were collected and analysed for thermotolerant coliforms (TTC) from 20 sources (17 developed or rehabilitated by Oxfam and 3 others) and from the stored household water supplies of 100 households (5 from each source) in 13 towns and villages in the Kailahun District of Sierra Leone. In addition, the female head of the 85 households drawing water from Oxfam improved sources was interviewed and information recorded on demographics, hygiene instruction and practices, sanitation facilities and water collection and storage practices. At the non-improved sources, the arithmetic mean TTC load was 407/100 ml at the point of distribution, rising to a mean count of 882/100 ml at the household level. Water from the improved sources met WHO guidelines, with no faecal contamination. At the household level, however, even this safe water was subject to frequent and extensive faecal contamination; 92.9% of stored household samples contained some level of TTC, 76.5% contained more than the 10 TTC per 100 ml threshold set by the Sphere Project for emergency conditions. The arithmetic mean TTC count for all samples from the sampled households was 244 TTC per 100 ml (geometric mean was 77). These results are consistent with other studies that demonstrate substantial levels of faecal contamination of even safe water during collection, storage and access in the home. They point to the need to extend drinking water quality beyond the point of distribution to the point of consumption. The options for such extended protection, including improved collection and storage methods and household-based water treatment, are discussed.
Diarrhea prevalence in a randomized, controlled prospective trial of point-of-use water filters in homes and schools in the Dominican Republic
