Assessing reported use and microbiological performance of a point-of-use household water filter in rural Fiji

A non-governmental organisation has distributed point-of-use water filtering units in the Western Division of Fiji. We sought to understand filter utilisation and water quality: both water flowing directly out of filters and stored water. We surveyed 270 households and 6 schools on filter use and performed hydrogen sulphide bacterial indicator testing on 24 water samples directly from filters and 37 stored water samples. Our response rate was 95%. Of these, only half (52%) reported consistently filtering their drinking water. Very few (8%) reported consistent use when preparing kava, a traditional drink. Factors associated with limited filter use included lost or broken filter parts (22%) (p < 0.05) and perception of source water quality as 44% of respondents who believed their source water was safe to drink reported consistent filter use compared to 68% of respondents who did not (p < 0.01). Bacterial indicator testing using hydrogen sulphide paper-strips showed that most water samples directly from the filter (71%) and from storage vessels (76%) were contaminated. Limited levels of use and high levels of contamination in both water directly from the filter and stored water raise serious questions as to the benefit of the filter even as an interim water quality solution in this setting.