Child undernutrition in households with microbiologically safer drinking water and ‘improved water’ in Tanna, Vanuatu

The Sustainable Development Goal drinking water indicators include microbiological safety measures, whereas the Millennium Development Goal indicator ‘improved water’ may be microbiologically unsafe. In rural Vanuatu, we undertook household surveys, child anthropometry, and tested stored drinking water, to investigate relationships between water and undernutrition. Using Escherichia coli most probable number, we categorized results according to Compartment Bag Test drinking water cutoffs: <1/100 mL (safe), 1–10/100 mL (intermediate risk), >10–100/100 mL (high risk), and >100/100 mL (very high risk). Of 201 households, 191 (95%) had microbiologically unsafe drinking water, regardless of ‘improved’ status. We investigated cross-sectional associations between households with microbiologically safer drinking water (≤10 E. coli/100 mL) versus ‘improved water’ and undernutrition among children. Of children under 5, 145 (48.8%, 95% CI: 42.8, 54.8) were stunted and 59 (19.1%, 95% CI: 14.4, 23.8) were underweight. Among households with ‘improved water’, the adjusted prevalence ratio (95% CI) of stunting was 0.61 (0.46, 0.80) and underweight was 0.46 (0.29, 0.73) compared with ‘unimproved water’. However, we found no association between having drinking water with ≤10 E. coli/100 mL at one point in time and undernutrition. Longer-term variations in water quality and unmeasured conditions beyond water may have contributed to these associations.

Water source quality testing in Gezira State, Sudan, using the compartment bag test

Although poor water quality is recognized as a public health threat, it has been little investigated in Sudan. In this paper, water sources in Gezira State, Greater Wad Medani locality, have been categorized as safe, intermediate safe and high-risk unsafe sources using the compartment bag test (CBT) to detect E. coli, which is an indicator of fecal contamination of water. The CBT is simple, portable and self-contained, and it can be done in the field environment. A total of 122 samples were collected from different water sources and included rivers, water treatment plant, boreholes/tube wells, hand pumps, public water taps, public water coolers, public elevated water tanks and household elevated water tanks. It was found that 69% (84/122) of investigated water sources were safe to drink. The sources most likely to be contaminated were those close to industrial points and factories or open sources exposed to pollution. The result showed that the highest level of contamination of water sources (high risk and unsafe) was observed in rural area (9.1%) followed by urban (5.7%) and peri-urban (1.6%). Frequent and routine qualitative analysis of water sources using CBT is recommended to improve human health and hence the country’s development.

Quality of water sources in Southwestern Uganda using the compartment bag test (CBT): a cross-sectional descriptive study

The aim of this study was to assess the bacteriological quality of water sources in the two rural areas of Uganda using the compartment bag test (CBT). In total, 200 water samples were collected from 69 different water sources and processed within 6 h of collection. Positive and negative controls were processed each day together with water samples. Physical parameters were measured in situ. Descriptive statistics were used to generate mean, minimum, maximum, standard deviations and percentages. The results indicated that 29% of the water sources met the National Standards and World Health Organization (WHO) Guidelines for drinking water. Sixty percent of the borehole, 44% of gravitational flow taps and 14% of roof rain water met the required standards. Of the open water sources, 75% of the rivers, 50% of open channels and 43% of unprotected dug wells plus 25% of protected springs and 9% of gravitational flow schemes had most probable number counts >100 Escherichia coli/100 mL of water. Most of the water sources in the study areas were not fit for human consumption without prior treatment. The CBT was found to be robust and easy to use in all field situations. The mean physical parameters of water sources were within the acceptable limits.

Well water quality in rural Nicaragua using a low-cost bacterial test and microbial source tracking

Water-related diseases, particularly diarrhea, are major contributors to morbidity and mortality in developing countries. Monitoring water quality on a global scale is crucial to making progress in terms of population health. Traditional analytical methods are difficult to use in many regions of the world in low-resource settings that face severe water quality issues due to the inaccessibility of laboratories. This study aimed to evaluate a new low-cost method (the compartment bag test (CBT)) in rural Nicaragua. The CBT was used to quantify the presence of Escherichia coli in drinking water wells and aimed to determine the source(s) of any microbial contamination. Results indicate that the CBT is a viable method for use in remote rural regions. The overall quality of well water in Pueblo Nuevo, Nicaragua was deemed unsafe, and results led to the conclusion that animal fecal wastes may be one of the leading causes of well contamination. Elevation and depth of wells were not found to impact overall water quality. However rope-pump wells had a 64.1% reduction in contamination when compared with simple wells.