The study assessed changes in water quality between the water source and the tap of locally produced low cost ceramic water filters used by a community living in hygienically critical conditions in a remote mountainous area in Western Nepal. Data was collected from 42 rural households during two visits. The effectiveness of filter handling on its performance was assessed through microbiological analysis, structured household interviews and structured observations. Water quality decreased significantly when source water was filled into transport containers, while the use of the filters improved drinking water quality for about 40% of the households. Highly inadequate filter cleaning practices involving the use of contaminated raw water, hands (geo mean = 110 E. coli CFU/100 mL) and cleaning tools (geo mean = 80 E. coli CFU/100 mL) stained hygienic parts of the filter. The use of boiling water to disinfect the filters was significantly correlated with improved filter performance and should be further promoted. However, even disinfected filters achieved a very low average LRV for E. coli of 0.4 in the field and performed worse than during laboratory tests (LRV for E. coli of 1.5–2). Comprehensive training on adequate filter handling, as well as better filter products, are required to improve the impact of filter use.

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