A study was undertaken in Njoro Township, Kenya to evaluate the extent to which drinking water was subjected to post-collection faecal contamination in low-income and high-income households. Boreholes were the main drinking water sources, accounting for roughly 70% singular access. The microbial quality of drinking water from the boreholes deteriorated from the point-of-collection through conveying containers of small-scale water vendors to household storage containers, irrespective of their income status. The densities of Escherichia coli (EC) were relatively low at the point-of-collection – median (M): 18 CFU/100 mL, range (R): 0–220, n = 60 – increasing considerably in the containers of water vendors (M: 290 CFU/100 mL, R: 30–350) and slightly (M: 360 CFU/100 mL, R: 0–520) between vendors and low-income households, many of whom used the services of vendors unlike high-income households who relied on a piped system on premises (M: 40 CFU/100 mL, R: 0–500). Post-collection contamination was high in low-income households compared to high-income households but differences were not significant between the two household categories with and without household water treatment (HWT). Different HWT methods in the two household categories significantly reduced faecal contamination, but unhygienic handling and poor storage practices afterwards caused recontamination. HWT and behavioural change measures need not selectively target household groups solely on the basis of their income status.

This work explores the application of the Water-Energy Nexus concept for water supply in the African context, where its operationalization is quite limited compared to developed regions. Furthermore, water supply and demand drivers and their influence on energy use are examined. This study found that there is limited literature available on the operationalization of the concept, and energy use is not considered a key performance indicator by water regulators and utilities. Regionally, most of the studies were carried out in the northern and southern Africa, where energy demand for water supply through desalination is high. An analysis of water supply and demand drivers show diminishing quantities of available freshwater, and increased anthropogenic pollutant loads in some areas are projected. Consequently, utilities will likely consider alternative energy-intensive water supply options. Increased population growth with the highest global urban growth rate is projected, with about 60% of the total population in Africa as urban dwellers by 2050. This implies huge growth in water demand that calls for investment in technology, infrastructure, and improved understanding of energy use and optimization, as the largest controllable input within utilities boundaries. However, it requires a data-driven understanding of the operational drivers for water supply and incorporation of energy assessment metrics to inform water-energy policies and to exploit the nexus opportunities.

This study examines supply-side and demand-side drivers of municipal water supply and describes how they interact to impact energy input for municipal water supply in Africa. Several key compound indicators were parameterized to generate cluster centers using k-means cluster analysis for 52 countries in Africa to show the impact of water supply–demand drivers on municipal water supply and associated energy input. The cluster analysis produced impact scores with five cluster centers that grouped countries with similar key compound indicators and impact scores. Three countries (Gambia, Libya, & Mauritius) were classified as outliers. Libya presented a unique case with the highest impact score on energy input for raw water abstraction, associated with largescale pumping from deep groundwater aquifers. Multivariate analysis of the key indicators for 20 countries in sub-Saharan Africa that are either water-secure or water-stressed illustrate the relative impact of drivers on energy input for municipal water supply. The analytical framework developed presents an approach to assessing the impact of drivers on energy input for municipal water supply, and the findings could be used to support planning processes to build resilient drinking water infrastructure in developing countries with data challenges.

This study examined the current state of water demand and associated energy input for water supply against a projected increase in water demand in sub-Saharan Africa. Three plausible scenarios, namely, Current State Extends (CSE), Current State Improves (CSI) and Current State Deteriorates (CSD) were developed and applied using nine quantifiable indicators for water demand projections and the associated impact on energy input for water supply for five Water Service Providers (WSPs) in Kenya to demonstrate the feasibility of the approach based on real data in sub-Saharan Africa. Currently, the daily per capita water-use in the service area of four of the five WSPs was below minimum daily requirement of 50 L/p/d. Further, non-revenue water losses were up to three times higher than the regulated benchmark (range 26–63%). Calculations showed a leakage reduction potential of up to 70% and energy savings of up to 12 MWh/a. The projected water demand is expected to increase by at least twelve times the current demand to achieve universal coverage and an average daily per capita consumption of 120 L/p/d for the urban population by 2030. Consequently, the energy input could increase almost twelve-folds with the CSI scenario or up to fifty-folds with the CSE scenario for WSPs where desalination or additional groundwater abstraction is proposed. The approach used can be applied for other WSPs which are experiencing a similar evolution of their water supply and demand drivers in sub-Saharan Africa. WSPs in the sub-region should explore aggressive strategies to jointly address persistent water losses and associated energy input. This would reduce the current water supply-demand gap and minimize the energy input that will be associated with exploring additional water sources that are typically energy intensive.

cases and 210 controls) were analysed regarding phenotypic characteristics for risk of melanoma as well as number of grandparents born in Europe. European ancestry (Spanish, Italian, Germanic or Slavic, and 2 or more European country), eye colour (light brown and green or blue), presence of nevi, use of sunscreen, referred episodes of sunburn in adolescence or not, were independently associated with melanoma. Portuguese ancestry was not associated in multivariate logistic regression analysis. Our data confirmed the importance of European ancestry as a susceptibility factor. The higher tendency to develop melanoma in persons with those ancestries could be related not only to the phenotypic but probably also to other genetic characteristics. Case-patients for a retrospective epidemiological cum microbiological study in Njoro Town, Kenya were selected after self-report of waterborne illness within 7 days of exposure through drinking water. Controls were matched for location, household income and type of drinking water source. Households with piped water in one highincome district reported considerably lower illness rates compared to unconnected households in two low-income districts. Analysis of the ORs identified water from the stream to be associated with the highest risk of illness (OR¼3.95, p¼0.03) compared to untreated rainwater (OR¼2.45, p¼0.02), untreated water from boreholes (OR¼1.90, p¼0.02) or treated water from any source (OR¼0.62, p¼0.01). Bacteria densities in water obtained from the stream were generally 1e3 log units higher compared to other sources, staying within 3e4 log units for HPC (cfu/ml) and TC (cfu/100 ml), 2e3 log units (cfu/ 100 ml) for Escherichia coli and intestinal enterococci and within 1 log unit (cfu/100 ml) for Salmonella. Several confounding risk factors other than contaminated water were identified. Their detection for over 50 % of all illness cases was significant. It was concluded that the importance of drinking water quality as the most likely source of endemic waterborne illness in the community may have been previously overestimated. Therefore, interventions on water supply in the town should include strategies that address confounding risk factors, especially, poor hygiene and occupational hazards, as well as piped water distribution to low-income households. Objectives To study the magnitude and determinants of growth faltering among 0e6 year 's children in adopted villages of rural medical college. Material and Methods A total 305 children of <6 years were followed monthly for 1 year to assess the growth faltering. At each visit, the mothers/caretaker of children were interviewed and information regarding immunisation, morbidity profile, dietary history and child feeding practices collected using a pre-tested interview schedule. Monthly anthropometric measurements of child were taken. P2-443 P2-444Growth faltering has been defined as failure to gain weight or actual loss of weight, and weight gain <300 g over a period of three consecutive months. Results The cumulative inc...