Staphylococcus aureus is an important nosocomial and communityacquired pathogen. Its genetic plasticity has facilitated the evolution of many virulent and drug-resistant strains, presenting a major and constantly changing clinical challenge. We sequenced the Ϸ2.8-Mbp genomes of two disease-causing S. aureus strains isolated from distinct clinical settings: a recent hospital-acquired representative of the epidemic methicillin-resistant S. aureus EMRSA-16 clone (MRSA252), a clinically important and globally prevalent lineage; and a representative of an invasive communityacquired methicillin-susceptible S. aureus clone (MSSA476). A comparative-genomics approach was used to explore the mechanisms of evolution of clinically important S. aureus genomes and to identify regions affecting virulence and drug resistance. The genome sequences of MRSA252 and MSSA476 have a well conserved core region but differ markedly in their accessory genetic elements. MRSA252 is the most genetically diverse S. aureus strain sequenced to date: Ϸ6% of the genome is novel compared with other published genomes, and it contains several unique genetic elements. MSSA476 is methicillin-susceptible, but it contains a novel Staphylococcal chromosomal cassette (SCC) mec-like element (designated SCC 476), which is integrated at the same site on the chromosome as SCCmec elements in MRSA strains but encodes a putative fusidic acid resistance protein. The crucial role that accessory elements play in the rapid evolution of S. aureus is clearly illustrated by comparing the MSSA476 genome with that of an extremely closely related MRSA community-acquired strain; the differential distribution of large mobile elements carrying virulence and drug-resistance determinants may be responsible for the clinically important phenotypic differences in these strains.

Rural water supply sustainability has remained an enduring policy challenge in sub-Saharan Africa for decades. Drawing on the largest data set assembled on rural water points in sub-Saharan Africa to date, this paper employs logistic regression analyses to identify operational, technical, institutional, financial, and environmental predictors of functionality for over 25 000 community-managed handpumps in Liberia, Sierra Leone, and Uganda. Risk factors significantly associated with nonfunctionality across all three countries were (a) system age, (b) distance from district/county capital, and (c) absence of user fee collection. In at least one of the three countries, other variables found to have significant multivariable adjusted associations with functionality status included well type, handpump type, funding organization, implementing organization, spare parts proximity, availability of a handpump mechanic, regular servicing, regular water committee meetings, women in key water committee positions, rainfall season, and perceived water quality. While the findings reinforce views that a multifaceted range of conditions is critical for the sustainability of community-managed handpumps, they also demonstrate that these factors remain absent from a high proportion of cases. Governments and development partners must significantly strengthen postconstruction support for operation and maintenance systems, and greater efforts are needed to test and evaluate alternative models for managing handpump water supplies.

Groundwater is widely acknowledged to be an important source of drinking water in low-income regions, and it, therefore, plays a critical role in the realization of the human right to water. However, the proportion of households using groundwater compared with other sources is rarely quantified, with national and global datasets more focused on facilities—rather than resources—used. This is a significant gap in knowledge, particularly in light of efforts to expand water services in line with the inclusive and integrated agenda of the Sustainable Development Goals. Understanding the prevalence of groundwater reliance for drinking is critical for those involved in water services planning and management, so they can better monitor and advocate for management of water resources that supports sustainable services for households. This paper contributes data that can be used to strengthen the integration of resource considerations within water service delivery and inform the work of development partners supporting this area. We approach this issue from two perspectives. Firstly, we collate data on the proportion of households using groundwater as their primary drinking water source for 10 Southeast Asian and Pacific nations, finding an average of 66% (range of 17–93% for individual countries) of households in urban areas and 60% (range of 22–95%) of households in rural areas rely on groundwater for drinking. Together, these constitute 79% of the total population across the case study countries. Secondly, we review current and emerging groundwater resource concerns within each country, using a systems thinking approach to assess how groundwater resource issues influence household water services. Findings support the case for governments and development agencies to strengthen engagement with groundwater resource management as foundational for achieving sustainable water services for all.

The routine use of multiple water sources to meet household water needs is widely practiced and has been reported in many developing countries. However, it is typically neglected by implementers, development organizations, and researchers who tend to focus exclusively on the "main source of drinking water." In this Perspective, we explain the nature and scope of multiple water source use (MWSU) at the household level in developing countries. We also describe the implications of MWSU for human health and water resilience, and identify key knowledge gaps, risks, and opportunities associated with MWSU. Finally, we argue that understanding MWSU is feasible for researchers and implementers and is essential for properly designing research studies and water supply projects.npj Clean Water (2019) 2:6 ; https://doi.

The continued expansion of mobile network coverage in rural Africa provides an opportunity for simple and low-cost hydroinformatic innovations to measure and transmit data on handpump use for policy and management improvements. We design, build and test a Waterpoint Data Transmitter to determine its robustness, functionality and scalability. Results demonstrate that this novel application using simple microprocessor, accelerometer and global system for mobile communications (GSM) components has significant potential in recording graduated time-step information flows of lever pumps which can be modelled into a reasonable water volume use approximation. Given the systemic informational deficit for rural waterpoints in Africa, where one in three handpumps is likely to be non-functioning, this innovation has the potential to provide universal, low-cost and immediate data to guide timely maintenance responses and planning decisions, as well as drive greater accountability and transparency in donor and government behaviour.