Water quality risks of ‘improved’ water sources: evidence from <scp>C</scp>ambodia

Shaheed, Ameer; Orgill, Jennifer; Ratana, Chuenpagdee; Montgomery, Maggie; Jeuland, Marc; Brown, Joe

doi:10.1111/tmi.12229

Cited by 89 publications

(81 citation statements)

References 48 publications

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“…These results are consistent with the findings of other studies that demonstrated improved sources are not necessarily safe. 5,6,8,[25][26][27][28] Although transporting water to the home from an offpremises source has been associated with contamination in other studies, 15,17 in this population, microbiologic quality of stored water tended to be similar to, or better than, source water. Under conditions of relatively high-quality source water as in this study, microbial settling and time-related die-off are unlikely to yield significant improvement in water quality.…”

Section: Discussionmentioning

confidence: 97%

“Improved” But Not Necessarily Safe: An Assessment of Fecal Contamination of Household Drinking Water in Rural Peru

Heitzinger¹,

Rocha²,

Quick³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. The indicator used to measure progress toward the Millennium Development Goal (MDG) for water is access to an improved water supply. However, improved supplies are frequently fecally contaminated in developing countries. We examined factors associated with Escherichia coli contamination of improved water supplies in rural Pisco province, Peru. A random sample of 207 households with at least one child less than 5 years old was surveyed, and water samples from the source and storage container were tested for E. coli contamination. Although over 90% of households used an improved water source, 47% of source and 43% of stored water samples were contaminated with E. coli. Pouring or using a spigot to obtain water from the storage container instead of dipping a hand or object was associated with decreased risk of contamination of stored water (adjusted prevalence ratio [aPR] = 0.58, 95% confidence interval [CI] = 0.42, 0.80). Container cleanliness (aPR = 0.67, 95% CI = 0.45, 1.00) and correct handwashing technique (aPR = 0.62, 95% CI = 0.42, 0.90) were also associated with decreased contamination risk. These findings highlighted the limitations of improved water supplies as an indicator of safe water access. To ensure water safety in the home, household water treatment and improved hygiene, water handling, and storage practices should be promoted.

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Section: Discussionmentioning

confidence: 97%

“Improved” But Not Necessarily Safe: An Assessment of Fecal Contamination of Household Drinking Water in Rural Peru

Heitzinger¹,

Rocha²,

Quick³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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“…However, leaking pipes and intermittent service can compromise the quality of piped water (Kumpel and Nelson, 2014), and fecal contamination of piped water is frequent in low-and middle-income countries, particularly in rural areas (Bain et al, 2014a;Christenson et al, 2014). Additionally, several included studies reported that water obtained on plot was stored in containers and subsequently contaminated; this was reported in a recent study in Cambodia, which also found that water collected on-plot was frequently stored in the same container with water from unimproved sources (Shaheed et al, 2014). Measured water quality was not associated with diarrhea except in households with on-plot water supply, water storage, and toilets (van der Hoek et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

On-plot drinking water supplies and health: A systematic review

Overbo

Williams

Evans

et al. 2016

International Journal of Hygiene and Environmental Health

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Many studies have found that household access to water supplies near or within the household plot can reduce the probability of diarrhea, trachoma, and other water-related diseases, and it is generally accepted that on-plot water supplies produce health benefits for households. However, the body of research literature has not been analyzed to weigh the evidence supporting this. A systematic review was conducted to investigate the impacts of on-plot water supplies on diarrhea, trachoma, child growth, and water-related diseases, to further examine the relationship between household health and distance to water source and to assess whether on-plot water supplies generate health gains for households. Studies provide evidence that households with on-plot water supplies experience fewer diarrheal and helminth infections and greater child height. Findings suggest that water-washed (hygiene associated) diseases are more strongly impacted by on-plot water access than waterborne diseases. Few studies analyzed the effects of on-plot water access on quantity of domestic water used, hygiene behavior, and use of multiple water sources, and the lack of evidence for these relationships reveals an important gap in current literature. The review findings indicate that on-plot water access is a useful health indicator and benchmark for the progressive realization of the Sustainable Development Goal target of universal safe water access as well as the human right to safe water.

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“…In our study of the quality of household water from "improved" sources in Cambodia, we observed substantial and statistically significant contamination of drinking water during storage. 19 Arithmetic mean counts of E. coli in stored household tap water were significantly higher than those in samples taken directly from the tap. 19 Despite a wealth of evidence indicating that safe storage of water lowers the risk of exposure to waterborne microbes associated with diarrhoea, there have been few epidemiological studies of safe water storage with health measures as outcomes.…”

Section: Water Safety Compromised By Storagementioning

confidence: 99%

“…19 Arithmetic mean counts of E. coli in stored household tap water were significantly higher than those in samples taken directly from the tap. 19 Despite a wealth of evidence indicating that safe storage of water lowers the risk of exposure to waterborne microbes associated with diarrhoea, there have been few epidemiological studies of safe water storage with health measures as outcomes. While several trials of household water treatment have included interventions that included safe storage, 20,21 only two published unblinded studies have attempted to measure a reduction in diarrhoea as the result of safe storage alone.…”

Section: Water Safety Compromised By Storagementioning

confidence: 99%

“…For example, in Kandal province in Cambodia -where water is plentiful and access to "improved" water sources is commonwe observed tremendous complexity in household water management. 19 There were multiple water sources in use at any given time and the sources in use varied according to the season and whether the water was needed for drinking, cooking, hygiene or laundry. 19 Some households that had a piped water supply or access to a nearby well preferred to use stored rainwater for drinking.…”

Section: Access Not a Guarantee Of Consistent Usementioning

confidence: 99%

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