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Effects of Sachet Water Consumption on Exposure to Microbe-Contaminated Drinking Water: Household Survey Evidence from Ghana.

ABSTRACT: There remain few nationally representative studies of drinking water quality at the point of consumption in developing countries. This study aimed to examine factors associated with E. coli contamination in Ghana. It drew on a nationally representative household survey, the 2012-2013 Living Standards Survey 6, which incorporated a novel water quality module. E. coli contamination in 3096 point-of-consumption samples was examined using multinomial regression. Surface water use was the strongest risk factor for high E. coli contamination (relative risk ratio (RRR) = 32.3, p < 0.001), whilst packaged (sachet or bottled) water use had the greatest protective effect (RRR = 0.06, p < 0.001), compared to water piped to premises. E. coli contamination followed plausible patterns with digit preference (tendency to report values ending in zero) in bacteria counts. The analysis suggests packaged drinking water use provides some protection against point-of-consumption E. coli contamination and may therefore benefit public health. It also suggests viable water quality data can be collected alongside household surveys, but field protocols require further revision.

SUBMITTER: Wright J

PROVIDER: S-EPMC4808966 | biostudies-literature | 2016 Mar

REPOSITORIES: biostudies-literature

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Effects of Sachet Water Consumption on Exposure to Microbe-Contaminated Drinking Water: Household Survey Evidence from Ghana.

Wright Jim J Dzodzomenyo Mawuli M Wardrop Nicola A NA Johnston Richard R Hill Allan A Aryeetey Genevieve G Adanu Richard R

International journal of environmental research and public health 20160309 3

There remain few nationally representative studies of drinking water quality at the point of consumption in developing countries. This study aimed to examine factors associated with E. coli contamination in Ghana. It drew on a nationally representative household survey, the 2012-2013 Living Standards Survey 6, which incorporated a novel water quality module. E. coli contamination in 3096 point-of-consumption samples was examined using multinomial regression. Surface water use was the strongest r ...[more]

PMID: 27005650

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Project description:IntroductionAccess to safe drinking water is crucial for health and survival, yet many developing countries face significant challenges in this regard. In West Africa, rapid urbanisation has outpaced efforts to improve access to potable water, compelling households to rely on private vendors for solutions, particularly through the growing market for sachet water. Widely consumed in Ghana, sachet water has become a convenient and affordable option, with over 37% of the population depending on it. However, concerns about its microbial safety persist, as studies indicate that sachet water often fails to meet necessary safety standards. This review consolidated existing research on microbial contaminants in sachet water, aiming to provide a representative overview of the microbial quality of sachet water in Ghana.MethodThe systematic review followed the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. A thorough literature search was conducted across multiple databases, including PubMed, Web of Science, ScienceDirect, Scopus and the search engine Google Scholar, using relevant search terms. Eligible studies were identified based on established criteria, and data were subsequently extracted and analysed.ResultsA total of 28 studies published from 2003 to 2024 were selected for inclusion in this review. Notably, 96% of these studies reported bacteria from 17 different genera, while 11% examined parasites from 5 genera. Some studies (7%) investigated both types of contaminants. Overall, 2,276 sachet water samples were analysed, with 1,727 (76%) showing microbial contamination. Escherichia coli was the most identified bacteria, while Cyclospora cayetanensis and Cryptosporidium parvum were the most identified parasites.ConclusionThis study highlighted critical public health risks associated with sachet water in Ghana, particularly the presence of harmful bacteria and parasites. It is important to implement stricter manufacturing and sanitation standards and encourage safe handling practices to ensure the safety and quality of sachet water. Additionally, future research should focus on bridging existing gaps by investigating parasitic, viral, and fungal contaminants, to provide a holistic overview of the microbial contaminants in sachet water in Ghana.

Project description:BackgroundThe synthetic solvent tetrachloroethylene (PCE), commonly used in dry cleaning operations, is a human neurotoxicant and carcinogen. However, its effect on reproduction is poorly understood, as prior studies have been limited to small occupational cohorts. We examined the association between PCE exposure from contamination of the public drinking water supply and time-to-pregnancy (TTP) in a cohort of mothers from Cape Cod, Massachusetts.MethodsThe Cape Cod Family Health Study is a retrospective cohort study designed to examine the reproductive and developmental health effects of exposure to PCE-contaminated drinking water. Our analysis included 1565 women who reported 3826 planned pregnancies from 1949 to 1990. Women completed self-administered questionnaires that ascertained TTP for each of her pregnancies, regardless of the outcome, as well as residential history and demographic information. We utilized EPANET water distribution system modeling software and a leaching and transport model to assess PCE exposure for each pregnancy. We used log-binomial regression models to estimate relative risks (RR) and 95% confidence intervals (CI), adjusting for potential confounders. We performed a probabilistic bias analysis to examine the effect of outcome misclassification on our results.ResultsAny cumulative PCE exposure before pregnancy was associated with a 15% reduction in risk of TTP > 12 months (RR = 0.85, 95% CI: 0.70, 1.03). However, women with the highest average monthly PCE exposure around the time of the pregnancy attempt (≥ 2.5 g) had increased risk of TTP > 12 months (RR = 1.36, 95% CI: 1.06, 1.76).ConclusionsWe found little evidence for long-term, cumulative adverse effects of PCE exposure on TTP, but high levels of PCE exposure around the time of the pregnancy attempt were associated with longer TTP. These associations may be underestimated due to the exclusion of unsuccessful pregnancy attempts from our study population, and may be biased by outcome and exposure misclassification given the long-term recall of TTP and use of a leaching and transport model to estimate PCE exposure.

Project description:While adult exposure to PCE is known to have toxic effects, there is little information on the long-term impact of prenatal and early childhood exposure. We undertook a retrospective cohort study to examine the effects of their early life exposure to PCE-contaminated drinking water. This retrospective cohort study examined whether prenatal and early childhood exposure to PCE-contaminated drinking water influenced the risk of a variety of chronic conditions among adults who were born between 1969 and 1983 in the Cape Cod area of Massachusetts.Eight hundred and thirty-one participants with prenatal and early childhood PCE exposure and 547 unexposed participants were studied. Individuals completed questionnaires to gather information on demographic characteristics, chronic conditions, and other sources of solvent exposure. The location of residences from birth through 1990 were used to estimate PCE exposure with U.S. EPA's water distribution system modeling software (EPANET) modified to incorporate a leaching and transport model.No associations were observed between early life PCE exposure and current occurrence of obesity, diabetes, cardiovascular disease, hypertension, color blindness, near- and far sightedness and dry eyes. In contrast, a 1.8-fold increased risk of cancer (95% CI: 0.8, 4.0) was seen among individuals with any early life exposure. These results were based on 31 participants (23 exposed and 8 unexposed) who reported cancers at a variety of anatomical sites, particularly the cervix. A 1.5-fold increase in the risk of epilepsy (95% CI: 0.6, 3.6, based on 16 exposed and 7 unexposed participants) was also observed among individuals with any early life exposure that was further increased to 1.8 (95% CI: 0.7, 4.6) among those with exposure at or above the sample median.These results suggest that the risk of epilepsy and certain types of cancer such as cervical cancer may be increased among adults who were exposed to PCE-contaminated drinking water exposure during gestation and early childhood. These findings should be interpreted cautiously because of the study limitations and confirmed in follow-up investigations of similarly exposed populations with medically-confirmed diagnoses. This relatively young study population should also be monitored periodically for subsequent changes in disease risk.

Dataset Information

Effects of Sachet Water Consumption on Exposure to Microbe-Contaminated Drinking Water: Household Survey Evidence from Ghana.

Publications

Effects of Sachet Water Consumption on Exposure to Microbe-Contaminated Drinking Water: Household Survey Evidence from Ghana.

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