Assessment of Bacteriological and Physicochemical Quality of Drinking Water from Source to Household Tap Connection in Nekemte, Oromia, Ethiopia

Evaluation of bottled drinking water and occurrence of multidrug-resistance and biofilm producing bacteria in Nepal

Health consequences arising from unsafe drinking water and water insecurity lead to increased reliance on usage of bottled water. Biofilm-producing antibiotic-resistant bacteria in bottled water may pose a risk to public health. This study aims to assess the quality of bottled drinking water with a focus on biofilm-producing and drug-resistant coliform. We analyzed 60 bottled water samples of 30 different brands purchased from Kathmandu for physicochemical and microbial analysis. The parameters pH, iron, total coliform count, Escherichia coli count, and fecal coliform count exceeded National Drinking Water Quality Standards, 2022 in 30.00%, 16.67%, 66.67%, 23.33%, and 16.67% of samples, respectively. Water quality index measurement showed 36.67% and 6.67% of bottled water samples were categorized as grade A and grade B indicating excellent and good water quality, respectively. However, 56.67% of bottled water samples fall under grade E meaning unsuitable for drinking. Among 14 coliform isolates, 85.71% and 14.29% were identified as E. coli and Klebsiella spp, respectively. The antibiotic susceptibility testing revealed that 28.57% of the isolates were multidrug-resistant and Gentamicin resistant isolates comprised 71.43%. However, none of the isolates were carbapenem (meropenem) resistant. In this study, 42.87% of the isolates were found biofilm producers with 14.29% each of strong, moderate, and weak biofilm producers. The genetic potential of biofilm-producing capacity of the isolates was assessed by Polymerase Chain Reaction amplification of bcsA and csgD genes. Our results showed that 66.67% and 50.00% of the isolates harbored bcsA and csgD genes, respectively. This study highlights potential public health hazards associated with the consumption of bottled water containing biofilm-producing and drug-resistant bacteria in Nepal.

Water quality and phenotypic antimicrobial resistance in isolated of E. coli from water for human consumption in Bagua, under One Health approach

The One Health approach acknowledges the interconnection between human health, animal health, and environmental health, recognizing that these domains are closely intertwined, as many diseases affecting humans are also common in animals. Water acts as a vehicle for the transmission of such diseases, highlighting the significance of monitoring the quality of water intended for human consumption. In 2022, a research study was conducted to evaluate the water quality for human consumption in Bagua, Amazonas Region. The physicochemical analysis indicated that most parameters were within normal range, except for residual chlorine, which was predominantly absent. Microbiological analysis revealed the presence of total coliforms and E. coli. Phenotypic characterization of E. coli isolates exhibited resistance to the several antibiotics, including nalidixic acid, gentamicin, amoxicillin plus clavulanic acid, norfloxacin, and ciprofloxacin. These findings indicate a compromised production of water for human consumption, as per the water quality regulations in Peru. The presence of fecal contamination poses a significant microbiological risk to consumers. These results underscore the breakdown of the human-environment-animal interface within the One Health approach, thereby endangering public health.

Assessment of Drinking Water Quality in Urban Water Supply Systems: The Case of Hawassa City, Ethiopia

In many developing countries, such as Ethiopia, water quality and the risk of water-related diseases are serious public health issues. The present study goal was to assess the drinking water quality from source to household tap water. To characterize and analyze drinking water quality parameters, 21 water samples were collected, of which 11 water samples were collected from sources (spring, borehole, and river), 4 from service reservoirs, and 6 from tap water. The mean values of the parameters were as follows: total dissolved solids (TDS) (142.79 mg/L), temperature (22.08°C), turbidity (9.49 NTU), electrical conductivity (EC) (250.14°μS/cm), pH (7.45 mg/L), fluoride (1.15 mg/L), nitrate (NO3-) (2.91 mg/L), total hardness (TH) (57.45 mg/L), calcium (41.7 6 mg/l), magnesium (10.74 mg/L), phosphate (0.44 mg/L), sulfate (3.99 mg/L), residual chlorine (1.53 mg/L), alkalinity (196.39 mg/L), and microbiological (total coliform and coliform/CFU) which were the main physiochemical parameters analyzed for the study. The findings revealed that the majority of the water quality parameters tested were within the WHO and National Drinking Water Quality Standards (NDWQS). However, some of the parameters such as temperature, turbidity, fluoride, and residual chlorine did not meet the standards. The mean temperatures at the source, reservoir, and tap water were 22.01°C 22.5°C,and 21.83°C, respectively. Turbidity levels in source samples ranged from 10 to 45 NTU, with a mean of 24.5 NTU, exceeding the WHO's recommendation of less than 5 NTU. The Boko Alamura well had a high fluoride content (3.9 mg/l), which was above the WHO and NDWQS permissible limits. There was no free residual chlorine in the tap water sample. The results show that the Hawassa drinking water supply did not contain total or fecal coliform in any of the samples tested. The overall WQI for the water source, reservoir, and tap water was also determined to be 89, 71, and 69.7 points, respectively. Therefore, based on the WQI result, Hawassa drinking water quality is good for the source, reservoir, and tap water.

Unimproved source of drinking water and its associated factors: a spatial and multilevel analysis of Ethiopian demographic and health survey

BACKGROUND

Drinking water quality has been a major public health concern in lower and middle income countries where access to improved water supplies is limited. Ethiopia is thought to have one of the worst drinking water infrastructures in the world. This study aimed to assess the spatial variation and determinants of using unimproved sources of drinking water in Ethiopia using recent nationally representative data.

METHODS

A population-based cross-sectional study was employed with the recent EDHS data of 2019. A total of 8663 households were sampled using a stratified two-stage cluster sampling method. Kuldorff's SaTScan version 9.6 software was used to generate spatial scan statistics. ArcGIS version 10.7 software was used to visualize the spatial patterns of unimproved drinking water sources. A multilevel multivariable mixed-effect logistic regression was used to identify factors associated with the use of an unimproved drinking water source. In the multivariable multilevel analysis, those variables with a p-value < 0.05 were considered to be significant predictors of using an unimproved source of drinking water.

RESULT

Around 31% (95% CI: 30%, 32%) of the population in Ethiopia uses unimproved sources of drinking water with significant spatial variation across the country. Households aged 41-60 [AOR = 0.69; 95%CI; 0.53, 0.89] as compared to the households aged 10-25, households having middle wealth index [AOR = 0.48; 95%CI; 0.40, 0.59], and households having a rich wealth index [AOR = 0.31; 95%CI; 0.25, 0.39] as compared to the poor households, living in high community literacy level [AOR = 0.36; 95%CI; 0.16, 0.80], living in high-level community poverty [AOR = 3.03; 95%CI; 1.32, 6.98], rural residence [AOR = 7.88; 95%CI; 2.74, 22.67] were significant predictors of use of unimproved source of drinking water. Hot spot areas of use of unimproved drinking water sources were observed in Amhara, Afar, and Somalia regions and some parts of SNNPR and Oromia regions in Ethiopia. The primary clusters were found in Ethiopia's Somalia and Oromia regions.

CONCLUSION

Around one third of the Ethiopian population utilizes unimproved source of drinking water and it was distributed non-randomly across regions of Ethiopia. The age of the household head, wealth status of the household, residence, community poverty level, and community literacy level were found to be significantly associated with utilizing unimproved drinking water source. State authorities, non-governmental organizations and local health administrators should work to improve the quality of drinking water particularly for high risk groups such as communities living in high poverty and low literacy, poor households, rural residents, and hot spot areas to decrease the adverse consequences of using unimproved drinking water source.

Drinking water contamination potential and associated factors among households with under-five children in rural areas of Dessie Zuria District, Northeast Ethiopia

Objective

More than half of the 700 million people worldwide who lack access to a safe water supply live in sub-Saharan Africa, including Ethiopia. Globally, approximately 2 billion people use drinking water sources that are contaminated with fecal matter. However, little is known about the relationship between fecal coliforms and determinants in drinking water. Therefore, the objective of this study was to investigate the potential for contamination of drinking water and its associated factors in households with children under 5 years of age in Dessie Zuria district in northeastern Ethiopia.

Methods

The water laboratory was conducted based on the American Public Health Association guidelines for water and wastewater assessment using a membrane filtration technique. A structured and pre-tested questionnaire was used to identify factors associated with the potential for contamination of drinking water in 412 selected households. A binary logistic regression analysis was performed to determine the factors associated with the presence or absence of fecal coliforms in drinking water, with a 95% confidence interval (CI) and a value of p ≤ 0.05. The overall goodness of the model was tested using the Hosmer-Lemeshow test, and the model was fit.

Results

A total of 241 (58.5%) households relied on unimproved water supply sources. In addition, approximately two-thirds 272 (66.0%) of the household water samples were positive for fecal coliform bacteria. Water storage duration ≥3 days (AOR = 4.632; 95% CI: 1.529-14.034), dipping method of water withdrawal from a water storage tank (AOR = 4.377; 95% CI: 1.382-7.171), uncovered water storage tank at control (AOR = 5.700; 95% CI: 2.017-31.189), lack of home-based water treatment (AOR = 4.822; 95% CI: 1.730-13.442), and unsafe household liquid waste disposal methods (AOR = 3.066; 95% CI: 1.706-8.735) were factors significantly associated with the presence of fecal contamination in drinking water.

Conclusion

Fecal contamination of water was high. The duration of water storage, the method of water withdrawal from the storage container, covering of the water storage container, the presence of home-based water treatment, and the method of liquid waste disposal were factors for fecal contamination in drinking water. Therefore, health professionals should continuously educate the public on proper water use and water quality assessment.

Antimicrobial Resistance Profile of Enterobacteriaceae and Drinking Water Quality Among Households in Bule Hora Town, South Ethiopia

Background

Antimicrobial resistance bacteria and unsafe water are contributing to the growing burden of diseases. Hence, isolation and antimicrobial susceptibility tests for drinking water samples are currently becoming vital to address the human health risks from drinking unsafe water.

Objective

This study aimed to assess the antimicrobial resistance profile of Enterobacteriaceae and quality of drinking water among households in Bule Hora Town, South Ethiopia.

Methods and Materials

A community-based cross-sectional study was used from June to August 2021. A total of 75 water samples were collected and analyzed at the Microbiological Laboratory of Bule Hora University within 6 hours. A membrane filtration method and biochemical tests were used for the isolation and identification of bacteria. An antimicrobial susceptibility test was performed using Kirby-Bauer disc-diffusion method on Mueller-Hinton Agar. Systematic and simple random probability sampling techniques were used to draw representative samples. The data were entered into Epi Data 3.1 and then exported to SPSS version 25 where univariate and bivariate analyses of the data were conducted.

Results

This study indicated that 59 (78.6%), 30 (40%), and 20 (26.6%) of water samples from the storage of households were contaminated with total coliforms, thermo-tolerant coliforms, and Escherichia coli, respectively. Similarly, Salmonella accounted for 18 (24%), Shigella 12 (16%), and other members of the Enterobacteriaceae such as Proteus, Citrobacter, Klebsiella, Escherichia coli, and Enterobacter species were also isolated. All isolates of Enterobacteriaceae showed resistance to amoxicillin plus clavulanic acid and ampicillin. Besides, Shigella showed 10 (83.3%), 2 (16.6%) and 10 (83.3%) and Salmonella showed 16 (88.9%), 5 (27.8%) and 15 (83.3%) resistant to cotrimoxazole, chloramphenicol and tetracycline, respectively. All the tested drinking water samples had no free chlorine at all at point of use.

Conclusion

There was contamination of drinking water with coliform and antibiotic-resistant Enterobacteriaceae in most surveyed households.

Safe water supply challenges for hand hygiene in the prevention of COVID-19 in Southern Nations, Nationalities, and People's Region (SNNPR), Ethiopia

Background

Proper hand hygiene practices are critical in disease prevention and control, including preventing the spread of the COVID-19 pandemic, but according to a recent global report, three billion people lack access to basic hand washing facilities (soap and water) at home. Therefore, this study aimed to determine the challenges related to safe and adequate water provision for hand hygiene in the prevention of COVID-19 in Gedeo Zone, SNNPR, Ethiopia.

Methods

An institutional-based cross-sectional study design was used to assess the challenges associated with safe water supply in the prevention of COVID-19 in Gedeo Zone. Simple random sampling was used. The water sector's challenges were assessed using in-depth interviews with key informants. Water samples were collected from hand washing stations using a sterile bottle and the standard tap water sampling procedure. Bacterial analysis was carried out using membrane filtration techniques. The Wagtech Palin test and the Delagua portable water testing kit procedure was used to analyze World Health Organization (WHO) critical physicochemical parameters.

Result

The physicochemical analysis of the sample water from the hand washing facilities reveals that the pH (6.5-8) is within the WHO guideline in all samples except Gedeb town (11.1%). The residual chlorine in the samples was less than 0.2 mg/l, which is below the standard in all towns, but 15.8% of the samples in Wonago town were between 0.2-0.5mg/l. Faecal coliforms were not found in 27.5%, 21.0%, 16.6%, and 40.7% of the samples collected in Dilla, Wonago, Yirgachefe, and Gedeb town, respectively. The remaining samples were all positive for faecal coliforms. Unbalanced demand versus supply, inaccessibility, supply interruptions, financial constraints, a scarcity of competent human resources, a lack of regular water quality assessments, and a lack of stakeholder support were all identified as major challenges by all water sectors of the study towns. The majority of hand washing water samples from all of the study towns were bacteriologically unsafe. The water sector must work hard to ensure that the community has safe drinking water. All responsible bodies and potential stakeholders must support the water sectors in the Gedeo zone.

Assessing the Water Quality of Lake Hawassa Ethiopia-Trophic State and Suitability for Anthropogenic Uses-Applying Common Water Quality Indices

The rapid growth of urbanization, industrialization and poor wastewater management practices have led to an intense water quality impediment in Lake Hawassa Watershed. This study has intended to engage the different water quality indices to categorize the suitability of the water quality of Lake Hawassa Watershed for anthropogenic uses and identify the trophic state of Lake Hawassa. Analysis of physicochemical water quality parameters at selected sites and periods was conducted throughout May 2020 to January 2021 to assess the present status of the Lake Watershed. In total, 19 monitoring sites and 21 physicochemical parameters were selected and analyzed in a laboratory. The Canadian council of ministries of the environment (CCME WQI) and weighted arithmetic (WA WQI) water quality indices have been used to cluster the water quality of Lake Hawassa Watershed and the Carlson trophic state index (TSI) has been employed to identify the trophic state of Lake Hawassa. The water quality is generally categorized as unsuitable for drinking, aquatic life and recreational purposes and it is excellent to unsuitable for irrigation depending on the sampling location and the applied indices. Specifically, in WA WQI, rivers were excellent for agricultural uses and Lake Hawassa was good for agricultural uses. However, the CCME WQI findings showed rivers were good for irrigation but lake Hawassa was marginal for agricultural use. Point sources were impaired for all envisioned purposes. The overall category of Lake Hawassa falls under a eutrophic state since the average TSI was 65.4 and the lake is phosphorous-deficient, having TN:TP of 31.1. The monitored point sources indicate that the city of Hawassa and its numerous industrial discharges are key polluters, requiring a fast and consequent set-up of an efficient wastewater infrastructure, accompanied by a rigorous monitoring of large point sources (e.g., industry, hospitals and hotels). In spite of the various efforts, the recovery of Lake Hawassa may take a long time as it is hydrologically closed. Therefore, to ensure safe drinking water supply, a central supply system according to World Health organization (WHO) standards also for the fringe inhabitants still using lake water is imperative. Introducing riparian buffer zones of vegetation and grasses can support the direct pollution alleviation measures and is helpful to reduce the dispersed pollution coming from the population using latrines. Additionally, integrating aeration systems like pumping atmospheric air into the bottom of the lake using solar energy panels or diffusers are effective mitigation measures that will improve the water quality of the lake. In parallel, the implementation and efficiency control of measures requires coordinated environmental monitoring with dedicated development targets.

Efficiency of Treatment Plant and Drinking Water Quality Assessment from Source to Household, Gondar City, Northwest Ethiopia

Introduction

Access to safe drinking water is essential to health, and it is a basic human right. However, drinking water treatment plant efficiency and its water quality are not well investigated in low-income countries including Ethiopia.

Methods

A laboratory-based cross-sectional study was conducted among 75 water samples. Data analysis was carried out using SPSS version 22 to generate descriptive statistics, and one-way ANOVA was used to test statistically significant difference.

Results

Physicochemical qualities of the water samples from tap water sources were found to be pH (6.88 ± 0.05), turbidity (5.15 ± 0.006 NTU), electrical conductivity (170.6 ± 0.1 μS/cm), residual chlorine (0.19 ± 0.003 mg/L), and fluoride (1.17 ± 0.009 mg/L). The removal efficiency of turbidity, total hardness, and nitrate was found to be 94.4%, 52.3%, and 88.7%, respectively. Removal efficiency of the treatment plant for total coliforms up to 91.6% (15 ± 0.26 CFU/100 mL in tap water) and faecal coliforms up to 99% (1.51 ± 0.03 CFU/100 mL in tap water) was recorded. Parameters of pH, temperature, and faecal coliform were statistically significant different at p < 0.05 in tap water source. The overall efficiency of the treatment plant (68.5%) and the water quality index (76) were recorded.

Conclusion

Based on the results, some of the investigated parameters of water quality (turbidity, residual chlorine, total coliform, and faecal coliform) were found to be not within the permissible limits of WHO guideline values for drinking water quality. The water quality index of the water samples was categorized under good water quality. To adequately treat drinking water and improve the treatment plant, adequate preliminary treatments like screening to reduce the incoming organic loading, proper chlorination of the drinking water system, and frequent monitoring and maintenance of the treatment plant system are required.

Quality and Safety of Rural Community Drinking Water Sources in Guto Gida District, Oromia, Ethiopia

The quality of drinking water has always been a major public health concern, especially in developing countries where access to improved water supply and sanitation is very low. This study aimed to assess the bacteriological and physicochemical quality of rural community drinking water sources in the Guto Gida district. A cross-sectional study was conducted in selected rural areas of the district from January to June 2016. Water samples were collected from four types of sources (protected dug well, open dug well, protected spring, and open spring) found in 8 locations of the study area. The membrane filtration technique was employed to determine the total coliform and faecal coliform load of the samples. The physicochemical characteristics such as total dissolved solid (TDS), pH, electrical conductivity (EC), turbidity, temperature, color, iron, manganese, lead, fluoride, zinc, sulphate, nitrate, and phosphate were analyzed following the American Public Health Association and WHO standard protocols. Our results revealed that 90.6% and 87.5% of water samples were positive for total coliform and faecal coliform, respectively. Thus, the majority of the studied water sources could be classified as polluted with respect to coliform load. Our results also have shown that most of the water sources showed marginally tolerable quality with respect to color, EC, TDS, turbidity, nitrate, sulphate, and phosphate. However, the protected sources had poor quality in zinc, lead, iron, manganese, and pH with values above the permissible levels. Thus, the drinking water source quality of the study areas requires appropriate interventions such as improving the existing water source infrastructure and access to sanitation services.

Bacteriological and physico-chemical quality of household drinking water in Kisii Town, Kisii County, Kenya

Water is a basic human need which is required in many operations especially in households. However, this essential commodity in most cases does not meet the generally accepted safety standards. The study was designed to investigate the physico-chemical and bacteriological quality of drinking water used in households in Kisii town, Kenya. Analytical cross-sectional study was conducted to obtain information concerning household drinking water quality and safety. Stratified random sampling was used to obtain 422 drinking water samples at the point of consumption from the 4 zones of Kisii town for analysis. From the study it was revealed that TDS and electrical conductivity of the analyzed water samples were within the recommended standards of less than 1000 ppm and 1500 μSCM-1 respectively. Further, it was found that 69.4% of the samples had pH range of between 6.5-8.5, 91.9% had turbidity of less than 5NTU, 3.8% had temperature below 15 °C and 31.2% of the chlorinated samples had chlorine residue above 0.2 ppm. In terms of bacteriological analysis, 39.3% of the samples were contaminated with total coliforms and 17.5% with E. coli. The main finding from the study was that the household water samples were contaminated with bacteria and unfit for human consumption because both total coliforms and E. coli exceeded the recommended Kenya Bureau of Standards (KEBS) and WHO standards. Therefore, public health officers should not only collect water samples from sources but also from households regularly to ascertain its quality and provide water safety promotion education to the general public. There was a strong relationship between bacterial contamination and temperature as well as chlorine residue. The study recommends Gusii Water and Sanitation Company (GWASCO) whose treatment and distribution capacity is expected to increase 4.5 times the current capacity to improve on their chlorine dosage at the treatment plant to ensure a minimum chlorine residue of 0.2 ppm at the household and community taps.

Bacteriological and Physicochemical Quality of Drinking Water in Wegeda Town, Northwest Ethiopia

Waterborne diseases continue to challenge communities in low-income countries like Ethiopia. Clinical information in Wegeda town showed that the prevalence of waterborne diseases was 58%. This study aimed to evaluate bacteriological and physicochemical drinking water quality in Wegeda town. This study will add valuable scientific data for future intervention. Water samples from protected and unprotected springs, hand-dug well, taps, and households' containers were collected from November 2018 to June 2019 for bacteriological and physicochemical analyses. Besides, information about the potential risk factors was collected using a structured questionnaire. A total of 120 water samples were collected and analyzed for total and fecal coliform counts using the multiple tube fermentation method (MPN). The presence of Escherichia coli was also checked from fecal coliform positive samples collected from households' containers. Selected physicochemical parameters were also determined using the standard methods. In all cases, the median values of total and fecal coliform counts ranged from 5 to 27 and 2 to 13 MPN/100 ml, respectively. Accordingly, all of the drinking water samples did not comply with the standards. Coliforms were significantly higher in the households' containers than in the sources (p < 0.05) and also significantly varied by water sources. The highest and lowest coliform counts were recorded in unprotected spring and taps, respectively. Besides, 18.33% of water samples collected from households' containers were tested positive for E. coli. Regarding physicochemical parameters, most values were within the acceptable limit values recommended by the WHO. However, water samples from unprotected spring and hand-dug well did not satisfy the turbidity limit value set by the WHO. Drinking water systems in Wegeda town were likely contaminated with pathogenic bacteria likely due to poor protection and sanitation practices. Providing the community with potable water, toilets, domestic and animal waste disposal systems, and intensive health education and sanitation practices for the community are highly recommended.

Bacteriological and Physicochemical Quality of Drinking Water in Adis Kidame Town, Northwest Ethiopia

Drinking water pollution and the resulting waterborne diseases have been among the major public health burden in low-income countries such as Ethiopia. A high prevalence of waterborne diseases, up to 65%, has been reported in Adis Kidame Town (Ethiopia). Moreover, there have been poor waste disposal practices in this town. Thus, this study aimed to assess bacteriological and physicochemical drinking water quality in Adis Kidame Town to get insight into any potential health risks due to waterborne diseases. A total of 90 water samples were analyzed for enumeration of coliform bacteria and basic physicochemical parameters. In this study, total and faecal coliform counts (CFU/100 ml) ranged from 0 to 23 and 0 to 18, respectively. In all cases, 89 and 77% of the water samples in terms of total and faecal coliforms, respectively, did not comply with WHO guidelines. The highest level of coliforms was found in drinking water samples from households' containers and taps, where 100% and 90% of samples were tested positive for total and faecal coliforms, respectively. Among the physicochemical parameters recorded, only temperature and residual chlorine did not comply with WHO guidelines. Temperature values in all samples ranged from 20 to 28°C, while the values of residual chlorine were below the recommended range in the 56.7% of water samples from the reservoir and almost in all (96.7%) water samples from the taps and households' containers. High coliform count in the water system demands proper chlorination, regular inspection of the distribution line, and good hygienic practices to improve the microbiological quality of drinking water in Adis Kidame Town.

Comprehensive Risk Assessment of Health-Related Hazardous Events in the Drinking Water Supply System from Source to Tap in Gaza Strip, Palestine

Background

The traditional approach in the management of the quality drinking water, and relying on end-product testing, has proven ineffective in protecting public health. Therefore, the transition to a systematic approach in drinking water supply systems management from the source to the consumer tap was taken as a water safety plan (WSP).

Objective

The study aims to investigate the health-related hazardous events in order to decide on the best risk-reduction strategies in the supply of drinking water in the Gaza strip.

Methods

A semiquantitative matrix method for risk assessment was applied. Also, chlorine residual, electrical conductivity, and nitrate concentration further tested in 109 water wells, 109 small-scale water desalination plants, 197 tanker trucks, and 384 households distributed over five governorates of the Gaza strip.

Results

The mean of the measured chlorine residual values was less than the recommended national and international limits (0.2–1 mg/liter). The mean of electrical conductivity at catchment points and household municipal water taps was 2165.1 μS·cm⁻¹ and 2000 μS·cm⁻¹, respectively. Furthermore, zero percent of water samples met the recommended criteria, indicating that the groundwater in the Gaza strip is nonpotable. Only 12.8% and 8.8% of water samples met the permissible levels at catchment areas and municipal water at household, respectively, indicating sever health impacts on the public. Moreover, the most hazardous events were related to high levels of groundwater salinity, the low level of disinfection, the effect of electricity outages on the efficiency of the desalination process, and leakage of water from the tanker truck tank reservoirs. Therefore, urgent interventions are required to improve the quality of water and to mitigate the possible health effects.

Conclusion

The prioritization of hazardous events that are proportional to the degree of their attributed risk could help guide in making the right risk-reduction decisions. Urgent interventions are required to improve the quality of water and to mitigate the possible health effects.