The quality of drinking and domestic water from the surface water sources (lakes, rivers, irrigation canals and ponds) and springs in cholera prone communities of Uganda: an analysis of vital physicochemical parameters

Assessment on urban lakes along the coastal region of Miri, NW Borneo: implication for hydrochemistry, water quality, and pollution risk

The main purpose of this study is to assess the urban lake water quality along the coastal region of Miri City, Sarawak, East Malaysia. This study concentrates on the hydrochemical characteristics and the mechanisms controlling the suitability of the lakes for domestic, irrigation, and industrial purposes. A total of 15 lake water samples were collected and analysed for physical parameters, major ions, nutrients, BOD, COD, and heavy metals. The results show that Lakes 6, 7, and 8 commonly exceeded the National Drinking Water Quality Standards (NDWQS) limits, particularly in physical parameters and major ions. The cation dominance was Na+  > Mg2+  > K+  > Ca2+, while the anion dominance was Cl-  > HCO3-  > SO42-. It is inferred that lake 8 was affected by the seawater intrusion through the inlet flow, resulting in an excess concentration of ions present in that lake. The concentrations of heavy metals in these lakes were considerably low, indicating that most of them were from the geogenic source. Most of the lakes were NaCl water type and the main controlling mechanism were weathering and ionic exchange processes, with anthropogenic impacts. Based on the calculated Water Quality Index (WQI) according to the National Water Quality Standards (NWQS), all lakes were suitable for irrigation use (class IV), while most of these lakes fell under the "polluted" index. Apart from that, based on the National Lake Water Quality Standards (NLWQS), all lakes were classified under category D, indicating that the lakes must be kept in good condition. According to the irrigation quality indices, lakes 1, 2, 3, 4, and 5 were the most suitable for irrigation purposes. As for metal pollution indices (HPI and HEI), lakes 1, 2, 3, 4, 5, and 15 were considered safe with low pollution status. From the multivariate statistical analysis, it is deduced that both anthropogenic and geogenic impacts mostly influenced the quality of these lake waters. The outcome of this study will help the policymakers under the national water department in sustainable management of water resources in this region.

Microbiological quality of irrigation water on highly diverse fresh produce smallholder farms: elucidating environmental routes of contamination

AIM

To evaluate the microbiological safety, potential multidrug-resistant bacterial presence and genetic relatedness (DNA fingerprints) of Escherichia coli isolated from the water-soil-plant nexus on highly diverse fresh produce smallholder farms.

METHODS AND RESULTS

Irrigation water (n = 44), soil (n = 85), and fresh produce (n = 95) samples from six smallholder farms with different production systems were analysed for hygiene indicator bacterial counts and the presence of shigatoxigenic E. coli and Salmonella spp. using standard microbiological methods. Identities of isolates were confirmed using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS), and the genetic relatedness of the E. coli isolates determined using enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) analysis. Irrigation water E. coli levels ranged between 0 and 3.45 log MPN/100 ml-1 with five farms having acceptable levels according to the World Health Organization limit (3 log MPN/100 ml-1). Fresh produce samples on four farms (n = 65) harboured E. coli at low levels (<1 log CFU/g-1) except for one sample from kale, spring onion, green pepper, onion, and two tomato samples, which exceeded international acceptable limits (100 CFU/g-1). Only one baby carrot fresh produce sample tested positive for Salmonella spp. Of the 224 samples, E. coli isolates were identified in 40% (n = 90) of all water, soil, and fresh produce types after enrichment. Additionally, the DNA fingerprints of E. coli isolates from the water-soil-plant nexus of each respective farm clustered together at high similarity values (>90%), with all phenotypically characterized as multidrug-resistant.

CONCLUSIONS

The clustering of E. coli isolated throughout the water-soil-plant nexus, implicated irrigation water in fresh produce contamination. Highlighting the importance of complying with irrigation water microbiological quality guidelines to limit the spread of potential foodborne pathogens throughout the fresh produce supply chain.

Assessing the quality of drinking water from selected water sources in Mbarara city, South-western Uganda

This study assessed the physical, chemical, and microbiological quality with emphasis on risk score, source apportionment, geochemistry, feacal coliforms and water quality index of drinking water from selected water sources. A cross-sectional study was conducted in six villages in Mbarara city, south-western Uganda. Each selected source was inspected using a WHO-adopted sanitary inspection questionnaire. Each source's risk score was calculated. Thirty-seven samples were taken from one borehole, nine open dug wells, four rain harvest tanks, and twenty-three taps. The values for apparent color and phosphate were higher than the permissible level as set by the World Health Organization and Ugandan standards (US EAS 12). The isolated organisms were Klebsiella spp. (8.11%), Citrobacter divergens (62.16%), Citrobacter fluendii (2.7%), E. coli (35.14%), Enterobacter aerogenes (8.11%), Enterobacter agglomerus (5.4%), Proteus spp. (2.7%), Enterobacter cloacae (13.5%), and Proteus mirabilis (2.7%). Twelve water sources (32.4%) had water that was unfit for human consumption that was unfit for human consumption (Grade E), Five sources (13.5%) had water that had a very poor index (Grade D), nine (24.3%) had water of poor index (Grade C), eight (21.6%) had water of good water index (Grade B), and only three (8.1%) had water of excellent water quality index (Grade A). The piper trilinear revealed that the dominant water type of the area were Mgso4 and Caso4 type. Gibbs plot represents precipitation dominance. PCA for source apportionment showed that well, tap and borehole water account for the highest variations in the quality of drinking water. These results suggest that drinking water from sources in Mbarara city is not suitable for direct human consumption without treatment. We recommend necessary improvements in water treatment, distribution, and maintenance of all the available water sources in Mbarara City, South Western Uganda.

Quantitative health risk assessment of microbial hazards from water sources for community and self-supply drinking water systems

In low and medium income countries (LMIC) drinking water sources (wells and boreholes) often contain a high number of pathogenic microorganisms, that can pose significant human and environmental health risks. In this study, a quantitative microbial risk assessment approach based on existing literature was conducted to evaluate and compare the quantitative health risks associated with different age groups using various drinking water supply systems. Results showed that both community-supply and self-supply modes exhibit similar levels of risk. However, the self-supply water source consistently showed higher risks compared to the community-supply one. Borehole water was found to be a more suitable option than well water, consistently showing between 5 and 8 lower health risks for E. coli and fecal coliform levels, respectively. The sensitivity analysis further showed the importance of prioritizing the reduction of E. coli concentration in well water and fecal coliform concentration in borehole water. This study offers a fresh perception on quantifying the impact of exposure concentration and age groups, shedding light on how they affect environmental health risks. These findings provide valuable insights for stakeholders involved in the management and protection of water sources.

Analyses of drinking water quality during a protracted cholera epidemic in Malawi - a cross-sectional study of key physicochemical and microbiological parameters

Anecdotal evidence and available literature indicated that contaminated water played a major role in spreading the prolonged cholera epidemic in Malawi from 2022 to 2023. This study assessed drinking water quality in 17 cholera-affected Malawi districts from February to April 2023. Six hundred and thirty-three records were analysed. The median counts/100 ml for thermotolerant coliform was 98 (interquartile range (IQR): 4-100) and that for Escherichia coli was 0 (IQR: 0-9). The drinking water in all (except one) districts was contaminated by thermotolerant coliform, while six districts had their drinking water sources contaminated by E. coli. The percentage of contaminated drinking water sources was significantly higher in shallow unprotected wells (80.0% for E. coli and 95.0% for thermotolerant coliform) and in households (55.8% for E. coli and 86.0% for thermotolerant coliform). Logistic regression showed that household water has three times more risk of being contaminated by E. coli and two and a half times more risk of being contaminated by thermotolerant coliform compared to other water sources. This study demonstrated widespread contamination of drinking water sources during a cholera epidemic in Malawi, which may be the plausible reason for the protracted nature of the epidemic.

Rapid cholera outbreak control following catastrophic landslides and floods: A case study of Bududa district, Uganda

Background

In June 2019, landslides and floods in Bududa district, eastern Uganda, claimed lives and led to a cholera outbreak. The affected communities had inadequate access to clean water and sanitation.

Objective

To share the experience of controlling a cholera outbreak in Bududa district, after landslides and floods.

Methods

A descriptive cross-sectional study was carried out in which outbreak investigation reports, weekly epidemiological data and disaster response reports were reviewed.

Results

On 4 - 5th June 2019, heavy rainfall resulted in four landslides which caused six fatalities, 27 injuries, floods and displaced 480 persons. Two weeks later, a cholera outbreak was confirmed in Bududa district. The Ministry of Health (MoH) rapidly deployed oral cholera vaccine (OCV) from local reserves and mass vaccinated 93% of the target population in 22 affected parishes. The outbreak was controlled in 10 weeks with 67 cholera cases and 1 death reported. However, WaSH conditions remained poor, with only, 24.2 % (879/3,628) of the households with washable latrines, 26.8% (1,023/3,818) had hand-washing facilities with soap and 33.6% (1617/4807) used unsafe water.

Conclusion

The OCV stockpile by the MoH helped Uganda to control cholera promptly in Bududa district. High-risk countries should keep OCV reserves for emergencies.

Health Risks from Intake and Contact with Toxic Metal-Contaminated Water from Pager River, Uganda

Pollution of water resources is one of the major impediments to the realization of Sustainable Development Goals, especially in developing countries. The aim of this study was to investigate the physicochemical quality and potentially toxic element (lead and cadmium) concentrations in surface water sampled from Pager River, a tributary of the Nile River in Northern Uganda. Water samples (n = 18) were taken from six different points upstream (A, B, and C) and downstream (D, E, and F) of the river and analyzed following standard methods for their physiochemical properties. Atomic absorption spectroscopy was used to quantify lead and cadmium concentrations. Human health risks from ingestion and dermal contact with potentially toxic metal-contaminated water were calculated. The results obtained indicated that the mean temperature (27.7 ± 0.5-29.5 ± 0.8 °C), turbidity (40.7 ± 2.1-50.1 ± 1.1 NTU), lead (0.296 ± 0.030-0.576 ± 0.163 mg/L) and cadmium (0.278 ± 0.040-0.524 ± 0.040 mg/L) occurred at levels that surpassed their permissible limits as per World Health Organization guidelines for drinking water. Human health risk assessment showed that there are potential non-cancer risks from the ingestion of water from Pager River by adults, as the total hazard quotients were greater than one. These results emphasize the urgency to restrict the dumping of wastes into the river to minimize chances of impacting the Nile River, which flows northwards to the Mediterranean Sea. Further studies should perform routine monitoring of the river during both dry and wet seasons to establish the spatiotemporal variations of physicochemical, microbial, and trace metal profiles of the river and the associated health risks.

Shotgun Metagenomic Analyses of Microbial Assemblages in the Aquatic Ecosystem of Winam Gulf of Lake Victoria, Kenya Reveals Multiclass Pollution

Lake Victoria, the second-largest freshwater lake in the world, provides an important source of food and income, particularly fish for both domestic consumption and for export market. In recent years, Lake Victoria has suffered massive pollution from both industrial and wastewater discharge. Microplastic biomes, pharmaceutical residues, drugs of abuse, heavy metals, agrochemicals, and personal care products are ubiquitous in the aquatic ecosystem of Winam Gulf. These pollutants are known to alter microbial assemblages in aquatic ecosystems with far-reaching ramification including a calamitous consequence to human health. Indeed, some of these pollutants have been associated with human cancers and antimicrobial resistance. There is a paucity of data on the microbial profiles of this important but heavily polluted aquatic ecosystem. The current study sought to investigate the metagenomic profiles of microbial assemblages in the Winam Gulf ecosystem. Water and sediment samples were collected from several locations within the study sites. Total genomic DNA pooled from all sampling sites was extracted and analyzed by whole-genome shotgun sequencing. Analyses revealed three major kingdoms: bacteria, archaea and eukaryotes belonging to 3 phyla, 13 classes, 14 families, 9 orders, 14 genera, and 10 species. Proteobacteria, Betaproteobacteria, Comamonadaceae, Burkholdariales, and Arcobacter were the dominated phyla, class, family, order, genera, and species, respectively. The Kyoto Encyclopedia of Genes and Genomes indicated the highest number of genes involved in metabolism. The presence of carbohydrate metabolism genes and enzymes was used to infer organic pollutions from sewage and agricultural runoffs. Similarly, the presence of xylene and nutrotoluene degradation genes and enzyme was used to infer industrial pollution into the lake. Drug metabolism genes lend credence to the possibility of pharmaceutical pollutants in water. Taken together, there is a clear indication of massive pollution. In addition, carbohydrate-active enzymes were the most abundant and included genes in glycoside hydrolases. Shotgun metagenomic analyses conveyed an understanding of the microbial communities of the massively polluted aquatic ecosystem of Winam Gulf, Lake Vicoria, Kenya. The current study documents the presence of multiclass pollutants in Lake Victoria and reveals information that might be useful for a potential bioremediation strategy using the native microbial communities.

Multifunctional Heterogeneous Ion-Exchange Membranes for Ion and Microbe Removal in Low-Salinity Water

Here, multifunctional heterogeneous ion-exchange metal nanocomposite membranes were prepared for surface water desalination and bacterial inactivation under low-pressure (0.05 MPa) filtration conditions. Ultrafiltration (UF) heterogeneous ion exchange membranes (IEMs) were modified with different concentrations of AgNO₃ and CuSO₄ solutions using the intermatrix synthesis (IMS) technique to produce metal nanocomposite membranes. Scanning electron microscopy (SEM) images revealed that the metal nanoparticles (MNPs) (Ag and Cu) were uniformly distributed on the surface and the interior of the nanocomposite membranes. With increasing metal precursor solution concentration (0.01 to 0.05 mol·L^-1), the metal content of Ag and Cu nanocomposite membranes increased from 0.020 to 0.084 mg·cm^-2 and from 0.031 to 0.218 m·cm^-2 respectively. Results showed that the hydrodynamic diameter diameters of Ag and Cu nanoparticles (NPs) increased from 62.42 to 121.10 nm and from 54.2 to 125.7 nm respectively, as the metal precursor concentration loaded increased. The leaching of metals from metal nanocomposite membranes was measured in a dead-end filtration system, and the highest leaching concentration levels were 8.72 ppb and 5.32 ppb for Ag and Cu, respectively. The salt rejection studies indicated that ionic selectivity was improved with increasing metal content. Bacterial filtration showed higher antibacterial activity for metal nanocomposite membranes, reaching 3.6 log bacterial inactivation.

In vitro genotoxic and mutagenic effects of water samples from Sapucaia and Esteio streams (Brazil) under the influence of different anthropogenic activities

Pollution of aquatic ecosystems is associated with the discharge of mainly industrial and urban effluents, which may cause damage to public health. This study aims to evaluate the cytotoxic, genotoxic, and mutagenic potential of surface water samples under the influence of different anthropogenic effluents in a human-derived liver cell line (HepG2). Samples were collected in Esteio and Sapucaia streams (Rio Grande do Sul; Brazil), which flow into the Sinos River, a source of water supply for more than one million people. Physicochemical and microbiological analyses were performed as well as an analysis of inorganic elements using the PIXE technique (Particle-Induced X-Ray Emission). The presence of pharmaceutical compounds and caffeine was evaluated by gas chromatography coupled to mass spectrometry. The cytotoxicity, genotoxicity, and mutagenicity of the samples were evaluated in HepG2 cells by cell viability assays, alkaline Comet Assay and Cytokinesis-block micronucleus (CBMN) assay. We verified alterations in the physicochemical and microbiological parameters and detected caffeine, diethyltoluamide, and different inorganic elements that corresponded to elements from domestic and industrial effluents and agricultural runoff. Although the samples in the concentration used were not cytotoxic, water samples from all sites induced DNA damage. However, it is difficult to attribute these damages to a specific substance since the factors are a complex mixture of different compounds. Despite this, it is observed that both urban and industrial contributions had a similar effect in the cells evaluated. Such results demonstrate the need to perform biomonitoring of surface waters under anthropogenic influence, especially those that flow into rivers that are a source of public supply water. We also highlight the need for research into emerging pollutants in these aquatic environments.

Water quality of improved water sources and associated factors in Kibuku District, Eastern Uganda

Globally, billions of people still lack access to safe water, including basic drinking water services, particularly in sub-Saharan Africa. We analyzed water quality for improved water sources and associated factors in Kibuku district, Eastern Uganda. The mixed-methods study employed included; water quality analysis, a questionnaire survey, and key informant interviews conducted in the months of April-June 2020. A total of 249 improved water sources were sampled for analysis of bacteriological quality, pH, and electrical conductivity. This was followed by a sanitary and people's attitudes survey at all the water sources visited. Among the water sources, 62.3% deep boreholes, 63.5% public tap stands, 14.3% rain-water harvesting tanks, and 28.6% protected springs had zero thermotolerant coliforms with 63.8% having acceptable pH levels (6.5-8.5) and 35.3% having acidic levels (less than 6.4). Furthermore, 96.3% deep boreholes, 99.1% public tap stands, all (100%) rain-water harvesting tanks, and 50% protected springs had their turbidity levels in the acceptable range (less than 5NTUs). Additionally, only 22.1% of improved water sources had electrical conductivity in the acceptable range (less than 300 microSiemens). Among the 249 participants, majority (91.2%) had low knowledge levels about various methods that can be used in improving the quality of water. Generally, water sources had poor quality of water which was attributed to agricultural activities, dirty water collection containers, and poor attitude to water chlorination. The Ministry of Health, Ministry of Water and Environment, and other agencies need to design sustainable and feasible models for water treatment for low resourced setting.

Cholera risk in cities in Uganda: understanding cases and contacts centered strategy (3CS) for rapid cholera outbreak control

Introduction

in the recent past, cities in sub-Saharan Africa have reported serious cholera outbreaks that last for several months. Uganda is one of the African countries where cities are prone to cholera outbreaks. Studies on cholera in Bangladesh show increased risk of cholera for the immediate household members (contacts) yet the control interventions mainly target cases with little or no focus on contacts. This study aimed to describe the rapid control of cholera outbreaks in Kampala and Mbale cities, Uganda, using, “Cases and Contacts Centered Strategy (3CS)” that consisted of identification and treatment of cases, promotion of safe water, sanitation, hygiene (WaSH) and selective chemoprophylaxis for the contacts.

Methods

a cross-sectional study was conducted in 2015-2016 in the Kampala and Mbale cities during cholera outbreaks. Cholera cases were treated and 816 contacts from 188 households were listed and given cholera preventive packages. Data were collected, cleaned, analysed and stored in spreadsheet. Comparison of categories was done using Chi-Square test.

Results

a total of 58 and 41 confirmed cholera cases out of 318 and 153 suspected cases were recorded in Kampala and Mbale cities respectively. The outbreaks lasted for 41 days in both cities. Case fatality rates were high; 12.1% (5/41) for Mbale city and 1.7% (1/58) for Kampala city. Fifty-five percent (210/379) of stool samples were tested by culture to confirm V. choleraeO1. No contacts listed and given cholera preventive package developed cholera. Both sexes and all age groups were affected. In Kampala city, the males were more affected than the females in the age groups less than 14 years, p-value of 0.0097.

Conclusion

this study showed that by implementing 3CS, it was possible to rapidly control cholera outbreaks in Kampala and Mbale cities and no cholera cases were reported amongst the listed household contacts. The findings on 3CS and specifically, selective antibiotic chemoprophylaxis for cholera prevention, could be used in similar manner to oral cholera vaccines to complement the core cholera control interventions (disease surveillance, treatment of cases and WaSH). However, studies are needed to guide such rollout and to understand the age-sex differences in Kampala city.

Physicochemical Quality of Water from Chuho Springs, Kisoro District, Uganda

In the current study, water from Chuho springs used as the main water source in Kisoro municipality, Uganda were assessed for their suitability as drinking water. The temperature, turbidity, conductivity, total dissolved solids, dissolved oxygen, biological oxygen demand, total hardness, total alkalinity, calcium, magnesium, phosphates, iron, copper, arsenic, chlorides and the fluoride content of the water samples were determined. Not all the parameters met World Health Organizations’ guidelines for drinking water. Temperature, dissolved oxygen and fluorides were outside the recommended limits of 15 ℃, 10-12 mg/L and 1.5 mg/L, respectively. Further studies should assess the microbiological and sanitary profile of the springs.