Comparing the microbial risks associated with household drinking water supplies used in peri-urban communities of Phnom Penh, Cambodia

Water-based technologies for improving water quality at the point of use: A review

Water safety concerns are increasing tremendously as a result of the rising population and environmental pollution. As a result, viable water treatment approaches need to be designed to meet the water consumption demands of the population, particularly in developing countries. The recent technological advances in water treatment and purification are well articulated in this review. The efficiency of the materials used for purification and their affordability for people living in rural and remote settlements in various parts of the world have been discussed. Water treatment techniques prior to the rapid advancement of science and technology included a variety of strategies such as coagulation/flocculation, filtration, disinfection, flotation and pH correction. The use of nanotechnology in water treatment and purification has modernized the purification process. Therefore, efficient removal of microbes such as bacteria and viruses are exquisitely accomplished. These technologies may include membrane filtration, ultraviolet irradiation, advanced oxidation ion-exchange and biological filtration technologies. Thus, nanotechnology allows for the fabrication of less expensive systems, allowing even low-income people to benefit from it. Most developing countries find these technologies particularly valuable because access to clean and safe water for drinking and residential needs is critical. This is because access to municipal water supplies is also difficult. This article is categorized under: Toxicology and Regulatory Issues in Nanomedicine > Toxicology of Nanomaterials Diagnostic Tools > In Vivo Nanodiagnostics and Imaging.

Physicochemical, microbiological quality, and risk assessment of water consumed by a quilombola community in midwestern Brazil

The quality of the water consumed by a given community is related to its quality of life. In this sense, this study aimed to evaluate, from the perspective of health risk, the physical, chemical, and microbiological quality of drinking water, in a quilombola community, and the qualitative aspects intrinsic to its use and storage. For this, water samples, collected at the exits of the collective water supply system and from eight cisterns that store rainwater, used for human consumption, were analyzed. The samples were subjected to physical, chemical, and microbiological analysis, including adenovirus (HAdV) and enterovirus (EV). The probability of an individual acquiring infection through water consumption was determined by quantitative microbiological risk analysis using HAdV and Escherichia coli (EC) as reference pathogens. The results showed that the water in the deep tubular well had 270.8 mg/L of total hardness, leading to the rejection of its consumption by ingestion. Alternativity, the people in the community consume rainwater stored in cisterns. For this type of water, the presence of heterotrophic bacteria was found in 75%, total coliform was present in 100%, and Enterococci were detected in 25%. Furthermore, EC was present in 25%, EV in 50%, and HAdV in 100% of the samples. The probability of annual infection with HAdV and EC was, in the worst situation, 100% and 1.3%, respectively. Regarding the qualitative and quantitative aspects, there was a significant positive correlation between the absence of EC and the withdrawal of water from the cistern using a pump and the opposite when the withdrawal was carried out using a bucket or hose. Based on the results found, it is important to carry out actions aimed at improving water quality and, consequently, the quality of life of people living in the study community.

A longitudinal study of the association between domestic contact with livestock and contamination of household point-of-use stored drinking water in rural Siaya County (Kenya)

Background

Emerging evidence suggests close domestic proximity of livestock and humans may lead to microbiological contamination of hands, objects, food and water supplies within domestic environments, adversely impacting public health. However, evidence quantifying the relationship between livestock, domestic animals, humans and microbiological contamination of household stored water remains limited.

Aim

This longitudinal study aimed to examine the relationship between domestic contact with livestock and domestic animals on microbiological contamination of household Point-of-Use (POU) stored drinking water in rural Kenya and assess the influence of choice of faecal indicator on such associations.

Methodology

A survey was performed in 234 households in Siaya county, Kenya, to observe presence of livestock (cattle, goats, poultry) and domestic animals (cats, dogs) in household compounds, alongside other risk factors for contamination of POU stored drinking water such as sanitation, storage conditions and hygiene practices. Samples from water sources (e.g. piped, spring/wells, boreholes, surface and rainwater) and from POU storage containers were tested for E. coli and intestinal enterococci. Livestock-related risk factors for water contamination were examined through multinomial regression, controlling for confounders.

Results

Rainwater was the main POU water source and was found to be highly susceptible to contamination. Multivariate analysis showed greater risk of gross (>100 CFU/100 mL) water contamination (with E. coli) for households where goats were observed, and/or where poultry roosted in proximity to stored household water (relative risk RR = 2.71; p = 0.001 and RR = 2.02; p = 0.012 respectively). Presence of a poultry coop was also associated with elevated intestinal enterococci densities (RR = 4.46; p = 0.001). Associations between contamination and livestock risk factors were thus similar for both bacteria groups, but E. coli counts declined more rapidly following collection from surface waters than enterococci counts (p = 0.024).

Conclusion

The presence of livestock (particularly goats) and poultry within household compounds increases POU water contamination risk, suggesting the need for improved interventions to address cross-contamination within rural domestic settings. Within Siaya county, more effective community education is needed to raise awareness of POU water quality protection, particularly of rainwater.

•

Poultry and goats are risk factors for household stored water contamination.

•

Poultry are risk factors for both enterococci and E. coli contamination.

•

Attenuation of enterococci in household stored water is lower than for E. coli.

•

Residual free chlorine is mostly too low to prevent stored water recontamination.

Implementation of quantitative microbial risk assessment (QMRA) for public drinking water supplies: Systematic review

In the more than 15 years since its introduction, quantitative microbial risk assessment (QMRA) has become a widely used technique for assessing population health risk posed by waterborne pathogens. However, the variation in approaches taken for QMRA in relation to drinking water supply is not well understood. This systematic review identifies, categorises, and critically synthesises peer-reviewed and academic case studies of QMRA implementation for existing distributed public drinking water supplies. Thirty-nine English-language, peer-reviewed and academic studies published from 2003 to 2019 were identified. Key findings were synthesised in narrative form. The overall designs of the included studies varied widely, as did the assumptions used in risk calculation, especially in relation to pathogen dose. There was also substantial variation in the degree to which the use of location-specific data weighed with the use of assumptions when performing risk calculation. In general, the included studies' complexity did not appear to be associated with greater result certainty. Factors relating to pathogen dose were commonly influential on risk estimates whereas dose-response parameters tended to be of low relative influence. In two of the included studies, use of the 'susceptible fraction' factor was inconsistent with recognised guidance and potentially led to the underestimation of risk. While approaches and assumptions used in QMRA need not be standardised, improvement in the reporting of QMRA results and uncertainties would be beneficial. It is recommended that future authors consider the water supply QMRA reporting checklist developed for the current review. Consideration of the broad types of uncertainty relevant to QMRA is also recommended. Policy-makers should consider emergent discussion on acute microbial health-based targets when setting normative guidelines. The continued representation of QMRA case studies within peer-reviewed and academic literature would also enhance future implementation. Further research is needed on the optimisation of QMRA resourcing given the application context.

Risk assessment of hybrid rain harvesting system and other small drinking water supply systems by game theory and fuzzy logic modeling

The complexity and uncertainties affecting drinking water supply systems and threatening hazards require a comprehensive and effective risk assessment to increase the reliability of drinking water safety, especially for small or household systems. This study presents a hierarchical structure risk assessment model based on fuzzy logic and game theory to assess the quantity, treatment technology, distribution systems, and storage at household level risks, for small systems in remote areas. Game theory combined with an analytical hierarchy process with entropy weight method is employed. The efficiency tradeoffs in risk from use of this model are examined in a case study which includes three types of small systems (i.e., rainwater harvesting, surface water combined with rainwater and groundwater) in Gansu Province, China. Fifteen risk factors are employed, with evaluation results showing that "Source water" is the most important factor. The hybrid (surface & rainwater) system in the driest year has "Medium" risk with the highest aggregate risk value as a result of source water availability and the distribution system is the most susceptible to failure. The groundwater system consistently has the lowest risk in the case study area. The utility of the model provides scientific support to decision-makers to plan for the most effective risk mitigation measures for water supply systems in remote areas. A cloud-based online-platform employing this methodology has been developed to facilitate the adoption of the methodology in remote areas with mobile or internet access.

Quantitative Microbial Risk Assessment and Infectious Disease Transmission Modeling of Waterborne Enteric Pathogens

PURPOSE OF REVIEW

Waterborne enteric pathogens remain a global health threat. Increasingly, quantitative microbial risk assessment (QMRA) and infectious disease transmission modeling (IDTM) are used to assess waterborne pathogen risks and evaluate mitigation. These modeling efforts, however, have largely been conducted independently for different purposes and in different settings. In this review, we examine the settings where each modeling strategy is employed.

RECENT FINDINGS

QMRA research has focused on food contamination and recreational water in high-income countries (HICs) and drinking water and wastewater in low- and middle-income countries (LMICs). IDTM research has focused on large outbreaks (predominately LMICs) and vaccine-preventable diseases (LMICs and HICs). Human ecology determines the niches that pathogens exploit, leading researchers to focus on different risk assessment research strategies in different settings. To enhance risk modeling, QMRA and IDTM approaches should be integrated to include dynamics of pathogens in the environment and pathogen transmission through populations.

A culture-dependent and metagenomic approach of household drinking water from the source to point of use in a developing country

Rural households in developing countries rely on communal water supplies and household water frequently becomes contaminated following its collection, transportation and during its storage. Using culture-dependent and -independent techniques, we examined the changes in microbial water quality between communal tap water and household water storage in a rural area of Cameroon, Africa. The culturable fecal indicator bacteria (FIB) were used to assess the potential health risks associated with different household water storage conditions (e.g., type of container and open vs. closed container) and interventions (e.g., water storage days, cleaned on the last day of use, and hygiene practices). Only the amount of days the water was stored significantly differed (p-value < 0.05), which showed that potential health risks increased when water was stored for more than 3 days. The higher abundance of molecular FIB in biofilm than household water suggested that omnipresent biofilm in household water could potential health risk. The high-throughput sequencing revealed that the most abundant phylum was Proteobacteria, followed by Actinobacteria and Bacteroidetes in both the water and the biofilm samples. Bacterial genera seen in biofilm bacteria, such as Pseudomonas, Acinetobacter and Comamonas. Acinetobacter, Chryseobacterium, Stenotrophomonas and Corynebacterium, were relatively more abundant in the biofilm than in the water. Potential bacterial pathogens including Acinetobacter baumannii, Citrobacter freundii, Stenotrophomonas maltophilia and Haemophilus influenza, were detected in household water and biofilm. The microbial quality might be affected by water-storage time and households repeatedly using the same water storage containers without proper sanitization, triggering microbial regrowth and biofilm formation on water containers. Higher bacterial diversity and potentially pathogenic bacteria found in the biofilm samples of a household water supply are unhealthy for the house's inhabitants. It is important to develop interventions aimed at preventing the formation of these dangerous biofilms in a communal water supply.