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Siwila J, Mwaba F, Chidumayo N, Mubanga C. Food and waterborne protozoan parasites: The African perspective. Food Waterborne Parasitol 2020; 20:e00088. [PMID: 32995582 PMCID: PMC7502820 DOI: 10.1016/j.fawpar.2020.e00088] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 01/22/2023] Open
Abstract
Parasitic food-borne diseases, particularly those caused by the protozoan parasites Cryptosporidium, Giardia, Cyclospora cayetanensis and Entamoeba are increasingly becoming common and have received considerable attention in the last two decades. The ability of the transmission stages of the parasites to survive in the environment for prolonged periods, globalization of the food industry and changes in eating habits have contributed to the numbers of human infections. This systematic scoping review highlights these important water- and foodborne parasites in the African context, detailing the burden in African water sources, wastewater/effluents and fresh produce. A scoping review search targeting African countries was conducted in Medline, Web of science and African journals online as well as back referencing from included studies covering the period 1990 to January 2020. Out of 1134 studies, 68 were included in the review. The articles covered 17 out of 54 African countries. There were 39/68 studies reporting on water sources while the rest reported on fresh produce. Cryptosporidium prevalence ranged from 6 to 100% in surface water, 4 to 100% in tap water and up to 100% in wastewater and sludge. In fresh produce, Cryptosporidium was reported from five countries with prevalence of 0.8-75%. Giardia was reported in 47 out of 68 articles; prevalence ranged from 2.4% in surface water; 1% to over 70% in tap water; 28-100% in wastewater and 2% - 99% in fresh produce. Prevalence of Cyclospora cayetanensis was lower. Prevalence of Entamoeba was 78% in surface water; 100% in wastewater and up to 99% in fresh produce. This study finds that Africa is no exception to the risk presented by the subject parasites from water and/or food sources. Routine screening for these parasites particularly at household level and provision of adequate and safe drinking water would help to control the parasites.
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Affiliation(s)
- Joyce Siwila
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, P.O. Box 32379, Lusaka, Zambia
| | - Florence Mwaba
- Department of Pathology and Microbiology, School of Medicine, University of Zambia, P.O. Box 50110, Lusaka, Zambia
| | - Nozyechi Chidumayo
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, P.O. Box 32379, Lusaka, Zambia
| | - Chishimba Mubanga
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, P.O. Box 32379, Lusaka, Zambia
- Ministry of Agriculture, P.O. Box 31658, Lusaka, Zambia
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Consumer Preference and Quality of Sachet Water Sold and Consumed in the Sunyani Municipality of Ghana. BIOMED RESEARCH INTERNATIONAL 2020; 2020:3865895. [PMID: 32832547 PMCID: PMC7428965 DOI: 10.1155/2020/3865895] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/01/2020] [Accepted: 07/24/2020] [Indexed: 11/17/2022]
Abstract
Good quality water is odourless, colourless, and free from faecal pollution, and a satisfactory safe supply must be made available to consumers. The study assessed consumer preference and quality of sachet water sold and consumed in the Sunyani Municipality of Ghana. A cross-sectional study design was used, and data were collected using a structured questionnaire from a sample size of 500 respondents. A total of twenty (20) samples of sachet water commonly sold and consumed in the Sunyani Municipality were also collected and analyzed for bacteriological and physicochemical parameters. Out of these 20 samples, 10 samples of sachet water were collected from the production site and the other 10 samples from the market site. Results showed that respondents' choice of sachet water was based on several indicators. While 70% (350/500) of consumers indicated that sachet water had taste, 58% (290/500) of them were not enthused when the water had colour. Using smell as an indicator, 71% of consumers have had an experience with sachet water smell being questionable. Water taste (p < 0.001), colour of water (p < 0.001), smell (p < 0.001), and increase in cost (p < 0.001) were found as determinants of consumer preference. Consumers who said the colour of water informed their decision when buying sachet water were seven times more likely to have a preference for a particular brand (OR 7.057, CI: 4.474-11.133). Those who checked for expiry dates when buying water (OR 4.871, CI: 3.110-7.628) and those who looked out for Food and Drugs Authority stamp (OR 4.433, CI: 2.806-7.003) were both four times more likely to have a preference for a particular brand. Water quality tests also indicated that 30% of all water samples collected from the production site were contaminated with total coliforms and 50% of sachet water samples collected from the markets were also contaminated with coliforms. The same brands of sachet water that contained total coliforms from the production site were the same brands that contained total coliforms selected from the market. From this study, only total coliforms other than Escherichia coli were detected in the water samples analyzed. It was observed that the evaluated physicochemical parameters of the water analyzed were within the accepted WHO limits. It is recommended that consumers be educated about the indicators to look out for when buying sachet water and, also, that regulatory bodies be empowered to ban the sale of unwholesome brands of sachet water on the market.
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Almeria S, Cinar HN, Dubey JP. Cyclospora cayetanensis and Cyclosporiasis: An Update. Microorganisms 2019; 7:E317. [PMID: 31487898 PMCID: PMC6780905 DOI: 10.3390/microorganisms7090317] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/28/2019] [Accepted: 09/02/2019] [Indexed: 12/18/2022] Open
Abstract
Cyclospora cayetanensis is a coccidian parasite of humans, with a direct fecal-oral transmission cycle. It is globally distributed and an important cause of foodborne outbreaks of enteric disease in many developed countries, mostly associated with the consumption of contaminated fresh produce. Because oocysts are excreted unsporulated and need to sporulate in the environment, direct person-to-person transmission is unlikely. Infection by C. cayetanensis is remarkably seasonal worldwide, although it varies by geographical regions. Most susceptible populations are children, foreigners, and immunocompromised patients in endemic countries, while in industrialized countries, C. cayetanensis affects people of any age. The risk of infection in developed countries is associated with travel to endemic areas and the domestic consumption of contaminated food, mainly fresh produce imported from endemic regions. Water and soil contaminated with fecal matter may act as a vehicle of transmission for C. cayetanensis infection. The disease is self-limiting in most immunocompetent patients, but it may present as a severe, protracted or chronic diarrhea in some cases, and may colonize extra-intestinal organs in immunocompromised patients. Trimetoprim-sulfamethoxazole is the antibiotic of choice for the treatment of cyclosporiasis, but relapses may occur. Further research is needed to understand many unknown epidemiological aspects of this parasitic disease. Here, we summarize the biology, epidemiology, outbreaks, clinical symptoms, diagnosis, treatment, control and prevention of C. cayetanensis; additionally, we outline future research needs for this parasite.
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Affiliation(s)
- Sonia Almeria
- Department of Health and Human Services, Food and Drug Administration, Center for Food Safety and Nutrition (CFSAN), Office of Applied Research and Safety Assessment (OARSA), Division of Virulence Assessment, Laurel, MD 20708, USA
| | - Hediye N Cinar
- Department of Health and Human Services, Food and Drug Administration, Center for Food Safety and Nutrition (CFSAN), Office of Applied Research and Safety Assessment (OARSA), Division of Virulence Assessment, Laurel, MD 20708, USA
| | - Jitender P Dubey
- Animal Parasitic Disease Laboratory, United States Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Center, Building 1001, BARC-East, Beltsville, MD 20705-2350, USA.
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Mosi L, Adadey SM, Sowah SA, Yeboah C. Microbiological assessment of sachet water "pure water" from five regions in Ghana. AAS Open Res 2019; 1:12. [PMID: 32259018 PMCID: PMC7117957 DOI: 10.12688/aasopenres.12837.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Sachet water, popularly known as “pure water” has become an invaluable entity in most Ghanaian households. Despite its importance, there is no extensive nationwide investigations on its wholesomeness for consumption. The aim of this study was to determine the microbiological quality of 41 brands of sachet water sampled in 16 districts across 5 regions in Ghana. Methods: The samples were analyzed for the presence of total and fecal coliform (
Escherichia coli) using the Colilert*- 18 Test Kit. Results: Majority of the samples (56.09%) were excellent, 4.87% satisfactory and 14.63% suspicious. Ten samples (24.4%) were unsatisfactory. For the degree of fecal contamination, (85.56%) were satisfactory, four (9.76%) were suspicious, and two others (4.88%) were unsatisfactory. The contaminations observed could be attributed to poor sanitary conditions (during and/or after production) and failure of some production facilities to adhere to standard manufacturing practices. Conclusion: Our data suggest that microbiological quality sachet water from some sources have not yet attained levels that make it absolutely pure and wholesome for consumption in many areas.
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Affiliation(s)
- Lydia Mosi
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, P.O. Box LG 54, Ghana
| | - Samuel Mawuli Adadey
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, P.O. Box LG 54, Ghana
| | - Sandra Akoley Sowah
- Australian Institute for Bioengineering and Nanotechnology , University of Queensland, Brisbane , QLD, Australia
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Wang Y, Moe CL, Teunis PFM. Children Are Exposed to Fecal Contamination via Multiple Interconnected Pathways: A Network Model for Exposure Assessment. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2018; 38:2478-2496. [PMID: 30053314 PMCID: PMC6282741 DOI: 10.1111/risa.13146] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 05/22/2018] [Accepted: 05/27/2018] [Indexed: 05/22/2023]
Abstract
In recent decades, quantitative microbial risk assessment (QMRA) has been widely used to assess exposure to fecal microbes and associated health risks. In this study, a multipathway exposure assessment model was developed to evaluate exposure to fecal microbes for children under 5 in highly contaminated urban environments. Children had contact with various environmental compartments. The contamination levels of these compartments were estimated from fecal indicator counts in the environmental samples. Structured observations of child behavior (including activities, locations, and time) were used to model behavioral sequences as a dynamic network. The exposure model combines behavior sequences with environmental contamination, using additional exposure factors when needed, to estimate the number of fecal microbes transferred from environmental sources to human oral ingestion. As fecal exposure in a highly contaminated urban environment consists of contributions from multiple pathways, it is imperative to study their relative importance. The model helps us better understand the characteristics of the exposure pathways that may be driven by variation in contamination and by variable behavior, like hygiene and high-risk activities. Importantly, the model also allows prediction of the quantitative effects of an intervention-the expected reduction in exposure due to infrastructural or behavioral changes-by means of scenario studies. Based on experience with this exposure model, we make specific recommendations for additional studies of child behavior and exposure factors in order to fill critical information gaps and improve the model structure and assumptions.
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Affiliation(s)
- Yuke Wang
- Center of Global Safe Water, Sanitation, and Hygiene, Hubert Department of Global HealthRollins School of Public Health, Emory UniversityAtlantaGAUSA
| | - Christine L. Moe
- Center of Global Safe Water, Sanitation, and Hygiene, Hubert Department of Global HealthRollins School of Public Health, Emory UniversityAtlantaGAUSA
| | - Peter F. M. Teunis
- Center of Global Safe Water, Sanitation, and Hygiene, Hubert Department of Global HealthRollins School of Public Health, Emory UniversityAtlantaGAUSA
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Opoku YK, Boampong JN, Ayi I, Kwakye-Nuako G, Obiri-Yeboah D, Koranteng H, Ghartey-Kwansah G, Asare KK. Socio-Behavioral Risk Factors Associated with Cryptosporidiosis in HIV/AIDS Patients Visiting the HIV Referral Clinic at Cape Coast Teaching Hospital, Ghana. Open AIDS J 2018; 12:106-116. [PMID: 30369995 PMCID: PMC6182914 DOI: 10.2174/1874613601812010106] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/12/2018] [Accepted: 08/18/2018] [Indexed: 01/08/2023] Open
Abstract
Objective: To identify the socio-behavioral risk factors associated with cryptosporidiosis among HIV/AIDS patients with chronic diarrhea symptoms visiting the HIV referral clinic at Cape Coast Teaching Hospital, Ghana. Methods: A cross-sectional study was conducted among 50 HIV/AIDS patients with recurrent diarrhea. Questionnaires were administered to collect social and behavioral risk factors associated with Cryptosporidium and other opportunistic protozoan parasitic infections in HIV patients. Stool samples were collected for the diagnosis of enteric protozoan pathogens using modified Ziehl-Neelsen and acid-fast staining methods. CD4+ cells counts of study subjects were obtained from patients clinical records. The data obtained were analyzed using Pearson chi-square and multivariate-adjusted statistics tool on SPSS 16 for Windows. Results: Twenty-seven (54%) of the subjects were infected with enteric protozoan pathogens. The prevalences of Cryptosporidium, Cyclospora and Microsporidium infections were 46%, 32% and 16%, respectively. Cryptosporidium infection was significantly associated with drinking water (×2=13.528, p<0.001), Cyclospora was associated with the type of drinking water (×2=14.931, p<0.001) and toilet facilities used by the study subjects (×2=12.463, p<0.01), whiles Microsporidium infection was associated with hand washing behavior (×2=12.463, p<0.01). Enteric protozoans were frequently encountered among subjects with CD4+ T-cell count <200 cells/mm3. However, coinfection of Cyclospora spp & Cryptosporidium spp was not observed in CD4+ cell count <200 and >500 cells/mm3. Multivariate analysis showed that the risk factor for Cryptosporidium infection among HIV/AIDS patients was the source of drinking water (pipe borne water 76.2% prevalence: sachet water 25%; OR=0.10, 95%CI: 0.03-0.39, p<0.001). Conclusion: We report the risk factor for exposure of Cryptosporidium infection among HIV/AIDS patients for the first time in Ghana. The contamination of drinking water by protozoan parasites should be a public health concern. These results provide the stepping block to understand the transmission dynamics of Cryptosporidium and other opportunistic pathogens in HIV/AIDS infected patients in Ghana.
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Affiliation(s)
- Yeboah K Opoku
- Department of Biomedical Sciences, School of Allied Health Sciences, Collage of Health and Allied Science, University of Cape Coast, Cape Coast, Ghana.,Biopharmaceutical Laboratory, College of Life Sciences, Northeast Agricultural University, Harbin 150030, China
| | - Johnson N Boampong
- Department of Biomedical Sciences, School of Allied Health Sciences, Collage of Health and Allied Science, University of Cape Coast, Cape Coast, Ghana
| | - Irene Ayi
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, P. O. Box LG 581, Legon, Accra, Ghana
| | - Godwin Kwakye-Nuako
- Department of Biomedical Sciences, School of Allied Health Sciences, Collage of Health and Allied Science, University of Cape Coast, Cape Coast, Ghana
| | | | - Harriet Koranteng
- Jiamusi University No. 148, Xuefu Road, Jiamusi, Heilongjiang, China
| | - George Ghartey-Kwansah
- Department of Biomedical Sciences, School of Allied Health Sciences, Collage of Health and Allied Science, University of Cape Coast, Cape Coast, Ghana.,Laboratory of Cell Biology, Genetics and Developmental Biology, College of Life Sciences, Shaanxi Normal University, Xi'an 710062, China
| | - Kwame K Asare
- Department of Biomedical Sciences, School of Allied Health Sciences, Collage of Health and Allied Science, University of Cape Coast, Cape Coast, Ghana.,Department of Protozoology, Institute of Tropical Medicine (NEKKEN), Nagasaki University Sakamoto 1-12-4, Nagasaki 852-8523, Japan.,Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Ahmed SA, Guerrero Flórez M, Karanis P. The impact of water crises and climate changes on the transmission of protozoan parasites in Africa. Pathog Glob Health 2018; 112:281-293. [PMID: 30332341 PMCID: PMC6381522 DOI: 10.1080/20477724.2018.1523778] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Waterborne protozoa (WBP) are important cause of several outbreaks all over the world. The report system of WBP in Africa is weak. More than one third of African countries (21/54) reported WBP with absent reports in the remaining countries (33/54). The top reported WBP were Cryptosporidium, Giardia, FLA and Entamoeba contaminating different African water resources. Other protozoa were less documented even though it is abundant and robust. More than one protozoa were detected in contaminated African water including drinking sources, a prediction index to popular epidemics and real presence of undocumented WBP outbreaks. Risk factors in Africa were observed to be abundant and multi-factorial 'socioeconomic, governmental, pathogen in water and climate change. Climate change is an important factor impacting Africa. Increasing droughts in Africa with other extreme weather events will lead to water crises. Incidence and transmission of WBP will change, with new manifested strains/species. Recognizing future consequences of water crises in Africa are important. Governments and population unity will be needed to protect against expected raise and spread of WBP diseases and water shortages.
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Affiliation(s)
- Shahira A. Ahmed
- Department of Parasitology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Milena Guerrero Flórez
- Center for Health Studies CESUN, University of Nariño. Ciudad Universitaria-Torobajo, Pasto, Colombia
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Quartey ET, Darkwah SA. A Review of the Suitability of Using Eco-Efficiency Principles in Managing Environmental Impacts of the Packaged Water Industry in Ghana. ACTA UNIVERSITATIS AGRICULTURAE ET SILVICULTURAE MENDELIANAE BRUNENSIS 2018. [DOI: 10.11118/actaun201866040979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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9
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Mosi L, Adadey SM, Sowah SA, Yeboah C. Microbiological assessment of sachet water “pure water” from five regions in Ghana. AAS Open Res 2018. [DOI: 10.12688/aasopenres.12837.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Sachet water, popularly known as “pure water” has become an invaluable entity in most Ghanaian households. Despite its importance, there is no extensive nationwide investigations on its wholesomeness for consumption. The aim of this study was to determine the microbiological quality of 41 brands of sachet water sampled in 16 districts across 5 regions in Ghana. Methods: The samples were analyzed for the presence of total and fecal coliform (Escherichia coli) using the Colilert*- 18 Test Kit. Results: Majority of the samples (56.09%) were excellent, 4.87% satisfactory and 14.63% suspicious. Ten samples (24.4%) were unsatisfactory. For the degree of fecal contamination, (85.56%) were satisfactory, four (9.76%) were suspicious, and two others (4.88%) were unsatisfactory. The contaminations observed could be attributed to poor sanitary conditions (during and/or after production) and failure of some production facilities to adhere to standard manufacturing practices. Conclusion: Our data suggest that microbiological quality sachet water from some sources have not yet attained levels that make it absolutely pure and wholesome for consumption in many areas.
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Squire SA, Ryan U. Cryptosporidium and Giardia in Africa: current and future challenges. Parasit Vectors 2017; 10:195. [PMID: 28427454 PMCID: PMC5397716 DOI: 10.1186/s13071-017-2111-y] [Citation(s) in RCA: 165] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 03/24/2017] [Indexed: 12/15/2022] Open
Abstract
Cryptosporidium and Giardia are important causes of diarrhoeal illness. Adequate knowledge of the molecular diversity and geographical distribution of these parasites and the environmental and climatic variables that influence their prevalence is important for effective control of infection in at-risk populations, yet relatively little is known about the epidemiology of these parasites in Africa. Cryptosporidium is associated with moderate to severe diarrhoea and increased mortality in African countries and both parasites negatively affect child growth and development. Malnutrition and HIV status are also important contributors to the prevalence of Cryptosporidium and Giardia in African countries. Molecular typing of both parasites in humans, domestic animals and wildlife to date indicates a complex picture of both anthroponotic, zoonotic and spill-back transmission cycles that requires further investigation. For Cryptosporidium, the only available drug (nitazoxanide) is ineffective in HIV and malnourished individuals and therefore more effective drugs are a high priority. Several classes of drugs with good efficacy exist for Giardia, but dosing regimens are suboptimal and emerging resistance threatens clinical utility. Climate change and population growth are also predicted to increase both malnutrition and the prevalence of these parasites in water sources. Dedicated and co-ordinated commitments from African governments involving "One Health" initiatives with multidisciplinary teams of veterinarians, medical workers, relevant government authorities, and public health specialists working together are essential to control and prevent the burden of disease caused by these parasites.
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Affiliation(s)
- Sylvia Afriyie Squire
- School of Veterinary and Life Sciences, Murdoch University, Perth, Australia
- Council for Scientific and Industrial Research, Animal Research Institute, Accra, Ghana
| | - Una Ryan
- School of Veterinary and Life Sciences, Murdoch University, Perth, Australia
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Vedachalam S, MacDonald LH, Omoluabi E, OlaOlorun F, Otupiri E, Schwab KJ. The role of packaged water in meeting global targets on improved water access. JOURNAL OF WATER, SANITATION, AND HYGIENE FOR DEVELOPMENT : A JOURNAL OF THE INTERNATIONAL WATER ASSOCIATION 2017; 7:369-377. [PMID: 33384863 PMCID: PMC7734372 DOI: 10.2166/washdev.2017.155] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 02/24/2017] [Indexed: 06/12/2023]
Abstract
Packaged water (as either refill, bottled, or sachet water) has become an important element of water security in many low- and middle-income countries, owing to poor reliability and lack of piped water infrastructure. However, over time and across countries, the Demographic and Health Surveys monitoring program has inconsistently classified packaged water components as either improved or unimproved. Using data collected as part of the Performance Monitoring and Accountability 2020 (PMA2020) surveys on water options in nine study geographies across eight countries, we identified five geographies where packaged water constituted one of several options for 5% or more of users. In this study, four scenarios were designed in which packaged water components were variously classified as either improved or unimproved. Unimproved water use was highest in scenarios where sachet or refill water was classified as an unimproved source. Across the four scenarios, the difference in the use of unimproved water as the main option was highest (65%) in Nigeria (Lagos). That difference increased to 78% when considering all regular options. The development of these scenarios highlights the importance of classifying a source as improved or unimproved in the overall metric that indicates progress at national and international levels.
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Affiliation(s)
- Sridhar Vedachalam
- Johns Hopkins Water Institute, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, E6638, Baltimore, MD 21205, USA
| | - Luke H MacDonald
- Johns Hopkins Water Institute, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, E6638, Baltimore, MD 21205, USA
| | - Elizabeth Omoluabi
- Center for Research, Evaluation Resources and Development, Ife, Nigeria And University of Western Cape, Cape Town, South Africa
| | - Funmilola OlaOlorun
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Easmon Otupiri
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kellogg J Schwab
- Johns Hopkins Water Institute, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, E6638, Baltimore, MD 21205, USA
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Nsoh FA, Wung BA, Atashili J, Benjamin PT, Marvlyn E, Ivo KK, Nguedia AJC. Prevalence, characteristics and correlates of enteric pathogenic protozoa in drinking water sources in Molyko and Bomaka, Cameroon: a cross-sectional study. BMC Microbiol 2016; 16:268. [PMID: 27825310 PMCID: PMC5101791 DOI: 10.1186/s12866-016-0890-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 11/04/2016] [Indexed: 11/22/2022] Open
Abstract
Background Access to potable water remains a major challenge particularly in resource-limited settings. Although the potential contaminants of water are varied, enteric pathogenic protozoa are known to cause waterborne diseases greatly. This study aimed at investigating the prevalence, characteristics and correlates of enteric pathogenic protozoa in drinking water sources in Buea, Cameroon. Methods A cross-sectional study was conducted using 155 water samples collected from various drinking sources (boreholes, springs, taps and wells). Each sample was subjected to physicochemical examinations (pH, turbidity, odour and sliminess) and parasitological analysis (wet mount, modified Ziehl-Neelsen stain) to determine the presence of enteric pathogenic protozoa. A data collection tool was used to note characteristics of collected samples and the data was analysed using EPI-INFO Version 3.5.3. Results The overall prevalence of enteric pathogenic protozoa in water sources was 62.6 %. Eight species of enteric protozoa were observed with Cryptosporidium parvum being the most predominant (45.8 %). Spring water was the most contaminated source with enteric protozoa (85.7 %) while pipe borne water had all eight species of protozoa identified. A pH of 6 was the only significant factor associated with the prevalence of these pathogens in water sources. Conclusion The prevalence of enteric protozoa in water sources in Molyko and Bomaka is high, spring water is the most contaminated water source and Cryptosporidium parvum is the most common protozoa contaminating water. A water pH of 6 is associated to the prevalence of protozoa. Community members need to be educated to treat water before drinking to avoid infection by enteric protozoa in water and further studies with larger samples of water need to be conducted to find other correlates of the presence of protozoa in water.
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Affiliation(s)
- Fuh Anold Nsoh
- Faculty of Health Sciences, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Buh Amos Wung
- Faculty of Health Sciences, University of Buea, P.O. Box 63, Buea, Cameroon. .,Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, P.O. Box 63, Buea, Cameroon.
| | - Julius Atashili
- Faculty of Health Sciences, University of Buea, P.O. Box 63, Buea, Cameroon.,Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, P.O. Box 63, Buea, Cameroon
| | | | - Eba Marvlyn
- Faculty of Health Sciences, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Keumami Katte Ivo
- Faculty of Health Sciences, University of Buea, P.O. Box 63, Buea, Cameroon.,Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, P.O. Box 63, Buea, Cameroon
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13
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Anim-Baidoo I, Narh CA, Oddei D, Brown CA, Enweronu-Laryea C, Bandoh B, Sampane-Donkor E, Armah G, Adjei AA, Adjei DN, Ayeh-Kumi PF, Gyan BA. Giardia lamblia infections in children in Ghana. Pan Afr Med J 2016; 24:217. [PMID: 27800072 PMCID: PMC5075441 DOI: 10.11604/pamj.2016.24.217.8012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 03/07/2016] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Though giardiasis is an important public health problem in Ghana, several aspects of its epidemiology, particularly the molecular epidemiology has not been investigated adequately. This could be a major hindrance to effective surveillance and control of giardiasis in the country. The study was carried out to determine the prevalence, risk factors and genotypes of Giardia lamblia infecting children at a paediatric hospital in Ghana. METHODS A total of 485 patients including 365 diarrhoea and 120 non-diarrhoea children were enrolled into the study. Stool samples were collected and analysed for parasite presence using microscopy, ELISA and PCR. Positive samples were subsequently characterized into assemblages by PCR-RFLP, and further confirmed with sequencing of the glutamate dehydrogenase (gdh) gene. Epidemiological data on demographic, clinical and behavioral features of the study subjects were also collected. RESULTS Prevalence of G. lamblia infections in diarrhoea and non-diarrhoea children were 5.8% and 5% respectively (P>0.5). Sequence data confirmed Giardia lamblia assemblage B as the predominant genotype in both diarrhoea and non-diarrhoea cases. There was no significant association of G. lamblia infection with any of the epidemiological variables investigated. CONCLUSION Our findings suggest that assemblage B could be the predominant genotype causing giardiasis in children. Increased public health education focusing on good sanitary practices, particularly among mothers and children, could decrease the risk of G. lamblia infection.
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Affiliation(s)
- Isaac Anim-Baidoo
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle-Bu Campus, Accra, Ghana
| | - Charles Akugbey Narh
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Dora Oddei
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Charles Addoquaye Brown
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle-Bu Campus, Accra, Ghana
| | - Christabel Enweronu-Laryea
- Department of Child Health, School of Medicine and Dentistry, University of Ghana, Korle-Bu Campus, Accra, Ghana
| | - Betty Bandoh
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Eric Sampane-Donkor
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, Korle-Bu Campus, Accra, Ghana
| | - George Armah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Andrew Anthony Adjei
- Department of Pathology, School of Biomedical and Allied Health Sciences, University of Ghana, Korle-Bu Campus, Accra, Ghana
| | - David Nana Adjei
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle-Bu Campus, Accra, Ghana
| | - Patrick Ferdinand Ayeh-Kumi
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle-Bu Campus, Accra, Ghana
| | - Ben Adu Gyan
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
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Duedu KO, Karikari YA, Attah SK, Ayeh-Kumi PF. Prevalence of intestinal parasites among patients of a Ghanaian psychiatry hospital. BMC Res Notes 2015; 8:651. [PMID: 26541287 PMCID: PMC4635531 DOI: 10.1186/s13104-015-1634-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 10/26/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Neglected tropical diseases are of major concern to sub-Saharan African countries. Though efforts to monitor the prevalence and control are in place, these are mostly restricted to groups within the population. This study was performed to determine the prevalence among patients of a Ghanaian psychiatric hospital and find out whether there is a reason for active monitoring in this population. METHODS A cross-sectional study was performed to determine the prevalence of intestinal parasites among patients of a Ghanaian psychiatric hospital. Stool samples were collected and analyzed in addition to data. RESULTS Of the 111 patients studied, asymptomatic carriage of parasites was 13.5 % and was higher in males (18.8 %) than in females (4.8 %). Carriage of parasites decreased with age but increase with duration of admission. CONCLUSION This is the first report of parasitic pathogens among patients of a psychiatric institution in Ghana. The data shows that there are risks of transmission of infectious diseases via the oral route hence, the need for regular monitoring and intervention is emphasized.
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Affiliation(s)
- Kwabena O Duedu
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.
- Department of Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana.
| | - Yaw A Karikari
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.
| | - Simon K Attah
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.
| | - Patrick F Ayeh-Kumi
- Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.
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Williams AR, Bain RES, Fisher MB, Cronk R, Kelly ER, Bartram J. A Systematic Review and Meta-Analysis of Fecal Contamination and Inadequate Treatment of Packaged Water. PLoS One 2015; 10:e0140899. [PMID: 26505745 PMCID: PMC4624706 DOI: 10.1371/journal.pone.0140899] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 10/01/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Packaged water products provide an increasingly important source of water for consumption. However, recent studies raise concerns over their safety. OBJECTIVES To assess the microbial safety of packaged water, examine differences between regions, country incomes, packaged water types, and compare packaged water with other water sources. METHODS We performed a systematic review and meta-analysis. Articles published in English, French, Portuguese, Spanish and Turkish, with no date restrictions were identified from online databases and two previous reviews. Studies published before April 2014 that assessed packaged water for the presence of Escherichia coli, thermotolerant or total coliforms were included provided they tested at least ten samples or brands. RESULTS A total of 170 studies were included in the review. The majority of studies did not detect fecal indicator bacteria in packaged water (78/141). Compared to packaged water from upper-middle and high-income countries, packaged water from low and lower-middle-income countries was 4.6 (95% CI: 2.6-8.1) and 13.6 (95% CI: 6.9-26.7) times more likely to contain fecal indicator bacteria and total coliforms, respectively. Compared to all other packaged water types, water from small bottles was less likely to be contaminated with fecal indicator bacteria (OR = 0.32, 95%CI: 0.17-0.58) and total coliforms (OR = 0.10, 95%CI: 0.05, 0.22). Packaged water was less likely to contain fecal indicator bacteria (OR = 0.35, 95%CI: 0.20, 0.62) compared to other water sources used for consumption. CONCLUSIONS Policymakers and regulators should recognize the potential benefits of packaged water in providing safer water for consumption at and away from home, especially for those who are otherwise unlikely to gain access to a reliable, safe water supply in the near future. To improve the quality of packaged water products they should be integrated into regulatory and monitoring frameworks.
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Affiliation(s)
- Ashley R. Williams
- The Water Institute, University of North Carolina, Chapel Hill, NC, United States of America
| | - Robert E. S. Bain
- The Water Institute, University of North Carolina, Chapel Hill, NC, United States of America
- UNICEF, New York, NY, United States of America
| | - Michael B. Fisher
- The Water Institute, University of North Carolina, Chapel Hill, NC, United States of America
| | - Ryan Cronk
- The Water Institute, University of North Carolina, Chapel Hill, NC, United States of America
| | - Emma R. Kelly
- The Water Institute, University of North Carolina, Chapel Hill, NC, United States of America
| | - Jamie Bartram
- The Water Institute, University of North Carolina, Chapel Hill, NC, United States of America
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Fisher MB, Williams AR, Jalloh MF, Saquee G, Bain RES, Bartram JK. Microbiological and Chemical Quality of Packaged Sachet Water and Household Stored Drinking Water in Freetown, Sierra Leone. PLoS One 2015; 10:e0131772. [PMID: 26162082 PMCID: PMC4498897 DOI: 10.1371/journal.pone.0131772] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 06/08/2015] [Indexed: 11/21/2022] Open
Abstract
Packaged drinking water (PW) sold in bottles and plastic bags/sachets is widely consumed in low- and middle-income countries (LMICs), and many urban users in sub-Saharan Africa (SSA) rely on packaged sachet water (PSW) as their primary source of water for consumption. However, few rigorous studies have investigated PSW quality in SSA, and none have compared PSW to stored household water for consumption (HWC). A clearer understanding of PSW quality in the context of alternative sources is needed to inform policy and regulation. As elsewhere in SSA, PSW is widely consumed in Sierra Leone, but government oversight is nearly nonexistent. This study examined the microbiological and chemical quality of a representative sample of PSW products in Freetown, Sierra Leone at packaged water manufacturing facilities (PWMFs) and at points of sale (POSs). Samples of HWC were also analyzed for comparison. The study did not find evidence of serious chemical contamination among the parameters studied. However, 19% of 45 PSW products sampled at the PWMF contained detectable Escherichia coli (EC), although only two samples exceeded 10 CFU/100 mL. Concentrations of total coliforms (TC) in PSW (but not EC) increased along the supply chain. Samples of HWC from 60 households in Freetown were significantly more likely to contain EC and TC than PSW at the point of production (p<0.01), and had significantly higher concentrations of both bacterial indicators (p<0.01). These results highlight the need for additional PSW regulation and surveillance, while demonstrating the need to prioritize the safety of HWC. At present, PSW may be the least unsafe option for many households.
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Affiliation(s)
- Michael B. Fisher
- The Water Institute at UNC, Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, North Carolina, United States of America
- * E-mail: (MBF); (JKB)
| | - Ashley R. Williams
- The Water Institute at UNC, Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | | | | | - Robert E. S. Bain
- The Water Institute at UNC, Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Jamie K. Bartram
- The Water Institute at UNC, Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, North Carolina, United States of America
- * E-mail: (MBF); (JKB)
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Singla A, Kundu H, P B, Singh S, Singh K, Jain S. Physico-chemical and bacterial evaluation of packaged drinking water marketed in delhi - potential public health implications. J Clin Diagn Res 2014; 8:246-50. [PMID: 24783149 DOI: 10.7860/jcdr/2014/7845.4175] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 01/17/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Quality of drinking water is a powerful environmental determinant of health. The main objective of introduction of bottled water in the society was its better safety, taste and convenience over tap water. The present study was conducted to assess physicochemical and bacterial qualities of bottled water and sachet water which were available in various markets of Delhi. MATERIALS AND METHODS Sixteen water bottles and four water sachets were selected through stratified random sampling from various public places in Delhi and their analysis was done at National Test House, Ghaziabad. RESULTS were then compared with national (IS10500, IS14543) and international (WHO, FDA, USEPA) standards. RESULTS Bottled water showed better quality than sachet water. The mean value of copper (0.0746mg/l) in bottles exceeded the standard values of IS10500 and IS14543(0.05), while the mean value of lead (0.008mg/l) exceeded the FDA standard value (0.005). When the results of sachets were compared with those of standards, the mean values of selenium (0.1195mg/l) and lead (0.862mg/l) were found to exceed values of both Indian and International standards. For the biological parameter i.e. coliform count, the mean value for bottles was 0 (nil), whereas the mean value for sachets was 16.75, which showed the unhealthy nature of sachets. CONCLUSION The parameters which were tested in the present study showed excess of various chemical and bacterial parameters in drinking water, which could pose serious threats to consumers. Thus, these results suggest a more stringent standardization of bottled water market with special attention to quality, identity and licensing by concerned authorities, to safeguard health of consumers.
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Affiliation(s)
- Ashish Singla
- Senior Lecturer, Department of Public Health Dentistry, D.J College of Dental Sciences and Research , Ghaziabad, India
| | - Hansa Kundu
- Postgraduate Student, Department of Public Health Dentistry, D.J College of Dental Sciences and Research , Ghaziabad, India
| | - Basavaraj P
- Professor and Head, Department of Public Health Dentistry, D.J College of Dental Sciences and Research , Ghaziabad, India
| | - Shilpi Singh
- Senior Lecturer, Department of Public Health Dentistry, D.J College of Dental Sciences and Research , Ghaziabad, India
| | - Khushboo Singh
- Postgraduate Student, Department of Public Health Dentistry, D.J College of Dental Sciences and Research , Ghaziabad, India
| | - Swati Jain
- Postgraduate Student, Department of Public Health Dentistry, D.J College of Dental Sciences and Research , Ghaziabad, India
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Stoler J, Tutu RA, Ahmed H, Frimpong LA, Bello M. Sachet water quality and brand reputation in two low-income urban communities in greater Accra, Ghana. Am J Trop Med Hyg 2013; 90:272-8. [PMID: 24379244 DOI: 10.4269/ajtmh.13-0461] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Sachet water has become an important primary source of drinking water in western Africa, but little is known about bacteriologic quality and improvements to quality control given the recent, rapid evolution of this industry. This report examines basic bacteriologic indicators for 60 sachet water samples from two very low-income communities in Accra, Ghana, and explores the relationship between local perceptions of brand quality and bacteriologic quality after controlling for characteristics of the vending environment. No fecal contamination was detected in any sample, and 82% of total heterotrophic bacteria counts were below the recommended limit for packaged water. Sachets from brands with a positive reputation for quality were 90% less likely to present any level of total heterotrophic bacteria after controlling for confounding factors. These results contrast with much of the recent sachet water quality literature and may indicate substantial progress in sachet water regulation and quality control.
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Affiliation(s)
- Justin Stoler
- Department of Geography and Regional Studies, University of Miami, Coral Gables, Florida; Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida; Department of History, Political Science, and Philosophy, Delaware State University, Dover, Delaware; Water Research Institute, Council for Scientific and Industrial Research, Accra, Ghana
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19
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Opryszko MC, Guo Y, MacDonald L, MacDonald L, Kiihl S, Schwab KJ. Impact of water-vending kiosks and hygiene education on household drinking water quality in rural Ghana. Am J Trop Med Hyg 2013; 88:651-60. [PMID: 23382168 DOI: 10.4269/ajtmh.12-0065] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Innovative solutions are essential to improving global access to potable water for nearly 1 billion people. This study presents an independent investigation of one alternative by examining for-profit water-vending kiosks, WaterHealth Centers (WHCs), in rural Ghana to determine their association with household drinking water quality. WHCs' design includes surface water treatment using filtration and ultraviolet light disinfection along with community-based hygiene education. Analyses of water samples for Escherichia coli and household surveys from 49 households across five villages collected one time per year for 3 years indicate that households using WHCs had improved water quality compared with households using untreated surface water (adjusted incidence rate ratio = 0.07, 95% confidence interval = 0.02, 0.21). However, only 38% of households used WHCs by the third year, and 60% of those households had E. coli in their water. Recontamination during water transport and storage is an obstacle to maintaining WHC-vended water quality.
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Affiliation(s)
- Melissa C Opryszko
- Departments of Environmental Health Sciences and Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
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Stoler J, Weeks JR, Fink G. Sachet drinking water in Ghana's Accra-Tema metropolitan area: past, present, and future. JOURNAL OF WATER, SANITATION, AND HYGIENE FOR DEVELOPMENT : A JOURNAL OF THE INTERNATIONAL WATER ASSOCIATION 2012; 2:10.2166/washdev.2012.104. [PMID: 24294481 PMCID: PMC3842094 DOI: 10.2166/washdev.2012.104] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Population growth in West Africa has outpaced local efforts to expand potable water services, and private sector sale of packaged drinking water has filled an important gap in household water security. Consumption of drinking water packaged in plastic sachets has soared in West Africa over the last decade, but the long-term implications of these changing consumption patterns remain unclear and unstudied. This paper reviews recent shifts in drinking water, drawing upon data from the 2003 and 2008 Demographic and Health Surveys, and provides an overview of the history, economics, quality, and regulation of sachet water in Ghana's Accra-Tema Metropolitan Area. Given the pros and cons of sachet water, we suggest that a more holistic understanding of the drinking water landscape is necessary for municipal planning and sustainable drinking water provision.
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Affiliation(s)
- Justin Stoler
- Department of Geography and Regional Studies, University of Miami, 1000 Memorial Drive, Coral Gables, FL 33124, USA
| | - John R. Weeks
- Department of Geography, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA
| | - Günther Fink
- Department of Global Health and Population, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA
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Stoler J, Fink G, Weeks JR, Otoo RA, Ampofo JA, Hill AG. When urban taps run dry: sachet water consumption and health effects in low income neighborhoods of Accra, Ghana. Health Place 2011; 18:250-62. [PMID: 22018970 DOI: 10.1016/j.healthplace.2011.09.020] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 09/18/2011] [Accepted: 09/26/2011] [Indexed: 11/29/2022]
Abstract
Intraurban differentials in safe drinking water in developing cities have been exacerbated by rapid population growth that exceeds expansion of local water infrastructure. In Accra, Ghana, municipal water is rationed to meet demand, and the gap in water services is increasingly being filled by private water vendors selling packaged "sachet" water. Sachets extend drinking water coverage deeper into low-income areas and alleviate the need for safe water storage, potentially introducing a health benefit over stored tap water. We explore correlates of using sachets as the primary drinking water source for 2093 women in 37 census areas classified as slums by UN-Habitat, and links between sachet water and reported diarrhea episodes in a subset of 810 children under five. We find that neighborhood rationing exerts a strong effect on a household's likelihood of buying sachet water, and that sachet customers tend to be the poorest of the poor. Sachet use is also associated with higher levels of self-reported overall health in women, and lower likelihood of diarrhea in children. We conclude with implications for sachet regulation in Accra and other sub-Saharan cities facing drinking water shortages.
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Affiliation(s)
- Justin Stoler
- Department of Geography, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA.
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Nkansah MA, Boadi NO, Badu M. Assessment of the quality of water from hand-dug wells in ghana. ENVIRONMENTAL HEALTH INSIGHTS 2010; 4:7-12. [PMID: 20523879 PMCID: PMC2879609 DOI: 10.4137/ehi.s3149] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
This study focused upon the determination of physicochemical and microbial properties, including metals, selected anions and coliform bacteria in drinking water samples from hand-dug wells in the Kumasi metropolis of the Republic of Ghana. The purpose was to assess the quality of water from these sources. Ten different water samples were taken from different parts of Kumasi, the capital of the Ashanti region of Ghana and analyzed for physicochemical parameters including pH, electrical conductivity, total dissolved solids, alkalinity total hardness and coliform bacteria. Metals and anions analyzed were Ca, Mg, Fe, Mn, NO(3) (-), NO(2) (-), SO(4) (2-), PO(4) (2-), F(-) and Cl(-). Bacteria analysed were total coliform and Escherichia coli.THE DATA SHOWED VARIATION OF THE INVESTIGATED PARAMETERS IN SAMPLES AS FOLLOWS: pH, 6.30-0.70; conductivity (EC), 46-682 muS/cm; PO(4) (3-), 0.67-76.00 mg/L; F(-), 0.20-0.80 mg/L; NO(3) (-), 0-0.968 mg/L; NO(2) (-), 0-0.063 mg/L; SO(4) (2-), 3.0-07.0 mg/L; Fe, 0-1.2 mg/L; Mn, 0-0.018 mg/L. Total coliform and Escherichia coli were below the minimum detection limit (MDL) of 20 MPN per 100 ml in all the samples. The concentrations of most of the investigated parameters in the drinking water samples from Ashanti region were within the permissible limits of the World Health Organization drinking water quality guidelines.
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Abstract
The coccidian parasite Cyclospora cayetanensis is recognized as an emerging pathogen that causes protracted diarrhea in humans. The first cases of Cyclospora infection were reported in the late 1970s and were observed among expatriates and travelers in regions where infections are endemic. Since then, Cyclospora has been considered a cause of traveler's diarrhea. Epidemiological investigations were reported and examined in areas of endemicity even before the true identity of Cyclospora was elucidated. Cyclospora was fully characterized in the early 1990s, but it was not until the 1995 Cyclospora outbreak in the United States and Canada that it caught the attention of the public and physicians. The biology, clinical presentation, epidemiology, diagnosis, treatment, and control of cyclosporiasis are reviewed, with a focus on diagnostic assays currently being used for clinical and environmental samples. Challenges and limitations in working with Cyclospora are also discussed.
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Effects of host temperature and gastric and duodenal environments on microsporidia spore germination and infectivity of intestinal epithelial cells. Parasitol Res 2008; 104:35-42. [PMID: 18751726 DOI: 10.1007/s00436-008-1156-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Accepted: 08/05/2008] [Indexed: 10/21/2022]
Abstract
Approximately 14 of the more than 1,000 species of microsporidia infect humans, only two of which, Enterocytozoon bieneusi and Encephalitozoon intestinalis, cause intestinal microsporidiosis. Clinical isolates of three microsporidia species, E. intestinalis, Encephalitozoon hellem, and the insect parasite, Anncaliia (Brachiola, Nosema) algerae were used in a spore germination assay, and enterocyte attachment and infection assays were performed to model the potential roles of gastric and duodenal environments and host temperature in determining why only one of these microsporidia species causes intestinal microsporidiosis. Enterocyte infection with A. algerae spores was 10% that of the Encephalitozoon species, a difference not attributable to differences in spore attachment to host cells. Prior spore treatment with pepsin in HCl, pancreatic enzymes, or ox bile did not inhibit germination or enterocyte infection by the three microsporidia species. While the Encephalitozoon species differentiated to mature spores within 3 days, the time taken for many enterocytes to turn over, A. algerae took 3-5 days to produce mature spores, near the upper limit for enterocyte turnover in vivo. Thus, host temperature may contribute to A. algerae not causing human intestinal microsporidiosis, but none of the factors tested account for the inability of E. hellem to cause such an infection.
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