Household Drinking Water Quality Updates

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Periodic Overview of Handwashing Literature

11 hours 21 min ago

Periodic Overview of Handwashing Literature: Summary of selected peer-reviewed and grey literature published July – December 2013. The Global Public-Private Partnership for Handwashing (PPPHW)

PPPHW aims to publish overviews of handwashing literature twice a year that provide practical guidance for implementers. We compiled peer-reviewed and grey literature publications (including e-publications and ahead-of-time publications) between July through December 2013.

From these, we selected relevant articles which allowed for practical guidance for implementation. We excluded most publications from high income and/or medical facility based settings. No single study is universally applicable. We strongly recommend considering the context of the study when interpreting results.

What does sustainability mean for handwashing and hygiene?

30 July 2014 15:28 (America/New_York)

What does sustainability mean for handwashing and hygiene? Handwashing/Hygiene Track, Sustainability Forum, July 2014. Overview by Track Lead: Julia Rosenbaum, USAID/WASHplus Project Senior Behavior Change Advisor

For the hygiene track, and this overview paper, we have limited the “hygiene” definition to include onlyhandwashing with soap (HWwS) and household drinking water treatment, safe handling and storage ( HWTS), rather than a broader treatment of hygiene which could include food hygiene, menstrual hygiene, compound hygiene including topics relevant to the emerging environmental enteropathy hypothesis such as safe disposal of animal feces.

Prevalence of antibiotic resistance in bacteria isolated from drinking well water available in Guinea-Bissau

29 July 2014 10:41 (America/New_York)

Prevalence of antibiotic resistance in bacteria isolated from drinking well water available in Guinea-Bissau (West Africa). Ecotoxicology and Environmental Safety, 106 (2014) 188–194.

A. Machado1; A.A. Bordalo2

1Laboratory of Hydrobiology and Ecology, Institute of Biomedical Sciences (ICBAS-UP), University of Porto, Rua Jorge Viterbo Ferreira 228, P 4050-313 Porto, Portugal; Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR ), University of Porto, Rua dos Bragas 289, P 4050-123 Porto, Portugal.
Electronic address: anaphmachado@gmail.com.
2Laboratory of Hydrobiology and Ecology, Institute of Biomedical Sciences (ICBAS-UP), University of Porto, Rua Jorge Viterbo Ferreira 228, P 4050-313 Porto, Portugal; Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR ), University of Porto, Rua dos Bragas 289, P 4050-123 Porto, Portugal.

Abstract: The dissemination of antibiotic-resistant bacteria and the spread of antibiotic resistance genes are a major public health concern worldwide, being even proposed as emerging contaminants. The aquatic environment is a recognized reservoir of antibiotic resistant bacteria, and antibiotic resistance genes have been recently detected in drinking water. In this study, the water quality and the prevalence of antibiotic resistance of heterotrophic culturable bacteria were characterized seasonally in wells that serve the population of Guinea-Bissau (West Africa) as the sole source of water for drinking and other domestic proposes.

The results revealed that well water was unfit for human consumption independently of the season, owing to high acidity and heavy fecal contamination. Moreover, potentially pathogenic bacteria, which showed resistance to the most prescribed antibiotics in Guinea-Bissau, were isolated from well water, posing an additional health risk. Our results suggest that well water not only fosters the transmission of potential pathogenic bacteria, but also represents an important reservoir for the proliferation of antibiotic resistant bacteria, that can aggravate the potential to cause disease in a very vulnerable population that has no other alternative but to consume such water.

Removal of As(III) and As(V) in surface modified ceramic filters

28 July 2014 13:14 (America/New_York)

Journal of Water, Sanitation and Hygiene for Development Vol 4 No 2 pp 214–222, 2014 doi:10.2166/washdev.2014.114 | (Order info)

Removal of As(III) and As(V) in surface modified ceramic filters

Emily C. Robbins, Jing Guo and Craig D. Adams

Department of Civil, Environmental, and Architectural Engineering, University of Kansas, Lawrence, KS 66045, USA
Department of Civil and Environmental Engineering, Utah State University, Logan, UT 84322, USA E-mail: craig.adams@usu.edu

A new point-of-use (POU) technology using porous ceramic filters with a ferric-iron coating was used to achieve simultaneous arsenic (III) and (V) removal along with filtrative disinfection. The surface modified ceramic filters (SMCF) were produced using standard ceramic filter methods with combustible materials to create a porous ceramic during firing, followed by coating with a ferric oxide surface coating. A majority of the testing was conducted using 2.0-cm thick, 1.3-cm diameter ceramic plugs to simulate full-scale filters in column studies. The SMCF was capable of filtering arsenic for long periods of time with essentially no As breakthrough. As in source water was reduced from 250 μg/L to less than the 10 μg/L WHO guideline for arsenic for 875 and 1,618 bed volumes (or 360 and 666 effective filter runs) with 0.51 and 2 M iron-coated filters, respectively. There was no significant difference in As(V) or As(III) removal performance over a pH range of 6 to 9. Filtration of lake water containing natural organic matter at 5 mg/L as C reduced performance of As(III) and As(V) removal approximately 34 to 38%, respectively. Other metals including cadmium, copper and chromate were also readily adsorbed by the SMCF while selenate was not.

The effect of increasing grain size in biosand water filters in combination with ultraviolet disinfection

28 July 2014 13:10 (America/New_York)

This paper is in the public domain: verbatim copying and redistribution of this paper are permitted in all media for any purpose, provided this notice is preserved along with the paper’s original DOI. Anyone using the paper is requested to properly cite and acknowledge the source as Journal of Water, Sanitation and Hygiene for Development 4(2), 206–213. doi:10.2166/washdev.2013.171 | (Order info)

The effect of increasing grain size in biosand water filters in combination with ultraviolet disinfection

Timothy E. Frank, Matthew L. Scheie, Victoria Cachro and Andrew S. Muñoz

2354 Fairchild Drive Suite 6J-117, USAF Academy, CO 80840, 01-719-660-6903, USA E-mail: tefrank18@gmail.com

With sand less than 0.70 mm often difficult to source in the field, it is of interest to study larger grained sand for use in biosand water filters (BSF). This study examined how sand grain size affects biological sand water filtration and how the combination of biological sand filtration and ultraviolet (UV) disinfection affects drinking water quality. Two BSFs were built: a control with maximum grain size, dmax = 0.70 mm and an experimental with grain sizes ranging from 0.70 mm to dmax = 2.0 mm. Untreated water was passed through each BSF daily. Results show Escherichia coli and turbidity removal characteristics of the control and experimental BSFs were not significantly different from one another. Both BSFs produced water that met World Health Organization (WHO) drinking water guidelines for turbidity, and although E. coli reduction was over 98% for each BSF, a high initial bacteria concentration resulted in effluent levels above WHO guidelines. Subsequently, effluent from each BSF was placed in clear plastic bottles under UV light, after which water from each BSF met E. coli guidelines. The data yielded promising results for using larger sand in BSFs, but longer duration studies with more data points are needed.

Foreign Assistance: Briefing on U.S. International Water-Related Assistance

28 July 2014 12:58 (America/New_York)

Foreign Assistance: Briefing on U.S. International Water-Related Assistance, 2014. Government Accounting Office.

Objectives

  • 1. Funding: How have U.S. agencies distributed funding for international water-related assistance, and to what extent have the agencies complied with congressional spending requirements?
  • 2. Agency roles: What are the roles and responsibilities of U.S. agencies providing international water-related assistance?
  • 3. Staffing: How are U.S. agencies staffed to provide international water-related assistance?
  • 4. Coordination: How do U.S. agencies coordinate and collaborate on international water-related programs?

U.S. agencies provide international water-related assistance in four sectors:

  • Water supply, sanitation, and hygiene (WASH) includes access to safe drinking water, improved sanitation services, and adoption of key hygiene behaviors.
  • Water resources management (WRM) includes natural resources management and protection of watersheds and ecosystems.
  • Water productivity (WP) includes management of water for agriculture, energy, and industry.
  • Disaster risk reduction (DRR) includes activities intended to reduce vulnerability to disasters and increase capacity to prepare for, respond to, and recover from disaster shocks.

WSUP & WASHplus – Working within and around challenging institutional frameworks

28 July 2014 12:35 (America/New_York)

Regardless of the setting, the local institutional framework for water and sanitation services will have a huge impact on the design and effectiveness of a WASH programme. These frameworks are not always functioning well, so the implementing organisation must answer some basic questions: who has the mandate to provide these services and how can we help them? What is the regulatory framework and which services does it cover? What are the bottlenecks to change?

In many cases, creative thinking is required to find solutions and provide essential services that comply with regulations. Drawing upon case studies from WSUP and the USAID-funded WASHplus project, this webinar explores how service provision can be improved in contexts with less-than-perfect institutional frameworks.

Presenters:

  • Baghi Baghirathan, Programme Director, WSUP, will talk about “Breaking the barriers to water connections in low-income urban communities: experience from Mozambique”
  • Orlando Hernandez, Monitoring & Evaluation Specialist, WASHplus, will talk about “Flexible institutional partnerships to support sustainable WASH services in Madagascar”

Panelists:

  • Baghi Baghirathan, Programme Director, WSUP
  • Orlando Hernandez, Monitoring & Evaluation Specialist, WASHplus
  • Andy Narracott, Deputy CEO, WSUP
  • Jonathan Annis, Sanitation and Innovation Adviser, WASHplus

Moderator: Guy Norman, Head of Evaluation, Research and Learning, WSUP

USAID Global Waters, July 2014 – Water for Peace

25 July 2014 14:49 (America/New_York)

Global Waters – July 2014

Download Global Waters (magazine spreads) (8.6 MB)

Download Global Waters (single pages) (8.4MB)

Global Waters Archive

A case study of income generation activities in Nairobi with the LifeStraw Community filter

22 July 2014 9:22 (America/New_York)

A case study of income generation activities in Nairobi with the LifeStraw Community filter, 2014.

Author: Felix Nyakundi Mangera

The LifeStraw Community filter is a 25 liter capacity filtration device which used hollow fiber membrane technology and does not need cartridges, electricity, chemicals and is easy to maintain and operate. The filter has a lifetime capacity of 80,000 liters. Access to safe drinking water is a challenge in many areas and this filter could be a solution for small scale water supply. We wanted to pilot different business models around Nairobi to see if the filter could be used for income generation. This would make the filter more interesting for microfinance projects and potential customers of the filter who would become micro-entrepreneurs.

July 23, 2014 WSUP/WASHplus Webinar – The power of creative thinking: working within and around challenging institutional frameworks

21 July 2014 12:05 (America/New_York)

The power of creative thinking: working within and around challenging institutional frameworks

Join WSUP and the WASHplus project for this webinar and discussion

  • Date:  Wednesday, July 23, 2014
  • Time: 10:00 AM – 11:00 AM EDT (New York);  15.00 PM – 16:00 PM BST (London)

Register today and reserve your webinar seat:
https://www1.gotomeeting.com/register/846901233

Regardless of the setting, the local institutional framework for water and sanitation services will have a huge impact on the design and effectiveness of a WASH programme. These frameworks are not always functioning well, so the implementing organisation must answer some basic questions: who has the mandate to provide these services and how can we help them? What is the regulatory framework and which services does it cover? What are the bottlenecks to change? In many cases, creative thinking is required to find solutions and provide essential services that comply with regulations. Drawing upon case studies from WSUP and the USAID-funded WASHplus project, this webinar will explore how service provision can be improved in contexts with less-than-perfect institutional frameworks: we invite you to participate and share your experience!

Presenters:

  • Baghi Baghirathan, Programme Director, WSUP, will talk about “Breaking the barriers to water connections in low-income urban communities: experience from Mozambique”
  • Orlando Hernandez, Monitoring & Evaluation Specialist, WASHplus, will talk about “Flexible institutional partnerships to support sustainable WASH services in Madagascar”

An interactive panel discussion will follow the presentations. Questions are welcome!

Panelists:

  • Baghi Baghirathan, Programme Director, WSUP
  • Orlando Hernandez, Monitoring & Evaluation Specialist, WASHplus
  • Andy Narracott, Deputy CEO, WSUP
  • Jonathan Annis, Sanitation and Innovation Adviser, WASHplus

ModeratorGuy Norman, Head of Evaluation, Research and Learning, WSUP

Impact of the Provision of Safe Drinking Water on School Absence Rates in Cambodia: A Quasi-Experimental Study

21 July 2014 10:30 (America/New_York)

Impact of the Provision of Safe Drinking Water on School Absence Rates in Cambodia: A Quasi-Experimental Study. PLoS One, March 2014.

Paul R. Hunter, Helen Risebro, Marie Yen, et al.

Background – Education is one of the most important drivers behind helping people in developing countries lift themselves out of poverty. However, even when schooling is available absenteeism rates can be high. Recently interest has focussed on whether or not WASH interventions can help reduce absenteeism in developing countries. However, none has focused exclusively on the role of drinking water provision. We report a study of the association between absenteeism and provision of treated water in containers into schools.

Methods and Findings – We undertook a quasi-experimental longitudinal study of absenteeism rates in 8 schools, 4 of which received one 20 L container of treated drinking water per day. The water had been treated by filtration and ultraviolet disinfection. Weekly absenteeism rates were compared across all schools using negative binomial model in generalized estimating equations. There was a strong association with provision of free water and reduced absenteeism (Incidence rate ratio = 0.39 (95% Confidence Intervals 0.27–0.56)). However there was also a strong association with season (wet versus dry) and a significant interaction between receiving free water and season. In one of the intervention schools it was discovered that the water supplier was not fulfilling his contract and was not delivering sufficient water each week. In this school we showed a significant association between the number of water containers delivered each week and absenteeism (IRR = 0.98 95%CI 0.96–1.00).

Conclusion – There appears to be a strong association between providing free safe drinking water and reduced absenteeism, though only in the dry season. The mechanism for this association is not clear but may in part be due to improved hydration leading to improved school experience for the children.

Evaluation of A Point-Of Use Water Purification System (Llaveoz) in a Rural Setting of Chiapas, Mexico

21 July 2014 10:26 (America/New_York)

Evaluation of A Point-Of Use Water Purification System (Llaveoz) in a Rural Setting of Chiapas, Mexico. J Microbiol Exp 2014, 1(3): 00015

*Corresponding author: Javier Gutierrez-Jimenez, University of Science and Arts of Chiapas, Libramiento norte poniente#1150, Col. Lajas Maciel, Tuxtla Gutierrez, Chiapas, Mexico, Tel: +52-9616170440/ 4303; E-mail: javier.gutierrez@unicach.mx

Access to potable water is a priority for highly-marginalized rural communities of Chiapas, Mexico where consumption of poorly sanitized water has fostered severe diarrheal diseases among children. Interventions aimed to reduce contaminants present in water are necessary to reduce morbidity and mortality rates. In this work we evaluated the efficiency of a point of use water purification system, Llaveoz, to eradicate total coliform (TC) bacteria and diarrheagenic E. coli (DEC) strains in 62 paired water samples obtained from households during the dry and rainy season. TC was determined by the membrane filtration method whereas DEC strains were evaluated by a multiplex PCR approach. After Llaveoz treatment, water samples collected during the dry season (N=20) had an 80.3% reduction of TC counts (p<0.05). Similarly, TC were significantly reduced (72.3%, (p<0.05)) in water samples treated during the rainy season (N=42). A total of 28 E. coli strains were isolated of which 14.3% (N=4) were identified as DEC strains (ETEC (N=2), EAEC (N=1) or EIEC (N=1)) in untreated water samples. Llaveoz-treated water did not contain DEC strains. Thus, the Llaveoz system represents an alternative method to obtain more pure water in regions where potable water sources are not available.

The Llaveoz™ water disinfection system (patent US2011/0215037 A1) consists in a plastic faucet which is placed at the base of a water container used at home for water storage; the faucet contains an ultraviolet light bulb UVC type which uses electricity (110V or 12V). Its light goes on when the faucet is opened in order to pour clean water. To eliminate suspended solids, parasites and bacteria, the faucet is connected to a microfiltration cartridge which contains polypropylene membranes with 0.1µm pore diameter. In vitro studies demonstrate that Llaveoz is able to eliminate ∼99, 100% and ∼99% of parasites, bacteria and virus, respectively. Llaveoz purification system is fabricated and distributed to rural and peri-urban communities by EOZ group, a non-profit organization funded by Flor Cassassuce with a self-funding mechanism.

Heterogeneous Effects of Information on Household Behaviors to Improve Water Quality

21 July 2014 10:21 (America/New_York)

Heterogeneous Effects of Information on Household Behaviors to Improve Water Quality, 2014.

Joe Brown, Georgia Institute of Technology – School of Civil and Environmental Engineering
Amar Hamoudi, Duke University – Sanford School of Public Policy
Marc Jeuland, Duke University
Gina Turrini, Duke University

Providing information about health risks only sometimes induces protective action. This raises questions about whether and how risk information is understood and acted upon, and how responses vary across contexts. We stratified a randomized experiment across two periurban areas in Cambodia, which differed in terms of socioeconomic status and infrastructure.

In one area, showing households specific evidence of water contamination altered their beliefs about health risk and increased their demand for a treatment product; in the other area, it had no effect on these outcomes. These findings highlight the importance of identifying specific drivers of responses to health risk information.

Health insurance and health environment: India’s subsidized health insurance in a context of limited water and sanitation services

21 July 2014 10:17 (America/New_York)

Health insurance and health environment: India’s subsidized health insurance in a context of limited water and sanitation services, 2014.

Florence McBain, Zentrum für EntwicklungsforschungCenter for Development ResearchUniversity of Bonn.

Recently, many emerging countries have established subsidized health insurance schemes to provide financial protection and support access to health care to poor households. The challenge to ensure the long term sustainability of such schemes is huge. In this paper, the impact of the health environment on the long term sustainability of a health insurance is explored, focusing on water and sanitation. India offers an interesting case to explore this question.

Indeed, since 2008 India launched a fully subsidized health insurance Rashtriya Swasthya Bima Yojana (RSBY) in a context where 56% of its population does not have access to safe sanitation and 8% do not have access to safe water (JMP, 2012). A framework is proposed linking water supply and sanitation; health status of the insured population; health insurance and the productivity of households. Next, based on a literature review, the outcomes of investments in water and sanitation and health insurance are reviewed and the potential synergies and trade-offs of combing these investments are explored. In a last section, the case of India is analysed in detail, with international comparisons and further research lines are proposed.

 

Looking beyond Technology: An Integrated Approach to Water, Sanitation and Hygiene in Low Income Countries

17 July 2014 10:22 (America/New_York)

Looking beyond Technology: An Integrated Approach to Water, Sanitation and Hygiene in Low Income Countries. Env Sci Tech, July 2014.

Elizabeth Tilley, Linda Strande, Christoph Lüthi, Hans-Joachim Mosler, Kai M. Udert, Heiko Gebauer, and Janet G. Hering

Despite investment stimulated by the Millennium Development Goals (MDGs), sanitation-related diseases, such as diarrhea, cholera and typhus, remain a leading cause of death of children under five in low-income countries. Prevention of diarrhea requires a combination of access to safe drinking water, good hygiene and adequate sanitation. The sanitation problem has proven to be particularly intractable, demonstrating the shortcomings of past efforts that have focused on increasing access to toilets.

An alternative view positions the toilet within a service chain that extends to the final point of disposal or end-use of excreta-derived products. An integrated perspective that addresses improved planning, takes advantage of economic opportunities, incorporates specialized technology, and follows-up with behavior change could help to ensure not only access but also sustainable use, operation and maintenance of water, sanitation and hygiene interventions.

 

Association between Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study (GEMS) and Types of Handwashing Materials Used by Caretakers in Mirzapur, Bangladesh

17 July 2014 10:16 (America/New_York)

Association between Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study (GEMS) and Types of Handwashing Materials Used by Caretakers in Mirzapur, Bangladesh. Am J Trop Med Hyg. 2014 Jul 2;91(1):181-9.

Authors: Baker KK, et al.

Abstract: Handwashing practices among caretakers of case and control children < 5 years of age enrolled in the Global Enteric Multicenter Study in Mirzapur, Bangladesh were characterized and analyzed for association with moderate-to-severe diarrhea. Soap or detergent ownership was common, yet 48% of case and 47.7% of control caretakers also kept ashes for handwashing, including 36.8% of the wealthiest households. Soap, detergent, and ash were used for multiple hygiene purposes and were kept together at handwashing areas. Caretakers preferred soap for handwashing, but frequently relied on ash, or a detergent/ash mixture, as a low-cost alternative. Moderate-to-severe diarrhea was equally likely for children of caretakers who kept soap versus those who kept ash (matched OR = 0.91; 0.62-1.32). Contact with ash and water reduced concentrations of bacterial enteropathogens, without mechanical scrubbing. Thus, washing hands with ash is a prevalent behavior in Mirzapur and may help diminish transmission of diarrheal pathogens to children.

Estimates of the WASH-related Global Burden of Disease

7 July 2014 14:31 (America/New_York)

Below are abstracts and links to the full-text of articles in the August 2014 issue of  Tropical Medicine and International Health Focus on the Global Burden of Disease from Water While the methods of Global Burden of Disease (GBD) study continue to evolve, recent changes raise questions about the basis of new estimates of the risk associated with water, sanitation and hygiene and warrant consideration of alternative approaches.

  • ​Inadequate water, sanitation and hygiene are estimated to have caused 842,000 deaths from diarrhoea in 2012, i.e., 1.5% of deaths worldwide. These include 361,000 deaths of children under five years.
  • ​A systematic review of the global prevalence of handwashing with soap and its effect on diarrhoeal diseases estimates that only 19% of the world’s population washes hands with soap after contact with excreta and that handwashing reduces the risk of diarrhoeal disease by 23%–40%.
  • ​Based on over 300 studies from a systematic review, an estimated 1.1 billion people are exposed to a drinking water source of moderate to high risk.
  • ​A meta-regression shows that risks of diarrhoea from inadequate drinking water and sanitation could be reduced considerably through targeted interventions. Risk differences depend on type of intervention.

1 – Authors:  Clasen, Thomas, Pruss-Ustun, Annette, Mathers, Colin D., et al. TI  - Estimating the impact of unsafe water, sanitation and hygiene on the global burden of disease: evolving and alternative methods Abstract - http://onlinelibrary.wiley.com/doi/10.1111/tmi.12330/abstract AB  - The 2010 global burden of disease (GBD) study represents the latest effort to estimate the global burden of disease and injuries and the associated risk factors. Like previous GBD studies, this latest iteration reflects a continuing evolution in methods, scope and evidence base. Since the first GBD Study in 1990, the burden of diarrhoeal disease and the burden attributable to inadequate water and sanitation have fallen dramatically. While this is consistent with trends in communicable disease and child mortality, the change in attributable risk is also due to new interpretations of the epidemiological evidence from studies of interventions to improve water quality. To provide context for a series of companion papers proposing alternative assumptions and methods concerning the disease burden and risks from inadequate water, sanitation and hygiene, we summarise evolving methods over previous GBD studies. We also describe an alternative approach using population intervention modelling. We conclude by emphasising the important role of GBD studies and the need to ensure that policy on interventions such as water and sanitation be grounded on methods that are transparent, peer-reviewed and widely accepted. 2 – Authors: Prüss-Ustün, Annette, Bartram, Jamie, Clasen, Thomas,  et al. TI  - Burden of disease from inadequate water, sanitation and hygiene in low- and middle-income settings: a retrospective analysis of data from 145 countries

Full text - http://onlinelibrary.wiley.com/doi/10.1111/tmi.12329/pdf

Objective - To estimate the burden of diarrhoeal diseases from exposure to inadequate water, sanitation and hand hygiene in low- and middle-income settings and provide an overview of the impact on other diseases. Methods - For estimating the impact of water, sanitation and hygiene on diarrhoea, we selected exposure levels with both sufficient global exposure data and a matching exposure-risk relationship. Global exposure data were estimated for the year 2012, and risk estimates were taken from the most recent systematic analyses. We estimated attributable deaths and disability-adjusted life years (DALYs) by country, age and sex for inadequate water, sanitation and hand hygiene separately, and as a cluster of risk factors. Uncertainty estimates were computed on the basis of uncertainty surrounding exposure estimates and relative risks. Results - In 2012, 502 000 diarrhoea deaths were estimated to be caused by inadequate drinking water and 280 000 deaths by inadequate sanitation. The most likely estimate of disease burden from inadequate hand hygiene amounts to 297 000 deaths. In total, 842 000 diarrhoea deaths are estimated to be caused by this cluster of risk factors, which amounts to 1.5% of the total disease burden and 58% of diarrhoeal diseases. In children under 5 years old, 361 000 deaths could be prevented, representing 5.5% of deaths in that age group. Conclusions - This estimate confirms the importance of improving water and sanitation in low- and middle-income settings for the prevention of diarrhoeal disease burden. It also underscores the need for better data on exposure and risk reductions that can be achieved with provision of reliable piped water, community sewage with treatment and hand hygiene. 3 – Authors: Freeman, Matthew C., Stocks, Meredith E., Cumming, Oliver,  et al. TI  - Systematic review: Hygiene and health: systematic review of handwashing practices worldwide and update of health effects

Full text: http://onlinelibrary.wiley.com/doi/10.1111/tmi.12339/pdf Objective - To estimate the global prevalence of handwashing with soap and derive a pooled estimate of the effect of hygiene on diarrhoeal diseases, based on a systematic search of the literature.

Methods – Studies with data on observed rates of handwashing with soap published between 1990 and August 2013 were identified from a systematic search of PubMed, Embase and ISI Web of Knowledge. A separate search was conducted for studies on the effect of hygiene on diarrhoeal disease that included randomised controlled trials, quasi-randomised trials with control group, observational studies using matching techniques and observational studies with a control group where the intervention was well defined. The search used Cochrane Library, Global Health, BIOSIS, PubMed, and Embase databases supplemented with reference lists from previously published systematic reviews to identify studies published between 1970 and August 2013. Results were combined using multilevel modelling for handwashing prevalence and meta-regression for risk estimates. Results - From the 42 studies reporting handwashing prevalence we estimate that approximately 19% of the world population washes hands with soap after contact with excreta (i.e. use of a sanitation facility or contact with children’s excreta). Meta-regression of risk estimates suggests that handwashing reduces the risk of diarrhoeal disease by 40% (risk ratio 0.60, 95% CI 0.53–0.68); however, when we included an adjustment for unblinded studies, the effect estimate was reduced to 23% (risk ratio 0.77, 95% CI 0.32–1.86). Conclusions- Our results show that handwashing after contact with excreta is poorly practiced globally, despite the likely positive health benefits. 4 – Authors: Bain, Robert, Cronk, Ryan, Hossain, Rifat,  et al. TI  - Global assessment of exposure to faecal contamination through drinking water based on a systematic review Full text: http://onlinelibrary.wiley.com/doi/10.1111/tmi.12334/pdf Objectives - To estimate exposure to faecal contamination through drinking water as indicated by levels of Escherichia coli (E. coli) or thermotolerant coliform (TTC) in water sources. Methods - We estimated coverage of different types of drinking water source based on household surveys and censuses using multilevel modelling. Coverage data were combined with water quality studies that assessed E. coli or TTC including those identified by a systematic review (n = 345). Predictive models for the presence and level of contamination of drinking water sources were developed using random effects logistic regression and selected covariates. We assessed sensitivity of estimated exposure to study quality, indicator bacteria and separately considered nationally randomised surveys. Results - We estimate that 1.8 billion people globally use a source of drinking water which suffers from faecal contamination, of these 1.1 billion drink water that is of at least ‘moderate’ risk (>10 E. coli or TTC per 100 ml). Data from nationally randomised studies suggest that 10% of improved sources may be ‘high’ risk, containing at least 100 E. coli or TTC per 100 ml. Drinking water is found to be more often contaminated in rural areas (41%, CI: 31%–51%) than in urban areas (12%, CI: 8–18%), and contamination is most prevalent in Africa (53%, CI: 42%–63%) and South-East Asia (35%, CI: 24%–45%). Estimates were not sensitive to the exclusion of low quality studies or restriction to studies reporting E. coli. Conclusions - Microbial contamination is widespread and affects all water source types, including piped supplies. Global burden of disease estimates may have substantially understated the disease burden associated with inadequate water services. 5 – Authors: Wolf, Jennyfer, Prüss-Ustün, Annette, Cumming, Oliver, et al. TI  - Systematic review: Assessing the impact of drinking water and sanitation on diarrhoeal disease in low- and middle-income settings: systematic review and meta-regression

Full text: http://onlinelibrary.wiley.com/doi/10.1111/tmi.12331/pdf Objective - To assess the impact of inadequate water and sanitation on diarrhoeal disease in low- and middle-income settings. Methods - The search strategy used Cochrane Library, MEDLINE & PubMed, Global Health, Embase and BIOSIS supplemented by screening of reference lists from previously published systematic reviews, to identify studies reporting on interventions examining the effect of drinking water and sanitation improvements in low- and middle-income settings published between 1970 and May 2013. Studies including randomised controlled trials, quasi-randomised trials with control group, observational studies using matching techniques and observational studies with a control group where the intervention was well defined were eligible. Risk of bias was assessed using a modified Ottawa–Newcastle scale. Study results were combined using meta-analysis and meta-regression to derive overall and intervention-specific risk estimates. Results - Of 6819 records identified for drinking water, 61 studies met the inclusion criteria, and of 12 515 records identified for sanitation, 11 studies were included. Overall, improvements in drinking water and sanitation were associated with decreased risks of diarrhoea. Specific improvements, such as the use of water filters, provision of high-quality piped water and sewer connections, were associated with greater reductions in diarrhoea compared with other interventions. Conclusions - The results show that inadequate water and sanitation are associated with considerable risks of diarrhoeal disease and that there are notable differences in illness reduction according to the type of improved water and sanitation implemented.

Synthetic organic water contaminants in developing communities: an overlooked challenge addressed by adsorption with locally generated char

1 July 2014 10:19 (America/New_York)

Synthetic organic water contaminants in developing communities: an overlooked challenge addressed by adsorption with locally generated char. Journal of Water, Sanitation and Hygiene for Development, In Press

  • Order info or contact Joshua Kearns at the email below to request a reprint.

Joshua P. Kearns, Detlef R. U. Knappe and R. Scott Summers

Department of Civil, Environmental, & Architectural Engineering, University of Colorado-Boulder, 1111 Engineering Dr, ECOT 441, UCB 428, Boulder, CO 80309, USA E-mail: joshua.kearns@colorado.edu
Department of Civil, Construction, & Environmental Engineering, North Carolina State University, 2501 Stinson Dr, Campus Box 7908, Raleigh, NC 27695, USA

Chemical contamination of drinking water sources is a worldwide problem. However, few locally managed, sustainable, and low-cost on-site treatment technologies are available in rural, remote, and emergency/disaster relief/humanitarian crisis situations. Char filter-adsorbers have been used to treat drinking water for thousands of years and are still widely used today. Our studies show that some chars produced by traditional means from a range of feedstocks develop favorable sorption properties for uptake of 2,4-dichlorophenoxyacetic acid (2,4-D), a prevalent herbicide and water contaminant. However, more energy efficient, environmentally sustainable and scalable production of consistent highly sorptive chars can be accomplished with biomass gasification. Our laboratory studies demonstrate that locally produced char adsorbents derived from surplus agricultural and forestry biomass are effective for adsorbing 2,4-D. A year-long study of field-scale application of chars in Thailand is also presented. Based on these studies we present design recommendations for integrating char adsorbers into low-cost, multi-barrier treatment trains for on-site water provision.

Marketing Household Water Treatment: Willingness to Pay Results from an Experiment in Rural Kenya

26 June 2014 13:05 (America/New_York)

Marketing Household Water Treatment: Willingness to Pay Results from an Experiment in Rural Kenya. Water 2014, 6, 1873-1886; doi:10.3390/w6071873.

Annalise G. Blum 1, Clair Null 2 and Vivian Hoffmann 3,*
1 Department of Environmental Sciences & Engineering, University of North Carolina at Chapel Hill, 148 Rosenau Hall, Chapel Hill, NC 27516, USA; E-Mail: annalise@live.unc.edu
2 Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322, USA; E-Mail: clair.null@emory.edu
3 International Food Policy Research Institute, 2033 K Street NW, Washington, DC 20006, USA
* Author to whom correspondence should be addressed; E-Mail: v.hoffmann@cgiar.org

Despite increasing availability of household water treatment products, demand in developing countries remains low. Willingness to pay for water treatment products and factors that affect demand are not well understood. In this study, we estimate willingness to pay for WaterGuard, a dilute chlorine solution for point-of-use water treatment, using actual purchase decisions at randomly assigned prices. Secondly, we identify household characteristics that are correlated with the purchase decision. Among a sample of 854 respondents from 107 villages in rural Kenya, we find that mean willingness to pay is approximately 80% of the market price. Although only 35% of sample households purchased WaterGuard at the market price, 67% of those offered a 50% discount purchased the product.

A marketing message emphasizing child health did not have a significant effect on purchase behavior, overall or among the subset of households with children under five. These findings suggest that rural Kenyans are willing to pay for WaterGuard at low prices but are very sensitive to increasing price. Households with young children that could benefit the most from use of WaterGuard do not appear to be more likely to purchase the product, and a marketing message designed to target this population was ineffective.

MS2 Bacteriophage Reduction and Microbial Communities in Biosand Filters

25 June 2014 13:13 (America/New_York)

MS2 Bacteriophage Reduction and Microbial Communities in Biosand Filters. Environ Sci Technol. 2014 Jun.

Wang H, et al.

This study evaluated the role of physical and biological filter characteristics on the reduction of MS2 bacteriophage in biosand filters (BSFs). Three full-scale concrete Version 10 BSFs, each with a 55 cm sand media depth and a 12 L charge volume, reached 4 log10 reduction of MS2 within 43 days of operation. A consistently high reduction of MS2 between 4 log10 and 7 log10 was demonstrated for up to 294 days. Further examining one of the filters revealed that an average of 2.8 log10 reduction of MS2 was achieved within the first 5 cm of the filter, and cumulative virus reduction reached an average of 5.6 log10 after 240 days. Core sand samples from this filter were taken for protein, carbohydrate, and genomic extraction. Higher reduction of MS2 in the top 5 cm of the sand media (0.56 log10 reduction per cm vs 0.06 log10 reduction per cm for the rest of the filter depth) coincided with greater diversity of microbial communities and increased concentrations of carbohydrates.

In the upper layers, “Candidatus Nitrosopumilus maritimus” and “Ca. Nitrospira defluvii” were found as dominant populations, while significant amounts of Thiobacillus-related OTUs were detected in the lower layers. Proteolytic bacterial populations such as the classes Sphingobacteria and Clostridia were observed over the entire filter depth. Thus, this study provides the first insight into microbial community structures that may play a role in MS2 reduction in BSF ecosystems. Overall, besides media ripening and physical reduction mechanisms such as filter depth and long residence time (45 min vs 24 ± 8.5 h), the establishment of chemolithotrophs and proteolytic bacteria could greatly enhance the reduction of MS2.

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