Background

Water scarcity combined with high incidences of diarrhoeal disease amongst many rural communities, suggests that the provision of ‘safe’ water supplies remains a challenge. Subsequent reliance on multi-source water supplies means that microbial transmission pathways may be numerous and complex.

Objectives

This study aimed to identify and elucidate water supply issues and potential microbial transmission pathways at the household level in rural communities in semi-arid Brazil.

Methods

Community and sanitary surveys were applied to 99 households from 10 communities located in four municipalities of Paraiba State, Brazil. Moreover, physicochemical and microbial parameters were investigated throughout the water supply chain.

Results

High levels of faecal indicator organisms (FIO) were detected in water from Water Storage Reservoirs (WSR) and from in-house Drinking Water Storage Containers (DWSC). A decrease in microbial water quality was observed between water stored within WSR's and DWSC's, suggesting potential cross-contamination at the household level. Several common practices were observed among rural residents, such as the use of collection buckets left unprotected outside on the ground, that may have also contributed to the observed decrease. Schematic diagrams illustrating the complex water supply chains and potential microbial transmission pathways were developed to facilitate identification of effective intervention strategies.

Discussion

Decreases in water supply quality were found to be predominantly caused by cross-contamination within the domestic environment due to several factors, including, a lack of awareness and knowledge of ‘safe’ collection, handling and storage of water, as well as inadequate sanitation services and/or unhygienic practices. In order to improve public health in such communities, more effort should be directed towards education and training of all stakeholders involved in the water supply chain. This would, certainly, support the successful implementation of further WASH interventions, consequently increasing the likelihood of achieving reduction of excreta-borne diseases.

中文翻译：

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在半干旱的巴西，使用多种替代水源的农村社区中潜在的微生物传播途径。

背景

在许多农村社区中，水资源短缺加上腹泻病的高发率表明，提供“安全”供水仍然是一项挑战。随后对多源水的依赖意味着微生物的传播途径可能是众多而复杂的。

目标

这项研究旨在确定和阐明半干旱巴西农村社区家庭层面的供水问题和潜在的微生物传播途径。

方法

对位于巴西帕拉伊巴州四个城市的10个社区的99户家庭进行了社区和卫生调查。此外，在整个供水链中对理化和微生物参数进行了研究。

结果

从储水水库（WSR）和室内饮用水储水容器（DWSC）的水中检测到高水平的粪便指示生物（FIO）。在WSR和DWSC中存储的水之间，微生物的水质有所下降，这表明在家庭层面存在潜在的交叉污染。在农村居民中观察到了几种常见的做法，例如使用了在地面上不受保护的收集桶，这也可能导致观察到的减少。图解说明了复杂的水供应链和潜在的微生物传播途径，目的是帮助确定有效的干预策略。

讨论

人们发现，供水质量下降的主要原因是家庭环境中的交叉污染，原因有以下几种，其中包括缺乏对“安全”收集，处理和储存水的认识和知识，以及卫生服务不足和/或不卫生的做法。为了改善此类社区的公共卫生，应加大力度对水供应链中涉及的所有利益相关者进行教育和培训。当然，这将支持成功实施进一步的WASH干预措施，从而增加减少排泄物传播疾病的可能性。