Water Safety Practices Along the Water Service Chain in Addis Ababa: A Cross-Sectional Study in a Cosmopolitan City

This study investigated water safety practices and risk levels along Addis Ababa's water supply service chain. The data came from 23 random woredas, 384 random households, 115 microbiological water quality tests, and diagnostic inspections from source to point of use. Findings from this study indicate that the surface water sources (53%) and the water source catchments (62%) are characterized by very high-risk and high risk contamination levels respectively. Conversely, the water treatment process (5%) and temporary reservoir (20%) indicates a low risk level. Whereas the water distribution system (40%), water source boreholes (44%), and Household level (29%) water safety practices are identified as medium risk levels. The microbial analysis of the drinking water at the source and point of use indicated low (<11 CFU/100 ml) to high levels (>100 CFU/100 ml) of risk with significant levels of contamination at the household level. Moreover, the household-level water safety practice assessment revealed intermediate to very high levels of risks. The Chi2 test shows that water supply type is significantly associated with occupation(X2(12,384) = 23.44, P < .05) and education(X2(8,384) = 15.4, P < .05). Multinomial regression analysis also showed better occupation is associated with increased access to safe bottled water compared to safe piped water on premises. It can be concluded that the water safety practice encountered low to very high levels of risk of contamination at different components along the water supply service chain and the household level. This study suggests ways to improve Addis Ababa residents' health and well-being through water safety interventions. These include safeguarding water sources, supporting local safe water businesses, providing household water treatment, and handling options, and addressing the barriers and incentives for adopting safe water practices.

Environmental health risk factors and cutaneous leishmaniasis (CL): A case-control study in northeastern Iran

Background & objectives

Cutaneous leishmaniasis (CL) is one of the main causes of vector-born diseases in younger population. To evaluate the association of environmental health factors on the odds of CL incidence, a case-control study was conducted in northeastern Iran.

Methods

This study was conducted within 2020-2021 based on individual and household data from a tertiary referral center. Cases were patients diagnosed with CL by PCR method; controls were selected among the patients' relatives, and information was obtained from a health registry system. Demographic and socioeconomic data of 1871 subjects, included age, sex, household information and environmental health factors. Multivariable models with environmental factors in various conditions and CL were separately fit by univariate and mixed multiple unconditional logistic regression.

Results

Participants included 617 cases (mean [SD] age, 13.62[13.72] years; 58.20% male) and 1264 controls (mean [SD] age, 16.45[15.44] years; 50.40% male). Results revealed that the use of well-water sources compared to surface water is significantly associated with CL (odds ratio [OR]=0.204; 95%CI, 0.13-0.33;P<0.001). Muddy houses, ruined buildings or wastelands and stagnant water, canals and rivers near the houses were also associated with CL (OR=3.85; 95%CI, 1.66-8.89; P=.002; OR=2.47; 95%CI, 1.76-3.47; P<.001). Besides, existence of pine tree was found to be a risk factor (OR=3.25; 95%CI, 2.12-4.99; P<.001) and similarly for the use of waste collection system (OR=4.43; 95%CI, 3.32-7.51; P<.001).

Interpretation & conclusion

Environmental factors related to houses were significantly associated with CL and may represent the modifiable risk factors of CL disease.

Knowledge coproduction on the impact of decisions for waterbird habitat in a changing climate

Scientists, resource managers, and decision makers increasingly use knowledge coproduction to guide the stewardship of future landscapes under climate change. This process was applied in the California Central Valley (USA) to solve complex conservation problems, where managed wetlands and croplands are flooded between fall and spring to support some of the largest concentrations of shorebirds and waterfowl in the world. We coproduced scenario narratives, spatially explicit flooded waterbird habitat models, data products, and new knowledge about climate adaptation potential. We documented our coproduction process, and using the coproduced models, we determined when and where management actions make a difference and when climate overrides these actions. The outcomes of this process provide lessons learned on how to cocreate usable information and how to increase climate adaptive capacity in a highly managed landscape. Actions to restore wetlands and prioritize their water supply created habitat outcomes resilient to climate change impacts particularly in March, when habitat was most limited; land protection combined with management can increase the ecosystem's resilience to climate change; and uptake and use of this information was influenced by the roles of different stakeholders, rapidly changing water policies, discrepancies in decision-making time frames, and immediate crises of extreme drought. Although a broad stakeholder group contributed knowledge to scenario narratives and model development, to coproduce usable information, data products were tailored to a small set of decision contexts, leading to fewer stakeholder participants over time. A boundary organization convened stakeholders across a large landscape, and early adopters helped build legitimacy. Yet, broadscale use of climate adaptation knowledge depends on state and local policies, engagement with decision makers that have legislative and budgetary authority, and the capacity to fit data products to specific decision needs.

Climate oscillation impacts on water supply augmentation planning

Climate oscillations ranging from years to decades drive precipitation variability in many river basins globally. As a result, many regions will require new water infrastructure investments to maintain reliable water supply. However, current adaptation approaches focus on long-term trends, preparing for average climate conditions at mid- or end-of-century. The impact of climate oscillations, which bring prolonged and variable but temporary dry periods, on water supply augmentation needs is unknown. Current approaches for theory development in nature-society systems are limited in their ability to realistically capture the impacts of climate oscillations on water supply. Here, we develop an approach to build middle-range theory on how common climate oscillations affect low-cost, reliable water supply augmentation strategies. We extract contrasting climate oscillation patterns across sub-Saharan Africa and study their impacts on a generic water supply system. Our approach integrates climate model projections, nonstationary signal processing, stochastic weather generation, and reinforcement learning-based advances in stochastic dynamic control. We find that longer climate oscillations often require greater water supply augmentation capacity but benefit more from dynamic approaches. Therefore, in settings with the adaptive capacity to revisit planning decisions frequently, longer climate oscillations do not require greater capacity. By building theory on the relationship between climate oscillations and least-cost reliable water supply augmentation, our findings can help planners target scarce resources and guide water technology and policy innovation. This approach can be used to support climate adaptation planning across large spatial scales in sectors impacted by climate variability.

[Schistosomiasis, soil-transmitted helminthiases and sanitation in Latin America and the Caribbean: a systematic reviewRelación entre la prevalencia de esquistosomiasis y geohelmintiasis y las condiciones sanitarias en América Latina y el Caribe: una revisión sistemática]

Objective

To investigate the relationship between the prevalence of schistosomiasis and soil-transmitted helminthiasis with variables related to access to water, sanitation and solid waste in Latin American and Caribbean (LAC) countries.

Method

A systematic review was performed in the LILACS, PubMed, Web of Science, and SciELO databases. Studies published between 1950 and August 2021, with an ecological design and a focus on population groups (states, municipalities and/or districts), having the prevalence of infection by Schistosoma mansoni, Ancylostoma sp., Necator americanus, Ascaris lumbricoides or Trichuris trichiura as primary variable and access to water, sewage and/or solid waste as explanatory variables were included. Open access articles with full text available in English, Spanish, or Portuguese were considered. The risk of bias and the quality of the studies were assessed according to the Joanna Briggs Institute manual.

Results

Of 2 714 articles, nine were eligible, published between 1994 and 2021 and covering 22 LAC countries and 14 350 municipalities. All articles had moderate methodological quality. Environmental variables indicated an association between water supply and solid waste collection with schistosomiasis; water supply with ascariasis, trichuriasis and hookworm; and sewage with ascariasis and hookworm. Except for one article, which had regional coverage for LAC, all the others were developed in Brazil.

Conclusion

There is a clear need to expand research on the association between household and collective health conditions and parasitic diseases for all endemic countries in LAC to support environmental strategies to control these diseases.

Assessment of cation exchange as conditioning processes of water chemistry in freshwater lenses

Freshwater lenses are groundwater sources of limited dimensions that can be usually found in a variety of climates worldwide. These aquifers' quality is important for socioeconomic development, being cation exchange one of the most important geochemical processes that can change the water geochemistry. This study aims to assess the cation exchange processes that determine the chemistry of freshwater lenses in a multilayer aquifer type, considering the center-east of the Pampean Region (Argentina) as a case study. Water samples were taken from the freshwater lenses at different depths to analyze major ions in the laboratory. In addition, geological profiles were made along with the extraction of sediment samples for X-ray diffractometry (XRD) and laboratory tests to analyze the cation exchange capacity. The results show that water stored in the lenses has a vertical facies variation from Ca-HCO₃ to Na-HCO₃ . According to the laboratory results, the change of water facies mainly occurs in the clayey sediments that divide the carbonate bioclastic material above and the loessic sediment below, being cation exchange the most important process. PRACTITIONER POINTS: Cation exchange is the main geochemical process regulating groundwater chemistry. Hydrochemical changes determine the quality of freshwater lenses. Na/Ca exchange is mainly regulated by the groundwater flow into the bioturbated clay. Batch exchange tests were also carried out to quantify the Na/Ca exchange processes.

Methods of Cleaning Taps to Prevent Hospital-Associated Infections: An Environmental Survey-Based Study

In hospitals, outbreaks can occur due to pathogens accumulating in the areas around the wards' washbasins. Carbapenem-resistant Enterobacterales (CRE) was detected in an environmental survey in the high-care unit of a university hospital in Isehara, Japan, and effective cleaning methods were investigated. This study investigated methods of cleaning taps using commonly used detergents and disinfectants, and it assessed their effectiveness in removing hard scale and pathogens, including CRE. The taps were cleaned using various methods and cleaning agents, including environmentally neutral detergent, citric acid, baking soda, cleanser, 80% ethanol, 0.1% sodium hypochlorite, and a phosphoric acid-based environmental detergent (Space Shot). The cleaning effect was assessed based on the agent's effectiveness at removing hard scale from taps. Biofilms and scale were identified on taps, and several bacterial species were cultured. Only phosphoric acid-based detergent was effective at removing hard scale. After cleaning with the phosphoric acid-based detergent, the bacterial count decreased, and no CRE or other pathogens were detected. These results provide a reference for other facilities considering introducing this cleaning method.

Changes in access to water and incidence of waterborne diseases after the Vale dam collapse in Brumadinho (MG), Brazil

OBJECTIVE

To describe, within the Human Rights to Water and Sanitation (HRWS) framework, the access to water supply services and the incidence of waterborne diseases in the communities affected by the dam disaster in Brumadinho (MG), Brazil.

METHODS

A quantitative and qualitative methodology was used, having as variables information on access to water supply services and waterborne diseases. The primary data were extracted from the "Brumadinho Health Project", using a sample stratum with 981 people interviewed, totaling 92.5% of the eligible population in the affected communities of Córrego do Feijão and Parque da Cachoeira. The secondary data from Brumadinho was extracted from the project "Sanitation conditions and the River Basin of the B1 River Basin of Mineradora Vale between 2017 and 2020", available in public databases between 2017 and 2020, and qualitative data was collected in 2022 through individual interviews with health professional also live in the communities.

RESULTS

With regard to access to water supply services, the results of this combined data analysis indicate that the HRWS is being neglected, especially with regard to availability, accessibility, acceptability and quality of water. The study also shows a significant increase in the incidence of waterborne diseases in the region after the disaster.

CONCLUSION

It is necessary to use the HRWS as the basis to the implementation of public policies aiming to reduce vulnerability in access to water supply services.

Spatiotemporal Variability of Groundwater Iodine in the Northern Arid Basins: Significance for Safe Water Supply

The genesis of geogenic iodine (I)-contaminated groundwater poses a significant threat to long-term water exploitation. Safe and sustainable water supply, particularly in the northern arid basins, demands a quantitative prediction of the high variability of I distribution over hydrogeological timescales. Here, bioenergetics-informed reactive transport modeling was combined with high-resolution molecular characterization of fueling organic matter to decipher the time-controlled interactions between vertical flow and (bio)geochemical processes in I transport within the Datong aquifers. The declining reactivities of I-bearing organic matter and Fe oxides in the 15-40 m depth decreased the rate of I release, while a growing number of pore volumes flushed through the aquifers to leach out I^- and organic I. This removal effect is compensated by the desorption of I^- from Fe oxides and secondary FeS generated from the concurrent reduction of Fe oxides and SO₄^2-. Consequently, peak concentrations of groundwater I^- may have appeared, depending upon the vertical recharge rate, at the first several pore volumes flushed through the aquifers. The current vertical distributions of the various I species likely represent a quasi-steady state between I mobilization and leaching. These new mechanistic insights into the dynamic hydrogeological-(bio)geochemical processes support secure groundwater use in the I-affected northern arid basins.

Expanding Roles of Accredited Social Health Activists (ASHAs) in the 2019 Hepatitis E Outbreak in a Peri-urban Slum, Nagpur, India

OBJECTIVE

Due to constraints in the dedicated health work force, outbreaks in peri-urban slums are often reported late. This study explores the feasibility of deploying Accredited Social Health Activists (ASHAs) in outbreak investigation and understand the extent to which this activity gives a balanced platform to fulfil their roles during public health emergencies to reduce its impact and improve mitigation measures.

METHODS

Activities of ASHAs involved in the hepatitis E outbreak were reviewed from various registers maintained at the subcenter. Also, various challenges perceived by ASHAs were explored through focus group discussion (FGD). During March to May 2019, 13 ASHAs involved in the hepatitis outbreak investigation and control efforts in a peri-urban slum of Nagpur with population of around 9000. In total, 192 suspected hepatitis E cases reported.

RESULTS

During the outbreak, ASHAs performed multiple roles comprising house-to-house search of suspected cases, escorting suspects to confirm diagnosis and referral, community mobilization for out-reach investigation camps, risk communication to vulnerable, etc. During the activity, ASHAs faced challenges such as constraints in the logistics, compromise in other health-related activities, and challenges in sustaining behavior of the community.

CONCLUSIONS

It is feasible to implement the investigation of outbreaks through ASHAs. Despite challenges, they are willing to participate in these activities as it gave them an opportunity to fulfil the role as an activist, link worker, as well as a community interface.

Genetic Diversity of Microcystin Producers (Cyanobacteria) and Microcystin Congeners in Aquatic Resources across Africa: A Review Paper

Microcystins are produced by multifaceted organisms called cyanobacteria, which are integral to Africa's freshwater environments. The excessive proliferation of cyanobacteria caused by rising temperature and eutrophication leads to the production and release of copious amounts of microcystins, requiring critical management and control approaches to prevent the adverse environmental and public health problems associated with these bioactive metabolites. Despite hypotheses reported to explain the phylogeography and mechanisms responsible for cyanobacterial blooms in aquatic water bodies, many aspects are scarcely understood in Africa due to the paucity of investigations and lack of uniformity of experimental methods. Due to a lack of information and large-scale studies, cyanobacteria occurrence and genetic diversity are seldom reported in African aquatic ecosystems. This review covers the diversity and geographical distribution of potential microcystin-producing and non-microcystin-producing cyanobacterial taxa in Africa. Molecular analyses using housekeeping genes (e.g., 16S rRNA, ITS, rpoC1, etc.) revealed significant sequence divergence across several cyanobacterial strains from East, North, West, and South Africa, but the lack of uniformity in molecular markers employed made continent-wise phylogenetic comparisons impossible. Planktothrix agardhii, Microcystis aeruginosa, and Cylindrospermopsis raciborskii (presently known as Raphidiopsis raciborskii) were the most commonly reported genera. Potential microcystin (MCs)-producing cyanobacteria were detected using mcy genes, and several microcystin congeners were recorded. Studying cyanobacteria species from the African continent is urgent to effectively safeguard public and environmental health because more than 80% of the continent has no data on these important microorganisms and their bioactive secondary metabolites.

Association between water source and chronic gastrointestinal diseases in Chinese: A cross-sectional and longitudinal study

Background

Gastrointestinal health is closely associated with the quality of the water supply. However, long-term associations between the water supply type and chronic gastrointestinal disease (CGD) are unclear.

Method

The water supply was categorized as "tap-water" or "non-tap water" use. Changes in water source use were categorized into four types: "non-tap water both at baseline and in follow-ups," "non-tap water at baseline and tap-water in follow-ups," "tap-water at baseline and non-tap water in follow-ups," or "tap-water at baseline and in follow-ups." We explored the association between tap-water use (and changes therein) and the risk of CGD in a cross-sectional and longitudinal population study based on national cohort data from 2011 to 2018.

Results

After the inclusion and exclusion process, 13,332 and 9,688 participants were included in the cross-sectional and longitudinal analyses, respectively. Tap-water use was associated with fewer CGD cases at baseline (OR = 0.98, 95% CI: 0.90, 1.07). Tap-water use at baseline was associated with significantly lower incidence of CGD in follow-ups (HR = 0.70, 95% CI: 0.70, 0.90). Compared with consistent non-tap water use in both baseline and follow-ups, switching from non-tap water to tap-water use in follow-ups was associated with a lower risk of CGD (HR = 0.79, 95% CI: 0.64, 0.97), tap water use at both baseline and in follow-ups was associated with a lower risk of CGD (HR = 0.72, 95% CI: 0.59, 0.88). The decreased risk of CGD followed a linear trend (P _fortrend < 0.01). Adjustment for indoor solid fuel use and outdoor air pollution exposure to PM_2.5 did not change the association between tap water use and CGD.

Conclusion

Tap water use was associated with a reduced risk of incident CGD. The results from this study should aid in effect assessment for water purification strategies and public decision support for gastrointestinal health management.

Assessment of Water, Sanitation and Hygiene Practices Among Households, 2019 - Sierra Leone: A Community-based Cluster Survey

INTRODUCTION

In Sierra Leone, diseases related to water, sanitation, and hygiene remain among the leading cause of morbidity and account for 20% of all death. This study assessed the water, sanitation, and hygiene services and practices at household level in Sierra Leone.

METHODS

A cluster survey was conducted among 1002 households in 4 districts of Sierra Leone. Data was collected on water, sanitation, and hygiene indicators, occurrence of diarrhoeal diseases at household level within 14-day prior to the survey. Chi-square test at 95% significant level was computed to compare the difference in accessing improved water sources, sanitation, and hygiene in urban and rural areas.

RESULT

Of the 1002 households surveyed, 650 (65%) had access to improved drinking water sources. In the urban areas, 432 (88%) out of 486 households had improved drinking water source, which is higher as compared to rural areas. Only 218 (42%) out of 516 households had improved drinking water (P < .001). Of the total households surveyed, 167 (17%) had improved sanitation with 45 (5%) having a handwashing facility. There were 173 households reporting diarrhoeal disease within 2 weeks prior to the survey, with prevalence of 17%.

CONCLUSION

Majority of households in rural areas do not have access to improved water sources, sanitation, and handwashing facilities. This study found a high prevalence of diarrhoeal disease at the household level. It is recommended that The Ministry of Health and Sanitation work with relevant sectors to increase access to improved drinking water, sanitation, and handwashing facilities in rural areas.

An integrated assessment of environmental sustainability and nutrient availability of food consumption patterns in Latin America and the Caribbean

BACKGROUND

In Latin America and the Caribbean, historical shifts away from traditional, plant-sourced food production and consumption patterns may undermine both nutritional status and environmental sustainability. Although agricultural intensification and increasingly animal-centric dietary preferences in the region are well-documented, their influence on environmental degradation remains unknown.

OBJECTIVE

This study aimed to 1) characterize the environmental impacts of current food consumption patterns in South America, Central America, and the Caribbean and 2) identify food groups that minimize impact while maintaining adequate nutrient availability.

DESIGN

Apparent regional food consumption was derived using data from the Food and Agriculture Organization's Food Balance Sheets on per capita food availability and levels of imported vs. local food production. Region-specific life cycle assessment data on greenhouse gas emissions, land use, and freshwater consumption were leveraged to estimate total, food group-level, and nutrient-specific environmental impacts.

RESULTS

Annual overall emissions were highest in Caribbean food consumption patterns (2521.2 kg/capita), largely derived from meat (26.7%) and fruit (23.8%) production. Land use (1941.0 m2/capita) and water consumption (2060.8 m3/capita), in contrast, were highest for the South American pattern, due to high consumption of meat and dairy. Across the regions, meat constituted 7.5-12.7% of food consumption yet accounted for as much as 73.1% of greenhouse gas emissions, 56.6% of land use, and 54.2% of water consumption. In contrast, legumes and seeds, cereals, roots, and vegetables demonstrated overall low environmental impacts, particularly relative to their contributions to dietary protein, iron, and zinc availability.

CONCLUSIONS

Findings point to the capacity of plant-sourced food consumption to minimize environmental harm without necessarily jeopardizing nutrient availability in Latin America and the Caribbean. Local agriculture can contribute to food system sustainability by producing diversified plant-sourced foods, cornerstones of many traditional food customs, and mitigating the impacts of industrialized livestock operations and imported, animal-centric dietary habits.

Association between nitrate concentration in drinking water and rate of colorectal cancer: a case study in northwestern Iran

Nitrate, as a major pollutant of drinking water, is associated with colorectal cancer (CRC) and serves as an environmental health concern, especially in the districts with unregulated agriculture. In this case study in northwestern Iran, we used two databases of nitrate concentration (1999-2013) and age-standardized incidence rate (ASR) for CRC (2002-2012) from 19 counties of East Azerbaijan province. The trend and correlation between nitrate and ASR was investigated. Inverse distance weighted technique was used to spatially interpolate the maps. Expectedly, drinking water nitrate has increased throughout the province (8-20.5 mg/L) as well as the ASR for CRC of men (from 2.07 to 18.05 mg/L) and women (from 1.57 to 10.94 mg/L). While ASR for CRC of men was positively correlated to nitrate (Pearson's r = 0.624, p-value = 0.040), no statistically significant correlation was found between nitrate and ASR for women's CRC (Pearson's r = 0.289, p-value = 0.351). According to our findings, the incidence of CRC was not higher for those residing in the regions with higher nitrate, suggesting that risk factors such as genetic predisposition and diet that were not taken into account could be determinants of this pattern. However, even a small increase in CRC rate due to water nitrate could translate into a large public health concern. The incremental pattern observed in nitrate levels of different counties over the years gives the health policymakers a better perspective of the problem and how the control of water nitrate level as a CRC risk factor might contribute to the prevention of CRC.

Effectiveness of water fluoridation in an upper-middle-income country: A systematic review and meta-analysis

AIM

To summarize the information on the effectiveness of community water fluoridation (CWF) on the reduction of dental caries in the context of the wide use of fluoridated toothpaste in Brazil.

DESIGN

A systematic review was conducted regarding the effect of CWF based on studies with Brazilian population groups using the following electronic databases: MEDLINE/PubMed, LILACS, SciELO, and SCOPUS. The literature search was conducted up to August 2019. Studies that compared caries experience in at least two areas, one fluoridated and the other non-fluoridated, by mean dmft/DMFT (decayed, missing, and filled teeth) index or caries prevalence (caries vs. caries-free) were included. Considering the beginning of widespread use of fluoride dentifrice and the time for producing dental caries decline, studies published before 1995 were excluded. Descriptive analysis and meta-analyses were carried out. The effect size was measured by mean difference for dmft and DMFT ± SD and odds ratios on a logarithmic scale for caries prevalence.

RESULTS

Of the 574 studies retrieved, 16 and 10 were included in the qualitative and quantitative analysis, respectively. Fluoridated areas exhibited lower mean dmft/DMFT than non-fluoridated areas did. The mean difference in the dmft between non-fluoridated and fluoridated areas was -2.28 (95% CI -3.26; -1.30) for children aged 5-8 years and -1.12 (95% CI -1.93; -0.32) for those aged 3-12 years; the mean difference in the DMFT was -0.61 (95% CI -0.80; -0.42) for the children aged between 7 and 12 years. The caries prevalence was 1.4 times and 57% lower, respectively, at primary and permanent dentition in fluoridated areas. Heterogeneity was observed in all age groups, ranging from 77.6% to 98.2%.

CONCLUSION

Community water fluoridation remains effective in preventing dental caries in children younger than 13 years, even with the widespread use of fluoridated toothpaste.

Determination of Moisture and Protein Content in Living Mealworm Larvae (Tenebrio molitor L.) Using Near-Infrared Reflectance Spectroscopy (NIRS)

Simple Summary

Insects are increasingly becoming a new protein source for animal feed and human food. Spectroscopic methods, such as near-infrared reflectance spectroscopy, represent a non-destructive and rapid technique that can be applied to perform an online analysis in chemical composition. The aim of the research was to determine the moisture and protein content of living mealworm larvae using near-infrared spectroscopy as a new technique in analyzing nutritional changes. The prediction results of the near-infrared reflectance measurements of living mealworm larvae are presented in this study. The moisture and protein content of the larvae could be predicted with high accuracy and were specifically manipulated by using different water sources (pure water and carrots) and amounts and varying humidity. It was also determined that the larvae can be optimally provided with pure water as well as carrots. High humidity led to faster growth and a higher final weight, which has a positive effect on reducing the time to harvest. This study can help insect producers to have the possibility to measure the composition of the larvae quickly and easily using near-infrared spectroscopy, modify larval composition with regard to water and protein content and improve rearing conditions in terms of water supply for mealworm larvae.

Abstract

Yellow mealworm larvae (Tenebrio molitor L.) are a sustainable source of protein for food and feed. This study represents a new approach in analyzing changes in the nutritional composition of mealworm larvae using near-infrared reflectance spectroscopy (NIRS) combined with multivariate analysis. The moisture and protein content of living larvae were scanned with a near-infrared spectrometer using wavelengths from 1100 to 2100 nm. Different feeding groups with varying moisture sources and amount and the difference between low (50%) and high (75%) humidity were tested, and the influence on larval moisture and protein content was measured. A calibration was developed, with modified partial least squares as the regression method. The NIR spectra were influenced by the moisture and protein content of the larvae, because the absorbance values of the larval groups differed greatly. The coefficient of the determination of calibration (R²_c) and prediction (R²_p) were over 0.98 for moisture and over 0.94 for protein content. The moisture source and content also had a significant influence on the weight gain of the larvae. Consequently, significant differences in protein content could be determined, depending on the water supply available. With respect to wet weight, the larvae moisture content varied from 60 to 74% and protein content from 16 to 24%. This investigation revealed that with non-invasive NIRS online monitoring, the composition of insects can be continuously recorded and evaluated so that specific feeding can be carried out in the course of larval development and composition.

Water, Sanitation and Hygiene in Schools in Low- and Middle-Income Countries: A Systematic Review and Implications for the COVID-19 Pandemic

The global COVID-19 pandemic has revealed the extent to which schools are struggling with the provision of safe drinking water, sanitation and hygiene (WASH). To describe the WASH conditions in schools and discuss the implications for the safe reopening of schools during the ongoing COVID-19 pandemic, a systematic review of peer-reviewed literature on WASH in schools in low- and middle-income countries was performed. In April 2021, five databases, including MEDLINE (via PubMed), Web of Science, Scopus, AJOL, and LILACS, were used to identify studies. Sixty-five papers met the inclusion criteria. We extracted and analyzed data considering the Joint Monitoring Programme (JMP) definitions and the normative contents of Human Rights to safe drinking water and sanitation. Publications included in this systematic review considered 18,465 schools, across 30 different countries. Results indicate a lack of adequate WASH conditions and menstrual hygiene management requirements in all countries. The largely insufficient and inadequate school infrastructure hampers students to practice healthy hygiene habits and handwashing in particular. In the context of the COVID-19 pandemic, being hindered to implement such a key strategy to contain the spread of SARS-CoV-2 in the school environment is of major concern.

Chlorate and perchlorate residues in food products on the Danish market

Upon the European commission's request in 2013, Denmark initiated a survey of the levels of chlorate and perchlorate in agriculture products from the Danish market over a period of 4 years from 2014 to 2017. The results of the survey were used to guide decision making with a view to setting maximum levels for intra-Union trade in 2013 and reviewing and updating the levels from 2020. The results of the Danish survey and the employed analytical method are documented in this paper. In addition to the 89 domestic samples, 30 samples of foreign origin were analysed for chlorate and perchlorate, together with ten samples of baby food and seven samples of infant formula collected from the Danish market. Samples were extracted using the Quick Polar Pesticides extraction method (QuPPe) and analysed on a triple quadrupole LC-MS/MS system. The levels of both chlorate and perchlorate detected in samples originating from Denmark were lower than the current MRLs except for a single sample of lettuce. Moreover, the percentage of foreign samples that were positive for chlorate and perchlorate residues was higher than the percentage of domestic samples. The reason for the generally low levels and low frequency of chlorate and perchlorate in Danish products is most likely linked to the fact that the water supply in Denmark is 100% unchlorinated ground water. The present study shows that residues of perchlorate and chlorate are found in Danish food products at a relatively low frequency and that the levels found are below the EU's MRLs implemented in 2020.

Applying a WASH Risk Assessment Tool in a Rural South African Setting to Identify Risks and Opportunities for Climate Resilient Communities

Climate change threatens the health and well-being of populations. We conducted a risk assessment of two climate-related variables (i.e., temperature and rainfall) and associated water, sanitation and hygiene (WASH)-related exposures and vulnerabilities for people living in Mopani District, Limpopo province, South Africa. Primary and secondary data were applied in a qualitative and quantitative assessment to generate classifications of risk (i.e., low, medium, or high) for components of hazard/threat, human exposure, and human vulnerability. Climate-related threats were likely to impact human health due to the relatively high risk of waterborne diseases and WASH-associated pathogens. Vulnerabilities that increased the susceptibility of the population to these adverse outcomes included environmental, human, physical infrastructure, and political and institutional elements. People of low socio-economic status were found to be least likely to cope with changes in these hazards. By identifying and assessing the risk to sanitation services and water supply, evidence exists to inform actions of government and WASH sector partners. This evidence should also be used to guide disaster risk reduction, and climate change and human health adaptation planning.

Urban Water Access and Use in the Kivus: Evaluating Behavioural Outcomes Following an Integrated WASH Intervention in Goma and Bukavu, Democratic Republic of Congo

Increasing the availability and reliability of community water sources is a primary pathway through which many water supply interventions aim to achieve health gains in communities with limited access to water. While previous studies in rural settings have shown that greater access to water is associated both with increased overall consumption of water and use of water for hygiene related activities, there is limited evidence from urban environments. Using data collected from 1253 households during the evaluation of a community water supply governance and hygiene promotion intervention in the cities of Goma and Bukavu, Democratic Republic of Congo, we conducted a secondary analysis to determine the impact of these interventions on household water collection and use habits. Using multiple and logistic regression models we compared differences in outcomes of interest between households in quartiers with and without the intervention. Outcomes of interest included litres per capita day (lpcd) of water brought to the household, lpcd used at the household, and lpcd used for hygiene-related activities. Results demonstrated that intervention households were more likely to use community tapstands than households located in comparison quartiers and collected on average 16.3 lpcd of water, compared with 13.5 lpcd among comparison households (adj. coef: 3.2, 95 CI: 0.84 to 5.53, p = 0.008). However, reported usage of water in the household for domestic purposes was lower among intervention households (8.2 lpcd) when compared with comparison households (9.4 lpcd) (adj. coef: -1.11, 95 CI: -2.29 to 0.07), p = 0.066) and there was no difference between study groups in the amount of water allocated to hygiene activities. These results show that in this setting, implementation of a water supply governance and hygiene promotion intervention was associated with a modest increase in the amount of water being bought to the household, but that this did not translate into an increase in either overall per capita consumption of water or the per capita amount of water being allocated to hygiene related activities.

Anatomies, vascular architectures, and mechanics underlying the leaf size-stem size spectrum in 42 Neotropical tree species

The leaf size-stem size spectrum is one of the main dimensions of plant ecological strategies. Yet the anatomical, mechanical, and hydraulic implications of small versus large shoots are still poorly understood. We investigated 42 tropical rainforest tree species in French Guiana, with a wide range of leaf areas at the shoot level. We quantified the scaling of hydraulic and mechanical constraints with shoot size, estimated as the water potential difference (ΔΨ) and the bending angle (ΔΦ), respectively. We investigated how anatomical tissue area, flexural stiffness and xylem vascular architecture affect such scaling by deviating (or not) from theoretical isometry with shoot size variation. Vessel diameter and conductive path length were found to be allometrically related to shoot size, thereby explaining the independence between ΔΨ and shoot size. Leaf mass per area, stem length, and the modulus of elasticity were allometrically related to shoot size, explaining the independence between ΔΦ and shoot size. Our study also shows that the maintenance of both water supply and mechanical stability across the shoot size range are not in conflict.

Surface Water Intrusion, Land Use Impacts, and Bacterial Community Composition in Shallow Groundwater Wells Supplying Potable Water in Sparsely Populated Areas of a Boreal Region

Rural communities often rely on groundwater for potable water supply. In this study, untreated groundwater samples from 28 shallow groundwater wells in Finland (<10 m deep and mostly supplying untreated groundwater to <200 users in rural areas) were assessed for physicochemical water quality, stable water isotopes, microbial water quality indicators, host-specific microbial source tracking (MST) markers, and bacterial community composition, activity, and diversity (using amplicon sequencing of the 16S rRNA gene and 16S rRNA). Indications of surface water intrusion were identified in five wells, and these indications were found to be negatively correlated, overall, with bacterial alpha diversity (based on amplicon sequencing of the 16S rRNA gene). High levels of turbidity, heterotrophs, and iron compromised water quality in two wells, with values up to 2.98 nephelometric turbidity units (NTU), 16,000 CFU/ml, and 2,300 μg/liter, respectively. Coliform bacteria and general fecal indicator Bacteroidales bacteria (GenBac3) were detected in 14 and 10 wells, respectively (albeit mostly at low levels), and correlations were identified between microbial, physicochemical, and environmental parameters, which may indicate impacts from nearby land use (e.g., agriculture, surface water, road salt used for deicing). Our results show that although water quality was generally adequate in most of the studied wells, the continued safe use of these wells should not be taken for granted.

IMPORTANCE Standard physicochemical water quality analyses and microbial indicator analyses leave much of the (largely uncultured) complexity of groundwater microbial communities unexplored. This study combined these standard methods with additional analyses of stable water isotopes, bacterial community data, and environmental data about the surrounding areas to investigate the associations between physicochemical and microbial properties of 28 shallow groundwater wells in Finland. We detected impaired groundwater quality in some wells, identified potential land use impacts, and revealed indications of surface water intrusion which were negatively correlated with bacterial alpha diversity. The potential influence of surface water intrusion on groundwater wells and their bacterial communities is of particular interest and warrants further investigation because surface water intrusion has previously been linked to groundwater contamination, which is the primary cause of waterborne outbreaks in the Nordic region and one of the major causes in the United States and Canada.

Structure and Functional Attributes of Bacterial Communities in Premise Plumbing Across the United States

Microbes that thrive in premise plumbing can have potentially important effects on human health. Yet, how and why plumbing-associated microbial communities vary across broad spatial scales remain undetermined. We characterized the bacterial communities in 496 showerheads collected from across the continental United States. The overall community structure, determined by 16S rRNA gene amplicon sequencing, revealed high levels of bacterial diversity. Although a large fraction of the observed variation in community composition could not be explained, differences in bacterial community composition were associated with water supply (private well water vs public municipal water), water source (groundwater vs surface water), and associated differences in water chemistry (pH and chlorine). Most notably, showerheads in homes supplied with public water had higher abundances of Blastomonas, Mycobacterium, and Porphyrobacter, while Pseudorhodoplanes, Novosphingobium, and Nitrospira were more abundant in those receiving private well water. We conducted shotgun metagenomic analyses on 92 of these samples to assess differences in genomic attributes. Public water-sourced showerheads had communities enriched in genes related to lipid and xenobiotic metabolisms, virulence factors, and antibiotic resistance. In contrast, genes associated with oxidative stress and membrane transporters were over-represented in communities from private well water-sourced showerheads compared to those supplied by public water systems. These results highlight the broad diversity of bacteria found in premise plumbing across the United States and the role of the water source and treatment in shaping the microbial community structure and functional potential.

Leveraging water, sanitation and hygiene for nutrition in low- and middle-income countries: A conceptual framework

In low‐ and middle‐income countries (LMICs), access to water, sanitation and hygiene (WASH) is associated with nutritional status including stunting, which affects 144 million children under 5 globally. Despite the consistent epidemiological association between WASH indicators and nutritional status, the provision of WASH interventions alone has not been found to improve child growth in recent randomized control trials. We conducted a literature review to develop a new conceptual framework that highlights what is known about the WASH to nutrition pathways, the limitations of certain interventions and how future WASH could be leveraged to benefit nutritional status in populations. This new conceptual framework will provide policy makers, program implementors and researchers with a visual tool to bring into perspective multiple levels of WASH and how it may effectively influence nutrition while identifying existing gaps in implementation and research.

A New, Practical Animal Welfare Assessment for Dairy Farmers

Simple Summary

To determine the level of welfare on a dairy farm is a complex task. There is no protocol available that can serve as a ‘gold standard’. The Welfare Quality protocol is the most extensive one, but it takes about a full day to perform. We, therefore, examined if it would be possible to replace the time-consuming parts, like lengthy behavioural observations, with simple measurements in the environment. This resulted in a new Welfare Monitor that can be executed in 1.5 h on a farm with 100 cows. Welfare assessment was appreciated by the farmers, and they responded to advice for improvements on their farm. Besides promoting better welfare, this approach also led to a better financial result for the farms.

Abstract

The Welfare Quality^® assessment protocol (WQ) is the most extensive way to measure animal welfare. This study was set up to determine if resource-based welfare indicators, that are easier and faster to measure, could replace the more time consuming, animal-based measurements of the WQ. The WQ was applied on 60 dairy farms in the Netherlands, with good, moderate and poor welfare. The WQ protocol classified most farms (87%) as ‘acceptable’. Several of the animal-based measures of WQ correlated well with measures in the environment. Using these correlations, an alternative welfare assessment protocol (new Welfare Monitor) was designed, which takes approximately 1.5 h for a farm with 100 dairy cows. Because the opinion of farmers about welfare assessment is important if one wants to improve conditions for the cows at a farm, another objective of this study was to evaluate the usefulness of the new Welfare Monitor for the farmer. Over two years, the farms were visited, and advice was given to improve the conditions at the farm. After the first welfare assessment and advice, farmers improved the conditions for their cows substantially. Farms where the category score had increased made more improvements on average than those that did not upgrade.

Childhood Malnutrition and the Association with Diarrhea, Water supply, Sanitation, and Hygiene Practices in Kersa and Omo Nada Districts of Jimma Zone, Ethiopia

BACKGROUND

Inadequate water supply, sanitation, hygiene practices, and diarrhea are related to malnutrition, but there is limited evidence in Ethiopia about their association. Thus, the objective of this study was to describe childhood malnutrition and the association with diarrhea, water supply, sanitation and hygiene practices.

METHODS

A case-control study design was performed from December 2018 to January 2019 in Kersa and Omo Nada districts of the Jimma Zone, Ethiopia. Both children aged 6 to 59 months were chosen randomly from malnourished and well-nourished children in 128 cases and 256 controls, respectively. Bodyweight, length/height, mid-upper arm circumference, and presence of edema of the children were measured according to the WHO references. Then, the nutritional status of the children was identified as a case or control using the cutoff points recommended by the WHO. To see the association-dependent and independent variables, logistic regression analysis was used.

RESULTS

A total of 378 children were included in this study (98.44%). Malnutrition was significantly increased among children who delayed breastfeeding initiation(AOR = 3.12; 95% CI: 1.62-6.00), had diarrhea (AOR = 9.22; 95% CI: 5.25-16.20), were living in households indexed as the poorest (AOR = 2.50; 95% CI: 1.12-5.62), defecated in a pit latrine without slab/open pit (AOR = 2.49; 95% CI: 1.17-5.30), collecting drinking water from less than/equal to 1 km distance (AOR = 4.77; 95% CI: 1.01-22.71) and sometimes practiced hand washing at the critical times (AOR = 2.58; 95% CI: 1.16-5.74) compared with their counterparts. However, lactating during the survey (AOR = 0.35; 95% CI: 0.18-0.67), water collection from unprotected sources (AOR = 0.22; 95% CI: 0.05-0.95) and collection and disposal of under-5 children feces elsewhere (AOR = 0.06; 95% CI: 0.01-0.49) significantly reduced the likelihood of malnutrition.

CONCLUSIONS

Early initiation of exclusive breastfeeding, diarrhea prevention, and the use of improved latrine and handwashing practices at critical times could be important variables to improve the nutritional status of children.

Novel Use of Premixed Dialysate Bags during Water Supply Interruption in Acute Hospital Setting

Patients on dialysis are exposed to large amounts of water during conventional intermittent hemodialysis; hence, there are strict regulations regarding the quality of water used to prepare dialysate. Occasionally, water systems fail due to natural disasters or structural supply issues, such as water-main breaks or unplanned changes in municipal or facility water quality. It is critical to regularly monitor and immediately recognize such a failure and take steps to avoid exposing the patients to contaminants. In addition to the recognition of the problem, the ability to pivot and continue to provide safe treatment to inpatients who are dependent on dialysis is essential, both from an ultrafiltration and a clearance standpoint. At our hospital, an unforeseen water disruption occurred and we were able to continue to provide KRT with premade, bagged dialysate to mitigate the effect on our patients on dialysis. This is a novel method using available machines and dialysate, which we normally stock for continuous KRT, for short dialysis sessions. The methodology is similar to that which has been widely used for short daily home hemodialysis with low dialysate flow rate. Because this situation occurred in the midst of the SARS-CoV-2 pandemic, we had to be mindful of dialysate volumes and staffing time. Here, we present our investigation into the cause of the water-system failure and how we quickly implemented the alternative dialysis method. Short dialysis with low-flow dialysate will not deliver the same Kt/V per session as standard dialysis; however, this method was successfully implemented and tailored with adjustments for patients requiring higher clearance for specific indications, such as severe hyperkalemia.

Impact of the 2016 Kumamoto earthquake on patients with nephrogenic diabetes insipidus and preparations for the future

Patients with nephrogenic diabetes insipidus should establish a support network system by contacting the government to ensure that water can be preferentially obtained in the event of a disaster and create and carry a medical alert card.

Environmental Performance of Small-Scale Seawater Reverse Osmosis Plant for Rural Area Water Supply

Seawater desalination is an alternative technology to provide safe drinking water and to solve water issues in an area having low water quality and limited drinking water supply. Currently, reverse osmosis (RO) is commonly used in the desalination technology and experiencing significant growth. The aim of this study was to analyze the environmental impacts of the seawater reverse osmosis (SWRO) plant installed in Kampung Pantai Senok, Kelantan, as this plant was the first installed in Malaysia. The software SimaPro 8.5 together with the ReCiPe 2016 database were used as tools to evaluate the life cycle assessment (LCA) of the SWRO plant. The results showed that the impact of global warming (3.90 kg CO2 eq/year) was the highest, followed by terrestrial ecotoxicity (1.62 kg 1,4-DCB/year) and fossil resource scarcity (1.29 kg oil eq/year). The impact of global warming was caused by the natural gas used to generate the electricity, mainly during the RO process. Reducing the environmental impact can be effectively achieved by decreasing the electricity usage for the seawater desalination process. As a suggestion, electricity generation can be overcome by using a high-flux membrane with other suitable renewable energy for the plant such as solar and wind energy.

Large waterborne Campylobacter outbreak: use of multiple approaches to investigate contamination of the drinking water supply system, Norway, June 2019

On 6 June 2019, the Norwegian Institute of Public Health was notified of more than 50 cases of gastroenteritis in Askøy. A reservoir in a water supply system was suspected as the source of the outbreak because of the acute onset and geographical distribution of cases. We investigated the outbreak to confirm the source, extent of the outbreak and effect of control measures. A case was defined as a person in a household served by Water Supply System A (WSS-A) who had gastroenteritis for more than 24 h between 1 and 19 June 2019. We conducted pilot interviews, a telephone survey and an SMS-based cohort study of residents served by WSS-A. System information of WSS-A was collected. Whole genome sequencing on human and environmental isolates was performed. Among 6,108 individuals, 1,573 fulfilled the case definition. Residents served by the reservoir had a 4.6× higher risk of illness than others. Campylobacter jejuni isolated from cases (n = 24) and water samples (n = 4) had identical core genome MLST profiles. Contamination through cracks in the reservoir most probably occurred during heavy rainfall. Water supply systems are susceptible to contamination, particularly to certain weather conditions. This highlights the importance of water safety planning and risk-based surveillance to mitigate risks.

Effect of Inter-Observer Variation on the Association between Contamination Hazards and the Microbiological Quality of Water Sources: A Longitudinal Study

Sanitary risk inspection protocols are often used to identify contamination hazards at water sources; however, different observers sometimes struggle to record hazards consistently. This study aimed to assess the effect of inter-observer variation in hazard observations on the strength of relationships between observed hazards and the bacterial contamination of water sources, particularly relationships with animal-related hazards. In a longitudinal study, five surveyors independently recorded hazards at 93 water sources used by 234 households in Siaya County, Kenya, in both wet and dry seasons. One surveyor collected samples from sources for subsequent Escherichia coli and intestinal enterococci testing. The relationship between each surveyor’s hazard observations and high bacterial contamination was examined using logistic regression. After controlling for water source type and preceding rainfall; percentage scores for animal-related hazards were significantly related to high contamination with enterococci and E. coli for one surveyor (odds ratio 1.02; 95% confidence intervals 1.00–1.03 for both parameters), but not for the remaining four surveyors. The relationship between observed contamination hazards and the microbiological contamination of water sources is sensitive to variation in hazard recording between surveyors. Sanitary risk protocols should be designed to enable robust and consistent observation of hazards.

The nexus between improved water supply and water-borne diseases in urban areas in Africa: a scoping review protocol

Introduction: Currently, an estimated two thirds of the world population is water insufficient. As of 2015, one out of every five people in developing countries do not have access to clean sufficient drinking water. In an attempt to share the limited resource, water has been distributed at irregular intervals in cities in developing countries. Residents in these cities seek alternative water sources to supplement the inadequate water supplied. Some of these alternative sources of water are unsafe for human consumption, leading to an increased risk in water-borne diseases. Africa contributes to 53% of the diarrheal cases reported globally, with contaminated drinking water being the main source of transmission. Water-borne diseases like diarrhea, cholera, typhoid, amoebiasis, dysentery, gastroenteritis, cryptosporidium, cyclosporiasis, giardiasis, guinea worm and rotavirus are a major public health concern. The main objective of this scoping review is to map the available evidence to understand the sources of water among residents in cities in Africa and the relationship between clean water sufficiency and water-borne diseases in urban Africa.

Methods and analysis: The search strategy will identify studies published in scientific journals and reports that are directly relevant to African cities that have a population of more than half a million residents as of 2014 AND studies on the ten emerging water-borne diseases, which are diarrhea, cholera, typhoid, amoebiasis, dysentery, gastroenteritis, cryptosporidium, cyclosporiasis, giardiasis, guinea worm and rotavirus.

Ethics and dissemination: This scoping review did not require any formal ethical approval. The findings will be published in a peer-reviewed journal.

Municipality-Level Characteristics Associated with Very Low to Good Quality of Water Fluoridation in São Paulo State, Brazil, in 2015

INTRODUCTION

Community water fluoridation (CWF) is a measure of recognized importance due to its effectiveness in preventing tooth decay at the population level. However, for the maximum benefit to be achieved, the high-quality standard of CWF must be maintained over time.

OBJECTIVE

To analyze the municipality-level characteristics associated with quality of water fluoridation in São Paulo state, Brazil.

METHODS

An ecological study was performed using official data sources on fluoride concentration surveillance in 2015. The outcome was municipalities that have not met the quality standard, identified as those with less than 80% of water samples within the optimal level for caries prevention. The independent variables were municipality-level indicators related to demographics, economics, and sanitation characteristics. Crude and adjusted prevalence ratios were estimated using Poisson regression with robust variance.

RESULTS

In total, 43.4% municipalities exhibited the outcome. Adjusted by Gini index, the prevalence ratio was 32% higher in municipalities with lower annual gross domestic product per capita. Adjusted by social responsibility index and earlier variables, the prevalence was higher in the municipalities with higher per capita expenditure on sanitation and health surveillance, where the urban population rate was lower, and with a human development index ≤0.761. Adjusted by earlier variables, the prevalence ratio was twice and 3.5 times higher for municipalities, respectively, with per capita income less than or equal to US$574 and where the type of sanitation utility was municipal and private; 50% higher in those with less than 100,000 habitants; and 20% higher in those with a chlorine concentration nonconformity rate above 0.82%.

CONCLUSIONS

To ensure high quality of CWF, additional management measures should be implemented in municipalities with less than 100,000 habitants, a higher chlorine concentration nonconformity rate, a lower per capita income, and where the type of sanitation utility was municipal or private.

KNOWLEDGE TRANSFER STATEMENT

The study showed that the quality of fluoridation was associated with municipality-level characteristics. The findings can be used by policy makers to identify and support municipalities that will need to improve fluoridation quality if they are to reach oral health goals.

Spatial and Temporal Variability in Trihalomethane Concentrations in the Bromine-Rich Public Waters of Perth, Australia

High concentrations of trihalomethanes (THMs) in public water supplies potentially pose a health hazard, but exposure assessment remains a complex task. To interpret research findings and monitoring data for THMs, it is important to evaluate spatial and temporal variations in both total THM and the individual constituent compounds (including brominated species). We therefore aimed to determine the concentrations, and spatial and temporal variability of concentrations, of THMs public water supplies in Perth, Western Australia, which is known historically to have high brominated THM concentrations. We analysed water samples from 21 water distribution zones around Perth (including Busselton and Bunbury) across different seasons over a period of two years. A total of 250 samples provided a median total THM of 72 µg/L (range of 0-157 µg/L), which falls well within Australia's National Health and Medical Research Council guidelines. The concentration of all species, including brominated forms, also fell the World Health Organization's guidelines. Total THM concentrations were typically higher in spring and summer. A high degree of spatial variability was detected and appears to relate to the source water. Both the temporal and spatial variability in THM concentrations have implications for epidemiological studies, and monitoring.

Prevalence and Genotypes of Cryptosporidium in Wildlife Populations Co-Located in a Protected Watershed in the Pacific Northwest, 2013 to 2016

Between October 2013 and May 2016, 506 scat samples were collected from 22 species of wildlife located in a protected watershed of a major municipal water supply in the Pacific Northwest, USA. Overall prevalence of Cryptosporidium in the wildlife scat was 13.8% (70/506), with 15 species of wildlife found positive for Cryptosporidium. Prevalence of Cryptosporidium varied among species of wildlife, with higher prevalences observed in cougars (50.0%), mountain beavers (40.0%), and bobcats (33.3%), but none of these species are riparian-dependent. Genotyping of Cryptosporidium by sequencing PCR amplicons from the 18S rRNA gene were successful for seven species of wildlife, including bobcat, unknown predator, black-tailed deer, deer mouse, snowshoe hare, mountain beaver, and western spotted skunk. BLAST and phylogenetic analyses indicated that multiple species and genotypes of Cryptosporidium were present, with some isolates possibly co-circulating within and between wildlife populations in this protected watershed. Evidence of oocyst exchange between infected prey and their predators was also found. During the study period, several zoonotic Cryptosporidium species and genotypes that are uncommon in humans were detected in bobcat (99.58% identical to Cryptosporidium felis), unknown predator (100% identical to Cryptosporidium canis), snowshoe hare (100% identical to Cryptosporidium sp. skunk genotype), and mountain beaver (100% identical to Cryptosporidium ubiquitum). Novel sequences were also found in mountain beaver. To our knowledge, this is the first published report of a unique genotype or species of Cryptosporidium in mountain beaver (Aplodontia rufa).

Arbuscular Mycorrhizal Fungus Rhizophagus irregularis Influences Artemisia annua Plant Parameters and Artemisinin Content under Different Soil Types and Cultivation Methods

Artemisinin extracted from Artemisia annua has been used efficiently in malaria treatment since 2005. In this study, the variations in plant parameters (plant biomass, glandular trichome density, essential oil total chemical content, artemisinin production, and polyphenol oxidase (PPO) activity) were tested under different soil types (Luvisol, Gleysol, Anthrosol and sterile peat) and cultivation conditions (potted plants in semi-open field, and open field experiments) for plants inoculated with arbuscular mycorrhizal fungus (AMF) Rizophagus irregularis. Under semi-open field conditions, the AMF colonization of A. annua plant roots varied, and presented the highest percentage in Luvisol and sterile peat. The increase in the root colonization rate positively influenced some plant parameters (biomass, glandular trichome density, artemisinin concentration, essential oil quantity and composition), but no effects on PPO enzyme activity were detected. AMF fungus R. irregularis significantly increased the artemisinin content and essential oil yield of plants cultivated in Luvisol, Gleysol, Anthrosol and in peat. These soil types can offer appropriate conditions for A. annua cultivation and artemisinin production even on a smaller scale. Under open field conditions, low (about 5%) AMF colonization was observed. No differences in artemisin contents were detected, but essential oil yield significantly increased compared to control plants. AMF treatment increased beta-farnesene and germacrene D concentrations in Artemisia plants in the open field experiment.

Chloramine Disinfection-Induced Nitrification Activities and Their Potential Public Health Risk Indications within Deposits of a Drinking Water Supply System

Microsensors were applied to study the diffusion reaction and activity of a nitrogen species of deposit sediment from a drinking water supply system. Microprofiles of dissolved oxygen (DO), NH₄⁺-N, NO₃^--N, and NO₂^-N in the sediment indicated that the DO concentration decreased from the highest at the sediment surface to zero at the bottom of the sediment. Similarly, with the increase of depth, NH₄⁺-N initially increased rapidly and then decreased slowly, while the concentration of NO₃^--N reached a maximum at around 6000 μm and then decreased to about 0.1 mg·L^-1 near the bottom of the sediment. Almost no change was observed for NO₂^--N. The decrease of NH₄⁺-N and DO corresponded well with the increase of NO₃^--N. Furthermore, based on a consumption and production rate analysis, DO has always been consumed; the NH₄⁺-N consumption rate increased rapidly within 0-1000 μm, reaching about 14 mg·L^-1·S^-1·10^-9. A small amount of NH₄⁺-N was produced in 2000-6000 μm, which could be attributed to denitrification activity. There was no change deeper than 6000 μm, while NO₃^--N was produced at a depth between 0 and 6000 μm and was consumed in the deeper zone. At the depth of 9000 μm, the NO₃^--N consumption reached a maximum of 5 mg·L^-1·S^-1·10^-9. The consumption of DO and NH₄⁺-N, which corresponded with the production of NO₃^--N in a specific microscale range within the sediment, demonstrated nitrification and denitrification activities. In addition, the time required for the diffusion of only DO, NH₄⁺-N, NO₃^--N, and NO₂^--N was estimated as 14 days; however, in the practical, even after 60 days of operation, there was still a continuous reaction, which provided further evidence towards microbial activities within the sediment.

First Detection of Microcystin-LR in the Amazon River at the Drinking Water Treatment Plant of the Municipality of Macapá, Brazil

Human poisoning by microcystin has been recorded in many countries, including Brazil, where fatal cases have already occurred. The Amazon River is the main source of drinking water in municipalities such as Macapá, where there is no monitoring of cyanobacteria and cyanotoxins. This study investigated the presence of cyanobacteria and cyanotoxins in samples from a drinking water treatment plant (DWTP) that catches water from the Amazon River. The toxin analyses employed ELISA, LC/MS, and molecular screening for genes involved in the production of cyanotoxins. The sampling was carried out monthly from April 2015 to April 2016 at the intake (raw water) and exit (treated water) of the DWTP. This study reports the first detection of microcystin-LR (MC-LR) in the Amazon River, the world's largest river, and in its treated water destined for drinking water purposes in Macapá, Brazil. The cyanobacterial density and MC-LR concentration were both low during the year. However, Limnothrix planctonica showed a density peak (± 900 cells mL-1) in the quarter of June-August 2015, when MC-LR was registered (2.1 µg L-1). Statistical analyses indicate that L. planctonica may produce the microcystin.

Emergency Department Visits for Acute Gastrointestinal Illness After a Major Water Pipe Break in 2010

BACKGROUND

When a water pipe breaks, contaminants can enter the drinking water system and cause waterborne illnesses such as acute gastrointestinal illness. In May 2010, a major water pipe broke near Boston, MA, and a boil water order was issued to nearly two million residents.

METHODS

Using a case-crossover study design, we examined the association between the water pipe break and subsequent emergency department visits for acute gastrointestinal illness. We identified cases of illness according to ICD-9-CM diagnosis codes and selected control dates 2 weeks before and after each case. We estimated the risk of visiting the emergency department during the 0-3 and 4-7 days after the water pipe break using conditional logistic regression models.

RESULTS

Our analysis included 5,726 emergency department visits for acute gastrointestinal illness from 3 April 2010 to 5 June 2010. Overall, there was a 1.3-fold increased odds for visiting the emergency department for acute gastrointestinal illness during the 0-3 days after the water pipe break (odds ratio [OR] = 1.3; 95% confidence interval [CI] = 1.1, 1.4) compared with referent dates selected 2 weeks before and after. During the 4-7 days after the break, the association diminished overall (OR = 1.1; 95% CI = 0.96, 1.2). However, in communities over 12 miles from the break, the 4- to 7-day association was elevated (OR = 1.4; 95% CI = 1.1, 1.8).

CONCLUSIONS

This study suggests that a major water pipe break was associated with emergency department visits for acute gastrointestinal illness, particularly during the 0-3 days after the break, when a boil water order was in effect.

Water safety plans for water supply utilities in China, Cuba, France, Morocco and Spain: costs, benefits, and enabling environment elements

Water Safety Plans (WSPs) are a management tool to identify and prioritize risks and implement appropriate control measures throughout the water supply chain, from catchment to consumer. WSPs have been implemented in over 90 countries; yet, costs, benefits and the enabling environment elements necessary for WSP implementation are under-studied. To better understand these factors, we conducted interviews with WSP implementation management teams from 20 private urban water utilities in China, Cuba, France, Morocco and Spain in 2014. Collectively, these utilities serve 10.6 million consumers and supply over 2.2 million m3/day of water to consumers. Time for WSP implementation to achieve certification averaged 13 months. The main startup cost was staff time, averaging 16.2 full-time equivalent person-months. Additional costs, averaging €16,777, were for training staff, hiring consultants, purchasing equipment, and certifying WSPs. Benefits commonly reported included improved hazard control, treatment practices, record keeping, and client and health agency confidence.

Prevalence of Trachoma in Kogi State, Nigeria: Results of four Local Government Area-Level Surveys from the Global Trachoma Mapping Project

PURPOSE

To determine the prevalence of trachoma in four Local Government Areas (LGAs) of Kogi State, Nigeria.

METHODS

In June 2014, we conducted population-based, cross-sectional surveys according to Global Trachoma Mapping Project (GTMP) protocols in selected LGAs of Kogi State. In each LGA, 25 clusters were selected with probability proportional to size. In each of these clusters, 25 households were enrolled for the survey. All residents of selected households aged ≥1 year were examined by GTMP-certified graders for trachomatous inflammation-follicular (TF) and trichiasis using the simplified trachoma grading scheme. Data on sources of household water and types of sanitation facilities were collected through questioning and direct observation.

RESULTS

The age-adjusted TF prevalence in 1-9-year-olds ranged from 0.4% (95% CI 0.1-0.8%) in Bassa to 1.0% (95% CI 0.3-1.9%) in Omala. Across all four LGAs, only one case of trichiasis was found; this individual was in Omala, giving that LGA a trichiasis prevalence in individuals aged ≥15 years of 0.02% (95% CI 0.00-0.07%). Between 77 and 88% of households had access to water for hygiene purposes, while only 10-30% had access to improved sanitation facilities.

CONCLUSION

Trachoma is not a public health problem in any of the 4 LGAs surveyed. There is, however, the need to increase access to adequate water and sanitation services to contribute to the health and social and economic well-being of these communities.

Impact Survey Results after SAFE Strategy Implementation in 15 Local Government Areas of Kebbi, Sokoto and Zamfara States, Nigeria

Purpose: To determine prevalence of trachoma after interventions in 15 local government areas (LGAs) of Kebbi, Sokoto and Zamfara States, Nigeria.

Methods: A population-based impact survey was conducted in each LGA using Global Trachoma Mapping Project (GTMP) protocols. In each LGA, 25 villages were selected, except in Arewa LGA, where we selected 25 villages from each of four subunits to obtain finer-resolution prevalence information. Villages were selected with probability proportional to size. In each village, 25 households were enrolled and all consenting residents aged ≥1 year were examined by GTMP-certified graders for trachomatous inflammation—follicular (TF) and trachomatous trichiasis (TT). Information on sources of household water and types of sanitation facilities used was collected through questioning and direct observation.

Results: The number of households enrolled per LGA ranged from 623 (Kware and Tangaza) to 2488 (Arewa). There have been marked reductions in the prevalence of TF and TT since baseline surveys were conducted in all 15 LGAs. Eight of the 15 LGAs have attained TF prevalences <5% in children, while 10 LGAs have attained TT prevalences <0.2% in persons aged ≥15 years. Between 49% and 96% of households had access to water for hygiene purposes within 1 km of the household, while only 10–59% had access to improved sanitation facilities.

Conclusion: Progress towards elimination of trachoma has been made in these 15 LGAs. Collaboration with water and sanitation agencies and community-based trichiasis surgery are still needed in order to eliminate trachoma by the year 2020.

Evaluating the sustainability of indirect potable reuse and direct potable reuse: a southern Nevada case study

This case study presents a framework for evaluating the sustainability of indirect potable reuse (IPR) and direct potable reuse (DPR) in Las Vegas, Nevada. A system dynamics model was developed to simulate population growth, water supply, water quality, energy costs, net present worth (NPW), and greenhouse gas (GHG) emissions. The model confirmed that DPR could achieve a net reduction in energy costs of up to US$250 million while still ensuring an adequate water supply. However, the high NPW of DPR ($1.0-$4.0 billion) relative to the status quo IPR approach ($0.6 billion) represents a significant economic hurdle, although future monetization of salt loadings and GHGs could reduce that disparity. DPR with ozone-biofiltration would also be hindered by an estimated concentration of total dissolved solids of up to 1,300 mg/L. Despite these barriers to implementation in Las Vegas, certain site-specific conditions may make DPR more attractive in other locations.

Responses of leaf C:N:P stoichiometry to water supply in the desert shrub Zygophyllum xanthoxylum

Based on the elemental composition of major biochemical molecules associated with different biological functions, the 'growth rate hypothesis' proposed that organisms with a higher growth rate would be coupled to lower C:N, especially lower C:P and N:P ratios. However, the applicability of the growth rate hypothesis for plants is unclear, especially for shrubs growing under different water supply. We performed an experiment with eight soil moisture levels (soil water content: 4%, 6%, 8%, 13%, 18%, 23%, 26% and 28%) to evaluate the effects of water availability on leaf C:N:P stoichiometry in the shrub Zygophyllum xanthoxylum. We found that leaves grew slowly and favored accumulation of P over C and N under both high and low water supply. Thus, leaf C:P and N:P ratios were unimodally related to soil water content, in parallel with individual leaf area and mass. As a result, there were significant positive correlations between leaf C:P and N:P with leaf growth (u). Our result that slower-growing leaves had lower C:P and N:P ratios does not support the growth rate hypothesis, which predicted a negative association of N:P ratio with growth rate, but it is consistent with recent theoretical derivations of growth-stoichiometry relations in plants, where N:P ratio is predicted to increase with increasing growth for very low growth rates, suggesting leaf growth limitation by C and N rather than P for drought and water saturation.

Challenges Regarding Water Quality of Eutrophic Reservoirs in Urban Landscapes: A Mapping Literature Review

Urbanized river basins usually suffer from anthropogenic pressure, compromising the quality of water. Unsafe water is a risk to public health, especially when there are occurrences of HABs (Harmful Algae Blooms) as in the case of cyanobacteria, which cause different human health problems. In this paper, we aimed to review the scientific literature documenting what has been studied in the scope of the stratified reservoirs of urbanized basins. The mapping review method was used to categorize existing literature on urbanized watersheds and eutrophic reservoirs. Using the keywords “Eutrophic Reservoir” and “Urban” and selecting all the years of open publication on the Science web page, we obtained 69 results, 53 of them meeting the requirements established for the search. Many of the studies mention as the most important determinant for eutrophication of reservoirs and the proliferation of algae, the anthropogenic influence through the diffuse load of streets, domestic and industrial sewage, and even drainage water from agricultural areas in the basin. The results of this study reinforce that informal settlements without sanitary infrastructure are aggravating the deterioration of water quality in urban water sources and therefore posing many risks to public health.

Multiple water source use in rural Vanuatu: are households choosing the safest option for drinking?

Households in low- and middle-income countries commonly make use of multiple water sources. However, it remains unclear to what extent their drinking water choices are optimal from a health perspective. This matched cohort study across 10 islands in Vanuatu examined communities with both a groundwater and rainwater source to determine whether their preferred drinking option was the safest in microbial terms. In communities that preferred to drink rainwater, 56.5% of rainwater sources had 'high-risk' or 'very high risk' Escherichia coli contamination (> 10 MPN/100 mL) compared with 26.1% of groundwater sources (p = 0.092). Moreover, a preference for drinking rainwater was significantly associated with rainwater sources having 'high-risk' or 'very high risk' levels of E. coli contamination (p = 0.045). Results show that communities do not necessarily choose the safest water source for drinking. Findings also highlight the need to bolster local capacity to manage water quality risks and for Sustainable Development Goal monitoring to distinguish between protected and unprotected rainwater tanks.

Assessing operational performance benefits of a Water Safety Plan implemented in Southwestern France

AIMS

The World Health Organization (WHO) has recommended Water Safety Plans (WSPs) since 2004 as a means to reduce drinking water contamination and risks to human health. These risk management programs have shown promise across several potential areas of evaluation, such as economic benefits and regulatory compliance. Since WSPs are largely carried out by people who interact with water treatment equipment and processes, operational performance indicators may be key to understanding the mechanisms behind desirable WSP impacts such as water quality and public health improvement.

METHOD

This study reports performance measures collected at a WSP implementation location in southwestern France over several years.

RESULTS

Quantitative assessment of performance measures supported qualitative reports from utility managers. Results indicate significantly reduced duration of low-chlorine events at one production facility and a significant decrease in customer complaints related to water quality, manifesting reported improvements in operational performance and the customer service culture.

CONCLUSION

The findings demonstrate some success stories and potential areas of future performance tracking. Cyclical iteration of the WSP can help to achieve continuous quality improvement. Successfully applied evaluation criteria such as the number of water quality complaints or alarm resolution time might be useful across other locations.

Variations in Dissolved Nitrate, Chloride, and Sulfate in Precipitation, Reservoir, and Tap Waters, Columbus, Ohio

Urban potable waters can be very susceptible to human activities that can impact water quality and, hence, public health. Columbus, Ohio, is currently the 14th largest city in the United States with an estimated population of ~860,000. Much of the urban population receives its water supply from a series of reservoirs located north of the city proper. These reservoirs are fed by river systems that drain either large agricultural lands, or rapidly growing suburban areas, or both. The agricultural activities introduce dissolved nitrate, and increased usage of de-icing salts on roads and highways within the drainage area introduce chloride into the river/reservoir systems. High nitrate in drinking water poses a potential health risk, particularly to infants, while high chloride, applied as halite, in drinking water can aid in the development of cardiovascular disease. In this work, we present a 19-month time series measuring nitrate, chloride, and sulfate in local precipitation, reservoir and household tap waters in order to better understand the relationship of the hydrologic residence time on the tap water chemistry, as well as to evaluate the anion concentrations. The highest chloride tap water concentration, 6.9 mM, occurred in early February 2011, while increases in nitrate occurred in both early summer and the middle of winter. In general, the anion concentrations in the precipitation are all equal to or lower than the reservoir waters. Similarly, the tap water had concentrations of chloride and sulfate higher than reservoir water, while nitrate was similar to reservoir water. Tap water had higher fluoride and sulfate concentrations, suggesting that they are added during the treatment of the reservoir water prior to residential distribution. These data clearly demonstrate the importance of watershed lands on the quality of water in the human distribution system.

Near Real-Time Detection of E. coli in Reclaimed Water

Advanced treatment of reclaimed water prior to potable reuse normally results in the inactivation of bacterial populations, however, incremental treatment failure can result in bacteria, including pathogens, remaining viable. Therefore, potential microorganisms need to be detected in real-time to preclude potential adverse human health effects. Real-time detection of microbes presents unique problems which are dependent on the water quality of the test water, including parameters such as particulate content and turbidity, and natural organic matter content. In addition, microbes are unusual in that: (i) viability and culturability are not always synonymous; (ii) viability in water can be reduced by osmotic stress; and (iii) bacteria can invoke repair mechanisms in response to UV disinfection resulting in regrowth of bacterial populations. All these issues related to bacteria affect the efficacy of real-time detection for bacteria. Here we evaluate three different sensors suitable for specific water qualities. The sensor A is an on-line, real-time sensor that allows for the continuous monitoring of particulates (including microbial contaminants) using multi-angle-light scattering (MALS) technology. The sensor B is a microbial detection system that uses optical technique, Mie light scattering, for particle sizing and fluorescence emission for viable bacteria detection. The last sensor C was based on adenosine triphosphate (ATP) production. E. coli was used a model organism and out of all tested sensors, we found the sensor C to be the most accurate. It has a great potential as a surrogate parameter for microbial loads in test waters and be useful for process control in treatment trains.