Volume 99, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Poor drinking water quality is one of the main causes of acute diarrheal disease in developing countries. The study investigated the relationship between fecal contamination of hands, stored drinking water, and source waters in India. We further evaluated the environmental and behavioral factors associated with recontamination of water between collection and consumption. The bacterial contamination, that is, (log most probable number per two hands), found on mothers’ hands (mean = 1.11, standard deviation [SD] = 1.2, = 152) was substantially higher than that on their children younger than 5 years (mean = 0.64, SD = 1.0, and = 152). We found a low level of (< 1 per 100 mL) in the source water samples; however, contamination in stored drinking water was above the recommended guidelines of the World Health Organization. The study also found that on hands was significantly associated with in the stored drinking water ( < 0.001). Moreover, was positively associated with gastrointestinal symptoms (odds ratio 1.42, < 0.05). In the households with elevated levels (> 100 /100 mL) of fecal contamination, we found that 43.5% had unimproved sanitation facilities, poor water handling practices, and higher diarrheal incidences. The water quality deterioration from the source to the point of consumption is significant. This necessitates effective interventions in collection, transport, storage, and extraction practices when hand–water contact is likely to occur. These findings support the role of hands in the contamination of stored drinking water and suggest that clean source water does not guarantee safe water at the point of consumption.


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  • Received : 18 Oct 2016
  • Accepted : 22 May 2018
  • Published online : 30 Jul 2018

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