Escherichia coli Contamination of Water for Human Consumption and Its Associated Factors in Peru: A Cross-Sectional Study

Akram Hernández-Vásquez Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru;

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Fabriccio J. Visconti-Lopez Universidad Peruana de Ciencias Aplicadas, Lima, Peru;

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Rodrigo Vargas-Fernández Universidad Científica del Sur, Lima, Peru

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ABSTRACT.

The objective of the study was to determine the factors associated with the presence of Escherichia coli contamination in water supplies for human consumption in Peru. A secondary analysis of the Food and Nutrition Surveillance by Life Stages survey (VIANEV) of 2017–2018 was performed. The presence of E. coli contamination in the water samples for human consumption of the households evaluated was defined as a dependent variable. A supply was considered contaminated when there was at least 1 colony-forming unit of E. coli in 100 mL of water for human consumption. Data from 886 participants were analyzed. It was found that 25.2% of household water supply sources for human consumption had E. coli at the time of sampling. Water reservoirs such as buckets or other containers (adjusted prevalence ratio [aPR]: 1.15; 95% confidence interval [CI]: 1.18–1.93), households belonging to a poor wealth quintile (aPR: 1.82; 95% CI: 1.01–3.25), residing in a rural area (aPR: 1.36; 95% CI: 1.01–1.83), and having a low human development index (aPR: 2.12; 95% CI: 1.15–3.91) were more likely to contain E. coli in water supplies for human consumption. However, households with chlorine concentrations of 0.5 mg/L or more in water (aPR: 0.20; 95% CI: 0.11–0.33) and with household members with a higher education (aPR: 0.67; 95% CI: 0.45–0.99) were less likely to contain E. coli in drinking-water supplies. From 2017 to 2018, one in four Peruvians had contamination by E. coli in the water supply to their homes, which was associated with sociodemographic factors, management, and water treatment.

Author Notes

Address correspondence to Akram Hernández-Vásquez, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Av. la Fontana 550, La Molina 15024, Peru. E-mail: ahernandez@usil.edu.pe

Authors’ addresses: Akram Hernández-Vásquez, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru, E-mail: ahernandez@usil.edu.pe. Fabriccio J. Visconti-Lopez, Universidad Peruana de Ciencias Aplicadas, Lima, Peru, E-mail: fabricciovisco@gmail.com. Rodrigo Vargas-Fernández, Universidad Científica del Sur, Lima, Peru, E-mail: jvargasf@cientifica.edu.pe.

  • 1.

    Boelee E , Geerling G , van der Zaan B , Blauw A , Vethaak AD , 2019. Water and health: from environmental pressures to integrated responses. Acta Trop 193: 217226.

  • 2.

    Bhaduri A et al., 2016. Achieving sustainable development goals from a water perspective. Front Environ Sci 4: 64.

  • 3.

    Murray CJL et al., 2020. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 396: 12231249.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    World Health Organization , 2011. Guidelines for drinking-water quality. WHO Chron 38: 104108.

  • 5.

    Ashbolt NJ , 2004. Microbial contamination of drinking water and disease outcomes in developing regions. Toxicology 198: 229238.

  • 6.

    Cabral JPS , 2010. Water microbiology. Bacterial pathogens and water. Int J Environ Res Public Health 7: 36573703.

  • 7.

    Jang J , Hur H-G , Sadowsky MJ , Byappanahalli MN , Yan T , Ishii S , 2017. Environmental Escherichia coli: ecology and public health implications-a review. J Appl Microbiol 123: 570581.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Savageau MA , 1983. Escherichia coli habitats, cell types, and molecular mechanisms of gene control. Am Nat 122: 732744.

  • 9.

    Devane ML , Moriarty E , Weaver L , Cookson A , Gilpin B , 2020. Fecal indicator bacteria from environmental sources; strategies for identification to improve water quality monitoring. Water Res 185: 116204.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Kaper JB , Nataro JP , Mobley HLT , 2004. Pathogenic Escherichia coli. Nat Rev Microbiol 2: 123140.

  • 11.

    Reiner RC et al., 2020. Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17: analysis for the Global Burden of Disease Study 2017. Lancet 395: 17791801.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Bain R et al., 2021. Monitoring drinking water quality in nationally representative household surveys in low- and middle-income countries: cross-sectional analysis of 27 multiple indicator cluster surveys 2014–2020. Environ Health Perspect 129: 097010.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Bain R et al., 2014. Fecal contamination of drinking-water in low- and middle-income countries: a systematic review and meta-analysis. PLoS Med 11: e1001644.

  • 14.

    Jung YT , Hum RJ , Lou W , Cheng Y-L , 2017. Effects of neighbourhood and household sanitation conditions on diarrhea morbidity: systematic review and meta-analysis. PLoS One 12: e0173808.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Delaire C , Peletz R , Kumpel E , Kisiangani J , Bain R , Khush R , 2017. How much will it cost to monitor microbial drinking water quality in sub-Saharan Africa? Environ Sci Technol 51: 58695878.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Thevenon F , Regier N , Benagli C , Tonolla M , Adatte T , Wildi W , Poté J , 2012. Characterization of fecal indicator bacteria in sediments cores from the largest freshwater lake of Western Europe (Lake Geneva, Switzerland). Ecotoxicol Environ Saf 78: 5056.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Cabezas Sánchez C , 2018. Enfermedades infecciosas relacionadas con el agua en el Perú. Rev Peru Med Exp Salud Publica 35: 309.

  • 18.

    Miranda M , Aramburú A , Junco J , Campos M , 2010. State of the quality of drinking water in households in children under five years in Peru, 2007-2010. Rev Peru Med Exp Salud Publica 27: 506511.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Wang A , McMahan L , Rutstein S , Stauber C , Reyes J , Sobsey MD , 2017. Household microbial water quality testing in a Peruvian demographic and health survey: Evaluation of the compartment bag test for Escherichia coli. Am J Trop Med Hyg 96: 970975.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Larson A et al., 2019. Antibiotic-resistant Escherichia coli in drinking water samples from rural Andean households in Cajamarca, Peru. Am J Trop Med Hyg 100: 13631368.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Tarqui Mamani CB , 2016. Calidad bacteriológica del agua para consumo en tres regiones del Perú. Rev Salud Publica (Bogota) 18: 904.

  • 22.

    Heitzinger K , Rocha CA , Quick RE , Montano SM , Tilley DH , Mock CN , Carrasco AJ , Cabrera RM , Hawes SE , 2015. “Improved” but not necessarily safe: An assessment of fecal contamination of household drinking water in rural Peru. Am J Trop Med Hyg 93: 501508.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Sinharoy SS , Pittluck R , Clasen T , 2019. Review of drivers and barriers of water and sanitation policies for urban informal settlements in low-income and middle-income countries. Util Policy 60: 100957.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Centro Nacional de Alimentación y Nutrición , 2021. Estado nutricional en adultos de 18 a 59 años VIANEV 2017–2018. Jesús María, Peru: Instituto Nacional de Salud.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Ministerio del Ambiente , 2016. Estudio de Desempeño Ambiental, 2003–2013. Quito, Equador: Ministerio del Ambiente.

  • 26.

    Vannavong N , Overgaard HJ , Chareonviriyaphap T , Dada N , Rangsin R , Sibounhom A , Stenström TA , Seidu R , 2018. Assessing factors of E. coli contamination of household drinking water in suburban and rural Laos and Thailand. Water Supply 18: 886900.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Getachew A , Tadie A , Chercos DH , Guadu T , 2018. Level of faecal coliform contamination of drinking water sources and its associated risk factors in rural settings of north Gondar Zone, Ethiopia: a cross-sectional community based study. Ethiop J Health Sci 28: 227234.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Gizachew M , Admasie A , Wegi C , Assefa E , 2020. Bacteriological contamination of drinking water supply from protected water sources to point of use and water handling practices among beneficiary households of Boloso Sore Woreda, Wolaita Zone, Ethiopia. Int J Microbiol 2020: 5340202.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    World Health Organization , 2021. Progress on Household Drinking Water, Sanitation and Hygiene 2000–2020: Five Years into the SDGs. Geneva, Switzerland: WHO.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Dada N , Vannavong N , Seidu R , Lenhart A , Stenström TA , Chareonviriyaphap T , Overgaard HJ , 2013. Relationship between Aedes aegypti production and occurrence of Escherichia coli in domestic water storage containers in rural and sub-urban villages in Thailand and Laos. Acta Trop 126: 177185.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Loyola S et al., 2020. Fecal contamination of drinking water was associated with diarrheal pathogen carriage among children younger than 5 years in three Peruvian rural communities. Am J Trop Med Hyg 102: 12791285.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Torres-Slimming PA , Wright C , Carcamo CP , Garcia PJ , Research Team I , Harper SL , 2019. Achieving the sustainable development goals: A mixed methods study of health-related water, sanitation, and hygiene (WASH) for indigenous shawi in the Peruvian Amazon. Int J Environ Res Public Health 16: 2429.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Water and Sanitation Program , 2018. Global Scaling Up Handwashing Project. Available at: https://www.wsp.org/global-initiatives/global-scaling-handwashing-project. Accessed November 15, 2022.

    • PubMed
    • Export Citation
  • 34.

    Ministerio de Salud , 2017. Directiva Sanitaria para la Promocionar el lavado de manos social como práctica saludable en el Perú. Dirección General de Intervenciones Estratégicas en Salud Pública. Lima Peru: Ministerio de Salud.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Ministerio de Vivienda, Construcción y Saneamiento , 2021. Efecto del Programa Nacional de Saneamiento Rural en las prácticas de higiene: revisión sistemática y evaluación cuantitativa. Lima, Peru: Oficina de Evaluación del Impacto.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Hartinger SM , Lanata CF , Hattendorf J , Gil AI , Verastegui H , Ochoa T , Mäusezahl D , 2011. A community randomised controlled trial evaluating a home-based environmental intervention package of improved stoves, solar water disinfection and kitchen sinks in rural Peru: rationale, trial design and baseline findings. Contemp Clin Trials 32: 864873.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Gil AI , Lanata CF , Hartinger SM , Mäusezahl D , Padilla B , Ochoa TJ , Lozada M , Pineda I , Verastegui H , 2014. Fecal contamination of food, water, hands, and kitchen utensils at the household level in rural areas of Peru. J Environ Health 76: 102106.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Cronin AA , Odagiri M , Arsyad B , Nuryetty MT , Amannullah G , Santoso H , Darundiyah K , Nasution N ’Aisyah , 2017. Piloting water quality testing coupled with a national socioeconomic survey in Yogyakarta province, Indonesia, towards tracking of Sustainable Development Goal 6. Int J Hyg Environ Health 220: 11411151.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Thiam S , Diène AN , Fuhrimann S , Winkler MS , Sy I , Ndione JA , Schindler C , Vounatsou P , Utzinger J , Faye O , Cissé G , 2017. Prevalence of diarrhoea and risk factors among children under five years old in Mbour, Senegal: a cross-sectional study. Infect Dis Poverty 6: 109.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Kumi-Kyereme A , Amo-Adjei J , 2015. Household wealth, residential status and the incidence of diarrhoea among children under-five years in Ghana. JEGH 6: 131.

  • 41.

    Hernández-Vasquéz A , Rojas-Roque C , Marques Sales D , Santero M , Bendezu-Quispe G , Barrientos-Gutiérrez T , Miranda JJ , 2021. Inequalities in access to safe drinking water in Peruvian households according to city size: an analysis from 2008 to 2018. Int J Equity Health 20: 133.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Malika NM , Barbagelatta G , Penny M , Reynolds KA , Sinclair R , 2021. Impact of housing and infrastructure on handwashing in Peru. Int Health 13: 615623.

  • 43.

    Mesclier É , Piron M , Gluski P , 2016. Territories and inclusion in the peripheries of Lima (Peru): An exploratory approach based on data about water supply and sewage disposal. L’Espace Géographique Tome 44: 273288.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Ministerio de Vivienda, Construcción y Saneamiento , 2022. Programa Agua Segura para Lima y Callao. Memoria Anual 2021. Lima. Peru: Ministerio de Vivienda.

  • 45.

    Andualem Z , Dagne H , Azene ZN , Taddese AA , Dagnew B , Fisseha R , Muluneh AG , Yeshaw Y , 2021. Households access to improved drinking water sources and toilet facilities in Ethiopia: a multilevel analysis based on 2016 Ethiopian Demographic and Health Survey. BMJ Open 11: e042071.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Adzawla W , Alhassan H , Jongare AI , 2020. Explaining the effects of socioeconomic and housing characteristics on the choice of toilet facilities among Ghanaian households. J Environ Public Health 2020: 4036045.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 47.

    Ko SH , Sakai H , 2022. Water sanitation, hygiene and the prevalence of diarrhea in the rural areas of the delta region of Myanmar. J Water Health 20: 149156.

  • 48.

    Ministerio de Vivienda, Construcción y Saneamiento , 2018. DATASS: Modelo para la toma de decisiones en Saneamiento Sistema de Diagnóstico sobre Abastecimiento de Agua y Saneamiento en el Ámbito Rural. Autoridad Nacional del Agua. Lima, Peru: Ministerio de Vivienda.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 49.

    Hunter PR , MacDonald AM , Carter RC , 2010. Water supply and health. PLOS Medicine 7: e1000361.

  • 50.

    Quispe-Coica A , Fernández S , Acharte Lume L , Pérez-Foguet A , 2020. Status of water quality for human consumption in high-Andean rural communities: Discrepancies between techniques for identifying trace metals. J 3: 162180.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 51.

    Ministerio de Agricultura y Riego , 2015. Plan Nacional de Recursos Hídricos. Autoridad Nacional del Agua. Lince, Peru: Ministerio de Agricultura y Riego.

  • 52.

    Motschmann A , Huggel C , Muñoz R , Thür A , 2020. Towards integrated assessments of water risks in deglaciating mountain areas: water scarcity and GLOF risk in the Peruvian Andes. Geoenvironmental Disasters 7: 26.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 53.

    Lozano-Povis A , Alvarez-Montalván CE , Moggiano N , 2021. Climate change in the Andes and its impact on agriculture: a systematic review. Sci agropecu 12: 101108.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 54.

    Gupta SK , Keck J , Ram PK , Crump JA , Miller MA , Mintz ED , 2008. Part III. Analysis of data gaps pertaining to enterotoxigenic Escherichia coli infections in low and medium human development index countries, 1984–2005. Epidemiol Infect 136: 721738.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 55.

    Morris J , 2019. Developing and exploring indicators of water sustainable development. Heliyon 5: e01778.

  • 56.

    Kirschke S et al., 2020. Capacity challenges in water quality monitoring: understanding the role of human development. Environ Monit Assess 192: 298.

  • 57.

    Valenzuela-Morales GY , Hernández-Téllez M , Ruiz-Gómez M de L , Gómez-Albores MA , Arévalo-Mejía R , Mastachi-Loza CA , 2022. Water conservation education in elementary schools: the case of the Nenetzingo River Catchment, Mexico. Sustainability 14: 2402.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 58.

    Dupree DE , Price RE , Burgess BA , Andress EL , Breidt F , 2019. Effects of sodium chloride or calcium chloride concentration on the growth and survival of Escherichia coli O157:H7 in model fegetable fermentations. J Food Prot 82: 570578.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 59.

    Arnold BF , Colford JM , 2007. Treating water with chlorine at point-of-use to improve water quality and reduce child diarrhea in developing countries: a systematic review and meta-analysis. Am J Trop Med Hyg 76: 354364.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 60.

    GIZ and UNICEF , 2016. Scaling Up Group Handwashing in Schools. Compendium of Group Washing Facilities across the Globe. New York, NY: UNICEF; Eschborn, Germany, Deutsche Gesellschaft für Zusammenarbeit.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 61.

    Galiani S , Gertler P , Ajzenman N , Orsola-Vidal A , 2016. Promoting handwashing behavior: The rffects of large-scale community and school-level interventions: Hygiene, handwashing, behavior change, randomized evaluation. Health Econ 25: 15451559.

    • PubMed
    • Search Google Scholar
    • Export Citation
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