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Volume 13 No. 5

December 2013



Addo HO1*, Addo KK2 and B Langbong3

Addo Henry Ofosu

*Corresponding author email: henzorder@yahoo.com


Faculty of Public Health and Allied Sciences, Catholic University College of Ghana,



Bacteriology Department, Noguchi Memorial Institute for Medical Research, Legon 3 Department of Animal Biology and Conservation Sciences, University of Ghana.

8258 Volume 13 No. 5 December 2013


Water constitutes about 70% of the earth’s total mass and all life is dependent on water. Inadequate sanitation is a major cause of disease worldwide and improving sanitation is known to have a significant beneficial impact on health both in households and across communities. Water and sanitation are closely related and cannot be isolated. If uncontaminated water is available, reliable and convenient to collect, more water is consumed, both for hygienic purposes and for drinking which can improve health. In this study, the effect of sanitation on the bacteriological quality of water was evaluated. The study also assessed the sanitation facilities available in the three communities, the water facilities used and the bacterial contamination of household water. A cluster survey system was employed in three communities namely Tetegu, Mayera and Ashongman village in the Greater Accra Region of Ghana. Thirty households were clustered within each community. Within each household in each community, domestic water stored was analyzed for bacterial contamination using UriSelect 4 medium. This was used because it allows the isolation and counting of all organisms using a standard bacteriological loop plating method. Standardized questionnaires were administered in each household to ascertain the type of water and sanitation infrastructure. Seventy-seven percent and 87% of respondents relied on public standpipes in the Ashongman and Tetegu communities, respectively. Eighty- three percent of respondents in Mayera relied on the Nsaki river. Eighty percent of respondents used the KVIP at Mayera, 97% of respondents at Tetegu resorted to open defecation, and 57% of respondents also used the pit latrine at Ashongman community. A total of ten bacterial species namely: Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterococcus faecalis, Proteus mirabilis, Streptococcus agalactiae. Enterobacter cloacae, Staphylococcus saprophytic, Candida albicans and Staphylococcus aureus were identified in domestic water stored. This study therefore recommendsthat policy makers must ensure the provision of basic infrastructure such as toilet facilities to reduce the likely contamination of water sources from poor sanitation facilities.

Key words: Sanitation, Coliform, Households, Water Quality

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Water constitutes about 70% of the earth’s total mass and all life is dependent on water. The average adult consumes and excretes 10 cups of water daily. Adults should drink six to eight cups of water per day [1]. Water not only plays vital roles in the maintenance of the body’s homeostasis but also serves as a very essential component of life, but water can be injurious if its source is not free from contaminations and impurities.

Along with differences in mineral composition, water contains different levels of microorganisms. Bacteriological tests are available to determine if water is bacteriologically safe for human consumption. Contaminated water plays an important role in the transmission of endopathogens, and there are usually strong desires at many levels of society for the provision of readily available, potable water [2].

Sanitation means different things to different people, but it generally refers to the provision of facilities and services for the safe disposal of human urine and faeces [3]. Inadequate sanitation is a major cause of disease worldwide and improving sanitation is known to have a significant beneficial impact on health. Improved sanitation involves access to sanitation facilities which allow for safe disposal of excreta. It is defined with respect to connection to a sewer or septic tank system, pourflush latrine, simple pit or ventilated improved pit latrine [4]. The excreta disposal system is considered adequate if it is private or shared (but not public), and if excreta are hygienically separated from human contact [5]. Consequently, improved sanitation interventions in developing countries do not necessarily include treatment or re-use of waste water, and sewage either stays in the location or is discharged to the wider environment [6]. In fact, it is estimated that less than 10% of all sewage is treated worldwide before it is discharged into the receiving environment [7].

Sanitation is described as having access to facilities for the safe disposal of human waste (faeces and urine), as well as having the ability to maintain hygienic conditions, through services such as garbage collection, industrial/hazardous waste management, and wastewater treatment and disposal (http://who.int/topics/sanitation/en). Many developing countries cannot provide adequate sanitation for their populations, leaving many people at risk for diseases caused by unsafe drinking water and unsanitary living conditions. Throughout the world, there are 2.6 billion people living without basic sanitation, almost 40% of the world's population (http://esa.un.org/iys/health.shtml; www.census.gov/ipc). Inadequate waste disposal facilities can further drive the infection cycle of many agents that can be transmitted through contaminated soil, food, and water, such as soil-transmitted helminths, also called intestinal worms. Without proper sanitation facilities, waste from individuals infected with soil-transmitted helminths can contaminate a community's land and water, increasing the risk of infection for others. Proper waste disposal can slow the infection cycle of many disease-causing agents. Furthermore, sanitation facilities

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should include soap, water, and a sink or an area for hand washing, to reduce the risk of disease transmission from contaminated hands.

In the less developed countries of the world, 80% of all ailments are attributed to inadequate supplies of water and sanitation facilities. This includes the effects of drinking contaminated water or water acting as a breeding ground for vectors of diseases [8].

In developing countries, it is not only water contaminated at source or during distribution that is an issue, but water stored within the home which may also become contaminated. For example, VanDerslice and Briscoe found 11 observational studies showing that mean coliform levels (an indicator of contamination) were considerably higher in household water containers than in the original source waters. In an experiment to determine whether faecal contamination of drinking water after collection was associated with household water handling and hygienic practices, Eschol et al., observed that 92% of water samples tested at water supply points were adequately chlorinated, and bacterial contamination was found in two samples with no residual chlorine.

The study objectives were to find out the sanitation facilities available for use in the selected study areas, the water infrastructure used and the presence of bacteria in household source of water.


Study Area A cluster survey system was employed in three communities in the Greater Accra Region: Ashongman village (Ga East Municipality), Tetegu (Ga South Municipality) and Mayera (Ga West Municipality).

Ashongman village (5° 44’ 17’’ N 0° 11’ 42° W) is a community in the Ga East Municipality and covers a land area of about 166 sq km (Figure 1). It is boarded on the west by the Ga West Municipality, on the east by the Tema Municipality, the South by Accra Metropolitan Area (AMA) and the North by the Akwapim South District in the Eastern Region. The population is concentrated mainly along the urban and the peri-urban areas of the municipality. The urban/peri-urban population constitutes about 73% with the remaining 27% residing in the rural portion towards the Akwapim hills. Ashongman village falls in the Savannah agro-ecological zone.

Rainfall pattern is bi-modal with average annual temperature ranging between 25.1°C in August and 28.4°C in February and March.

Mayera (5° 029’ -5° 048’N 0° 008’ -0° 030’W) is a community in the Ga West Municipality (Figure 1). The Municipality occupies a land area of approximately

710.2 sq km. The community lies wholly in the Coastal Savanna Agro-ecological Zone. The Mayera community has a major river called the Nsaki River which serves

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as a major source of water for most households in this community. There are about seventy households with an average of six persons per household.

Tetegu is also a community of the Ga South municipality (Figure 1). This is a newly created municipality which was part of Ga West municipality. Most of the inhabitants are farmers and fishermen.

Figure 1: Map showing the study area Sampling Each selected community formed a cluster with 30 households, making 90 households from the three clusters. A household referred to individuals who occupy the same living space and normally share food and amenities. The households in each cluster were selected by a systematic sampling technique. The households were arranged serially and selection was based on a random number. Random procedure was then used to select the starting number. The researcher then picked every third household until the thirtieth household was reached.

Data collection and analysis Standardized questionnaires were administered to the participating households for the collection of demographic information such as age, sex, type of water and toilet facilities used and the number of individuals in each household. Knowledge, attitude and practices concerning diarrhoeal diseases and soil-transmitted helminthic infections were also assessed. Analysis of questionnaires was done using Statistical Package for Social Scientists (SPSS) version 16. The domestic water stored at home in each household in all the three clusters was assessed for faecal contamination as well as other water quality measurements.

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Water Quality Analysis Water was collected from the various households in the three clusters and transported to the Bacteriology Department of the Noguchi Memorial Institute for Medical Research for bacteriological analysis of the water.

Bacteriological Analysis Testing water for the presence of bacteria Only qualitative analysis was done. The UriSelect 4 medium (Bio-Rad Laboratories) was used in the analysis of bacteria, because it allows the isolation and counting of all urinary tract organisms using a standard bacteriological loop plating method. It also allows for direct identification via demonstration of enzyme activities of the bacteria most often responsible for urinary tract infections, namely Escherichia coli, Proteus and enterococci.

The UriSelect 4 is a non-selective agar medium composed of:

 a rich nutrient base containing four peptones, which sustain growth of all urinary tract pathogens,  two chromogenic substrates for detection of the bacterial enzymes β galactosidase and β glucosidase,  tryptophan for detection of tryptophanase activity (indole production) and of tryptophan deaminase activity.

Preparation of the Medium An amount of 56.8 g of the powder was weighed and suspended in one litre of distilled water, then stirred continuously for about 10 minutes until a homogenous suspension was obtained. It was then put in a water bath, and stirred frequently, until optimal dissolution of the agar. The medium was sterilized by autoclaving at 120°C for 15 minutes, and poured into the plates and incubated overnight at 37°C according to the Manufacturer’s guide.

Plating of Medium with Water Samples The water samples were vortexed to produce an even mixture and sterilized inoculating tube was used to pick up the water sample. The water samples were then inoculated onto the medium by the streaking method. It was then incubated at 37°C for 18 to 24 hours.

Identification of the Various Bacterial Species After incubation for 18 to 24 hours at 37°C, the various bacteria present in the water

samples were identified as follows:

 a pink colony formed represented the presence of Escherichia coli;

 orange-brown colonies represented Proteus mirabilis;

 Enterococcus faecalis were identified as turquoise blue colonies;

 blue-purple colonies represented Klebsiella pneumoniae;

 white colonies were identified as Staphylococcus aureus.

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the rest are Enterobacter cloacae (deep blue colonies), Streptococcus  agalactiae (whitish brown colonies), Candida albicans (cream colonies) and Staphylococcus saprophyticus (deep brown colonies).

RESULTS At the Mayera community, the sources of water for domestic use were borehole and a river. Out of 30 households sampled, 25 (83%) used the river as their water source.

Fourteen (46%) out of the 25 households used the river because it was closer to them.

Eight households (26%) stated that the river was far away while 3 households (10%) stated that the river was very close to them.

Four out of the 30 households (13%) sampled used both the borehole and the river.

Two households stated that both the river and the borehole were closer to them whereas one respondent each stated that both facilities were very close and very far from them. Only one out of the 30 households sampled (3%) used only the borehole since it was closer to them (Table 1).

At the Tetegu community, the sources of water were public stand-pipe, river and dug well. Out of the 30 households sampled, 26 (86%) used the public stand-pipe.

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