Date of Award

11-13-2009

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Christine Stauber - Committee Chair

Second Advisor

George Pierce - Committee Member

Abstract

INTRODUCTION: More than 2.2 million people die each year from diarrheal disease. Most cases of diarrheal disease can be linked with a lack of access to clean water and sanitation. The proper usage of sanitation, hygiene and safe drinking water are all mechanisms by which to prevent or limit fecal contamination, and in turn, reduce the risk of diarrheal disease. As a result, it is imperative to examine and understand risk factors for fecal contamination of drinking water in the home. One way to assess fecal contamination is to use indicator bacteria such as E. coli. These bacteria can be easily measured and have been weakly associated with increased risk of gastrointestinal illness. PURPOSE: The purpose of this study was to determine if characteristics of household drinking water storage containers impacted the concentration of total coliforms and E. coli in the stored household drinking water in rural Dominican Republic communities. METHODS: The data were collected through a cross-sectional survey and from a four month prospective cohort study in rural communities in the Dominican Republic during 2005. Data analysis was conducted using STATA 10. Descriptive statistics were calculated and reported as percentages. Bivariate statistics were carried out to test independent associations between container characteristics and E. coli. In addition, t-tests were used to examine differences in concentrations of E. coli and total coliforms as well as other household and water characteristics that may play an important role in household drinking water management and practice and contamination. RESULTS: After testing independent potential risk factors for E. coli contamination, it was determined that household storage practices have a significant impact on drinking water quality. More specifically, households that stored drinking water in containers with narrow openings (typically < 2 inches in diameter) had lower concentrations of E. coli. The water was more likely to remain protected from additional contamination once stored in the home. DISCUSSION: The association with household storage practices with E. coli contamination reveals the importance of point of drinking water management in the home. Specifically, we documented simple storage practices (commonly practiced in homes in the Dominican Republic) that can protect or reduce drinking water from contamination once in the home. While previous literature has been unable to identify a single most important risk factor of E. coli contamination in drinking water, findings from this study and previous studies indicate that more research is needed to further elucidate the role of household drinking water storage techniques in protecting household members and reducing risk of disease.

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