title: Community and household determinants of water quality in coastal Ghana.
abstract: Associations between water sources, socio-demographic characteristics and household drinking water quality are described in a representative sample of six coastal districts of Ghana's Central Region. Thirty-six enumeration areas (EAs) were randomly chosen from a representative survey of 90 EAs in rural, semi-urban and urban residence strata. In each EA, 24 households were randomly chosen for water quality sampling and socio-demographic interview. Escherichia coli per 100 ml H2O was quantified using the IDEXX Colilert system and multi-stage regression models estimated cross-sectional associations between water sources, sanitation and socio-demographic factors. Almost three quarters, 74%, of the households have > 2 E. coli /100 ml H2O. Tap water has significantly lower E. coli levels compared with surface or rainwater and well water had the highest levels. Households with a water closet toilet have significantly lower E. coli compared with those using pit latrines or no toilets. Household size is positively associated, and a possessions index is negatively associated, with E. coli. Variations in community and household socio-demographic and behavioural factors are key determinants of drinking water quality. These factors should be included in planning health education associated with investments in water systems.
authors.affiliation: International Health Institute, Brown University, Box G-3121, 121 South Main Street, Room 220, Providence, BI 02912, USA. Stephen_McGarvey@brown.edu
authors.forename: Stephen T
authors.initials: ST
authors.lastname: McGarvey
authors.forename: Justin
authors.initials: J
authors.lastname: Buszin
authors.forename: Holly
authors.initials: H
authors.lastname: Reed
authors.forename: David C
authors.initials: DC
authors.lastname: Smith
authors.forename: Zarah
authors.initials: Z
authors.lastname: Rahman
authors.forename: Catherine
authors.initials: C
authors.lastname: Andrzejewski
authors.forename: Kofi
authors.initials: K
authors.lastname: Awusabo-Asare
authors.forename: Michael J
authors.initials: MJ
authors.lastname: White
mesh_terms: D004926:Escherichia coli / Q000302:isolation & purification; D005191:Family Characteristics; D005618:Fresh Water / Q000032:analysis* / Q000382:microbiology; D005869:Ghana; D006801:Humans; D007407:Interviews as Topic; D015233:Models, Statistical; D012111:Residence Characteristics; D012499:Sanitation; D012923:Social Class; D014871:Water Microbiology