title: Quality of piped and stored water in households with children under five years of age enrolled in the Mali site of the Global Enteric Multi-Center Study (GEMS).
abstract: Water, sanitation, and hygiene information was collected during a matched case-control study of moderate and severe diarrhea (MSD) among 4,096 children < 5 years of age in Bamako, Mali. Primary use of piped water (conditional odds ratio [cOR] = 0.45; 0.34-0.62), continuous water access (cOR = 0.30; 0.20-0.43), fetching water daily (cOR = 0.77; 0.63-0.96), and breastfeeding (cOR = 0.65; 0.49-0.88) significantly reduced the likelihood of MSD. Fetching water in > 30 minutes (cOR = 2.56; 1.55-4.23) was associated with MSD. Piped tap water and courier-delivered water contained high (> 2 mg/L) concentrations of free residual chlorine and no detectable Escherichia coli. However, many households stored water overnight, resulting in inadequate free residual chlorine (< 0.2 mg/L) for preventing microbial contamination. Coliforms and E. coli were detected in 48% and 8% of stored household water samples, respectively. Although most of Bamako's population enjoys access to an improved water source, water quality is often compromised during household storage.
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Baker
authors.forename: Samba O
authors.initials: SO
authors.lastname: Sow
authors.forename: Karen L
authors.initials: KL
authors.lastname: Kotloff
authors.forename: James P
authors.initials: JP
authors.lastname: Nataro
authors.forename: Tamer H
authors.initials: TH
authors.lastname: Farag
authors.forename: Boubou
authors.initials: B
authors.lastname: Tamboura
authors.forename: Mama
authors.initials: M
authors.lastname: Doumbia
authors.forename: Doh
authors.initials: D
authors.lastname: Sanogo
authors.forename: Drissa
authors.initials: D
authors.lastname: Diarra
authors.forename: Ciara E
authors.initials: CE
authors.lastname: O'Reilly
authors.forename: Eric
authors.initials: E
authors.lastname: Mintz
authors.forename: Sandra
authors.initials: S
authors.lastname: Panchalingam
authors.forename: Yukun
authors.initials: Y
authors.lastname: Wu
authors.forename: William C
authors.initials: WC
authors.lastname: Blackwelder
authors.forename: Myron M
authors.initials: MM
authors.lastname: Levine
mesh_terms: D016022:Case-Control Studies; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D004755:Enterobacteriaceae / Q000302:isolation & purification; D005191:Family Characteristics; D006801:Humans; D007223:Infant; D008302:Mali / Q000453:epidemiology; D016017:Odds Ratio; D012307:Risk Factors; D014871:Water Microbiology / Q000592:standards; D014881:Water Supply / Q000592:standards*