title: Fecal contamination of drinking water in Kericho District, Western Kenya: role of source and household water handling and hygiene practices.
abstract: Inadequate protection of water sources, and poor household hygienic and handling practices have exacerbated fecal water contamination in Kenya. This study evaluated the rate and correlates of thermotolerant coliform (TTC) household water contamination in Kericho District, Western Kenya. Culture and multiplex polymerase chain reaction (PCR) techniques were used to characterize TTCs. The disk diffusion method was used for antibiotic susceptibility profiling of pathogenic Escherichia coli. Out of the 103 households surveyed, 48 (46.6%) had TTC contaminated drinking water (TTC levels of >10 cfu/100 mL). Five of these households were contaminated with pathogenic E. coli, including 40% enteroaggregative E. coli, 40% enterotoxigenic E. coli, and 20% enteropathogenic E. coli. All these pathogenic E. coli strains were multidrug resistant to sulfamethoxazole/trimethoprim, ampicillin, tetracycline and ampicillin/sulbactam. Rural household locality, drinking water hand contact, water storage container cleaning practice, hand washing before water withdrawal, water source total coliforms <10 cfu/100 mL, temperature, and free chlorine levels were associated with TTC contamination of household drinking water. Significant proportions of household drinking water in Kericho District are contaminated with TTCs including with pathogenic multidrug-resistant E. coli. Source and household hygiene and practices contribute significantly to drinking water contamination.
authors.affiliation: Field Epidemiology Laboratory Training Programme, Ministry of Health, PO Box 225-00202, Nairobi, Kenya; Institute of Tropical Medicine and Infectious Diseases, Jomo Kenyatta University of Agriculture and Technology, PO Box 62000-00200, Nairobi, Kenya.
authors.forename: Johana Kiplagat
authors.initials: JK
authors.lastname: Too
authors.affiliation: Centre of Microbiology and Research, Kenya Medical Research Institute, PO Box 19464-00202, Nairobi, Kenya E-mail: mngayo@kemri.org.
authors.forename: Willy
authors.initials: W
authors.lastname: Kipkemboi Sang
authors.affiliation: Institute of Tropical Medicine and Infectious Diseases, Jomo Kenyatta University of Agriculture and Technology, PO Box 62000-00200, Nairobi, Kenya.
authors.forename: Zipporah
authors.initials: Z
authors.lastname: Ng'ang'a
authors.affiliation: Centre of Microbiology and Research, Kenya Medical Research Institute, PO Box 19464-00202, Nairobi, Kenya E-mail: mngayo@kemri.org.
authors.forename: Musa Otieno
authors.initials: MO
authors.lastname: Ngayo
mesh_terms: D060766:Drinking Water / Q000382:microbiology*; D004926:Escherichia coli / Q000145:classification / Q000302:isolation & purification / Q000502:physiology*; D005243:Feces / Q000382:microbiology*; D006801:Humans; D006920:Hygiene; D007630:Kenya; D012424:Rural Population; D014876:Water Pollution / Q000032:analysis*; D014881:Water Supply
chemical_list: D060766:Drinking Water