title: Water Quality, Sanitation, and Hygiene Conditions in Schools and Households in Dolakha and Ramechhap Districts, Nepal: Results from A Cross-Sectional Survey.
abstract: This study assessed drinking water quality, sanitation, and hygiene (WASH) conditions among 708 schoolchildren and 562 households in Dolakha and Ramechhap districts of Nepal. Cross-sectional surveys were carried out in March and June 2015. A Delagua water quality testing kit was employed on 634 water samples obtained from 16 purposively selected schools, 40 community water sources, and 562 households to examine water quality. A flame atomic absorption spectrophotometer was used to test lead and arsenic content of the same samples. Additionally, a questionnaire survey was conducted to obtain WASH predictors. A total of 75% of school drinking water source samples and 76.9% point-of-use samples (water bottles) at schools, 39.5% water source samples in the community, and 27.4% point-of-use samples at household levels were contaminated with thermo-tolerant coliforms. The values of water samples for pH (6.8-7.6), free and total residual chlorine (0.1-0.5 mg/L), mean lead concentration (0.01 mg/L), and mean arsenic concentration (0.05 mg/L) were within national drinking water quality standards. The presence of domestic animals roaming inside schoolchildren's homes was significantly associated with drinking water contamination (adjusted odds ratio: 1.64; 95% confidence interval: 1.08-2.50;p= 0.02). Our findings call for an improvement of WASH conditions at the unit of school, households, and communities.
authors.affiliation: Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, P.O. Box, CH-4002 Basel, Switzerland. akina.shrestha@unibas.ch.|University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland. akina.shrestha@unibas.ch.|School of Medical Sciences, Kathmandu University, P.O. Box 11008, Dhulikhel, Nepal. akina.shrestha@unibas.ch.
authors.forename: Akina
authors.initials: A
authors.lastname: Shrestha
authors.affiliation: Aquatic Ecology Centre, School of Science, Kathmandu University, P.O. Box 6250, Dhulikhel, Nepal. subodh.sharma@ku.edu.np.
authors.forename: Subodh
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, P.O. Box, CH-4002 Basel, Switzerland. jana.gerold@unibas.ch.|University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland. jana.gerold@unibas.ch.
authors.forename: Jana
authors.initials: J
authors.lastname: Gerold
authors.affiliation: Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, P.O. Box, CH-4002 Basel, Switzerland. severine.erismann@unibas.ch.|University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland. severine.erismann@unibas.ch.
authors.forename: Séverine
authors.initials: S
authors.lastname: Erismann
authors.affiliation: Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, P.O. Box, CH-4002 Basel, Switzerland. sanjay.sagar@unibas.ch.|University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland. sanjay.sagar@unibas.ch.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sagar
authors.affiliation: School of Medical Sciences, Kathmandu University, P.O. Box 11008, Dhulikhel, Nepal. rajendrakoju@gmail.com.
authors.forename: Rajendra
authors.initials: R
authors.lastname: Koju
authors.affiliation: Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, P.O. Box, CH-4002 Basel, Switzerland. christian.schindler@unibas.ch.|University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland. christian.schindler@unibas.ch.
authors.forename: Christian
authors.initials: C
authors.lastname: Schindler
authors.affiliation: Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, P.O. Box, CH-4002 Basel, Switzerland. peter.odermatt@unibas.ch.|University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland. peter.odermatt@unibas.ch.
authors.forename: Peter
authors.initials: P
authors.lastname: Odermatt
authors.affiliation: Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, P.O. Box, CH-4002 Basel, Switzerland. juerg.utzinger@unibas.ch.|University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland. juerg.utzinger@unibas.ch.
authors.forename: Jürg
authors.initials: J
authors.lastname: Utzinger
authors.affiliation: Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, P.O. Box, CH-4002 Basel, Switzerland. gueladio.cisse@unibas.ch.|University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland. gueladio.cisse@unibas.ch.
authors.forename: Guéladio
authors.initials: G
authors.lastname: Cissé
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D060766:Drinking Water / Q000737:chemistry*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D006920:Hygiene; D008297:Male; D009390:Nepal; D016017:Odds Ratio; D012499:Sanitation / Q000706:statistics & numerical data*; D012574:Schools / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D060753:Water Quality; D014881:Water Supply / Q000706:statistics & numerical data*
chemical_list: D060766:Drinking Water
keywords: Nepal; cross-sectional survey; drinking water quality; hygiene; sanitation; schoolchildren