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• W2803535123 abstract "According to the United Nations (2015), more than 40% of the world’s populationalready face water scarcity. Although past reports estimate that 91% of the globalpopulation have access to some form of improved drinking water source, this doesnot necessarily guarantee the consumption of ‘safe’ drinking water. Furthermore,huge disparities still exist in sanitation and water supply services between urban andrural areas, and rural populations demonstrate higher levels of human excreta-bornediseases.The research described in this thesis aimed to develop an evidence-based tieredapproach to risk assessment that can be used to support the development of watersafety plan to protect the health of rural communities in semi-arid regions. Informationon current provision of sanitation and water supplies, as well as local perceptions withregard to drinking water supply issues and hygiene practice were recorded throughthe use of community surveys, sanitary inspections and field observations.Furthermore, a microbial monitoring programme was undertaken to measure levelsof faecal contamination through the water supply chain. Finally, quantitative microbialrisk assessment (QMRA) was developed and used to predict the risk of infectionposed by locally relevant pathogens through the hand-to-mouth and drinking waterroutes, considering all alternative water sources identified and hypotheticalinterventions in water, sanitation and hygiene (WASH).Relatively high levels of E. coli and intestinal enterococci were observed in mostwater storage reservoirs (22 CFU/100 mL and 103 CFU/100 mL, respectively) andin-house storage containers (3 CFU/100 mL and 54 CFU/100 mL, respectively),which appears to be strongly related to a significant lack of awareness and knowledgeregarding the relationship between domestic water-related activities and domesticand personal hygiene among local householders. Moreover, stakeholders involved inthe water supply, as well as health adviser professionals working at the communities,demonstrated a limited understanding of water-related hygiene issues. The QMRAoutcomes indicated that the rural communities in the ‘Sertao’ of Brazil are likely to beat a high risk of infection from waterborne pathogens, including Salmonella spp. (3.97x 10-2), Giardia lamblia (6.24 x 10-2) and norovirus (one) via both the drinking waterin relation to the maximum level of risk (10-4) suggested by the US-EPA guidelines.The hand-to-mouth route also resulted in high levels of risk for Salmonella spp. (1.12x 10-2), Giardia lamblia (3.65 x 10-2) and norovirus (8.00 x 10-1).The tiered approach to risk assessment developed in this research helped to identifyand elucidate microbial transmission pathways and supported the development oflocally-appropriate safety plans to reduce the incidence of excreta-borne diseases. Itwas concluded that a significant reduction in the burden of human infectious diseasescould be achieved through a combination of simple interventions (e.g., chlorinationand filtration of water, training on water handling and storage and hand hygiene).Furthermore, domestic ‘WASH safety plans’ appear to offer greater potential thanwater safety plans as a way to minimise the transmission of infectious diseases withinthe household environment of these communities. Finally, practicalrecommendations to support the reduction of excreta-borne disease in the rural‘Sertao’ of Brazil, such as raising awareness and understanding on potential crosscontaminationroutes within the domestic environment, are provided." @default.
• W2803535123 created "2018-06-01" @default.
• W2803535123 creator A5051409480 @default.
• W2803535123 date "2017-12-01" @default.
• W2803535123 modified "2023-09-23" @default.
• W2803535123 title "Risk-based tools to prevent excreta-bornedisease transmission in semi-arid ruralcommunities" @default.
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