Abstract

Regular monitoring of microbial quality of water used for drinking is an important aspect of public health. Microbiological quality, using a novel microbial water quality test kit – Compartment Bag Test (CBT; AguaGenX, LLC, Chapel Hill, NC, USA), and physical parameters (pH, dissolved oxygen, turbidity, temperature and electrical conductivity) of 94 different water sources used by communities in the Ahenema Kokoben area of Ghana for drinking were tested. Using the WHO drinking water quality risk categories for the presence of Escherichia coli indicator bacteria, only 56% (53/94) of the water sources were safe for drinking, while 29% (27/94) of the water sources were classified as high risk and unsafe for human purposes. Some of the physical parameters were also higher than guideline values and could have been a contributing factor to poor water quality. Overall, the CBT proved to be a reliable alternative to traditional and laboratory-dependent microbial drinking water quality tests which can be easily used by water authorities to make sure that water is safe to drink.

INTRODUCTION

The provision of safe and accessible drinking water is an effective pathway to health promotion and poverty reduction. Globally, approximately 844 million people still lacked the basic drinking water services (an improved source within 30 minutes' round trip) at the end of 2015 (WHO/UNICEF 2017). In sub-Saharan Africa, 319 million people (the highest in the world) are without access to improved water sources (WHO 2015) even though the Millenium Development Goal (MDG) target on drinking water was met in 2010 (WHO/UNICEF 2014). It is also acknowledged in the water sector that even improved water sources do not reliably predict microbial safety of water (McMahan et al. 2011; Bain et al. 2014; Shaheed et al. 2014), but are rather ‘technologies with a high level of probability to deliver safe and clean drinking-water’ (WHO 2012). The Sustainable Development Goals (SDGs), especially target 6.1, therefore, hope to achieve universal and equitable access to safe and affordable drinking water for all by 2030. The assessment of microbial quality of drinking water is the next big step in the quest to meet this target (Bain et al. 2012).

Major microbial threats are related to the consumption of water that is contaminated with faeces from either humans or animals (Dufour et al. 2012). Although long-term solutions will require improvement in water quality and sanitation infrastructures, a great deal can be achieved through more frequent and widespread water quality testing (WHO 2012; Launch 2017). There are, however, significant challenges in implementing efficient microbial water quality tests that are appropriate for low-resource settings such as rural and peri-urban Ghana (Bain et al. 2012; WHO 2012). Several portable test kits have been developed for microbial water quality analysis and include Enterolert®, Colisure®, Colilert®, m-ColiBlue®, ColiComplete® and PathoScreen. However, these kits are expensive, cannot quantify indicator bacteria, are time-consuming, or require a skilled technician or laboratory setting (Bain et al. 2012; Gronewold et al. 2017). The Compartment Bag Test (CBT) overcomes such shortfalls in microbial water quality testing (Stauber et al. 2014). The CBT quantifies Escherichia coli (E. coli) levels in a 100 mL sample – as recommended by WHO (WHO 2008) – using a chromogenic medium. It does not require electricity and provides built-in decontamination. It is affordable, portable and self-contained, and does not require a laboratory or specialist training. It allows for incubation at ambient temperatures (25–44.5 °C) (Stauber et al. 2014). The CBT is designed to be used completely on-site, eliminating the costs and associated delays for refrigeration, sample transportation, and laboratory sample analysis and processing. The CBT has been compared with laboratory membrane filtration (McMahan et al. 2011; Stauber et al. 2014) and a highly rated portable test such as Colisure/Colilert Quantity tray method (Knee et al. 2012) where it gave comparable results (statistically insignificant difference). The CBT has so far proved to give comparable results around the world including Ghana (McMahan et al. 2011; Weiss et al. 2013; Stauber et al. 2014; Heitzinger et al. 2015; Murcott et al. 2015), and the statistical basis for its design as well as the recommended interpretation of its results has been formally documented (Gronewold et al. 2017).

Ahenema Kokoben in Ghana is a low-resource/peri-urban setting where the microbial quality of drinking water is not monitored by the central government or its representation at the district level. The first and only attempt so far by the Government of Ghana at microbial water quality monitoring is through the Ghana Living Standards Survey (Ghana Statistical Service 2014b). There is no continuous or regular monitoring in Ghana to evaluate the safety of water sources for human consumption. The objective of this study was therefore to use a fast and affordable water quality test such as the CBT test to assess water sources in Ghana which could be an answer to regular water quality monitoring.

MATERIALS AND METHODS

Study area

Ahenema Kokoben (Figure 1) is a peri-urban community in the Atwima-Kwanwoma District of the Ashanti Region (Figure 2) of Ghana (Ghana Statistical Service 2014a; Ministry of Finance 2014) and home to approximately 7,166 inhabitants (Ghana Statistical Service 2012). It is ranked 202/216 in the district league table of poverty incidence in Ghana with a poverty incidence of 4.9 (Ghana Statistical Service 2015). It is popularly known as ‘The Island City’ because it is surrounded by two rivers: Akebosu to the north and Aboabo to the south. The district is located at the latitude of 6°24″ N and 6°43″ N and the longitude of 1°15″ W and 1°46″ W (Ghana Statistical Service 2014a; Ministry of Finance 2014). About 45% of the total drinking water in Ghana is produced from groundwater and most of the small towns, such as Ahenema Kokoben, depend on wells for their drinking water supply (Buamah et al. 2008).

Figure 1

Map of Atwima-Kwanwoma District (Ghana Statistical Service 2014a).

Figure 1

Map of Atwima-Kwanwoma District (Ghana Statistical Service 2014a).

Figure 2

District map of Ashanti Region, Ghana (Ghana Statistical Service 2015).

Figure 2

District map of Ashanti Region, Ghana (Ghana Statistical Service 2015).

Sample sources

Inventory of drinking water source points in the Ahenema Kokoben community yielded a total of 123 drinking water sources. Stratified randomisation, based on water source type (yard tap, communal tap, hand dug well, borehole and spring), was used to select a total of 94 (76%) of drinking water sources to be included in the study and tested for physical and microbial parameters. The water sources comprised of eight communal taps, nine yard taps, three boreholes, 47 hand dug wells, 25 tank water and two springs (Table 1).

Table 1

Description of water sources

Source type Description of source type Sample picture 
Tap (yard and communal) Both communal and yard taps were connected to the municipal water supply system which derives its source from the Barekese Dam in Kumasi. Supply is intermittent; households have to store water. Communal or public taps were shared by the whole community and were operated on a commercial basis. Yard taps were mostly shared by more than one household and located in the compound.  





Boreholes 
Mostly communal or public because it is more expensive to construct. Communal boreholes were fitted with hand-pumps while privately owned ones had electric pumps.  





Hand-dug wells (protected and unprotected) 
These were circular wells 5–20 m deep and may be lined or unlined. Water is generally drawn with a rope tied to a water collection bowl. The rope and the collection bowl are sometimes left outside the well or hung inside the well. Hand-dug wells are sometimes fitted with hand-pumps or electric pumps.  






Tank water 
Water storage tanks were mostly employed to minimise the effect of intermittent water supply from the municipal water supply system or unreliable electricity. Water from the municipal water supply system is pumped or flows under gravity into tanks owned by households and private water vendors during periods of regular water supply. Water from hand-dug wells and boreholes, which are reliable sources, are also sometimes pumped into overhead storage tanks. Water from the tanks then flows under gravity.  






Springs 
These are natural water bodies. Springs were not properly protected from animals. The natural vegetative cover was the only barrier to contamination. Bird droppings pose the greatest threat to the quality of these sources. Domestic animals such as goats and sheep rarely get to the springs.  
Source type Description of source type Sample picture 
Tap (yard and communal) Both communal and yard taps were connected to the municipal water supply system which derives its source from the Barekese Dam in Kumasi. Supply is intermittent; households have to store water. Communal or public taps were shared by the whole community and were operated on a commercial basis. Yard taps were mostly shared by more than one household and located in the compound.  





Boreholes 
Mostly communal or public because it is more expensive to construct. Communal boreholes were fitted with hand-pumps while privately owned ones had electric pumps.  





Hand-dug wells (protected and unprotected) 
These were circular wells 5–20 m deep and may be lined or unlined. Water is generally drawn with a rope tied to a water collection bowl. The rope and the collection bowl are sometimes left outside the well or hung inside the well. Hand-dug wells are sometimes fitted with hand-pumps or electric pumps.  






Tank water 
Water storage tanks were mostly employed to minimise the effect of intermittent water supply from the municipal water supply system or unreliable electricity. Water from the municipal water supply system is pumped or flows under gravity into tanks owned by households and private water vendors during periods of regular water supply. Water from hand-dug wells and boreholes, which are reliable sources, are also sometimes pumped into overhead storage tanks. Water from the tanks then flows under gravity.  






Springs 
These are natural water bodies. Springs were not properly protected from animals. The natural vegetative cover was the only barrier to contamination. Bird droppings pose the greatest threat to the quality of these sources. Domestic animals such as goats and sheep rarely get to the springs.  

Sample collection

The APHA/AWWA/WEF (1999) standard method for the examination of water and wastewater (1060A) general sampling protocols was used in this study. A sampling of water was done once off during 13 days which was spread over 4 weeks. Sterilised 100 mL glass bottles were used to collect water samples which were then stored in an ice-chest stocked with crushed ice. The sample collection bottles were sterilised daily for re-use.

Sample testing

Physical parameter testing

Physical parameters were measured in situ during sample collection. They included temperature, pH, electrical conductivity (EC) and dissolved oxygen (DO). EC, pH and temperature were measured using a Eutect Multi-parameter Tester (PCSTEST35-01 × 441506/Oakton35425-01, Eutech Instruments®, Thermo Scientific Ltd, Oakton Instruments, USA). DO was measured using the Hach LDO (HQ30d), and turbidity was measured in the laboratory with a Turbidity meter (Hanna HI 93414, Hanna® Instruments, Limena, Italy). All equipment was calibrated following manufacturers' instructions.

Microbiological quality testing

The Aquagenx CBT (Aquagenx Chapel Hill, NC, USA) was used as per the manufacturer's instructions in an aseptic chamber in the Environmental Quality Engineering Laboratory of the Kwame Nkrumah University of Science and Technology. Water samples of 100 mL volume were emptied into the CBT bottles and the chromogenic medium was added. The bottles were mixed until the medium completely dissolved. This took about 15 min. The contents of the bottles were then emptied into the specially designed compartmentalised bags, making sure they were evenly distributed across all compartments. The bags were then incubated at 32 °C for 24–30 h in an incubator (Incubator Avantgarde.Line, BD 115, Binder®, BINDER GmbH, Tuttlingen, Germany). The colour changes in the contents of the bags were noted and their corresponding MPN values read from a chart supplied by the manufacturer. Sterile distilled water samples were used for negative controls and sterile distilled water with pure E. coli culture was used as positive control.

Statistical analysis

Data entry was entered into Microsoft Excel spreadsheets where it was cleaned, and the Stata 14 statistical package was used for data analysis. The data were descriptive in nature including percentages, frequencies, and cross tables.

RESULTS AND DISCUSSION

Water source types

Water sources are grouped according to the WHO/UNICEF Joint Monitoring Programme groupings. The proportion of the various water source types is shown in Figure 3. Water storage tanks were the secondary sources and therefore not included in the WHO/UNICEF Joint Monitoring Programme classifications. The primary sources from which water tanks were filled were all improved sources (tap, borehole and dug well).

Figure 3

Water source types in the study.

Figure 3

Water source types in the study.

The trend (high patronage of groundwater) observed in Ahenema Kokoben is similar to what occurs in most peri-urban and rural communities in Ghana where there has been a shift from surface water to groundwater (hand-dug wells and boreholes) (Kortatsi et al. 2008). The majority of the drinking water sources in this study were from groundwater which is consistent with other studies in Ghana (Maxwell et al. 2012; Ghana Statistical Service 2014b; Ghana Statistical Service et al. 2015). There were ‘tap water into premises’ but such dwellings were mostly gated and residents were absent during weekdays when samples were taken.

Quality of water sources

Physical characteristics

A summary of the physical characteristics of the 94 water sources is presented in Table 2. The Ghana Standard Authority (GSA)'s (Ghana Standards Authority 2013) recommended that a minimum value for pH in water used for drinking purposes is between 6.5 and 8.5. In this study, the mean values for all sources were within the guideline values. There is no guideline value for temperature, although the GSA states that the temperature should not be objectionable to the consumer (Ghana Standards Authority 2013). In this study, the temperature of the water samples at the time of sampling ranged from 24.3 °C to 30.6 °C. Water temperature was determined by the following factors: (1) the time of sample collection; (2) the weather conditions at the time of sample collection; and (3) the type of water source. The time of sampling spun from mornings till noon which affected temperature readings. Water temperature from the sources at the time of sampling (24.3–30.6 °C) was suitable for E. coli activity and its possible growth (WHO 2003, 2004; Sakyi & Asare 2012).

Table 2

Physical parameters of water sources

Water source pH
 
Temperature (°C)
 
Electrical conductivity (μS/cm−1)
 
Dissolved oxygen (mg/L)
 
Turbidity (NTU)
 
Mean Min Max SD Mean Min Max SD Mean Min Max SD Mean Min Max SD Mean Min Max SD 
Yard tap (n = 9) 7.3 6.6 7.9 0.5 27.1 26.1 28.3 0.7 151 136 169 11 0.7 0.9 0.5 1.3 0.3 
Communal tap (n = 8) 7.1 6.8 7.4 0.2 28.3 26.6 30.6 1.4 152 143 165 0.3 0.8 0.4 1.5 0.3 
Unprotected spring (n = 2) 7.5 7.5 7.5 25.9 24.9 26.8 1.3 212 165 258 66 9.3 0.98 17.7 11.8 
Tank water (n = 25) 6.9 6.4 7.8 0.4 27.6 24.3 30.1 1.5 116 37 322 74 1.7 0.2 17.7 3.6 
Borehole water (n = 3) 7.2 7.4 0.2 27.6 27.1 28.1 0.5 241 123 374 126 0.6 5.2 0.4 13.7 7.4 
Protected dug well (n = 43) 6.8 5.7 7.7 0.49 27.4 26.5 28.6 0.5 152 39 557 108 0.9 1.7 0.1 8.3 1.8 
Unprotected dug well (n = 4) 7.1 6.8 7.3 0.3 27.4 26.8 28.2 0.6 315 72 500 218 0.7 8.3 18.1 7.1 
Water source pH
 
Temperature (°C)
 
Electrical conductivity (μS/cm−1)
 
Dissolved oxygen (mg/L)
 
Turbidity (NTU)
 
Mean Min Max SD Mean Min Max SD Mean Min Max SD Mean Min Max SD Mean Min Max SD 
Yard tap (n = 9) 7.3 6.6 7.9 0.5 27.1 26.1 28.3 0.7 151 136 169 11 0.7 0.9 0.5 1.3 0.3 
Communal tap (n = 8) 7.1 6.8 7.4 0.2 28.3 26.6 30.6 1.4 152 143 165 0.3 0.8 0.4 1.5 0.3 
Unprotected spring (n = 2) 7.5 7.5 7.5 25.9 24.9 26.8 1.3 212 165 258 66 9.3 0.98 17.7 11.8 
Tank water (n = 25) 6.9 6.4 7.8 0.4 27.6 24.3 30.1 1.5 116 37 322 74 1.7 0.2 17.7 3.6 
Borehole water (n = 3) 7.2 7.4 0.2 27.6 27.1 28.1 0.5 241 123 374 126 0.6 5.2 0.4 13.7 7.4 
Protected dug well (n = 43) 6.8 5.7 7.7 0.49 27.4 26.5 28.6 0.5 152 39 557 108 0.9 1.7 0.1 8.3 1.8 
Unprotected dug well (n = 4) 7.1 6.8 7.3 0.3 27.4 26.8 28.2 0.6 315 72 500 218 0.7 8.3 18.1 7.1 

No source water recorded an EC reading above the WHO/GSA guideline value of 1,000 μS/cm (Ghana Standards Authority 2013). Groundwater sources recorded high EC values probably due to the dissolution of elements which occur naturally in the earth into groundwater. Nkansah et al. (2010) who only looked at hand-dug wells in the Kumasi Metropolis of the Ashanti Region of Ghana also found all measurements meeting the WHO/GSA guideline value. No health-based guideline value is recommended for DO (WHO 2011). Yard tap, followed by communal tap and water tanks, had the highest DO (9 mg/L) and boreholes had the lowest DO of 3 mg/L. Tap water in the study area is from a central water treatment plant (Barekese Treatment plant), which improves DO content through aeration. Besides, raw water for the treatment plant is sourced from surface water which generally has relatively higher DO content than groundwater. Boreholes being narrow, are least exposed to atmospheric oxygen and hence generally have low DO. Unprotected dug wells are prone to the introduction of microorganisms which deplete the limited oxygen in water resulting in low DO content of such sources (Penn et al. 2009; Ukpaka 2013).

The GSA guideline for turbidity is 5 NTU (Ghana Standards Authority 2013). Turbidity in water is caused by the presence of suspended materials like clay, silt, and fine particles of organic and inorganic matter (Ukpaka 2013). In this study, maximum turbidity values recorded were 1.3 NTU for tap water and 18.1 NTU for unprotected dug wells. Unprotected dug wells had the highest mean turbidity (8.3 NTU), which is consistent with a study done by Sorlini et al. (2013). While water of high turbidity may not adversely affect health, it reduces the efficacy of disinfectants (Boamah et al. 2011). Higher turbidity values were most probably due to the wearing of the lining of the wells. Unprotected dug wells, additionally, could be contaminated due to debris carried by the wind (Dekker et al. 2015).

Microbial quality of water sources

The drinking water source test results from the CBT tests are shown in Table 3 and categorised following the WHO microbial water quality risk categories. A total of 56% (53/94) of the water sources tested were negative for any presence of E. coli bacteria and was categorised as safe according to the WHO/GSA standard of 0 MPN/100 mL for E. coli. Tap water (communal and yard) were generally safe (McGarvey et al. 2008). This was expected as the water treatment process at the Barekese Treatment plant includes a disinfection step which leaves the water with some residual chlorine. Chlorine residual in tap water aims at ensuring microbial safety at the point of use and contamination usually happens during transmission through pipe bursts and seepage through loose joints to consumers or at the point of collection of water (Shaheed et al. 2014). Tank water was generally safe to drink; however, some of the samples did have contamination which could have been due to water stagnation, sedimentation and poor pipes (Shaheed et al. 2014). The results further indicated that unprotected sources like springs and dug wells were most likely to be polluted due to contamination from household run-offs due to poor drainage systems and waste sewer systems, animal droppings, insect and rodents' faeces as well as debris carried by the wind (Dekker et al. 2015). Spatial plotting has shown that microbial contaminated and non-contaminated water sources were almost evenly distributed across the study area (Figure 4), blue icons show water sources which gave negative results for E. coli and the red icons denote sources which tested positive for E. coli). There was, however, a slight concentration of sources which tested positive for E. coli in the northern part of the area. The contamination did not happen with tap water found in that area but only in the groundwater sources. These sources were close to a polluted spring, which potentially contaminated the groundwater sources (US EPA 2002).

Table 3

Microbial quality of water sources using the WHO water quality risk categories

Water source WHO water quality risk categories
 
Safe 0 MPN/100 mL Intermediate 1–10 MPN/100 mL High risk 11–100 MPN/100 mL Unsafe >100 MPN/100 mL 
Yard tap (n = 9; 10%) 8 (89%) 1 (11%) – – 
Communal tap (n = 8; 9%) 7 (88%) 1 (13%) – – 
Unprotected spring (n = 2; 2%) – – 1 (50%) 1 (50%) 
Tank water (n = 25; 27%) 17 (68%) 2 (8%) 3 (12%) 3 (12%) 
Borehole (n = 3; 3%) 2 (67%) – – 1 (33%) 
Protected dug well (n = 43; 46%) 18 (39%) 9 (21%) 11 (26%) 5 (12%) 
Unprotected dug well (n = 4; 4%) 1 (25%) 1 (25%) 1 (25%) 1 (25%) 
Total = 94 (100%) 53 (56%) 14 (15%) 16 (17%) 11 (12%) 
Water source WHO water quality risk categories
 
Safe 0 MPN/100 mL Intermediate 1–10 MPN/100 mL High risk 11–100 MPN/100 mL Unsafe >100 MPN/100 mL 
Yard tap (n = 9; 10%) 8 (89%) 1 (11%) – – 
Communal tap (n = 8; 9%) 7 (88%) 1 (13%) – – 
Unprotected spring (n = 2; 2%) – – 1 (50%) 1 (50%) 
Tank water (n = 25; 27%) 17 (68%) 2 (8%) 3 (12%) 3 (12%) 
Borehole (n = 3; 3%) 2 (67%) – – 1 (33%) 
Protected dug well (n = 43; 46%) 18 (39%) 9 (21%) 11 (26%) 5 (12%) 
Unprotected dug well (n = 4; 4%) 1 (25%) 1 (25%) 1 (25%) 1 (25%) 
Total = 94 (100%) 53 (56%) 14 (15%) 16 (17%) 11 (12%) 
Figure 4

Spatial distribution of microbial contamination of source water. Please refer to the online version of this paper to see this figure in colour: http://dx.doi.org/10.2166/washdev.2019.048.

Figure 4

Spatial distribution of microbial contamination of source water. Please refer to the online version of this paper to see this figure in colour: http://dx.doi.org/10.2166/washdev.2019.048.

CONCLUSIONS

The CBT simplified the microbial water quality testing and was convenient and suitable in a low-resource setting. It was very easy to read MPN values off the chart provided by the manufacturers (Aquagenx, LLC, Chapel Hill, NC, USA). Colour change is just between two colours; yellow and blue/blue-green. The bright yellow and blue or blue-green eliminate difficulty that could be faced by colour-blind individuals. The study has shown that only 53 (56%) of the 94 water sources in the Ahenema Kokoben community were safe to drink which must be a concern for health authorities. To achieve the SDG, regular monitoring of microbial water quality is key to improving public health. Point-of-use technologies should also be employed to complement efforts in improvements in water quality at the source (Sobsey et al. 2008).

AUTHOR CONTRIBUTIONS

Amadu Salifu collected and analysed the water samples. Helen Essandoh trained and supervised Amadu Salifu. Afsatou Ndama Traore provided training of trainers on the CBT and Natasha Potgieter was the project leader. All authors contributed to the writing of the article.

CONFLICT OF INTEREST

None declared.

ACKNOWLEDGEMENTS

The authors would like to acknowledge funding from the WELLCOME TRUST through Scientists Networked for Outcomes from Water and Sanitation (SNOWS) Consortium; the Directorate of Research and Innovative of the University of Venda for funding and training (Project I493); the Kwame Nkrumah University of Science and Technology for use of its environmental laboratory; and the Tamale Technical University for giving Amadu Salifu a study leave.

REFERENCES

REFERENCES
APHA/AWWA/WEF
1999
Standard Methods for the Examination of Water and Wastewater; Part 1000-3000
,
20th edn
.
American Public Health Association, American Water Works Association and Water Environment Federation, USA
.
Bain
R.
,
Bartram
J.
,
Elliot
M.
,
Matthews
R.
,
McMahan
L.
,
Tung
R.
,
Chuang
P.
&
Gundry
S.
2012
A summary catalogue of microbial drinking water tests for low and medium resource settings
.
International Journal of Environmental Research and Public Health
9
,
1609
1625
.
Bain
R.
,
Cronk
R.
,
Wright
J.
,
Yang
H.
,
Slaymaker
T.
&
Bartram
J.
2014
Fecal contamination of drinking-water in low- and middle-income countries: a systematic review and meta-analysis
.
PLoS Medicine
11
(
5
),
1
23
.
Boamah
V. E.
,
Gbedema
S. Y.
,
Adu
F.
&
Ofori-Kwakye
K.
2011
Microbial quality of household water sources and incidence of diarrhoea in three peri-urban communities in Kumasi, Ghana
.
Journal of Pharmaceutical Sciences and Research
3
(
3
),
1087
1092
.
Buamah
R.
,
Petrusevski
B.
&
Shippers
J. C.
2008
Presence of arsenic, iron and manganese in groundwater within the gold-belt zone of Ghana
.
Journal of Water Supply: Research and Technology
57
(
7
),
519
529
.
Dekker
D. M.
,
Krumkamp
R.
,
Sarpong
N.
,
Frickmann
H.
,
Boahen
K. G.
,
Frimpong
M.
,
Asare
R.
,
Larbi
R.
,
Hagen
R. M.
,
Poppert
S.
,
Rabsch
W.
,
Marks
F.
,
Adu-Sarkodie
Y.
&
May
J.
2015
Drinking water from dug wells in rural Ghana – Salmonella contamination, environmental factors, and genotypes
.
International Journal of Environmental Research and Public Health
12
(
4
),
3535
3546
.
Dufour
A.
,
Bartram
J.
,
Bos
R.
&
Ganon
V.
, (eds)
2012
Animal Waste, Water Quality and Human Health
.
IWA Publishing
,
London
,
UK
, pp.
1
476
. .
Ghana Standards Authority
2013
Ghana Standard 175-1:2013. Water Quality: Specification for Drinking Water
.
Ghana Statistical Service
2012
2010 Population and Housing Census: Final Results
.
Accra
,
Ghana
. .
Ghana Statistical Service
2014a
2010 Population and Housing Census; District Analytical Report, Atwima Kwanwoma District
.
Accra
,
Ghana
.
Ghana Statistical Service
2014b
Ghana Living Standards Survey Round 6 (GLSS 6)
.
The DHS Programme, ICF International, Rockville, Maryland, USA
.
Ghana Statistical Service
2015
Ghana Poverty Mapping Report
.
Accra
,
Ghana
.
Ghana Statistical Service (GSS), Ghana Health Service (GHS) & ICF International
2015
Ghana Demographic and Health Survey 2014
.
The DHS Programme, ICF International, Rockville, Maryland
,
USA
.
Gronewold
A. D.
,
Sobsey
M. D.
&
McMahan
L.
2017
The Compartment Bag Test (CBT) for enumerating fecal indicator bacteria: basis for design and interpretation of results
.
Science of the Total Environment
587
,
102
108
.
http://dx.doi.org/10.1016/j.scitotenv.2017.02.055
.
Heitzinger
K.
,
Rocha
C. A.
,
Quick
R. E.
,
Montano
S. M.
,
Tilley
D. H.
Jr.
,
Mock
C. N.
,
Carrasco
A. J.
,
Cabrera
R. M.
&
Hawes
S. E.
2015
‘Improved’ but not necessarily safe: an assessment of fecal contamination of household drinking water in rural Peru
.
The American Journal of Tropical Medicine and Hygiene
93
(
3
),
501
508
.
https://doi.org/10.4269/ajtmh.14-0802
.
Knee
J.
,
McMahan
K.
,
Dada
N.
,
Vannavong
A.
,
Overgaard
H. J.
,
Stenstrom
T. A.
&
Sobsey
M.
2012
Field Evaluation of a Low-Cost Compartmentalized Bag MPN Method for the Detection and Quantification of E. coli in Stored Household Rainwater Samples Collected in Northeastern Thailand
. In:
Annual Meeting of the American Society for Microbiology
,
June 2012
,
San Francisco, CA, USA
.
Kortatsi
B. K.
,
Asigbe
J.
,
Dartey
G. A.
,
Tay
C.
,
Anornu
G. K.
&
Hayford
E.
2008
Reconnaissance survey of arsenic concentration in ground-water in South-Eastern Ghana
.
West African Journal of Applied Ecology
13
(
1
),
16
36
.
Launch
2017
Low-Cost Bacterial Water Tests
.
Available from: https://www.launch.org/innovators/mark-sobsey (accessed 3 December 2017)
.
Maxwell
A. G.
,
Geophrey
A.
&
Kasei
R. A.
2012
Prediction of potential groundwater over-abstraction: a safe-yield approach – a case study of Kasena-Nankana district of UE Region of Ghana
.
Research Journal of Applied Sciences, Engineering and Technology
4
(
19
),
3775
3782
.
McGarvey
S. T.
,
Buszin
J.
,
Reed
H.
,
Smith
D. C.
,
Rahman
Z.
,
Andrzekewski
C.
,
Awusabo-Asare
K.
&
White
M. J.
2008
Community and household determinants of water quality in coastal Ghana
.
Journal of Water and Health
6
(
3
),
339
349
.
McMahan
L.
,
Wang
A.
,
Rutstein
S.
,
Stauber
C.
&
Sobsey
M. D.
2011
Evaluation of Household Microbial Water Quality Testing in a Pilot Peruvian Demographic and Health Survey Using the Portable Compartment Bag Test (CBT) for E. coli
. In:
The Annual Meeting of the American Society of Tropical Medicine
,
Philadelphia, PA. USA
. .
Ministry of Finance, Government of Ghana
2014
The Composite Budget of the Atwima Kwanwoma District Assembly, 2014 Fiscal Year
. .
Murcott
S.
,
Keegan
M.
,
Hanson
A.
,
Jain
A.
,
Knutson
J.
,
Liu
S.
,
Tanphanich
J.
&
Wong
T. K.
2015
Evaluation of microbial water quality tests for humanitarian emergency and development settings
.
Procedia Engineering
107
,
237
246
.
http://dx.doi.org/10.1016/j.proeng.2015.06.078
.
Nkansah
M. A.
,
Boadi
N. O.
&
Badu
M.
2010
Assessment of the quality of water from hand-dug wells in Ghana
.
Environmental Health Insights
4
,
7
12
.
Penn
M. R.
,
Pauer
J. J.
&
Mihelcic
J. R.
2009
Biochemical oxygen demand
. In:
Environmental and Ecological Chemistry
(
Sabljic
A.
, ed.).
Encyclopedia of Life Support Systems (EOLSS) Publishers Co. Ltd
,
Oxford
,
UK
, pp.
231
264
. .
Sakyi
P. A.
&
Asare
R.
2012
Impact of temperature on bacterial growth and survival in drinking-water pipes
.
Research Journal of Environmental and Earth Sciences
4
(
8
),
807
817
.
Shaheed
A.
,
Orgill
J.
,
Montgomery
M. A.
,
Jeuland
M. A.
&
Brown
J.
2014
Why ‘improved’ water sources are not always safe
.
Bulletin of World Health Organization
92
(
4
),
283
289
.
Sobsey
M. D.
,
Stauber
C. E.
,
Casanova
L. M.
,
Brown
J. M.
&
Elliott
M. A.
2008
Point of use household drinking water filtration: a practical, effective solution for providing sustained access to safe drinking water in the developing world
.
Environmental Science and Technology
42
(
12
),
4261
4467
.
Sorlini
S.
,
Palazzini
D.
,
Sieliechi
J. M.
&
Ngassoum
M. B.
2013
Assessment of physical-chemical drinking water quality in the Logone Valley (Chad-Cameroon)
.
Sustainability
5
(
7
),
3060
3076
.
Stauber
C.
,
Miller
C.
,
Cantrell
B.
&
Kroell
K.
2014
Evaluation of the compartment bag test for the detection of Escherichia coli in water
.
Journal of Microbiological Methods
99
,
66
70
.
http://blogs.washplus.org/drinkingwaterupdates/2014/02/evaluation-of-the-compartment-bag-test-for-the-detection-of-escherichia-coli-in-water/
.
Ukpaka
C. P.
2013
The concept of chemical and biochemical oxygen demand in inhibiting crude oil degradation in fresh water pond system
.
Merit Research Journal of Environmental Science and Toxicology
1
(
7
),
136
146
. .
US EPA
2002
Drinking Water from Household Wells
.
US Environmental Protection Agency, Washington, DC. Available from: https://www.epa.gov/sites/production/files/2015-05/documents/epa816k02003.pdf
.
Weiss
P.
,
Gim
T.
&
Rose
J. B.
2013
Microbial Quality and Safety of Well Water in Rural Nicaragua as Determined by Low Cost Bacterial Test
. In:
2013 Water and Health Conference: Where Water Meets Policy
.
WHO
2003
Heterotrophic Plate Counts and Drinking-Water Safety
(
Bartram
J.
,
Cotruvo
J.
,
Exner
M.
,
Fricker
C.
&
Glasmacher
A.
, eds).
IWA Publishing
,
UK
.
WHO
2004
Safe Piped Water: Managing Microbial Water Quality in Piped Distribution Systems
(
Ainsworth
R.
, ed.).
IWA Publishing, London, UK
. .
WHO
2008
Guidelines for Drinking-Water Quality
,
3rd edn
.
World Health Organization
,
Geneva
,
Switzerland
, pp.
1
515
. .
WHO
2011
Guidelines for Drinking-Water Quality
,
4th edn
.
World Health Organization Press
,
Geneva
,
Switzerland
, pp.
1
541
.
WHO
2012
Rapid Assessment of Drinking- Water Quality
.
World Health Organization Press
,
Geneva
,
Switzerland
, pp.
1
138
. .
WHO
2015
Key Facts From Joint Monitoring Programme 2015
. pp.
1
4
. .
WHO/UNICEF
2014
Progress on Drinking Water and Sanitation; 2014 Update
.
World Health Organization Press
,
Geneva
,
Switzerland
, pp.
1
75
.
WHO/UNICEF
2017
Progress on Drinking Water, Sanitation and Hygiene; 2017 Update and SDG Baselines
(
Grojec
A.
, ed.).
World Health Organization Press
,
Switzerland
, pp.
1
108
.