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      Suboptimal Bacteriological Quality of Household Water in Municipal Ibadan, Nigeria

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          ABSTRACT.

          Access to potable water is difficult for many African residents. This study evaluated the bacteriological quality of household water collected in the dry and wet seasons across five municipal local government areas (LGAs) in Ibadan, a large city in southwest Nigeria. A total of 447 water samples (dry season, n = 250; wet season, n = 197) were aseptically collected from a random sample of mapped households within Ibadan’s five municipal LGAs. The pH values and total aerobic and coliform bacterial counts were measured, and samples were screened for Escherichia coli, Salmonella, Shigella, and Yersinia by standard phenotypic techniques and multiplex polymerase chain reaction. The most common source of water was well (53.2%), followed by borehole (34%). None of the households used municipal tap water. Cumulatively, aerobic ( P = 0.0002) and coliform ( P = 0.0001) counts as well as pH values ( P = 0.0002) changed significantly between seasons, with increasing and decreasing counts depending on the LGA. Nonpotable water samples were found to be very common during the dry (86.8%) and wet (74.1%) seasons. Escherichia coli spp., as indicators of recent fecal contamination, were isolated from 115 (25.7%) of the household water sources. Thirty three Salmonella, four enteroaggregative E. coli, and four enterotoxigenic E. coli isolates but no Shigella or Yersinia isolates were identified. This study revealed the absence of treated tap water and the poor quality of alternative sources with detectable pathogens in municipal Ibadan. Addressing the city-wide lack of access to potable water is an essential priority for preventing a high prevalence of feco-orally transmitted infections.

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          Water Supply and Health

          As one article in a four-part PLoS Medicine series on water and sanitation, Paul Hunter and colleagues argue that much more effort is needed to improve access to safe and sustainable water supplies.
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            Pit Latrines and Their Impacts on Groundwater Quality: A Systematic Review

            Background: Pit latrines are one of the most common human excreta disposal systems in low-income countries, and their use is on the rise as countries aim to meet the sanitation-related target of the Millennium Development Goals. There is concern, however, that discharges of chemical and microbial contaminants from pit latrines to groundwater may negatively affect human health. Objectives: Our goals were to a) calculate global pit latrine coverage, b) systematically review empirical studies of the impacts of pit latrines on groundwater quality, c) evaluate latrine siting standards, and d) identify knowledge gaps regarding the potential for and consequences of groundwater contamination by latrines. Methods: We used existing survey and population data to calculate global pit latrine coverage. We reviewed the scientific literature on the occurrence of contaminants originating from pit latrines and considered the factors affecting transport of these contaminants. Data were extracted from peer-reviewed articles, books, and reports identified using Web of ScienceSM, PubMed, Google, and document reference lists. Discussion: We estimated that approximately 1.77 billion people use pit latrines as their primary means of sanitation. Studies of pit latrines and groundwater are limited and have generally focused on only a few indicator contaminants. Although groundwater contamination is frequently observed downstream of latrines, contaminant transport distances, recommendations based on empirical studies, and siting guidelines are variable and not well aligned with one another. Conclusions: In order to improve environmental and human health, future research should examine a larger set of contextual variables, improve measurement approaches, and develop better criteria for siting pit latrines.
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              Efficacy and safety of a modified killed-whole-cell oral cholera vaccine in India: an interim analysis of a cluster-randomised, double-blind, placebo-controlled trial.

              Oral cholera vaccines consisting of killed whole cells have been available for many years, but they have not been used extensively in populations with endemic disease. An inexpensive, locally produced oral killed-whole-cell vaccine has been used in high-risk areas in Vietnam. To expand the use of this vaccine, it was modified to comply with WHO standards. We assessed the efficacy and safety of this modified vaccine in a population with endemic cholera. In this double-blind trial, 107 774 non-pregnant residents of Kolkata, India, aged 1 year or older, were cluster-randomised by dwelling to receive two doses of either modified killed-whole-cell cholera vaccine (n=52 212; 1966 clusters) or heat-killed Escherichia coli K12 placebo (n=55 562; 1967 clusters), both delivered orally. Randomisation was done by computer-generated sequence in blocks of four. The primary endpoint was prevention of episodes of culture-confirmed Vibrio cholerae O1 diarrhoea severe enough for the patient to seek treatment in a health-care facility. We undertook an interim, per-protocol analysis at 2 years of follow-up that included individuals who received two completely ingested doses of vaccine or placebo. We assessed first episodes of cholera that occurred between 14 days and 730 days after receipt of the second dose. This study is registered with ClinicalTrials.gov, number NCT00289224. 31 932 participants assigned to vaccine (1721 clusters) and 34 968 assigned to placebo (1757 clusters) received two doses of study treatment. There were 20 episodes of cholera in the vaccine group and 68 episodes in the placebo group (protective efficacy 67%; one-tailed 99% CI, lower bound 35%, p<0.0001). The vaccine protected individuals in age-groups 1.0-4.9 years, 5.0-14.9 years, and 15 years and older, and protective efficacy did not differ significantly between age-groups (p=0.28). We recorded no vaccine-related serious adverse events. This modified killed-whole-cell oral vaccine, compliant with WHO standards, is safe, provides protection against clinically significant cholera in an endemic setting, and can be used in children aged 1.0-4.9 years, who are at highest risk of developing cholera in endemic settings. Bill & Melinda Gates Foundation, Swedish International Development Cooperation Agency, Governments of South Korea, Sweden, and Kuwait.
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                Author and article information

                Journal
                Am J Trop Med Hyg
                Am J Trop Med Hyg
                tpmd
                tropmed
                The American Journal of Tropical Medicine and Hygiene
                The American Society of Tropical Medicine and Hygiene
                0002-9637
                1476-1645
                2 January 2024
                February 2024
                2 January 2024
                : 110
                : 2
                : 346-355
                Affiliations
                [ 1 ]Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Nigeria;
                [ 2 ]Department of Pharmacology and Therapeutics, College of Health Sciences, Benue State University, Makurdi, Nigeria;
                [ 3 ]Keck School of Medicine, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California;
                [ 4 ]Department of Community Medicine, College of Medicine, University of Ibadan, Nigeria;
                [ 5 ]Epidemiology, Public Health, Implementation & Clinical Development Unit, International Vaccine Institute, Seoul, South Korea;
                [ 6 ]Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom;
                [ 7 ]Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany;
                [ 8 ]Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar
                Author notes

                Disclosure: This study was nested in a larger health care utilization study, and approval was granted by the University of Ibadan/University College Hospital Ethics Committee (approval number UI/EC/17/0378). Written informed consent to participate in the study was obtained from the head of each household.

                Financial support: This study was supported by an African Research Leader Award to I. N. Okeke from the UK Medical Research Council (MRC), the UK Department for International Development (DFID) under the MRC/DFID and part of the EDCTP2 Programme supported by the European Union, and by grant number OPP1127988 from the Bill and Melinda Gates Foundation Severe Typhoid in Africa (SETA). I. N. Okeke is a Calestous Juma Science Leadership fellow supported by the Bill and Melinda Gates Foundation ( OPP1127988).

                Authors’ addresses: Olumuyiwa S. Alabi, Ifeoluwa Akintayo, Jesutofunmi S. Odeyemi, and Iruka N. Okeke, Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Nigeria, E-mails: os.alabi.ui@ 123456gmail.com , akintayoife94@ 123456gmail.com , jesutofunmi.odeyemi@ 123456gmail.com , and iruka.n.okeke@ 123456gmail.com . Jeremiah J. Oloche, Department of Pharmacology and Therapeutics, College of Health Sciences, Benue State University, Makurdi, Nigeria, E-mail: joloche1012@ 123456gmail.com . Chibuzor M. Babalola, Keck School of Medicine, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, E-mail: chibuzor.babalola@ 123456med.usc.edu . Chukwuemeka Nwimo and Oluwafemi Popoola, College of Medicine, University of Ibadan, Nigeria, E-mails: emeka.nwimo@ 123456gmail.com and drpopee@ 123456gmail.com . Ondari D. Mogeni and Florian Marks, Epidemiology, Public Health, Implementation & Clinical Development Unit, International Vaccine Institute, Seoul, South Korea; Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom; Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany; Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar, E-mails: ondari.mogeni@ 123456ivi.int and fmarks@ 123456ivi.int .

                [* ]Address correspondence to Olumuyiwa S. Alabi, Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Oyo State, Nigeria. E-mail: os.alabi.ui@ 123456gmail.com
                Article
                tpmd230134
                10.4269/ajtmh.23-0134
                10859799
                38167625
                e678ee7f-b668-4746-a566-07fcc29aaca1
                © The author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 03 March 2023
                : 05 October 2023
                Page count
                Pages: 10
                Categories
                Research Article

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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