Introduction: Household drinking water can be contaminated by diarrheagenic enteropathogens at numerous points between the source and actual consumption. Interventions to prevent this contamination have focused on preventing exposure to human waste through interventions to improve drinking water, sanitation and hygiene (WASH). In many cases though, the infectious agent may be of zoonotic rather than human origin suggesting that unsafely managed animal waste may contribute to the contamination of household drinking water and the associated diarrheal disease burden.
Methods: A cross-sectional household survey of 800 households was conducted across three informal peri-urban neighborhoods of Kisumu, Kenya, collecting stored drinking water samples, administering a household survey including water, sanitation and hygiene infrastructure and behaviors, and recording domestic animal presence and ownership. We used multivariate logistic regression to assess the association of traditional WASH factors and domestic animal presence and ownership on microbial contamination of household drinking water.
Results: The majority of households sampled had fecally contaminated drinking water (67%), defined by the presence of any colony forming units of the fecal indicator bacteria enterococci. After adjustment for potential confounders, including socio-economic status and water and sanitation access, both household animal ownership (aOR 1.31; CI 1.00-1.73, p = 0.05) and the presence of animal waste in the household compound (aOR 1.38; CI 1.01, 1.89, p = 0.04) were found to be significantly associated with household drinking water contamination. None of the conventional WASH variables were found to be significantly associated with household drinking water contamination in the study population.
Conclusions: Water, sanitation, and hygiene strategies to reduce diarrheal disease should consider the promotion of safe animal contact alongside more traditional interventions focusing on the management of human waste. Future research on fecal contamination of unsafe household drinking water should utilize host-specific markers to determine whether the source is human or animal to prepare targeted public health messages.