CHAPTER ONE

INTRODUCTION

 1.1       BACKGROUND TO THE STUDY

Access to safe drinking water and improved sanitation is essential for healthy life and can significantly reduce public expenditure on preventable diseases and epidemics (e.g. cholera, diarrhea, typhoid, and dracunculiasis) arising from contaminated drinking water and unhygienic disposal of human waste (WHO, 2007). According to the same document, about 1.7 million deaths annually are related to drinking unsafe water and poor disposal of wastes. Children are the most vulnerable, due to their low natural immunity, and a high percentage of infant mortality is linked to contaminated water and lack of hygienic sanitation (Sunday and Martine, 2011).   Available estimate shows that 783 million people do not have access to clean water and almost 2.5 billion do not have access to adequate sanitation while 6 to 8 million people die annually from the consequences of water related diseases globally (UNESCO, 2013). Between 1999 and 2008, over ₦706 billion of public funds were devoted to provision of safe drinking water, improved sanitation, and health-related services by the Federal Government of Nigeria, excluding contributions by states and local governments (CBN, 2009). What is not clear, however, is the quality of water the government has been providing and its effects on the health outcomes of the people. About 42% of Nigeria‟s populations have no access to clean drinking water, which is almost 20% of Africa‟s population in the same position of difficulty (WHO/UNICEF 2010). The implication is that African children are exposed to deadly but preventable water-borne diseases, which affects their growth and health in general (Kingdon and Monk, 2010).

Viable bacteria (among them was Salmonella typhi) have been identified in the popular sachet packed water and has been seen to be microbially unsafe for human consumption, constituting potential health risk, and this can be linked to the increasing incidence of typhoid fever among other food and water-borne infections (Edema, Omemu, and Fapetu, 2001).

Commercialization of drinking water is inevitable considering the increasing population of Nigeria vis-avis incapability of supplying pipe-borne potable water through public water supply. Therefore, the production and distribution of commercial sachet-packaged water in Nigeria require increased attention and close monitoring by the regulatory agencies. Also most of the natural sources of drinking water (tap, tube well and well) can be highly contaminated. The detection of pathogenic enteric bacteria in different sources of drinking water in Kathmandu valley, Nepal with Salmonella typhi comprising 3.3% of the microorganism also reveals the alarming situation for water borne epidemics in the valley (Tista, Binod, Dev, Madhav, 2007).The major danger associated with drinking water sources is the possibility of its contamination by sewage or human and animal excreta (Uzoigwe and Agwa, 2012). Another problem is the siting of drinking water system near a refuse dumpsite or landfill. Water is essential to sustain life and a satisfactory supply of drinking water must be made available to all consumers (WHO, 2006a).  Potable water is the water that is safe enough to be consumed by humans or used with low risk of immediate or long term harm (WHO 2006b).

There are several rules and regulations guiding provision and supply of drinking water. In Nigeria, such regulations are monitored by the National Agency for Food and Drug

Administration and Control (NAFDAC), which was established as a parastatal of the Federal Ministry of Health by Decree No. 15 of 1993. Surveillance carried out by NAFDAC between 2004 and 2005 revealed that some producers of packaged water indulge in sharp practices such as packaging of untreated water, production under unhygienic conditions, illegal production of unregistered water in unapproved premises, use of non-food grade sachets and release of packaged water for distribution and sale without date marking (Edema, Atayese and Bankole, 2011). These malpractices compelled the agency to formulate guidelines for the production of wholesome packaged water. Despite the standards formulated by NAFDAC to address this problem, there is no evidence that the situation has improved.

IDAH is blessed with abundant water resource both ground and surface and the distribution of this resource have very little variation in both time and space amongst the subsettlements (Yusuf, Iguisi and Bello, 2007). In spite of its potentials for good groundwater storage, there is incessant water shortage in IDAH. People are always complaining about inadequate drinking water because the distribution and supply system are very poor. Communities and sub-settlements served by the Sabon Gari Water Works had to go through periods of complete no tap water for days and weeks. Therefore, searching for drinking, bathing, washing and cooking water has become part of the daily routine for both children and married women. Where the supply is made, it does not exceed 2 hours in some areas. This poor distribution and supply of tap water has made people to constantly use well or boreholes (where possible), for multiple purposes.

This practice combined with unsafe storage of water is prevalent in IDAH and has contributed to increasing incidences of water borne diseases such as cholera and typhoid (Musa, Shehu and Lukman, 2009).In order to effectively solve the problem of contamination of potable water, there is a need to fully assess the extent of the problem. Moreover the reliance of people on public water sources calls for concern as some of these have been associated with some water-borne diseases. These issues are the focus of this research in Sabon Gari local government area of Kaduna State.

1.2      STATEMENT OF THE RESEARCH PROBLEM

It has been observed that high prevalence of diarrhoea amongst children and infants can be traced to the consumption of unsafe water and unhygienic practices. It is estimated that 150 000 to 200 000 children are lost to diarrhoea related death each year in Nigeria (Nigeria Support to the Federal Ministry of Water Resources Management and Policy, 2006). Cholera, typhoid, paratyphoid, guinea worm, and Schistosomiasis are all common. Mortality and morbidity rates are high due to the absence of clean and adequate sanitation, and where potable water is available, the potential gains are frequently negated by contamination of the water delivery due to poor sanitation. Water borne diseases account for one third of intestinal infections globally. Another study reported that poor hygiene was responsible for 40% of all death and 5.7% of total disease burden occurring worldwide (Nigeria Support to the Federal Ministry of Water Resources Management and Policy, 2006).

Idah has limited supply of tapwater. In this area tap water sometimes runs for about 2 – 3 hours at 3-day interval on the average. The only alternatives are water from wells, boreholes, sachet water and purchased water from wheel truck pushers. Some villages, like Bomo, Zabi, and Samaru do not have piped water distribution system, making supply of wholesome drinking water in these villages critical. The piped water distribution system in IDAH is poorly managed. Most of the pipes that distribute tapwater in the study area have rusted and exposed to contamination while some of the sites for the production of sachet water are sometimes places being used to wash cloth, plate and other domestic use. Some of the pipes that convey tap water in Chekene and Akutavillages have been sited to be broken. These broken pipes pass through gutters while some of them pass through filthy areas where all kinds of unclean substances stick to them. Also, some boreholes and wells are sited near refuse dumpsites or landfills, these have the possibility of contaminating the water meant for drinking, or to be packaged as sachet water. These have created doubt in the mind of the people as to the quality of drinking water being consumed in this local government area. Issues relating to incidence of diseases from drinking unwholesome water have been examined by several authors. Some of them are critically overviewed.

Tista et al, (2007), carried out microbial analysis of drinking water of Kathmandu valley,

Nepal. 238 isolates of enteric bacteria were obtained and identified as Escherichia coli(26.4%),

Enterobacter spp (25.6%), Citrobacter spp (22.6%), Pseudomonas aeruginosa (6.3%),

Klebsiella spp (5.4%), Shigella spp (3.78%), Salmonella typhi (3.3%), Proteus vulgaris (2.9%), Serratia spp (2.52%), and Vibrio cholerae (0.84%). The results revealed that 31.5%, 43.7%, 16.0% and 8.8% of isolates were obtained from water samples of tube well, well, tap and stone spout sources respectively.                                                                                        

In Minna metropolis of Niger State, Nigeria, Omalu et al (2012), collected five brands of packaged water samples labelled A – E from different locations within the metropolis,  for bacteriological and physico-chemical analyses. Results of the test indicates that water from brand A had the highest total coliform counts of 398 MPN/100ml followed by water from brand B having 49 MPN/100ml while the least was that of brand D. Results show that the total coliform count of these water samples were high, hence grossly contaminated. The organisms isolated were Escherichia coli, Streptococci feacalis, Bacillus subtilis, Staphylococcus aureus, Salmonella typhi, Klebsilla spp, and Pseudomonas aeruginosa. The isolates were initially differentiated on the basis of the cultural and morphological studies after which they were subjected to various biochemical tests. The presence of coliform groups in these water samples generally suggest that the water may have been contaminated with faeces either of human or animal origin or contaminants enters the production cycle. The presence of Salmonella typhi, in the water sample could cause typhoid fever which is indicative of poor drinking water quality.  Dada (2009) studied the bacterial quality of sachet water sold in Lagos, Nigeria and identified the contributory factors that determine the fate of the packaged water product as it moves from catchment to consumers. The author observed that microbial quality deteriorated considerably as products moved farther down the distribution chain. As low as 6.6% showed contamination after production, 40% of the samples obtained from the distributors shed were contaminated, while the highest level of contamination (45%) was observed from samples obtained from the extreme part of the distribution chain.

Olaoye and Onilude (2009) assessed the microbiological quality of sachet-packaged drinking water in Western Nigeria and its public health significance. The authors collected ninety-two sachet-packaged water which were analysed for microbiological and metal contents. Total bacterial and coliform counts were determined, and the presence of Escherichia coli, an important water quality indicator, was tested. The level of conformity of the water processors with the guidelines of Nigeria’s quality regulatory agency was also determined. The researchers discovered varying levels of microbial contamination in samples from the different sampling locations. The bacteria that were identified from the water samples included E. coli, Pseudomonas aeruginosa, Enterobacter aerogenes, Klebsiella sp, Proteus vulgaris, Alcaligenes faecalis, Bacillus cereus, Staphylococcus aureus, Streptococcus lactis, Aeromonas sp. and Micrococcus luteum. Many of the water processors did not comply with the guidelines of the quality regulatory agency. So the researchers concluded that some of the sachet-packaged

samples of drinking water were of poor quality.

Uzoigwe and Agwa (2012) studied the microbiological quality of water collected from boreholes sited near refuse dumpsites in Port Harcourt, Nigeria. The author collected water samples from six private boreholes, three samples were from boreholes located near dumpsites, and the other three samples were from boreholes located in areas without dumpsite in Obio/Akpor and Ikwerre Local Government Areas (LGA) in Port Harcourt. Nine genera of microorganisms (or bacteria) were identified from a total of 21 isolates. These genera include: Shigella, Esherichia, Salmonella, Vibrio, Enterobacter, Pseudomonas, Proteus, Staphylococus and Bacillus. Out of the nine genera, Shigella sp. had the highest percentage frequency of occurrence (23.81%) followed by Esherichia and Salmonella (14.29%), then Enterobacter and Vibrio (9.52%).

This research work seeks to collect multiple samples of drinking water for

microbiological analysis of Salmonella typhi within the study area so as to examine the areas with high probability of Salmonella typhi and incidence of typhoid fever, as most of the previous studies have only examined water sample from single sources. The questions this research seeks to address are,

1. What are the major sources of drinking water within the study area?
2. How common is Salmonella typhi in potable water within the study area?
3. How prevalent is typhoid fever in IDAH?
4. What is the relationship between Salmonella typhi in drinking water and occurance of typhoid fever in the study area?
5. Are there socio-environmental explanations for the occurrence of Salmonella typhi and typhoid fever in the study area?

 1.3       AIM AND OBJECTIVES

 The aim of this study is to evaluate the presence of Salmonella typhi in drinking water in Idah town , Kogi State and the objectives are to:

1. characterise the major sources of drinking water within the study area
2. examine the prevalence of Salmonella typhi in drinking water within the study area. iii.         determine the prevalence of typhoid fever in IDAH.
3. establish the relationship between the concentration of Salmonella typhi in potable drinking water and the occurrence of typhoid disease in the study area.
4. examine the social and environmental bases for the occurrence of Salmonella typhi and typhoid fever in the study area.

1.4       SCOPE OF THE STUDY

Spatial extent of this study are selected areas within Idah local government area, Kogi state.

Concerning the focus of the study, attention was on drinking water sources within Idah town including tap water, boreholes, well water, and sachet water. This is because they are the most readily available, and consumed drinking water in the location under study. The study evaluates the presence of Salmonella typhi on these waters and assesses the prevalence of typhoid fever in different villages of the Town. The samples were collected for microbiological analysis in November, 2014.

1.5       SIGNIFICANCE OF THE STUDY

A reliable supply of clean wholesome water is highly essential to promoting healthy living among the inhabitants of a definite geographical location. New figure in the 2015 WHO/UNICEF Joint Monitoring Programme (JMP) reports showed worsening trend for Nigeria in the areas of sanitation and open defecation as only 9% of the population has gained access to improve sanitation since 1990. The standard for delivering safe drinking water and sanitation technology in the industrialized world is, however, not affordable in most of the developing world (Dada, 2009). This potable water, however, is necessary to all living things as it makes up approximately 70% of the human body’s weight and plays a role in its functions, such as digestion and cooling. They also serve as habitat for some pathogenic micro-organism (Salmonella typhi inclusive). Without clean drinking water, humans cannot survive.  If drinking water within this local government is contaminated with Salmonella typhi, frequent diagnosis of typhoid fever among the inhabitant of this region will be the order of the day which may apparently explain some of the incidental health problem (typhoid) occasionally experienced.  The results of this study will hopefully be useful for agencies responsible for the provision of water within IDAH and other government institutions that are concerned with provision of water. It is hoped that the findings of this study would contribute to the understanding of the factors that influence the spread of typhoid fever in the study area. This study would shed light on whether the control measures in place are effective in the control of typhoid fever. It is hoped that the results would be of great use to programme planners, academics, policy formulators and implementers, donors, curriculum developers and otherservice providers in control of typhoid fever.

This research will further shed light on the need to examine properly drinking water consumed. Also, findings of this study when published will bring awareness to the people of this local government and the producers of sachet water the need to properly treat the packaged water for sale due to continuous contamination of rivers, public piping system and the site for the production of sachet water.