Effects of Sachet Water Consumption on Exposure to Microbe-Contaminated Drinking Water: Household Survey Evidence from Ghana
Open accessAbstract
There remain few nationally representative studies of drinking water quality at the point of consumption in developing countries. This study aimed to examine factors associated with E. coli contamination in Ghana. It drew on a nationally representative household survey, the 2012−2013 Living Standards Survey 6, which incorporated a novel water quality module. E. coli contamination in 3096 point-of-consumption samples was examined using multinomial regression. Surface water use was the strongest risk factor for high E. coli contamination (relative risk ratio (RRR) = 32.3, p < 0.001), whilst packaged (sachet or bottled) water use had the greatest protective effect (RRR = 0.06, p < 0.001), compared to water piped to premises. E. coli contamination followed plausible patterns with digit preference (tendency to report values ending in zero) in bacteria counts. The analysis suggests packaged drinking water use provides some protection against point-of-consumption E. coli contamination and may therefore benefit public health. It also suggests viable water quality data can be collected alongside household surveys, but field protocols require further revision.
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In Ghana, GWCL treats piped water, running two treatment plants in Accra, but water supplied to consumers is frequently microbially contaminated.
“In Ghana, the Ghana Water Company Limited (GWCL) is the national urban water utility and while GWCL treats piped water, running two treatment plants in Accra, water supplied to consumers is frequently microbially contaminated (Wright et al. ).”
From Characteristics of packaged water production facilities in Greater Accra, Ghana: implications for water safety and associated environmental impacts (2020) · cites this paper as Wright et al. 2016
The Data section (2.1; page unavailable) calls the Ghana Water Company the main utility. The Discussion (section 4; page unavailable) reports E. coli contamination even in piped supplies, supporting the contamination point. Our copy does not say that GWCL treats piped water or runs two treatment plants in Accra, and its household samples do not establish how frequently GWCL-supplied water is contaminated. (LLM, conf=0.88)
Experimental — accuracy not yet measuredA nationally representative water quality survey found significantly lower E. coli contamination in sachet water compared with water piped to the home.
“while a nationally representative water quality survey found signi fi cantly lower E. coli contamination in sachet water compared with water piped to the home (Wright et al. ).”
From Characteristics of packaged water production facilities in Greater Accra, Ghana: implications for water safety and associated environmental impacts (2020) · cites this paper as Wright et al. 2016
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Cites
Escherichia coli: the best biological drinking water indicator for public health protection
Edberg, S. C., Rice, E. W., Karlin, R. J., & Allen, M. J. (2000) · Journal of Applied Microbiology · doi:10.1111/j.1365-2672.2000.tb05338.x · Cited by 919 · see citing works
Wright, J., Gundry, S., & Conroy, R. M. (2004) · Tropical Medicine & International Health · doi:10.1046/j.1365-3156.2003.01160.x · Cited by 853 · see citing works
Self-citationBain, R., Cronk, R., Wright, J., Yang, H., Slaymaker, T., & Bartram, J. (2014) · PLoS Medicine · doi:10.1371/journal.pmed.1001644 · Cited by 619 · see citing works
Self-citationSavichtcheva, O., & OKABE, S. (2006) · Water Research · doi:10.1016/j.watres.2006.04.040 · Cited by 382 · see citing works
Risk factors contributing to microbiological contamination of shallow groundwater in Kampala, Uganda
Howard, G., Pedley, S., Barrett, M., Nalubega, M., & Johal, K. (2003) · Water Research · doi:10.1016/s0043-1354(03)00235-5 · Cited by 308 · see citing works
Are microbial indicators and pathogens correlated? A statistical analysis of 40 years of research
Wu, J., Long, S. C., Das, D., & Dorner, S. M. (2011) · Journal of Water and Health · doi:10.2166/wh.2011.117 · Cited by 307 · see citing works
Gundry, S., Wright, J., & Conroy, R. M. (2004) · Journal of Water and Health · doi:10.2166/wh.2004.0001 · Cited by 280 · see citing works
Self-citationComparing microbial water quality in an intermittent and continuous piped water supply
Kumpel, E., & Nelson, K. L. (2013) · Water Research · doi:10.1016/j.watres.2013.05.058 · Cited by 226 · see citing works
An Empirical Analysis of State and Private-Sector Provision of Water Services in Africa
Kirkpatrick, C. H., Parker, D., & Zhang, Y. (2006) · The World Bank Economic Review · doi:10.1093/wber/lhj001 · Cited by 212 · see citing works
Gruber, J. S., Ercümen, A., & Colford, J. M. (2014) · PLoS ONE · doi:10.1371/journal.pone.0107429 · Cited by 181 · see citing works
Sachet drinking water in Ghana's Accra-Tema metropolitan area: past, present, and future
Stoler, J., Weeks, J. R., & Fink, G. (2012) · Journal of Water, Sanitation and Hygiene for Development · doi:10.2166/washdev.2012.104 · Cited by 139 · see citing works
Water Safety and Inequality in Access to Drinking-water between Rich and Poor Households
Yang, H., Bain, R., Bartram, J., Gundry, S., Pedley, S., & Wright, J. (2012) · Environmental Science & Technology · doi:10.1021/es303345p · Cited by 135 · see citing works
Self-citationShields, K. F., Bain, R., Cronk, R., Wright, J., & Bartram, J. (2015) · Environmental Health Perspectives · doi:10.1289/ehp.1409002 · Cited by 132 · see citing works
Self-citationGundry, S., Wright, J., Conroy, R. M., du Preez, M., Genthe, B., Moyo, S., Mutisi, C., Ndamba, J., & Potgieter, N. (2006) · Water Practice & Technology · doi:10.2166/wpt.2006.032 · Cited by 118 · see citing works
Self-citationFecal Contamination of Drinking Water within Peri-Urban Households, Lima, Peru
Oswald, W. E., Lescano, A. G., Bern, C., Calderon, M. M., Cabrera, L. Z., & Gilman, R. H. (2007) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.2007.77.699 · Cited by 116 · see citing works
Stoler, J. B., Fink, G., Weeks, J. R., Otoo, R. A., Ampofo, J. A., & Hill, A. G. (2011) · Health & Place · doi:10.1016/j.healthplace.2011.09.020 · Cited by 109 · see citing works
Self-citationA Summary Catalogue of Microbial Drinking Water Tests for Low and Medium Resource Settings
Bain, R., Bartram, J., Ellıott, M., Matthews, R. L., McMahan, L., Tung, R., Chuang, P., & Gundry, S. (2012) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph9051609 · Cited by 106 · see citing works
Fisher, M. B., Williams, A. R., Jalloh, M. F., Saquee, G., Bain, R., & Bartram, J. (2015) · PLoS ONE · doi:10.1371/journal.pone.0131772 · Cited by 80 · see citing works
Escherichia coli in household drinking water and diarrheal disease risk: evidence from Cambodia
Brown, J. M., Proum, S., & Sobsey, M. D. (2008) · Water Science & Technology · doi:10.2166/wst.2008.439 · Cited by 79 · see citing works
The Coliform Index and Waterborne Disease: Problems of microbial drinking water assessment
Gleeson, C., & Gray, N. (1996) · Thammasat University Digital Collections · Cited by 74 · see citing works
Jensen, P. K. M., Jayasinghe, G., van der Hoek, W., Cairncross, S., & Dalsgaard, A. (2004) · Tropical Medicine & International Health · doi:10.1111/j.1365-3156.2004.01329.x · Cited by 65 · see citing works
Gundry, S. (2006) · Water Practice & Technology · doi:10.2166/wpt.2006032 · Cited by 57
Quality of age reporting : extension and application of the modified Whipple's index
Spoorenberg, T. (2007) · Population (English Edition) · doi:10.3917/pope.704.0729 · Cited by 49 · see citing works
Stoler, J. B., Tutu, R. A., Ahmed, H., Frimpong, L. A., & Bello, M. (2013) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.13-0461 · Cited by 43 · see citing works
Self supply systems: Urban dug wells in Abeokuta, Nigeria
Oluwasanya, G., Smith, J., & Carter, R. (2011) · Water Science & Technology Water Supply · doi:10.2166/ws.2011.026 · Cited by 34 · see citing works
Christenson, E., Bain, R., Wright, J., Aondoakaa, S. C., Hossain, R., & Bartram, J. (2014) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2014.05.010 · Cited by 33 · see citing works
Self-citationModeling and correction of digit preference in tuberculin surveys.
Eilers, P. H. C., & Borgdorff, M. W. (2004) · PubMed · Cited by 32 · see citing works
Graves, J. W., Bailey, K. R., Grossardt, B. R., Gullerud, R. E., Meverden, R. A., Grill, D. E., & Sheps, S. G. (2006) · American Journal of Hypertension · doi:10.1016/j.amjhyper.2005.04.004 · Cited by 30 · see citing works
La qualité des déclarations par âge : extension et application de l'indice de Whipple modifié
Spoorenberg, T. (2007) · Population · doi:10.2307/20451056 · Cited by 22 · see citing works
Migration and poverty reduction: evidence from the Ghana Living Standards Survey
Litchfield, J., & Waddington, H. S. (2003) · Cited by 15 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [18]World Health Organization Guidelines for Drinking-Water Quality. Vol. 3—Surveillance and Control of Community Supplies World Health Organization Geneva, Switzerland 1997
Cited by
Sorted by citations
Prüss-Ustün, A., Wolf, J., Bartram, J., Clasen, T., Cumming, O., Freeman, M. C., Gordon, B., Hunter, P. R., Medlicott, K., & Johnston, R. (2019) · International Journal of Hygiene and Environmental Health · doi:10.1016/j.ijheh.2019.05.004 · Cited by 1,308 · see citing works
Self-citationWolf, J., Hunter, P. R., Freeman, M. C., Cumming, O., Clasen, T., Bartram, J., Higgins, J. P. T., Johnston, R., Medlicott, K., Boisson, S., et al. (2018) · Tropical Medicine & International Health · doi:10.1111/tmi.13051 · Cited by 403 · see citing works
Self-citationFrom curiosity to commodity: a review of the evolution of sachet drinking water in West Africa
Stoler, J. B. (2017) · Wiley Interdisciplinary Reviews Water · doi:10.1002/wat2.1206 · Cited by 62 · see citing works
Wardrop, N. A., Hill, A. G., Dzodzomenyo, M., Aryeetey, G. C., & Wright, J. (2017) · International Journal of Hygiene and Environmental Health · doi:10.1016/j.ijheh.2017.09.014 · Cited by 58 · see citing works
Self-citationWardrop, N. A., Dzodzomenyo, M., Aryeetey, G., Hill, A. G., Bain, R. E. S., & Wright, J. (2017) · Environmental Research Letters · doi:10.1088/1748-9326/aa751f · Cited by 52 · see citing works
Self-citationGlobal Bottled Water Industry: A Review of Impacts and Trends
Bouhlel, Z., Köpke, J., Mina, M., & Smakhtin, V. (2023) · doi:10.53328/agym7357 · Cited by 39 · see citing works
Akano, O. I., Oderinde, F. O., & Omotayo, A. O. (2023) · Journal of Agriculture and Food Research · doi:10.1016/j.jafr.2023.100525 · Cited by 27 · see citing works
The role of packaged water in meeting global targets on improved water access
Vedachalam, S., MacDonald, L. H., Omoluabi, E., OlaOlorun, F. M., Otupiri, E., & Schwab, K. J. (2017) · Journal of Water Sanitation and Hygiene for Development · doi:10.2166/washdev.2017.155 · Cited by 24 · see citing works
Recycling of polyethylene: an attempt to sachet and bottled water sustainability in Ghana
Baffour-Awuah, E., Akinlabi, S. A., & Jen, T. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-819496-6.00010-5 · Cited by 23 · see citing works
Evaluating the potability and human health risk of sachet water in Wukari, Nigeria
Kusa, R., & Joshua, W. K. (2022) · Archives of Environmental & Occupational Health · doi:10.1080/19338244.2022.2063785 · Cited by 22 · see citing works
Sachet water quality and product registration: a cross-sectional study in Accra, Ghana
Dzodzomenyo, M., Fink, G., Dotse-Gborgbortsi, W., Wardrop, N., Aryeetey, G., Coleman, N., Hill, A., & Wright, J. (2018) · Journal of Water and Health · doi:10.2166/wh.2018.055 · Cited by 22 · see citing works
Self-citationDomestic drinking water management: Quality assessment in Oforikrom municipality, Ghana
Appiah–Effah, E., Ahenkorah, E., Duku, G. A., & Nyarko, K. B. (2021) · Science Progress · doi:10.1177/00368504211035997 · Cited by 21 · see citing works
Guzman, D. B., & Stoler, J. B. (2018) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.17-0804 · Cited by 20 · see citing works
An assessment of the water, sanitation and hygiene (WASH) situation in rural Volta Region, Ghana
Osarfo, J., Ampofo, G. D., Arhin, Y. A., Ekpor, E., Azagba, C. K., & Tagbor, H. K. (2023) · PLOS Water · doi:10.1371/journal.pwat.0000134 · Cited by 17 · see citing works
Mantey, E. P., Kanwar, R. S., & Appiah–Effah, E. (2024) · Water · doi:10.3390/w16223193 · Cited by 13 · see citing works
da Silva, D. T. G., Ebdon, J., Okotto-Okotto, J., Ade, F., Mito, O., Wanza, P., Kwoba, E. N., Thumbi, S. M., Yu, W., & Wright, J. (2020) · International Journal of Hygiene and Environmental Health · doi:10.1016/j.ijheh.2020.113602 · Cited by 13 · see citing works
Self-citationKingebeni, P. M., VOGT, F. M., Miwanda, B. N., Sundika, T., Mbula, N., Pankwa, I., Lubula, L., Vanlerberghe, V., Magazani, A. N., Afoumbom, M. T., et al. (2021) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0009477 · Cited by 12 · see citing works
Semey, M. D. K., Dotse-Gborgbortsi, W., Dzodzomenyo, M., & Wright, J. (2020) · Journal of Water, Sanitation and Hygiene for Development · doi:10.2166/washdev.2020.110 · Cited by 8 · see citing works
Self-citationYu, W., Wardrop, N. A., Bain, R., & Wright, J. (2017) · International Journal of Hygiene and Environmental Health · doi:10.1016/j.ijheh.2017.04.006 · Cited by 8 · see citing works
Self-citationZimmer, C., Boyer, R., Cassivi, A., Tilley, E., Bain, R., Johnston, R. B., & Dorea, C. C. (2025) · PLOS Water · doi:10.1371/journal.pwat.0000367 · Cited by 6 · see citing works
Self-citationOsikanmi, B. O., Mustapha, M., Sridhar, M. K. C., & Coker, A. O. (2020) · Journal of Environmental Protection · doi:10.4236/jep.2020.111005 · Cited by 6 · see citing works
Microbial diversity and ecology of bottled water
Boas, D. M. V., Alegbeleye, O. O., & Sant’Ana, A. S. (2024) · Current Opinion in Food Science · doi:10.1016/j.cofs.2024.101218 · Cited by 5 · see citing works
Angnunavuri, P. N., Attiogbe, F. K., & Mensah, B. (2022) · Journal of Water and Health · doi:10.2166/wh.2022.163 · Cited by 4 · see citing works
Okeola, F. O., Taofeeqat, A. B. U., Mohammed, A. A., Orosun, M. M., Baba, A. A., & ADEBOJE, M. B. (2023) · Journal of the Turkish Chemical Society Section A Chemistry · doi:10.18596/jotcsa.1116034 · Cited by 4 · see citing works
Ogisma, L., Sawadgo, W., O'Donnell, F. C., Molnar, J. J., Huluka, G., Preux, J. F. S., Louis, N., & Nord, O. (2025) · Water Environment Research · doi:10.1002/wer.70179 · Cited by 3 · see citing works
Evaluation of Microbial and Elemental contaminants of Open Market Sachet Water in Nnewi Metropolis
Nwobodo, E. (2021) · INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY RESEARCH AND ANALYSIS · doi:10.47191/ijmra/v4-i2-11 · Cited by 3 · see citing works
Rasuanto, R. P., Triyono, A., Tisnanta, H., Sumarja, F. X., & Prayoga, S. (2025) · Al-Zayn. · doi:10.61104/alz.v3i3.1388 · Cited by 2 · see citing works
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Bolarinwa, M. A., & ABODUNDE, A. (2023) · European Journal of Engineering and Technology Research · doi:10.24018/ejeng.2023.8.5.3076 · Cited by 2 · see citing works
- Authors
- Wright, J., Dzodzomenyo, M., Wardrop, N., Johnston, R., Hill, A., Aryeetey, G., & Adanu, R.
- Affiliations
- University of Southampton (GB)
- University of Ghana (GH)
- World Health Organization (CH)
- Corresponding author
- Wright, Jim
- ORCID
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2016-03-09
- Volume
- 13
- Issue
- 3
- Pages
- 303
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC4808966
- OpenAlex
- W2295316460
- Cited by
- 27
- References
- 29
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 5 · 2022: 2 · 2021: 3 · 2020: 4 · 2019: 1 · 2018: 3 · 2017: 5
- FWCI
- 1.78
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Research Councils UK (MR/M008940/1)
- Department for International Development, UK Government (MR/M008940/1)
- Topics
- Physical Sciences › Environmental Science › Water Science and Technology › Fecal contamination and water quality
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Water Treatment and Disinfection
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Keywords
- sachet water, bottled water, Escherichia coli contamination, drinking water quality, surface water use, piped water, Ghana
- MeSH terms
- Cross-Sectional Studies, Environmental Exposure, Escherichia coli, Ghana, Humans, Surveys and Questionnaires, Risk Factors, Water Microbiology, Water Pollution, Water Quality, Drinking Water
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