{"title":"Water management practices and antibiotic-resistant <i>Pseudomonas aeruginosa</i> contamination in Ethiopian tertiary hospitals: implications for waterborne healthcare-associated infections.","authors":"Etsub Brhanesilassie Hailemichael, Adey Feleke Desta, Girma Taye, Sirak Robele Gari, Amare Alemu, Waktole Gobena, Wondwossen Amogne","doi":"10.2166/wh.2025.042","DOIUrl":"https://doi.org/10.2166/wh.2025.042","url":null,"abstract":"<p><p>The threat of healthcare-associated infections is significantly heightened when caused by drug-resistant pathogens. This study evaluates water management practices and prevalence of antibiotic-resistant <i>Pseudomonas aeruginosa</i> in water systems of two tertiary hospitals of Ethiopia. We employed a mixed-methods approach, combining the qualitative data thematic analysis with quantitative microbiological results from 120 potable water samples. <i>P. aeruginosa</i> isolates were identified and subjected to antimicrobial susceptibility testing. Data collection was conducted between December 2023 and January 2024. The findings indicate that neither hospital had a dedicated water management programme for preventive maintenance. Microbial analysis revealed a 16% prevalence of <i>P. aeruginosa</i> in the water samples, with 26.3% of isolates demonstrating resistant to at least one antibiotic class. Notably, two isolates from the maternity ward of Hospital A exhibited multidrug resistance (MDR) to ciprofloxacin, amikacin, and imipenem. Overall, the structural and operational standard of the water management programmes in both hospitals were found to be non-conformant to international standards. A higher rate of Pseudomonas positivity, including resistant and MDR strains, indicates persistent hospital water contamination and a tangible risk for HAIs. These results underscore the critical need for the formation of multidisciplinary water safety team to optimize water quality management in these hospitals.</p>","PeriodicalId":17436,"journal":{"name":"Journal of water and health","volume":"23 10","pages":"1180-1195"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hadis Kalantari, Khosro Issazadeh, Abbas Hajizade, Mohammad Faezi Ghasemi
{"title":"Investigating the presence of virulence determinants and vancomycin-resistant genes in <i>enterococci</i> isolated from the Anzali Lagoon and recreational waters in Guilan Province, Iran.","authors":"Hadis Kalantari, Khosro Issazadeh, Abbas Hajizade, Mohammad Faezi Ghasemi","doi":"10.2166/wh.2025.062","DOIUrl":"https://doi.org/10.2166/wh.2025.062","url":null,"abstract":"<p><p>This study characterizes vancomycin-resistant <i>Enterococci</i> (VRE) in Iran's Anzali Lagoon recreational waters through analysis of 268 samples collected seasonally (2019). Culture and PCR methods identified Enterococcus in 57.5% (154/268) of samples, with 40.3% (62/154) showing vancomycin resistance. Resistance gene profiling revealed <i>vanA</i> and <i>vanH</i> predominance (56.5% each, 35/62), demonstrating complete co-occurrence, while vanB was rare (3.2%, 2/62) and vanC absent. Virulence factors displayed divergent prevalence: esp (62.9%, 39/62) exceeded clinical isolate rates, whereas hyl (3.2%, 2/62) was uncommon. Biofilm assays showed VRE isolates formed significantly denser biofilms than susceptible strains (2.3-fold higher OD570, <i>p</i> < 0.001), with esp-positive isolates exhibiting the strongest biofilm production. These findings demonstrate that recreational waters harbor VRE populations with: (1) elevated esp prevalence suggesting environmental selection pressures, and (2) enhanced biofilm capacity promoting persistence. The 100% <i>vanA</i>-<i>vanH</i> co-occurrence and 62.9% esp frequency surpass WHO risk thresholds for recreational waters, indicating need for revised monitoring protocols. This study provides the first evidence of aquatic-specific VRE genotypes in the region and their potential public health impacts through resistance gene dissemination and waterborne exposure risks.</p>","PeriodicalId":17436,"journal":{"name":"Journal of water and health","volume":"23 10","pages":"1224-1239"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"QMRA for assessing treatment needs of surface water for drinking: trends and challenges in fecal pathogen quantification.","authors":"Thi Thu Huong Nguyen, Midori Yasui, Jie Zeng, Tomohiro Nakanishi, Sadahiko Itoh","doi":"10.2166/wh.2025.096","DOIUrl":"https://doi.org/10.2166/wh.2025.096","url":null,"abstract":"<p><p>Pathogens are widespread in surface waters, necessitating effective microbial removal by drinking water treatment systems to ensure public health. Quantitative microbial risk assessment (QMRA) provides a robust framework to estimate required pathogen reduction by integrating source water pathogen levels with acceptable health risk thresholds. Accurate quantification of pathogen loads is a critical first step in QMRA. This review provides a comprehensive overview of methods for quantifying fecal pathogen loads in surface waters for QMRA applications. We conducted an extensive literature review to identify the most commonly targeted fecal pathogens and the quantification strategies used, including approaches that measure the pathogens directly and indirect approaches that use surrogate indicators of fecal contamination. The applicability, strengths, and limitations of these methods are critically evaluated. This review guides QMRA in surface waters toward more reliable and appropriate risk assessments to support safe drinking water goals.</p>","PeriodicalId":17436,"journal":{"name":"Journal of water and health","volume":"23 10","pages":"1269-1285"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kondwani Luwe, Kingsley Lungu, Tracy Morse, Kevin G McGuigan, Ronan M Conroy, Lyndon Buck, Evanson Z Sambala
{"title":"Adherence to solar disinfection water treatment reduces diarrheal incidence among children in Malawi: a secondary analysis of a cluster quasi-experimental study.","authors":"Kondwani Luwe, Kingsley Lungu, Tracy Morse, Kevin G McGuigan, Ronan M Conroy, Lyndon Buck, Evanson Z Sambala","doi":"10.2166/wh.2025.092","DOIUrl":"https://doi.org/10.2166/wh.2025.092","url":null,"abstract":"<p><strong>Background: </strong>Diarrhoea is a leading cause of morbidity and mortality among children under five in low-income regions. This study assessed the effectiveness of household solar disinfection (SODIS) in reducing diarrhoeal incidence among children in Chikwawa District, Malawi.</p><p><strong>Methods: </strong>We conducted a secondary analysis of a cluster quasi-experimental trial (March 2019-March 2020) involving 985 children from 793 households: control (369 children, 271 households), 20 L transparent polypropylene SODIS bucket (336 children, 258 households), and SODIS bucket with cloth filter (380 children, 264 households). Variables included water source, child age, sex, rotavirus vaccination, SODIS adherence. Analyses employed descriptive statistics, Chi-square, Kruskal-Wallis tests, and Poisson regression with robust standard errors in Stata 17.</p><p><strong>Results: </strong>Overall, diarrhoeal incidence was two cases per child-year. Households using SODIS buckets had an 88% reduction in incidence (adjusted incidence rate ratio (IRR): 0.12; 95% CI: 0.04-0.23), while those using SODIS with a cloth filter saw a 70% reduction (adjusted IRR: 0.30; 95% CI: 0.18-0.50). High SODIS adherence was linked to 90% reduction (adjusted IRR: 0.13; 95% CI: 0.02-0.81); medium adherence showed no significant effect.</p><p><strong>Conclusion: </strong>These findings support SODIS as an effective point-of-use water treatment, with adherence critical to health impact.</p>","PeriodicalId":17436,"journal":{"name":"Journal of water and health","volume":"23 10","pages":"1255-1268"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mercy O Kehinde, Corinne Schuster-Wallace, David Fowler, Lalita A Bharadwaj
{"title":"Weaving knowledge systems to eradicate drinking water crises in First Nations across Canada.","authors":"Mercy O Kehinde, Corinne Schuster-Wallace, David Fowler, Lalita A Bharadwaj","doi":"10.2166/wh.2025.346","DOIUrl":"10.2166/wh.2025.346","url":null,"abstract":"<p><p>In Canada, First Nations (FN) are the largest of three Indigenous groups who have occupied and lived on the land for thousands of years. With a current population of about 1.1 million, universal access to safe drinking water remains a persistent problem, with advisories a norm rather than an exception in many FN communities. This study examines the Federal Government's approach to resolving the issues of long-term drinking water advisories (LTDWAs) across FN Reserves in Canada. The objective was to determine the acknowledgment and application of FN water principles and values within the federal LTDWA intervention framework. Financial and technical capacity was also explored. Results indicate that the Federal Government's approach to eradicating LTDWA in FN focuses on infrastructure technologies, overlooking other aspects of sustainable water supply, such as advanced source water protection. As such, it overlooked (1) FN water management principles and values; (2) FN strength and capacity to manage their water; and (3) First Nations' right to self-determination. It is argued that the poor attention to FN water principles and values, including the failure to address the issues of financial and technological capacity, undermines FN rights to self-determination and contributes to the continuous presence of LTDWAs in communities.</p>","PeriodicalId":17436,"journal":{"name":"Journal of water and health","volume":"23 9","pages":"991-1003"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andy Bastable, Paul Knox-Clarke, Laurence Hamai, Raissa Azzalini, Vi Nguyen
{"title":"Climate adaptation in water, sanitation, and hygiene (WASH) in humanitarian crises: research and innovation priorities.","authors":"Andy Bastable, Paul Knox-Clarke, Laurence Hamai, Raissa Azzalini, Vi Nguyen","doi":"10.2166/wh.2025.028","DOIUrl":"10.2166/wh.2025.028","url":null,"abstract":"<p><p>The climate crisis is having profound and far-reaching consequences for humanitarian Water, Sanitation, and Hygiene (WASH) systems. Rising global temperatures, shifting precipitation patterns, and an increase in extreme weather events are placing unprecedented strain on WASH services, particularly in vulnerable humanitarian contexts. As climate-induced disruptions intensify, humanitarian actors face significant challenges in ensuring access to clean water, adequate sanitation, and hygiene services. Displaced populations, communities facing food insecurity, and regions already experiencing conflict are particularly at risk, as climate change exacerbates existing vulnerabilities. This paper outlines opportunities for research and innovation that will support humanitarian WASH to respond to the climate challenge. It is the result of a research process, incorporating a literature review, analysis of field data, expert insights, and survey responses. The study outlines eleven actionable research and innovation priorities for the humanitarian WASH sector related to improving water security, strengthening sanitation infrastructure, and enhancing public health responses. The findings emphasise the urgent need for climate-adaptive WASH solutions that not only address current risks but also build resilience to future climate shocks.</p>","PeriodicalId":17436,"journal":{"name":"Journal of water and health","volume":"23 9","pages":"1004-1014"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kata Farkas, Devrim Kaya, Rasha Maal-Bared, Ahmad I Al-Mustapha, Sarmila Tandukar, Ishi Keenum, Teemu Gunnar, Aaron Bivins, Matthew J Wade, Kyle Bibby, Tarja M Pitkänen, Ananda Tiwari
{"title":"Communicating wastewater-based surveillance data to drive action.","authors":"Kata Farkas, Devrim Kaya, Rasha Maal-Bared, Ahmad I Al-Mustapha, Sarmila Tandukar, Ishi Keenum, Teemu Gunnar, Aaron Bivins, Matthew J Wade, Kyle Bibby, Tarja M Pitkänen, Ananda Tiwari","doi":"10.2166/wh.2025.080","DOIUrl":"https://doi.org/10.2166/wh.2025.080","url":null,"abstract":"<p><p>As exemplified during the COVID-19 pandemic, wastewater-based surveillance (WBS) can deliver near real-time, population-level pathogen data to guide public health action. Its impact, however, hinges on timely, transparent, and context-specific communication to stakeholders, including health authorities, policymakers, scientists, clinicians, and the public. This review examines current WBS communication practices, identifies persistent challenges, and proposes strategies to enhance relevance. Key challenges include data complexity, lack of standardised communication frameworks, ethical and privacy concerns, and variable stakeholder capabilities. The strategic use of digital platforms, such as dashboards, reports, press releases, and social media, alongside traditional media, can broaden reach and aid interpretation. Rapid, accurate, and empathetic communication is essential during health crises to maintain trust and counter misinformation. Standardised messaging, simplified data visualisations, and integration with clinical surveillance systems enhance credibility and usability. Strengthening cross-sector collaboration, improving data interpretation, and translating findings into actionable insights are essential to maximising the public health benefits of WBS. Immediate efforts should prioritise building globally coordinated, adaptive communication networks that can evolve alongside surveillance technologies and emerging health threats. Overall, the review underscores the key role of strategic communication in advancing WBS for global health preparedness and optimising public health actions.</p>","PeriodicalId":17436,"journal":{"name":"Journal of water and health","volume":"23 9","pages":"1095-1108"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Reza Rashidi, Seyed Mohammad Mousavi, Mohammad Ali Mohammadi, Saeid Nasibi, Saeedeh Shamsaddini, Fatemeh Mollaee, Mohammad Ebrahimipour, Saiedeh Haji-Maghsoudi, Majid Fasihi Harandi
{"title":"Surface water contamination with <i>Echinococcus granulosus</i> eggs in the endemic regions of cystic echinococcosis in the southeast of Iran: significance and public health implications.","authors":"Mohammad Reza Rashidi, Seyed Mohammad Mousavi, Mohammad Ali Mohammadi, Saeid Nasibi, Saeedeh Shamsaddini, Fatemeh Mollaee, Mohammad Ebrahimipour, Saiedeh Haji-Maghsoudi, Majid Fasihi Harandi","doi":"10.2166/wh.2025.244","DOIUrl":"https://doi.org/10.2166/wh.2025.244","url":null,"abstract":"<p><p>Cystic echinococcosis (CE), caused by the dog tapeworm, <i>Echinococcus granulosus</i>, is a worldwide public health concern in different endemic countries. CE is transmitted through the ingestion of the parasite eggs excreted in dog feces. However, limited molecular parasitological evidence is available regarding the environmental sources of CE transmission to humans and animals. Water is probably one of the environmental sources of CE transmission; however, very few studies have investigated the presence of <i>E. granulosus</i> eggs in water. The aim of this study was to investigate the contamination of surface water sources with <i>E. granulosus</i>. Three hundred samples, each of 10 L volume, were collected from rivers, streams, agricultural fields, ponds, pools and marshes in six counties in the south of Kerman province, Iran. After filtration, the samples were analyzed by microscopy, PCR assay and nested-PCR-sequencing. <i>Echinococcus granulosus</i> DNA was detected in 1.7% of the samples, mainly collected from streams, agricultural lands and marshes in Jiroft and Anbarabad. PCR-sequencing identified the parasites as <i>E. granulosus sensu stricto</i>, G1 genotype. The findings of the study indicate the potential of water as an environmental source of human CE, suggesting the role of water in perpetuating the life cycle and transmission of <i>E. granulosus</i> eggs.</p>","PeriodicalId":17436,"journal":{"name":"Journal of water and health","volume":"23 9","pages":"981-990"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Respah Nawanjaya Sifuna, James M Raude, Sheillah Simiyu, Jackline A Ndiiri
{"title":"Environmental faecal contamination and associated health risks along multiple exposure pathways in Yatta Sub-County, Machakos County, Kenya.","authors":"Respah Nawanjaya Sifuna, James M Raude, Sheillah Simiyu, Jackline A Ndiiri","doi":"10.2166/wh.2025.098","DOIUrl":"https://doi.org/10.2166/wh.2025.098","url":null,"abstract":"<p><p>Access to safe drinking water and sanitation is a fundamental human right. However, in many regions, particularly in low- and middle-income countries, the prevalence of faecal contamination of water poses health risks. In Kenya, a substantial portion of the population relies on unimproved water sources that are susceptible to faecal contamination from various environmental pathways, including open drains, surface water, and inadequate sanitation facilities. The SaniPath study framework provided a robust approach for assessing faecal exposure pathways by examining the behaviors and environmental factors contributing to contamination and was used in Yatta Sub-County, Machakos County. The study revealed significant faecal contamination across various environmental pathways. The highest <i>E. coli</i> concentrations were found in raw produce (4.09 Log<sub>10</sub> CFU/mL) and public latrines (3.87 Log<sub>10</sub> CFU/mL), suggesting a serious public health risks associated with these exposure routes. Adults and children frequently encountered contaminated water and food. The reliance on contaminated drinking water sources (mean concentration of 3.11 Log<sub>10</sub> CFU/mL) and high usage of public latrines underscore the necessity for urgent improvements in sanitation infrastructure and hygiene practices to mitigate possible health risks associated with faecal contamination.</p>","PeriodicalId":17436,"journal":{"name":"Journal of water and health","volume":"23 9","pages":"1123-1134"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kate Albi, Leigh-Anne Krometis, Erin Ling, Alasdair Cohen, Kang Xia, Austin Gray, Emerald Dudzinski, Kimberly Ellis
{"title":"Comparing in-home and bottled drinking water quality: regulated and emerging contaminants in rural Central Appalachia.","authors":"Kate Albi, Leigh-Anne Krometis, Erin Ling, Alasdair Cohen, Kang Xia, Austin Gray, Emerald Dudzinski, Kimberly Ellis","doi":"10.2166/wh.2025.073","DOIUrl":"https://doi.org/10.2166/wh.2025.073","url":null,"abstract":"<p><p>An increasing number of Americans rely on bottled water for household use, citing perceptions of poor in-home water quality and/or distrust of public water utilities. We analyzed in-home (<i>n</i> = 23), roadside spring (<i>n</i> = 4), and bottled drinking water (<i>n</i> = 36) in Central Appalachia. All samples were analyzed for regulated (bacteria, inorganic ions) and emerging (PFAS, microplastics) contaminants. Study survey results indicated the majority (83%) of participants viewed their in-home water quality as satisfactory or poor due to negative organoleptic perceptions. Coliform bacteria and sodium levels exceeding recommended levels were detected in 52% of home water samples, though detections varied by source, i.e., high sodium was more often observed in municipal water, while bacteria were more often observed in private system water. Bottled water samples did not exceed any regulations, though median microplastic concentrations were statistically higher (<i>p</i> = 0.001, Wilcoxon rank-sum test) than those recovered from in-home samples. PFAS compounds were detected in some in-home and bottled water samples at very low levels. While in general bottled water appears to be a safe drinking water source in these areas, the associated costs in time and money for lower-income households are considerable, and were estimated by participants as $68-400/month.</p>","PeriodicalId":17436,"journal":{"name":"Journal of water and health","volume":"23 9","pages":"1078-1094"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}