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. 2017 Apr 20;14(4):441.
doi: 10.3390/ijerph14040441.

Water Access, Sanitation, and Hygiene Conditions and Health Outcomes among Two Settlement Types in Rural Far North Cameroon

Tyler J Gorham  1 , Joshua Yoo  2 , Rebecca Garabed  3 , Arabi Mouhaman  4 , Jiyoung Lee  5   6
Affiliations

Water Access, Sanitation, and Hygiene Conditions and Health Outcomes among Two Settlement Types in Rural Far North Cameroon

Tyler J Gorham et al. Int J Environ Res Public Health. .

Abstract

The Far North region in Cameroon has been more heavily impacted by cholera than any other region over the past decade, but very little has been done to study the drivers of waterborne diseases in the region. We investigated the relationship between water, sanitation, and hygiene (WASH) parameters, microbial and antibiotic resistance (AR) contamination levels in drinking water, and health outcomes using health survey and molecular analysis during June and July of 2014 in two settlement types (agro-pastoralist villages and transhumant pastoralist camps). Quantitative polymerase chain reaction was used to determine fecal contamination sources, enteric pathogens, and antibiotic resistance genes. Ruminant-associated fecal contamination was widespread in both settlement types (81.2%), with human-associated contamination detected in 21.7% of the samples. Salmonella spp. (59.4%) and Shiga toxin-producing E. coli (stx1 44.9% and stx2 31.9%) were detected across all samples. Tetracycline resistance was found only in village samples. A significant difference in diarrheal incidence within the past 28 days among young children was found between camps (31.3%) and villages (0.0%). Our findings suggest that water contamination may play an important role in contributing to gastrointestinal illness, supporting the need for future research and public health intervention to reduce gastrointestinal illness in the area.

Keywords: antibiotic resistance; diarrhea disease; enteric pathogens; health behavior; microbial source tracking.

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Conflict of interest statement

The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Figures

Figure 1
Figure 1
Locations of health survey administration and water sampling, over June and July 2014. Six transhumant pastoralist camps and six sedentary villages within a triangle formed by the cities of Maroua, Yagoua, and Kaele were arbitrarily selected for sampling.
Figure 2
Figure 2
Concentration of microbial source tracking (MST) and antibiotic resistance (AR) genes by water sample type. Among the samples detected, HF183 was present at much higher concentrations than Rum2Bac. tetQ was only detected in village samples. Error bars represent the standard error of the mean.
Figure 3
Figure 3
Concentrations of pathogens detected by quantitative PCR (qPCR) in different water sample types (camp vs. village and water at home vs. water from the source water). The drinking water from the source at camps showed the highest concentrations of pathogens. Among villages, water from homes had slightly higher contamination levels, whereas source water contamination levels were higher in camps. Error bars represent the standard error of the mean.
Figure 4
Figure 4
Water storage methods and reported primary sources of drinking water. Village residents reported high borehole reliance (A), while those in transhumant pastoralist camps relied primarily on surface water (B). For water storage, most village residents use clay jars (C) while nomadic camp residents rely heavily on bottles and jerry cans (D).
See this image and copyright information in PMC

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