literature review on sachet water

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Peer-reviewed

Research Article

Sachet water in Ghana: A spatiotemporal analysis of the recent upward trend in consumption and its relationship with changing household characteristics, 2010–2017

Roles Conceptualization, Formal analysis, Methodology, Software, Writing – original draft

* E-mail: [email protected]

Affiliation School of Geography and the Environment, University of Oxford, Oxford, United Kingdom

Affiliation Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom

Roles Conceptualization, Formal analysis, Methodology

Affiliation Department of Geography and Resource Development, University of Ghana, Accra, Ghana

Roles Formal analysis, Methodology, Software, Writing – original draft

Affiliation Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada

Roles Conceptualization, Supervision, Writing – original draft

Affiliation Institute of Statistical, Social and Economic Research, University of Ghana, Accra, Ghana

Affiliations MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom, Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, United Kingdom, Regional Institute for Population Studies, University of Ghana, Accra, Ghana

Roles Conceptualization, Formal analysis, Methodology, Supervision, Writing – original draft

• Simon Moulds, 
• Anson C. H. Chan, 
• Jacob D. Tetteh, 
• Honor Bixby, 
• George Owusu, 
• Samuel Agyei-Mensah, 
• Majid Ezzati, 
• Wouter Buytaert, 
• Michael R. Templeton

• Published: May 26, 2022
• https://doi.org/10.1371/journal.pone.0265167
• Reader Comments

The consumption of packaged water in Ghana has grown significantly in recent years. By 2017, “sachet water”—machine-sealed 500ml plastic bags of drinking water—was consumed by 33% of Ghanaian households. Reliance on sachet water has previously been associated with the urban poor, yet recent evidence suggests a customer base which crosses socioeconomic lines. Here, we conduct a repeated cross-sectional analysis of three nationally representative datasets to examine the changing demography of sachet water consumers between 2010 and 2017. Our results show that over the course of the study period sachet water has become a ubiquitous source of drinking water in Ghana, with relatively wealthy households notably increasing their consumption. In 2017, the majority of sachet water drinking households had access to another improved water source. The current rate and form of urbanisation, inadequate water governance, and an emphasis on cost recovery pose significant challenges for the expansion of the piped water supply network, leading us to conclude that sachet water will likely continue to be a prominent source of drinking water in Ghana for the foreseeable future. The main challenge for policymakers is to ensure that the growing sachet water market enhances rather than undermines Ghana’s efforts towards achieving universal and equitable access to clean drinking water and sanitation.

Citation: Moulds S, Chan ACH, Tetteh JD, Bixby H, Owusu G, Agyei-Mensah S, et al. (2022) Sachet water in Ghana: A spatiotemporal analysis of the recent upward trend in consumption and its relationship with changing household characteristics, 2010–2017. PLoS ONE 17(5): e0265167. https://doi.org/10.1371/journal.pone.0265167

Editor: Godfred O. Boateng, University of Texas at Arlington, UNITED STATES

Received: March 2, 2021; Accepted: February 24, 2022; Published: May 26, 2022

Copyright: © 2022 Moulds et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The data and scripts used in the analysis are available online ( http://doi.org/10.5281/zenodo.4556980 ).

Funding: This work is supported by the Pathways to Equitable Healthy Cities grant from the Wellcome Trust [209376/Z/17/Z]. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.

Competing interests: The authors have declared that no competing interests exist.

Introduction

In many West African nations the rate of urbanisation has outpaced official efforts to expand the provision of safe drinking water [ 1 ]. Instead, many households have turned to the private sector to fulfil their drinking water demand [ 2 ]. Among the modes and mediums used by the private sector to supply water, the market for sachet water—machine-sealed 500ml plastic bags of drinking water—has risen dramatically over the last two decades in West African nations including Ghana and Nigeria [ 3 ]. As the previous ideal of a single water utility providing a consistent and universal service has come to be seen as increasingly unrealistic for many developing countries [ 4 , 5 ], the potential of the private sector to expand the provision of safe drinking water to underserved populations has received significant attention in recent years [ 5 ]. However, there are concerns that the growing sachet water market, left unchecked, may undermine the principle of water as a public good and threaten the goal of universal access [ 5 – 7 ]. As policymakers grapple with these issues, there is a need to understand the role of sachet water in shaping recent trends in West Africa’s drinking water landscape. This study aims to contribute to the emerging discourse on sachet water consumption in West Africa by identifying spatiotemporal trends in drinking water preferences among households in Ghana—one of the largest markets for sachet water in the region—between 2010 and 2017.

The purchase of small volumes of drinking water has a long history in Ghana [ 5 ]. In the 1970s and 1980s it was common for Ghanaian street vendors to sell drinking water in cups scooped out of water storage tanks [ 1 ]. Increasing demand and hygiene concerns through the 1990s led to water being sold in plastic bags with the corners tied at the top, sometimes chilled by ice-blocks [ 1 , 8 ]. Around the same time, Chinese machines which packaged filtered water into heat-sealed plastic sleeves started to be imported, creating sachet water as it is known today [ 3 ]. Sachet water—popularly known as “pure water” [ 5 ]—has the second-highest cost by volume after bottled water [ 9 ]. Nevertheless, its unit price of around 0.05 USD [ 9 ] remains within reach of those in absolute poverty [ 10 ]. The water source used to produce sachet water varies by location. In Accra, it is typically produced in parts of the city with a reliable connection to the piped supply network [ 1 ], while in peri-urban and rural areas manufacturers often rely on groundwater [ 1 , 11 ]. Several studies have shown that sachet water exhibits low levels of contamination compared with other drinking water sources [ 9 , 12 , 13 ].

Vended water is often taken as a symptom of failure in the piped water supply networks [ 14 ]. Undoubtedly, the rapid growth of Ghana’s sachet water market has been fuelled by water resources mismanagement, water governance failures, and long-term neglect of water infrastructure [ 3 , 15 ]. Ghana’s water supply infrastructure has not been strategically developed since independence in 1957 [ 16 ], with the result that spatial disparities in water access inherent to the colonial water system persist to this day [ 17 ]. The pressure on municipal water services has been exacerbated by rapid population growth and urbanisation, with Ghana’s urban population increasing from around 4 million in 1984 to more than 16 million in 2017 [ 18 ]. The failure to properly manage this process—albeit in the face of considerable political and economic challenges—has precluded a strategic approach to expanding the coverage of the piped supply network [ 19 ]. Meanwhile, the proliferation of unplanned urban settlements has challenged the role of the state in providing basic services to those living informally [ 20 ]. Given an unreliable and sometimes non-existent municipal water source, Ghanaian households have tended to diversify their water sources to ensure their drinking water demand is consistently met [ 9 , 21 ]. Sachet water is appealing in this respect as it can be easily vended, transported, and stored before consumption as a primary or supplementary drinking water source, either inside or outside of the home [ 5 ].

Household survey data from Accra collected during 2009–2010 linked sachet consumption with the urban poor [ 10 ], with 50% of households from an informal settlement reporting sachet water as their primary source of drinking water. The survey data revealed that sachet drinking households were more likely to live in informal dwellings (e.g. huts, tents), use inferior bathing facilities (e.g. open spaces, rivers), cook with charcoal, and lack drainage infrastructure and access to electricity [ 10 ], leading to the conclusion that sachet water drinking households in urban Accra tended to be the “poorest of the poor” [ 10 ]. These findings were supported by a 2008 survey of women in informal settlements in Accra [ 22 ], which also found that sachet water consumers were generally younger with lower self-reported health. However, an opposing trend was observed in an informal settlement with reliable piped water supply in Ashaiman, a city in Greater Accra, where sachet water consumption was associated with proxies of higher disposable income [ 23 ]. Among the survey participants, more than half used sachet water as their primary drinking water source, with convenience and better perceived water quality cited as the main reasons for their choice. Of the respondents who did not drink sachet water most cited a lack of affordability as the main reason for their choice, with only a minority referring to a lack of piped water.

Ultimately, the dramatic increase in sachet water consumption in Ghana has been driven by the failure of municipal water supplies to reach large swathes of the population [ 10 , 22 ]. Moreover, many of those with nominal access to the piped network report an unreliable service [ 10 ], and a perception of poor water quality [ 5 ]. The supposed convenience of piped water is further diminished for those who are obliged to use communal standpipes [ 10 ]. At the same time, it is clear that many consumers are attracted by the convenience and perceived water quality of sachet water [ 23 ]. While demand side factors have positioned sachet water as a highly appealing product, the rapid growth of the sachet water market over the last two decades would not have been possible without significant changes on the supply side which have enabled manufacturers to rapidly scale up production to meet demand, maintain a degree of control on quality standards, and resist periodic government threats to ban the industry [ 3 ].

As the aim of expanding the coverage of municipal piped supply networks comes to be seen as both unrealistic and perhaps outdated [ 24 ], it seems likely that sachet water will have a noticeable influence on Ghana’s progress towards the United Nations Sustainable Development Goal 6.1 (SDG 6.1), which aims towards “universal and equitable access to safe and affordable drinking water for all” by the year 2030 [ 25 ]. Some scholars have suggested that integrating packaged water into water delivery governance frameworks appears the best way to address remaining concerns around water quality and environmental sustainability [ 3 ]. While the capacity of the sachet water market to widen access to safe drinking water is clear, there are outstanding questions about the social justice implications of formally integrating sachet water into Ghana’s drinking water landscape. In particular, there is concern that such a move would legitimize the provision of water as a discrete private good, and undermine efforts towards universal to safe drinking water [ 5 , 24 ]. In itself, increasing the regulatory burden on the sachet water sector may increase costs to consumers, while doing little to curb the proliferation of small-scale informal producers which are most susceptible to water quality issues [ 24 ]. At the same time, there are fears that focusing on sachet water as a solution to Ghana’s water supply deficit ignores problems related to the supply of non-drinking water [ 5 ].

Statistical reports indicate that sachet water consumption increased rapidly between 2010 and 2017 [ 26 – 28 ]. During the same period Ghana’s gross domestic product (GDP) [ 29 ] and human development index (HDI) [ 30 ] increased considerably. The continued rise in sachet water consumption in Ghana over the past decade raises important questions for Ghana’s water security. Do sachet water consumers still mostly belong to low-income households? Is sachet water consumption restricted to urban areas, or is it gaining market share in rural areas? Is there evidence that sachet water consumption is increasing outside of Accra? As the private sector grows, how does the state manage progress towards universal access to clean and affordable drinking water? Answering these questions is vital to inform sustainable and equitable water resource management policies towards universal access to clean drinking water and sanitation. To that end, we conduct a repeated cross-sectional analysis of three nationally representative datasets from 2010, 2013 and 2017 to gain an updated understanding of the changing demography of sachet water consumption in Ghana. The paper is structured as follows. In the next section we describe the three datasets we use in the study and the analyses we have carried out in order to answer the research questions outlined above. We present our results and discuss our findings in the context of previous studies on sachet water consumption and the tension between centralised and decentralised water supply systems. Lastly, we draw brief conclusions and outline future research priorities.

Materials and methods

Research design.

Our study follows a quantitative research design consisting of descriptive and correlational elements. We first implemented a descriptive design to identify recent trends in the consumption of drinking water in Ghana. We then followed a correlational design to establish relationships between the observed trends in drinking water consumption and other aspects of socioeconomic development. At each time point we computed the global and local Moran’s I to identify the presence of spatial autocorrelation at the district level, and its variability in space. We performed a repeated measures correlation analysis to assess the relationship between sachet water consumption and multiple household characteristics consistently recorded over the three surveys, as well as subnational human development indices. The analysis was performed in the statistical programming language R ( http://cran.r-project.org/ ).

Our analysis draws on three national surveys comprising the 2010 Population and Housing Census [ 26 ] and the 2013 and 2017 Ghana Living Standards Survey (GLSS) [ 27 , 28 ]. These datasets have a nationally representative sample and include information on primary drinking water sources as well as household characteristics relating to sanitation and access to technologies. Ghana’s 2010 decennial Population and Housing Census was the first study conducted by the Ghana Statistical Service (GSS) which recognised the “patchwork” of water sources consumed by Ghanaian households [ 2 , 26 ]. A notable change in the 2010 census compared to previous censuses included inquiring about the household’s source of drinking and household (non-drinking) water. In addition, it was the first census of Ghana which included packaged water (divided between “bottled water” and “sachet water”) as possible answer choices for expressing drinking water preferences. The 2010 census was a nationwide study which enumerated every person in Ghana—irrespective of nationality—on the midnight of 26th September 2010 [ 26 ]. Here, we use the 10% sample of census records which are in the public domain, comprising a random sample of 10% of records from each enumeration area ( n = 37, 642).

The GLSS studies are held by the GSS in the years between the decennial censuses. The most recent GLSS studies were conducted in 2013 (GLSS6) and 2017 (GLSS7). In comparison to the Population and Housing Census, which aims for a general overview of the population, the GLSS studies are specifically designed to measure the living conditions and wellbeing of Ghana’s residents, profiling participants to a greater depth than is possible in the main census. The GLSS studies do not sample Ghana’s entire population but instead rely on a smaller representative sample. Each household included in the survey is weighted according to the inverse of the probability of selection so that the results reflect Ghana’s entire population.

Data harmonisation

Comparisons between the census and the GLSS datasets are possible because the questions asked in the GLSS studies are in general a superset of those asked in the census, albeit with minor wording differences in the questions and possible answers. Both the 2010 Population and Housing Census and the GLSS studies record the household’s primary source of drinking water rather than the preferences of individual household members, allowing a direct comparison between the results. During the analysis we applied sample weights to correct imbalances between the respective samples and the population as a whole. We first computed weights to account for missing data, by dividing the total number of households by the number of households who provided a response to each of the survey questions relevant to the analysis outlined here. Weights were computed at the district level. The 10% sample of the 2010 Population and Housing Census is assumed to be representative of the entire population, so we multiplied the weights accounting for missing data by a factor of 10 and applied these across the dataset. For the GLSS studies we computed missing data weights in the same way, and multiplied these by the precomputed sample weights which are provided with the dataset. To analyse spatial trends in the data we linked the datasets with spatial polygons of Ghana’s districts ( n = 170) and regions ( n = 10), which were obtained from GSS [ 31 , 32 ] ( Fig 1 ). In 2012, the number of administrative districts in Ghana was increased from 170 to 216 by dividing several existing districts. To allow for comparisons between the datasets we reprocessed the Population and Housing Census and GLSS7 data, which reference the post-2012 boundaries, to instead use pre-2012 classification. The number of administrative regions did not change during the study period, although we note that Ghana has subsequently been divided into 16 regions.

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The regional boundaries shown are consistent with those in place during the study period (2010–2017), although the number of regions has subsequently increased to 16. Maps were created with data from the Humanitarian Data Exchange [ 33 ], which are made available under a CC-BY license [ 34 ].

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Statistical analysis

Trends in drinking water preferences..

To analyse trends in drinking water sources we reclassified the water sources used in the Population and Housing Census and GLSS surveys to the system used by the Joint Monitoring Program (JMP) of UNICEF/WHO, allowing us to distinguish between improved and unimproved water sources ( Table 1 ). In general, improved sources include piped water and groundwater that is safely sourced, while unimproved sources comprise surface water that is unsafely sourced [ 35 ]. Since 2017 the JMP has treated sachet water and bottled water as improved sources in recognition of their generally superior quality compared with unimproved sources [ 35 ]. Prior to 2017 the JMP had taken a two-staged approach, with packaged water defined as an improved source only when the source of non-drinking water used by the household is also an improved source [ 36 ]. Here, we follow the post-2017 approach of the JMP in classifying sachet water as an improved source regardless of the household water source. However, to provide additional insight we distinguish between sachet water consuming households which use improved water for non-drinking purposes versus those which use unimproved water sources. We note that the JMP definitions have been supplemented by a “service ladder” which divides improved sources into safely managed, basic, and limited service levels [ 37 ]. Unfortunately the census data contains insufficient detail to classify water sources according to this framework.

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To identify temporal trends in the consumption of different water sources we counted the number of households identifying each source as their primary water source at three administrative levels (country, region, district). Within these levels we also studied the variation between rural and urban households, and households found in Greater Accra. To identify the extent of spatial clustering in sachet water consumption we computed the global Moran’s I at the district level for each time point in the study period. We then calculated the local Moran’s I to show how spatial autocorrelation varied across the country. These results were interpreted by deriving the Local Indicators of Spatial Association (LISA) clusters for the study region [ 38 ].

National and subnational development trends.

In the next part of the analysis we focused on Ghana’s development trends during the study period. Living standards were estimated through the identification of relevant household characteristics which were consistently recorded across the three surveys. The indicators relate to the dwelling itself (type, ownership), access to electricity (source of lighting), access to sanitation services (type of toilet, liquid and solid waste disposal methods, type of water used for non-drinking purposes), type of cooking fuel, and access to technology (mobile phone, computer). For each indicator, the possible answers were aggregated to opposing pairs which generally represented positive and negative categories (with the exception of the type of toilet, where we used three categories to distinguish between water closets, Kumasi Ventilated Improved Pit (KVIP) latrine, and other types). Where indicators referred to accessibility to a service the derivation of categories was for the most part self-explanatory (i.e. has access/does not have access). We divided cooking fuels into solid and liquid types, reflecting the fact that the use of solid fuels tends to be associated with higher levels of household poverty [ 39 ]. However, we note that the energy stacking hypothesis calls in to question this assertion, and therefore urge caution in the interpretation of these results [ 40 ]. All the selected indicators have been used previously as proxies of living standards [ 23 , 39 , 41 – 43 , e.g.]. Once these categories were defined we computed the percentage of households exhibiting the different aspects of each indicator at the district level.

We supplemented the development indicators with the Subnational Human Development Index (SHDI) [ 44 ] to gain a broader understanding of Ghana’s development trends beyond the household characteristics outlined above. The SHDI is a metric based on the United Nations’ Human Development Index (HDI), a composite index of life expectancy, education and per capita income available at the country level. The SHDI extends the HDI methodology with additional publicly available data to produce analogous data at a finer geographical level. For Ghana the SHDI data is available for the 10 administrative regions used in the analysis ( Fig 1 ). Other than the SHDI itself we also considered some of its constituents, namely the gross national income (GNI), education index (EI) and health index (HI).

Trends in development from both the census data and the SHDI were regressed against trends in changing drinking water sources over the study period using repeated measures correlation [ 45 ]. This was achieved by considering the regional ( n = 10) data in 2010, 2013, and 2017 as separate data points, giving a total of 30 data points on which to perform the regression.

The number of Ghanaian households identifying sachet water as their preferred source of drinking water increased fivefold between 2010 and 2017 ( Fig 2 ). By the end of the study period in 2017, sachet water was consumed by 35% of households as their primary source of drinking water, mostly driven by increasing consumption in urban areas. The consumption of piped water decreased from 46% of households in 2010 to 27% in 2017, corresponding to a fall of around 750,000 households in absolute terms ( S1 Fig ). In 2017 the vast majority of households in Ghana consumed water from an improved source, increasing from 85% to 90% between 2010 and 2017. By 2017, the number of households drinking unimproved water sources had decreased by around 165,000 from a total of almost 900,000 in 2010.

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In urban areas the consumption of sachet water has risen both in terms of the total number of households and market share. Between 2010 and 2017, the number of urban households reporting sachet water as their preferred drinking water source increased from 450,000 to 2.1 million ( S2 Fig ). The growth in sachet water consumption coincides with an increase of around 810,000 households during the study period, as well as a fall in the number of households consuming piped water of approximately 800,000, from a total of 2.11 million in 2010. The number of urban households consuming groundwater increased slightly by about 20,000 to a total of 535,000 households in 2017. By the end of the study period in 2017 sachet water was the preferred drinking water source of 51% of urban households, compared to 14% in 2010.

There was a sixfold increase in the number of rural households consuming sachet water as their preferred drinking water source, from around 70,000 households in 2010 to 450,000 households by 2017, representing a market share of 14% ( S2 Fig ). The number of households reporting unimproved surface water as their main drinking water source decreased from approximately 720,000 in 2010 to 630,000 in 2017, despite an increase in the number of rural households of around 560,000 over the study period.

In Greater Accra, sachet water was the primary source of drinking water for 80% of households in 2017. Between 2010 and 2017, the market share of sachet water increased from 28% to 80% of households, representing a threefold increase from 310,000 to 1.05 million households identifying sachet water as their primary water source during the study period ( S3 Fig ). The consumption rate of sachet water in Greater Accra was higher than the national average across all the years considered.

In 2017 more than 90% of households using sachet water as their main source of drinking water used an improved water source for their household uses ( Fig 3 ). In urban areas the percentage of sachet consumers with a private connection to the piped supply network increased from around 53% in 2010 to 65% in 2017, while in Greater Accra the percentage increased from 62% to 78%. Nevertheless, in 2017 around 10% of households consuming sachet water in Greater Accra relied on unimproved sources for their household uses. In rural areas the majority of sachet water consumers used groundwater for household uses, although 23% of households relied on an unimproved source.

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The number of districts ( n = 170) where sachet water is the most common drinking water source increased from three to 36 between 2010 and 2017 ( Fig 4 ). Groundwater was the most common in 88 districts—the highest number of any drinking water source—mainly due to its predominance in rural regions. In general, districts consuming sachet water tend to cluster in the southern half of the country ( Fig 5 ). Here, sachet water consumption appears to have grown fastest in the regions surrounding Accra, spreading to other coastal regions before moving inland towards Kumasi.

Maps were created with data from the Humanitarian Data Exchange [ 33 ], which are made available under a CC-BY license [ 34 ]. For copyright reasons the district boundaries shown are from the present day ( n = 260).

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Spatial autocorrelation is observed in all years ( Table 2 ), suggesting that districts with a relatively high rate of sachet water consumption tend to be clustered. The degree of clustering increased slightly between the years considered, suggesting that sachet water could be a phenomenon which spreads from high consumption districts to neighbouring low consumption districts as user habits and manufacturing expertise cross district boundaries. The LISA analysis reveals that clustering has tended to occur in the southern part of the country, notably around Accra in all years but most recently around Kumasi ( Fig 6 ).

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Indicators of improved living conditions have generally become more prevalent between 2010 and 2017 ( Table 3 ), including access to electrical lighting, improved toilets (WC or KVIP), improved cooking fuel (gas, electric or kerosene), waste collection service, connection to a sewage network, and access to computers and mobile phones. Home ownership saw a consistent decrease between 2010 and 2017. The increase in living standards shown by the indicators in Table 3 is consistent with the changes in the SHDI and its constituents during the study period.

https://doi.org/10.1371/journal.pone.0265167.t003

Sachet water consumption is positively correlated with multiple indicators of improved living conditions ( Table 4 ). It is strongly correlated with the use of gas, electricity or kerosene as cooking fuel in both rural (r = 0.86, p<0.001) and urban (r = 0.79, p<0.001) contexts. Possession of a computer is also correlated with sachet water consumption in both urban and rural settings. Among household characteristics related to sanitation, there is a strong correlation between sachet water consumption in urban areas and access to the sewage network (r = 0.75, p<0.001). Sachet water consumption is also positively correlated with SHDI and its constituents. For the most part, we find that an increase in SHDI has corresponded with an increase in the consumption of sachet water and a decrease in the consumption of piped water for drinking water ( Fig 7 ).

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Only values significant at the 5% level are reported.

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The rate of sachet water consumption varies by geography and household characteristics (Tables 5 and 6 ). Between 2010 and 2017 the rate of sachet water consumption increased in households with and without characteristics indicative of improved living conditions, suggesting that sachet water is a phenomenon gaining popularity in all sections of society. Households with indicators of better living conditions have taken up sachet water at higher rates. The consumption of sachet water among households with WC or KVIP as their toilet type increased more than households using less sophisticated means such as pit latrines or buckets. Similar patterns were observed in waste disposal characteristics, where urban households with access to the sewage network or rubbish collection services saw higher uptakes of sachet water in comparison to households with less sophisticated methods of waste disposal.

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Despite its origins as a niche product in Accra, sachet water is now consumed throughout Ghana. In general it remains an urban phenomenon, although it is increasingly used by rural households. Consumption continues to be highest in Accra, where sachet water first gained a foothold in Ghana’s water market. There is evidence that districts with a high incidence of sachet water consumption are clustered, suggesting that the market for sachet water may expand from urban centres. This is most evident in districts surrounding Accra, in which the percentage of households citing sachet water as their main drinking water source has increased from less than 20% in 2010 to more than 70% by 2017. Usage appears to have spread westwards from Accra along the coast and inland towards Kumasi, Ghana’s second largest city ( Fig 5 ). While previous research showed that households consuming sachet water as their primary drinking water source tended to be from socioeconomically disadvantaged backgrounds [ 10 , 22 ], our results show that sachet water is increasingly consumed by housholds with indicators of relative wealth. This shows that the market has changed significantly since 2010, when it was associated mainly with the “poorest of the poor” [ 10 ], and points to the challenges facing Ghana’s water utility as it seeks to keep pace with the country’s economic development. Accordingly, we find that sachet water is now a ubiquitous product in Ghana, consumed across socioeconomic groups, which is playing an increasingly important role in the provision of drinking water to its population.

Our analysis shows that many urban households are choosing sachet water as their primary source of drinking water despite having access to another improved water source ( Fig 3 ). This is most apparent in Greater Accra, where 78% of households used sachet water as their primary drinking water source despite having a private connection to the piped supply network. However, although piped water is nominally considered an improved source under the JMP, the perceived and actual quality of water from Ghana’s piped system is highly variable [ 5 ]. In Accra, the relative quality of sachet water is likely to be the main driver of the shift away from piped water [ 3 , 23 ]. Here, the notion of sachet water being of superior quality to piped water is well established and regularly exploited by vendors of sachet water [ 46 ]. This is not without reason: Accra’s decaying pipe network is made up of shallow, occasionally exposed pipes which often run adjacent to sewers [ 5 ]. The reliability of piped water is also highly variable [ 2 ]. For instance, water rationing is used in Accra to manage the deficit between supply and demand, with some residents going up to a week without receiving piped water [ 15 ]. The relatively low unit price of sachet water, which bridges the large gap between bottled water and piped water [ 3 ], enables the industry to exploit the inadequate municipal supply.

With urbanisation expected to continue unabated across sub-Saharan Africa for at least the next three decades [ 47 ], it is unlikely that Ghana will have the capacity to provide universal access to its piped supply network [ 5 , 46 ]. The potential contribution of sachet water towards SDG 6 is obvious, with many commentators suggesting that sachet water is likely to play an important role in achieving universal access to improved drinking water. As Stoler [ 3 ] states, “[t]he ability of many West African nations to achieve universal access to safe drinking water may depend on their willingness to understand and incorporate the sachet water industry into an integrated drinking water platform.” Williams et al . [ 13 ] agrees, arguing that “policymakers and regulators should recognize the potential benefits of packaged water in providing safer water for consumption at and away from home, especially for those who are otherwise unlikely to gain access to a reliable, safe water supply in the near future.” The ubiquity of sachet water in Accra, and its growing presence elsewhere in the country, suggests that sachet water is already an indispensable part of Ghana’s water landscape.

There is broad agreement about the need for better governance of the packaged water industry to ensure it supports the drive towards universal access without compromising other aspects of Ghana’s development agenda. Important issues discussed in the literature include how best to achieve consistent water quality standards, as well as how to curb the environmental impact associated with the production of vast quantities of single-use plastic waste [ 5 ]. With respect to water quality, Stoler et al . suggest that in areas where the sachet market is mature and competitive the quality of water generally exceeds drinking water standards [ 3 , 22 ], although there remains considerable variability amongst smaller producers [ 48 ]. Outside of large urban centres the quality is less assured due to the predominance of smaller manufacturers [ 9 , 12 , 13 ]. There are also outstanding questions about the potential impact of plastic degradation on water quality [ 3 ]. On the environmental impact, plastic waste associated with sachet water consumption has been linked to blocked drains, localised flooding, and ecological degradation [ 49 ]. Wardrop et al . [ 50 ] estimated that in 2015 around 8.2 billion sachets were consumed, producing approximately 14,000 tonnes of plastic waste. Outright bans on plastic sachets are periodically suggested as a way to curb the amount of waste which is generated by the sachet water market [ 3 , 49 ]. However, inadequate solid waste management in Ghana is a problem which transcends any particular sector or consumer product, and instead speaks to the inability of municipal authorities to provide sufficient solid waste disposal services [ 51 , 52 ]. Indeed, addressing the lack of solid waste management in Ghana is a critical development challenge which intersects many of the SDGs [ 53 ].

Aside from the practical considerations of water quality and environmental degradation, there are concerns that Ghana’s rapidly expanding sachet water market may threaten the ideals of universal access to affordable drinking water [ 5 ]. Left unchecked, sachet water has the potential to directly compete with the public water utility [ 6 ], undermining the traditional notion of water as a basic human right and establishing a system of water governance which views water as a discrete private good [ 54 ]. In Ghana the provision of sachet water is not viewed by the state as part of an essential public service [ 5 ], even though for many Ghanaians it is their only source of clean drinking water [ 55 ]. On the one hand, the lack of regulation leaves consumers vulnerable to price fluctuations, varying water quality, and inconsistent supply [ 3 , 7 , 54 ]. Despite some efforts towards regulating water quality, including the introduction of a quality seal issued to producers who pass an inspection by Ghana’s Food and Drug Authority [ 56 ], the sheer number of producers—many of which are unregistered [ 5 ]—renders the enforcement of regulations a Sisyphean task. On the other hand, it is true that considerable progress on water quality and price stability have been achieved through competition and industrialisation alone. While Ghana’s overall committment to universal access to water is assured, the means by which this is achieved requires careful monitoring to ensure that the most vulnerable members of society are not further disadvantaged by the increasing reliance on packaged water.

As the sachet water industry spreads across the country to participate in diverse water markets it appears increasingly unlikely that a top-down regulatory framework will be effective at addressing quality and environmental concerns and widening access to clean, affordable drinking water [ 54 , 57 ]. In the face of rapid environmental and socioeconomic change the involvement of local stakeholders in managing their water is recognised as a key strategy for achieving water security, as advocated by SDG 6.b (“support and strengthen the participation of local communities in improving water and sanitation management”) [ 25 ]. It therefore seems likely that integrating the sachet water market into participatory water governance mechanisms offers the best chance for reestablishing the principle of water as public service [ 13 , 54 ]. Such efforts could perhaps be modelled on the Local Water Boards which currently operate in Accra, even though to date these have faced considerable challenges in maintaining access to affordable drinking water [ 55 , 58 ]. Indeed, there is a need for further empirical research towards effective water governance in Africa’s rapidly expanding cities and towns [ 3 ]. On this point, a critical analysis of Ghana’s initiative to provide free water for all during the Covid-19 pandemic may provide valuable evidence on the ability of the state to harness sachet water to guarantee the supply of clean drinking water to its constituents [ 59 ].

Nevertheless, participatory approaches to water governance should not be seen as a panacea, nor absolve the state of its ultimate responsbility to provide its citizens with universal access to safe and affordable drinking water. Widespread public distrust of tap water is clearly a major driver of the observed trend in sachet water consumption, especially amongst households which have access to another improved water source [ 15 ]. Renewing confidence in the quality of tap water should therefore be a matter of priority for the water utility, backed up by remedial works where necessary. Lastly, we highlight that the relative cost of sachet water means that it can only realistically alleviate the demand for clean drinking water [ 5 ]. The focus on sachet water as a solution to drinking water tends to overshadow the shortage of water for other domestic uses, including sanitation [ 5 , 60 ]. This is part of a wider development trend which has tended to promote efforts aimed at improving drinking water access over sanitation needs [ 35 ]. According to the government’s own estimates only 15% of Ghana’s population have access to improved sanitation facilities, with the state of sanitation especially poor in urban areas [ 61 ]. While the ubiquity of sachet water may reduce the level of dependence on the piped network for meeting drinking water demand, the extension of the public water supply is likely to be a necessary feature of efforts to raise sanitation standards and enhance the water security of Ghana’s urban residents.

Conclusion and future outlook

We studied three nationally representative datasets from 2010, 2013 and 2017 to better understand the changing demography of sachet water consumers in Ghana. The results show that sachet water is now a ubiquitous source of drinking water in Ghana which is used in both urban and rural settings. The capital city, Accra, remains the largest consumer of sachet water. However, during the study period sachet water consumption has spread westwards along the coast and inland to Kumasi, Ghana’s second city. Despite a 34% increase in Ghana’s population between 2010 and 2017, the percentage of households with access to improved water increased, due in part to the growth in sachet water usage.

Households with indicators of relative wealth increased their consumption of sachet water during the study period. In 2017, the majority of households citing sachet water as their primary source of drinking water already had access to an improved water source. On the one hand, this suggests that for some households the switch to sachet water from piped water has been by choice rather than necessity. It is possible that increasing prosperity has enabled some households to meet their drinking water demand with sachet water because of pre-existing concerns (real or perceived) about the quality and reliability of the piped supply network. That said, it should be noted that we did not attempt to establish causal relationships between variables. Although concerns about the quality and environmental impact of sachet water abound, additional regulation of the industry is fraught with difficulty. In the face of climate change, socioeconomic development, and rapid urbanisation, we suggest that strengthening participatory mechanisms for water governance is a practicable way forward to ensure that Ghana’s growing sachet water industry makes a positive contribution towards SDG 6.

The survey datasets we have analysed have some important characteristics and shortcomings which should be taken into account when interpreting our results. Most importantly, we reiterate that the datasets inquired about water preferences at the household level and not the individual level. It is likely that different members of the the household have different preferences for water depending on their daily lives and routines. Moreover, previous research has observed that households in Ghana tend to have multiple sources of drinking water [ 9 , 21 ]. While the censuses capture relatively fine-grained information on the water sources available to households, they do not provide insight into the motivations behind the choice of one drinking water source over another. We suggest the question asked by Stoler et al . [ 23 ]—“why do you use or not use sachet water?”—could be used as a reference in the design of future large-scale surveys to gain additional information about consumer choices. In our analysis we used the UNICEF/WHO JMP definitions to classify drinking water sources as improved or unimproved. However, due to limitations of the survey data it was not possible to apply the complete JMP service ladder [ 37 ]. Further work should consider how the service ladder could be applied to Ghanaian census data, as this may provide valuable insights into the drivers of sachet water consumption.

It is important to bear in mind that the indicators of living standards we have used in our analysis represent those which could be applied with some confidence across urban and rural households nationally. The indicators do not encompass every potential source of improved living standards, and it is inevitable that we may have disregarded some indicators which are important only in certain regions or urban/rural contexts. Our analysis in the spatial dimension was constrained by the relatively coarse resolution of the GLSS datasets, in which data points are georeferenced to the district level ( n = 170). As a result, our analysis inevitably fails to pick up on important spatial heterogeneities which may provide additional insight into the physical and socioeconomic drivers of sachet water consumption. In contrast, the Population and Housing Census—which surveys the entire population—georeferences responses to enumeration areas ( n = 37, 642). In this respect, the results of the forthcoming Population and Housing Census, postponed from 2020 to 2021 as a result of the Covid-19 pandemic, will likely be highly relevant to the study of Ghana’s sachet water phenomenon.

Supporting information

S1 fig. primary drinking water source for households in ghana..

https://doi.org/10.1371/journal.pone.0265167.s001

S2 Fig. Primary drinking water source for urban and rural households.

https://doi.org/10.1371/journal.pone.0265167.s002

S3 Fig. Primary drinking water source for households in Greater Accra.

https://doi.org/10.1371/journal.pone.0265167.s003

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A Review on Heavy Metal Concentration in Potable Water Sources in Nigeria: Human Health Effects and Mitigating Measures

• Review Paper
• Published: 27 February 2016
• Volume 8 , pages 285–304, ( 2016 )

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• Sylvester Chibueze Izah 1 ,
• Neelima Chakrabarty 2 &
• Arun Lal Srivastav 3  

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Nigeria is one of the most populated black nation in the world with a population of about 170 million. Over the years, potable water source which is one of the basic essential requirements for healthy living has been challenging due to inadequate controlled anthropogenic activities and by lesser extent natural conditions. This paper reviews the various potable water sources, heavy metal concentration, and its associated health effects in Nigeria. The study found that surface water such as stream, river, lake; ground water including borehole and hand-dug well; rain water; and packaged water such as bottled and sachet are the major source of potable water. The dominant heavy metals found in potable water include iron, zinc, copper, chromium, lead, and manganese. The concentration of heavy metals like mercury, lead, cadmium, iron, cobalt, manganese, chromium, nickel, zinc, and copper often exceed the maximum permissible limit recommended by standard organization of Nigeria and World Health Organization. The concentration of heavy metals fluctuates in most states/geographical coverage depending on the type of potable water sources. To a large extent, industrialization causes heavy metals concentration to exceed the permissible limits. The high concentration reported in most locations could cause various disease conditions depending on the type of metal and level of exposure. This study also suggest possible treatment and mitigating measures to avoid such harmful effects.

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Izah, S.C., Chakrabarty, N. & Srivastav, A.L. A Review on Heavy Metal Concentration in Potable Water Sources in Nigeria: Human Health Effects and Mitigating Measures. Expo Health 8 , 285–304 (2016). https://doi.org/10.1007/s12403-016-0195-9

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Home > Books > Pathogenic Bacteria

Bacteriological Quality of Borehole and Sachet Water from a Community in Southeastern Nigeria

Submitted: 04 June 2019 Reviewed: 18 February 2020 Published: 20 August 2020

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Water from boreholes and packaged commercial sachet water from different areas in a community in southern Nigeria was analyzed with membrane filtration for a snapshot of heterotrophic count and coliforms. Two boreholes out of the 20 analyzed had counts of over 500 Cfu/mL and 7 boreholes indicated the presence of coliforms. Sixteen samples out of 20 sachet water brands analyzed showed a regulatory product registration code, whereas 4 samples had no number or code indicating that they were not registered. The heterotrophic count of all sachet water was well within the limit for all samples analyzed, and coliform was detected in only two samples. The overall quality of borehole water in the community studied was rated D (65%), whereas the sachet water was rated C (90%) according to the World Health Organization (WHO) surveillance guidelines. Improvements in water quality structure in the community studied are required to help achieve WHO sustainable development goals on water sanitation. The etiology, virulence properties, epidemiology, and pathogenicity of bacteria associated with borehole and sachet water are also discussed.

• sachet water
• heterotrophic count

Author Information

Ogueri nwaiwu *.

• School of Biosciences, University of Nottingham, Sutton Bonington Campus, United Kingdom

Chiugo Claret Aduba

• Department of Science Laboratory Technology, University of Nigeria, Nigeria

Oluyemisi Eniola Oni

• Department of Microbiology, Federal University of Agriculture, Nigeria

*Address all correspondence to: [email protected]

1. Introduction

Up to 2.1 billion people worldwide lack access to safe, readily available water at home according to a WHO/UNICEF report [ 1 ]. The report emphasized that majority of the people without good quality water are from developing countries and the lives of millions of children are at risk every day, with many dying from preventable diseases caused by poor water supply. The importance of good quality water is the reason why clean water and sanitation have been included as goal number 6 out of the 17 proposed sustainable development goals (SDGs) of the United Nations [ 2 ]. The proposal is that the SDGs will be the blueprint to achieving a better and more sustainable future for humanity by 2030.

In Nigeria, the public water supply is in a state of comatose in most towns and villages and dry taps without any hope of water running through the taps soon affect millions of homes. This has forced individuals and institutions to resort to self-help by using water from boreholes as the only source of water supply for drinking and general use. Use of borehole is a simple way of obtaining potable water from the aquifer below the ground, after which the water can be pumped into storage tanks before distribution.

Many people that went into borehole drilling business, which reduced the price of new boreholes, aided the proliferation of boreholes in Nigeria, and many citizens were ready to pay more money in rent for houses, which had boreholes. Furthermore, the dependence on groundwater, which is believed to be purified, is on the increase due to the increasing contamination of the surface water [ 3 ]. It is known that properly designed and constructed borehole both ensures the success of the borehole as an adequate supply of water and minimizes the risk of local pollution affecting the source [ 4 ]. If a borehole facility is not properly managed, contamination may occur in the process through the accumulation of physical, chemical, and biological agents in the pipelines and storage tanks of a distribution system or water packaging company. One direct use of boreholes is in the production and packaging of drinking water in sachets made from low-density polyethylene sheets. These products are popularly known as “pure water” in Nigeria. From the early 1990s, the production of sachet water increased exponentially and provided jobs for producers and sellers of the product. There is hardly any community in Nigeria without a sachet water facility. It is possibly the most widely consumed commercial liquid in Nigeria, and no sophistication is required for production. The quest for a cheap, readily available, and inexpensive source of potable water contributed to the emergence of sachet water [ 5 ], and it is far better and safer than the hand-filled, hand-tied packaged water in polyethylene bag [ 6 ] sold in Nigeria in the past. In developing countries, production and consumption of sachet water are rapidly on the rise [ 7 ], and many unregulated producers exist.

Packaged drinking water like the sachet water could be water from any potable source such as tap, well, and rain, which may be subjected to further treatments like decantation, filtration, demineralization, remineralization, and other methods to meet established drinking standards [ 8 , 9 ]. Packaged water is susceptible to microbial and chemical contamination regardless of their source [ 10 ]. Researchers have previously performed microbial analysis of sachet water in Nigeria using different laboratory techniques and found different bacteria and fungi. Occurrence of bacteria could lead to different disease conditions such as gastroenteritis, typhoid fever, cholera, bacillary dysentery, and hepatitis [ 11 ]. It has been reported [ 12 ] that waterborne diseases account for 80% of illnesses and diseases in developing countries, which leads to the death of several children every 8 seconds. In Nigeria, like most developing countries, various factors predispose packaged sachet water to contamination, and these include poor sanitation and source of raw material for food or water production [ 13 ]. Long storage of sachet under unfavorable environmental conditions and lack of good manufacturing practices (GMP) in general also contribute to contamination.

It has been found that the microbiome dynamically changes during different stages of water treatment distribution and the main important group in the past and present are fecal-associated bacterial pathogens like Escherichia coli [ 14 ]. However, opportunistic bacteria like Legionella and process-related bacteria, which form biofilms, are also a cause for concern [ 15 , 16 ]. A review [ 17 ] elucidated that drinking water comprises a complex microbiota that is influenced by disinfection and that members of the phylum Proteobacteria represent the most frequent bacteria in drinking water. It was also pointed out that their ubiquity has serious implications for human health and that the first step to address the persistent nature of bacteria in water would be to identify and characterize ubiquitous bacteria. The manifestation of bacterial contamination in drinking water can become known when outbreaks occur, and surveillance data provides insights on the microbial etiology of diseases and process failures that facilitated the outbreak [ 18 ]. Sometimes it can also be detected from laboratory results especially when water treatment facility is contaminated by bacterial biofilms [ 19 , 20 ].

In Nigeria, regulatory oversight is inadequate due to limited resources. Surveillance of bacteria in drinking water from boreholes and sachet water is necessary for the benefit of public health; hence, periodic surveys can help establish trends and identify where water quality of boreholes and sachet water is deficient. This chapter reports a survey, explores reports of bacteria associated with water from borehole and sachet water in Nigeria, and compares data found with WHO water standards. The organisms associated with boreholes and sachet water are discussed.

Water samples from boreholes were collected on different days using Whirl-Pak sampling bags (Nasco, Wisconsin, USA) and analyzed within 2 hours after collection. Twenty private boreholes and 20 different brands of commercial sachet water sold in four areas of a community were analyzed on different days. Sachet water was purchased (five each) from the different areas and were inspected for the inscription of an approved product registration code from the National Agency for Food and Drug Administration and Control (NAFDAC), the Nigerian national regulatory body. It was ensured that the same brand was not purchased twice from one area. The human population of the community (all 4 areas) was estimated to be over 5000 but less than 100,000.

Heterotrophic plate and total coliform count of bacteria were carried out using standard membrane filtration performed previously [ 21 ]. A slight modification of the method was introduced. Instead of using factory-made ready to use nutrient media sets, plate count agar (Oxoid, United Kingdom, CM0325) and violet red bile lactose agar (Oxoid, CM0107) for coliforms were prepared and used according to manufacturer’s instructions. Briefly, the filtration process involved placing of 100 ml of water sample in a sterile multibranched stainless steel manifold and filter holder system. A 0.45 μm membrane filter was fitted into the filter system after which water was drawn through to retain bacteria on the membrane. The membrane filter was placed on the media prepared and then incubated at 32°C over 48 h for membrane filters placed on plate count agar, whereas incubation at 30°C for 48 h was used for filters grown on violet red bile lactose agar. The heterotrophic count was noted, and estimated coliform results obtained for boreholes and sachet water were compared to WHO quality guidelines for drinking water [ 22 ].

3.1 Heterotrophic and total coliform count of borehole samples

This survey was carried out to have an overview of the bacterial load in water quality of some boreholes in the community surveyed. The borehole owners were apprehensive and thought they were being investigated for possible closure. To allow sample collection, it was agreed that the name of borehole owners and their location should remain anonymous when the findings were published. Results showed that borehole samples from area “C2” had the highest heterotrophic aerobic count. Two boreholes had counts of over 500 Cfu/mL, which is above the recommended heterotrophic limit [ 21 ]. All the other samples were below 500 Cfu/mL. Seven boreholes indicated the presence of coliforms because purple-pink colonies, which were 1–2 mm in diameter surrounded by a purple zone, were formed on the plates after incubation. Samples C2a, C2b, C2c, C2d, and C2e had coliform count of 17, 15, 9, 6, and 5 Cfu/mL, respectively, whereas samples C3b and C4b had coliform count of 4 and 2 Cfu/mL. The rest of the samples had no coliform on the plate used after incubation. A definitive trend was that samples with the highest heterotrophic count had the most coliform count ( Figure 1 ).

Heterotrophic plate count of borehole water sourced from different areas of the community studied (C1–C4). The letters a to e represent different samples.

3.2 Heterotrophic and total coliform count of sachet water samples

Periodic analysis of sachet water is important to public health because millions of people in Nigeria consume it. An ideal situation would be to analyze every borehole water from which sachet water is produced to establish water treatment effectiveness. Enquiries made to sachet water producers for access to their source of water for production were not successful. To refuse access some companies gave information and advice that they do not have a borehole and their water for production is sourced from the supply by water tankers. Hence, commercial samples of sachet water were purchased from different locations with unknown source of initial water for production of sachet water on sale. Sixteen samples out of the 20 analyzed showed a NAFDAC product registration code, whereas 4 samples had no number or code indicating that they were not registered. The heterotrophic count was well within the limit for all samples analyzed, and coliform was detected in only two samples. Sample SC1c and SC3c had a coliform count of 2 Cfu/mL each ( Figure 2 ).

Heterotrophic plate count of sachet water (S) sourced from different areas of the community studied (C1–C4). Letters a to e represent different samples.

3.3 Comparisons with WHO guidelines

The WHO standards and guidelines are usually used to monitor water quality. The WHO categorizes drinking water systems based on population size and quality rating to prioritize actions. A quality score from A to D is awarded (quality decreases A to D) based on the proportion (%) of samples negative for E. coli . However, the samples under study were assessed for total coliforms and not E.coli ; the scoring was carried out with the presumption that samples with high coliform count may contain E. coli . Total coliforms serve as a parameter to provide basic information on water quality [ 23 ]. On this basis, the overall quality of borehole water in the community studied (all areas combined) was rated D (proportion of samples negative for coliform =13; 65%), whereas the sachet water was rated C (18 = 90%).

4. Discussion

4.1 bacteria associated with boreholes in nigeria.

Pathogenic bacteria often occur in borehole water systems especially in developing nations [ 24 , 25 , 26 ]. Coliforms found in this study and other Gram-negative bacteria have been isolated from boreholes in different parts of Nigeria by many investigators [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ]. The organisms mentioned in these studies include Enterobacter aerogenes , Escherichia coli , Klebsiella aerogenes , Klebsiella sp., Klebsiella pneumoniae , Klebsiella variicola , Proteus sp., and Proteus vulgaris . Other bacteria isolated are Providencia sneebia , Pseudomonas aeruginosa , Salmonella paratyphi , Salmonella sp., Salmonella typhi , Staphylococcus aureus , and Vibrio cholera .

The prevalence of the aforementioned species and genera may be due to the classical microbiological methods used for isolation. In most cases, MacConkey media was used for E.coli and coliform identification with no molecular studies that included 16S or whole-genome sequencing essential for establishing the actual prevalent bacteria species and strains in boreholes. An opportunity exists for regular molecular characterization of bacteria found in boreholes to help differentiate between harmless coliforms, fecal coliforms, and the deadly E. coli strain O157: H7. Borehole operators are required to deliver safe and reliable drinking water to their customers. If a community consistently consumes contaminated water, they may become unwell. Hence, regular monitoring and assessment of borehole water sources help maintain quality and provide data on groundwater management [ 35 , 36 , 37 , 38 ].

4.1.1 Bacteria contamination of groundwater

In Africa, many people rely on water from a borehole, but the purity of the drinking water from this source remains questionable [ 39 , 40 ]. The high heterotrophic count found in Area “2” of the community studied suggests that the groundwater of that area may be contaminated. The corresponding increased coliform count observed is consistent with the findings of Amanidaz et al. [ 41 ], which showed that when the concentration of coliforms and fecal Streptococci bacteria increased in a water network system, there was also an increased concentration of heterotrophic bacteria. These contrasts with the work of others [ 42 ] where it was shown that high heterotrophic count inhibits coliform proliferation. Despite increased heterotrophic count and coliforms in the study of Amanidaz et al. [ 41 ], it was concluded that no correlation exists, and increased numbers could be due to variability in nutrient composition [ 43 ]. Another factor could be biofilm formation because it has been shown that attached bacteria in biofilms of a water system are more metabolically active than the ones that are free-living [ 44 ]. Groundwater is susceptible to contamination by both organic and inorganic contaminants [ 45 , 46 , 47 , 48 ]. Contamination could happen through natural processes, such as geological weathering and dissolution of numerous minerals beneath the earth’s surface, which results in low natural concentrations of contaminants in groundwater [ 49 ]. Anthropogenic sources, such as seepages from agricultural wastewaters, domestic sewages, mining activities, and industrial effluents, can also affect the quality of groundwater in many parts of the world [ 50 , 51 , 52 ]. Other reports showed that borehole contamination may occur through domestic wastewater and livestock manure [ 53 ] industrialization and urbanization [ 54 ] and leakages from septic tanks [ 55 ] or pit latrines [ 56 ]. Seasonal environmental conditions may also contribute to increased bacteria count from borehole water because other investigators [ 57 , 58 ] have demonstrated that higher bacterial count in borehole water occurs during the rainy season. This has been attributed to flooding which may allow floodwater to get into borehole systems that are not properly constructed.

4.2 Cases of sachet water contamination in Nigeria

Postproduction improper handling [ 59 ] and compromising safety and quality for profit during production [ 60 ] are factors that can affect sachet water contamination in Nigeria. Sachet water producers are expected to be food safety conscious in order not to jeopardize the health of the public. A large number of sachet water-producing companies in Nigeria are not registered and do not practice good manufacturing practices or follow international quality standards of water treatment [ 61 ] despite the efforts of NAFDAC to improve standards. Up to 25% of samples analyzed in this study had no regulation or expiration date code as recommended previously [ 62 ]. However, the fact that 75% of sachet water analyzed had date codes is a remarkable improvement from what was the norm (0%) when sachet water production started in the country. Unlike a previous study with larger sample size [ 11 ], which reported isolation of bacterial species in 54 out of 720 (7.5%) from 6 different brands of sachet water in northern Nigeria, all the samples in this study (100%) showed heterotrophic growth that were within permissible limits (<500 Cfu/mL).

Sachet water analysis from other parts of Nigeria has shown different levels of contamination. In this study, 10% (2 out of 20) of samples contained coliforms. In other studies carried out on samples sourced from Aba in the southeast, an analysis of 20 sachet water samples showed that 32% of the samples reportedly tested positive for Staphylococcus spp., 23% for Pseudomonas , 20% for Klebsiella spp., 15% for Proteus , and 10% for Enterobacter [ 59 ]. Another study in the same region reported a contamination in 8 out of the 10 sachet water samples analyzed, isolated microorganisms included E. coli , Klebsiella spp., Pseudomonas spp., Bacillus spp., Proteus spp., and Staphylococcus spp. [ 5 ]. Also 66% and 73% prevalence of pathogens have been reported [ 63 ] in this region after two batches of 30 sachet water samples were analyzed. In Oyo, which is situated in the southwest of Nigeria, E. coli (13.3%), Pseudomonas aeruginosa (39.9%), and Enterobacter aerogenes (53.3%) were isolated from commercially sold sachet water [ 64 ]. Another report in this region [ 26 ] highlighted that all brands of sachet water (100%) analyzed had the presence of coliforms.

4.3 Compliance with world standards

A recent SDGs progress report [ 3 ] shows that between 2000 and 2017, the proportion of the global population using safely managed drinking water increased from 61 to 71%. The report highlighted that despite the increase, water stress affects people on every continent, requiring immediate and accelerated collective action to provide billions of people with safely managed drinking water. The quality score for the boreholes and sachet water from the community studied showed that the water needs improvement to achieve the desired “A” rating. In this study, the borehole water quality in Area “2” is a source of concern, and the owners in that area were advised to boil and filter the water before drinking. It is common knowledge in Nigeria that some boreholes are not deep enough to produce clean water from the aquifer; hence, such boreholes are used for other domestic purposes but not for cooking food or drinking. Owners of such boreholes normally boil and filter the water for drinking.

Water quality specifications may depend on the particular use, but the presence of coliforms in drinking water indicates that disease-causing organisms could be in the water system and may pose an immediate health risk to the water consumers. When coliforms and other bacteria are found, it is always recommended [ 65 ] that an investigation should be carried out to establish the sources of contamination. This confirmation will enable risk assessment and identification of solutions that will eliminate or reduce the risk of waterborne disease within a large population [ 66 ].

4.4 Etiology, virulence, epidemiology, and pathogenicity of bacteria associated with borehole and sachet water

From the studies reviewed, the organisms found in borehole water are well-known food- and waterborne bacteria that are constantly monitored by regulatory authorities in many parts of the world. Outbreaks can occur in a community and cause fatalities and economic losses. Hence, a constant review of the growth conditions that enable the bacteria to proliferate, the features that enable survival in different environments, infection mode, and prevalence pattern of these bacteria is important to reduce outbreaks.

4.4.1 Staphylococcus

The bacterium Staphylococcus aureus from the genus Staphylococcus is known for methicillin resistance of some strains. The bacterium is a major environmental contaminant of food and water, and the human skin and nose are known to be major sources of the organism. Nasal colonization [ 67 , 68 ] and atopic dermatitis of the skin [ 69 , 70 ] are considered risk factors. Environmental contamination may be the source of contamination in borehole water analyzed in this study, whereas humans or personnel involved in sachet water production are likely to be contributors to contamination. In Nigeria, sachet water producers are known to lack resources; hence, it is possible that respiratory protective equipment like nose masks are not worn during production in some facilities. Since it is possible to distinguish community-associated MRSA from healthcare-associated MRSA based on genetic, epidemiologic, or microbiological profiles [ 71 ], it would be beneficial to screen the strains found in this study to determine if they are methicillin resistant and community-related.

The pathogenicity, epidemiology, and virulence factors of Staphylococcus have been comprehensively reviewed [ 72 ]. It was highlighted that colonization is aided by biofilm formation that is housed in extracellular polymeric substance (EPS) found in many bacteria and that virulence factors are expressed with accessory gene regulator (agr) system in response to cell density [ 73 ]. To avoid formation of biofilms and EPS in the sachet water-producing environment, adequate personnel hygiene and good manufacturing practices that meet food safety standards must be implemented.

4.4.2 Pseudomonas

The genus Pseudomonas especially P. aeruginosa is known globally as endemic [ 74 ] and an opportunistic pathogen that causes several infections [ 75 ]. They are often isolated in clinics [ 76 ], and other sources may include residential, recreational, or surface water [ 77 ]. The colonies are usually heavily mucoid on solid media. It has been reported that mechanisms of antimicrobial resistance in Pseudomonas strains and most bacteria include multidrug efflux pumps and downregulation of outer membrane porins, whereas virulence may include secretion of toxins and the ability to form biofilms [ 78 , 79 ]. A natural property of Pseudomonas is the possession of multiple mechanisms for different forms of antibiotic resistance [ 80 ], and this may have facilitated its occurrence in boreholes and sachet water.

4.4.3 Klebsiella

Klebsiella causes many infections, which includes urinary tract infections, pneumonia, bacteremia, and liver abscesses [ 81 ]. The genus is associated with water, and this may be why it has been isolated in both borehole and sachet water. The organism is found in drinking water [ 82 ], rivers [ 83 ], and sewage water [ 84 ], which may encourage environmental spread. It has been reported that the organism has a variety of virulence and immune evasive factors, which contribute to uptake of genes associated with antimicrobial resistance and pathogenicity [ 85 ]. A report [ 86 ] suggested that the species K. pneumoniae acquired antimicrobial resistance genes independently and their population is highly diverse. An analysis of strains from human and animal isolates spanning four continents has shown convergence of virulence and resistance genes, which may lead to untreatable invasive K. pneumoniae infections [ 87 ].

4.4.4 Escherichia

The most studied species of the Escherichia genus is E. coli , a coliform bacteria used to verify hygiene status in food and water. Usually, the presence of various strains of pathogenic or nonpathogenic E. coli in food or water samples indicates fecal contamination [ 88 ]. It has been reported that [ 89 ] a comparative analysis show that avian and human E. coli isolates contain similar sets of genes encoding virulence factors and that they belong to the same phylogenetic groups, which may indicate the zoonotic origin of extraintestinal pathogenic E. coli .

A study of the prevalence of E. coli strain O157:H7 in England and Scotland showed that it has a seasonal dependency, with greater fecal shedding of the organism in the warmer months together with increased reporting of E. coli O157:H7 infection among hospitalized patients [ 90 ]. This finding is very worrying because it suggests that there could be high prevalence when applied to Nigeria because the country has a warm climate all year round. However, good manufacturing practices irrespective of the climate appear to be the key factor in producing packaged water free of coliforms. It has been shown that levels of coliform bacteria and E. coli detected in sachet water samples in Ghana, a country with similar climate to Nigeria, were statistically and significantly lower than levels detected from several water sources including public taps [ 91 ].

4.4.5 Enterobacter

The genus Enterobacter consists of coliforms that are known to be of non-fecal origin. It is believed [ 92 ] that many Enterobacter species, which could act as pathogens, are widely encountered in nature but are most frequently isolated in human clinical specimens possibly because phenotypic identification of all species belonging to this taxon is usually difficult and not always reliable. Therefore, the identification of this genus in borehole and sachet water may need a revisit since molecular methods were not used. The organism is known as a ubiquitous and persistent Gram-negative bacterium in drinking water [ 17 ], but there are few studies of its occurrence or prevalence in borehole and sachet water or other water sources in Nigeria.

To understand the carbapenemase-producing Enterobacter spp. and the development of molecular diagnostics, Chavda et al. [ 93 ] used genomic analysis of 447 sequenced strains to establish diverse mechanisms underlying the molecular evolutionary trajectory of drug-resistant Enterobacter spp. Their findings showed the acquisition of an antibiotic resistance plasmid, followed by clonal spread and horizontal transfer of blaKPC -harboring plasmids between different phylogenomic groups. The report also showed repeated transposition of the blaKPC gene among different plasmid backbones.

4.4.6 Proteus

Proteus species are Gram-negative opportunistic rod-shaped bacteria known for its swarming motility and contamination of agar plates. Furthermore, on agar plates, the bacteria undergoes a morphological conversion to a filamentous swarmer cell expressing hundreds of flagella, and during infection, histological damage is caused by cytotoxins including hemolysin and a variety of proteases [ 94 ]. The organism is reported to have negative and positive advantages. According to Drzewiecka [ 95 ], Proteus species may be indicators of fecal pollution, which may cause food poisoning when the contaminated water or seafood is consumed, and it could be used for bioremediation activity due to its tolerance and ability to utilize polluting compounds as sources of energy.

Virulence factors may include fimbriae, flagella, outer membrane proteins, lipopolysaccharide, capsule antigen, urease, immunoglobulin A, proteases, hemolysins, and amino acid deaminases [ 96 ]. The ability to swarm and survive is facilitated by the upregulation of FlhD(2)C(2) transcription activator, which activates the flagellar regulon [ 97 ]. The prevalence of Proteus spp. in borehole or sachet water may be aided by its ability to swarm and colonize the production environment.

4.4.7 Vibrio

In Nigeria, the most reported species among the Vibrio species that cause water-related infection is Vibrio cholerae . The organism causes cholera, which is an infection that is characterized by watery stooling. The disease has killed hundreds of people in Nigeria in the last decade. According to Faruque et al. [ 98 ], a lysogenic bacteriophage designated CTXΦ encodes the Cholera toxin (CT), which is strongly influenced by environmental conditions [ 99 ]. The organism is responsible for the profuse diarrhea, and molecular epidemiological surveillance has revealed clonal diversity among toxigenic V. cholerae strains with continuous emergence of new epidemic clones. It has not been established if the strains found in boreholes and sachet water are the V. cholerae O1 or O139 strains that cause cholera [ 100 ]. There is a possibility that they could be non-O1 or non-O139 strains that are common in the environment.

In 2017, the WHO launched a global strategy on cholera control with a target to reduce cholera deaths worldwide by 90% [ 101 ]. The strategy is to use safe oral cholera vaccines in conjunction with improvements in water and sanitation to control cholera outbreaks and for prevention in areas known to be high risk for cholera. Nigeria can be classified as a high-risk area, and the occurrence of Vibrio species in borehole or sachet water suggests that they could transmit cholera. Outbreaks occur regularly in Nigeria, and it is always difficult to bring it under control. An outbreak in 2018 was characterized by four epidemiological waves and led to 836 deaths out of 43,996 cases [ 102 ], whereas that of 2010 killed a total of 1716 out of 41, 787 cases [ 103 ]. In both cases, the case fatality rate was over 1% recommended by WHO.

4.4.8 Bacillus

Bacillus cereus is a food safety concern among several species of Bacillus . It is naturally widely distributed in nature, and it is known as a Gram-positive rod bacterium that is responsible for food poisoning [ 104 ]. It can proliferate because of unhygienic practices [ 105 ] and can attach to drinking water infrastructure [ 106 ]. This suggests that the ubiquity of the organism, poor hygiene, and attachment to equipment may be why Bacillus has been repeatedly isolated from boreholes and sachet water by previous investigators.

Bacillus growth is sometimes considered an insignificant contaminant. Some strains like B. subtilis is used for probiotics [ 107 ], whereas a strain like B. cereus which secrets toxins like hemolysins, phospholipases, an emesis-inducing toxin, and proteases [ 108 ] is not used due to obvious reasons. Toxin production in B. cereus requires the transcription factor PlcR , which controls expression of virulence factors [ 109 ]. Virulence-associated gene profiles have been used to evaluate the genetic backgrounds and relationships of food poisoning cases among other isolates from the environment, and it was concluded that both molecular and epidemiological surveillance studies could be used effectively to estimate virulence [ 110 ].

4.4.9 Salmonella

The species Salmonella typhi and Salmonella paratyphi cause typhoid fever and remain a major public health concern in Asia and Africa [ 111 ] due to antimicrobial resistance. For developed countries, it is believed that some non-typhoidal strains are zoonotic in origin and acquire their resistance in the food animal host before onward transmission to humans through the food chain [ 112 ]. It has been reported that the overall global burden of Salmonella infections is high and this may be the reason why in 2017, the WHO listed fluoroquinolone-resistant Salmonella spp. as priority pathogens for which new antibiotics were urgently needed [ 113 ].

The bacterium can survive in aquatic environments by a number of mechanisms, including entry into the viable but non-culturable state or residence within free-living protozoa [ 114 ]. Survival in water may have contributed to the isolation from borehole and sachet water in studies by others. It is not certain if the isolates encountered in this study cause typhoid fever or are the non-typhoid causing strains. Hence, additional studies are required to establish the prevalent type of Salmonella in water-producing facilities in Nigeria. A recent report found that typhoid fever still poses a serious health challenge in Nigeria and is a major health security issue [ 115 ]. It was recommended that a combined approach that includes the use of typhoid vaccines, improvements in sanitation, and safe water supply is essential.

5. Conclusions

The overall bacteria quality of the borehole and sachet water in the community studied needs improvement. An improvement can be achieved by focusing on areas with coliform contamination. Boreholes should be sited where pollutants will not easily contaminate them. Regular water testing should be carried out to ensure the attainment of WHO guidelines always. Where deviations are found, corrective actions should be undertaken. The literature on bacteria from boreholes and sachet water in Nigeria shows that not much molecular characterization has been carried out; hence an opportunity exists for more investigations. Regulatory oversight for sachet water production and the use of boreholes by large community populations requires improvement. It is recommended that universities should carry out periodic surveillance of boreholes and sachet water sold near them to support the SDG targets of the WHO.

Conflict of interest

The authors declare no conflict of interest.

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Bacteriological Assessment of the Surface of Hawked Sachet Water Bags Sold in Gboko, North Central Nigeria

Bacterial contamination of drinking water, particularly in developing countries, affects 80% of the global population and poses a major health problem, causing various diseases and threatening the existence of the population.This study assessed the bacteriological quality of sachet water surface collected with swabs obtained from Ortese, Yandev and Gboko main markets of Gboko, North Central Nigeria. The samples were analyzed for coliform bacteria following the most probable number (MPN) protocol. The results showed that all surface swab samples were heavily contaminated with lactose fermenting bacteria. The highest counts were recorded for samples A6, C1, C3 and C4 resulting in >1,600 MPN/100ml while the lowest count was observed in A13 as 2 MPN/100ml. The confirmatory analysis revealed that 23 samples out of 60 samples produced a green metallic sheen which indicates the presence of coliform ( Escherichia coli ) thus making the sachet surface unsafe. The 23 Escherichia coli isolates were further confirmed by their Gram reaction. Therefore, the results of the present study showed that surfaces (exterior part) of sachet water sold within the region may be a source of contamination of the water during consumption. The presence of indicator bacteria suggests the possible occurrence of faecal contamination. Thus, attention should be given to this risk factor identified in order to ensure public health safety.