The impact of hygiene and localised treatment on the quality of drinking water in Masaka, Rwanda.

The worldwide prevalence of waterborne diseases has been attributed to the lack of safe water, inadequate sanitation and hygiene. This study evaluated socio-demographic factors, microbiological quality of water at source and point of use (POU) at households, water handling and sanitation practices in a rural Rwandan community. Thirty five water samples from the source, Nyabarongo River, and water at point of use (POU) treated with the Slow Sand Filter (SSF) and Sûr'Eau methods, were analysed for total coliform and faecal coliform counts. Turbidity was measured in household samples. A structured questionnaire regarding water collection, storage, usage and waterborne disease awareness was administered to 324 women. Despite the significant reduction in coliforms and faecal coliforms from the Nyabarongo River following treatment using either SSF or Sûr'Eau, the water at point of use was found to be unsafe for human consumption. The frequency of diarrheal diseases were significantly higher among people who did not wash hands before food preparation (P = 0.002) and after using a toilet (P = 0.007) than among those who did. There was a statistically significant association between education levels and water treatment practices at the households (P < 0.05). Participants had limited knowledge regarding water storage practices for prevention of household water contamination. A combination of treatment methods with appropriate water handling should be considered. In addition, education is a fundamental precursor to advocating water treatment at POU.