College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Department of Clinical Pharmacy and Pharmacy Management, Kaduna State University, Kaduna, Nigeria.
Trop Med Int Health. 2021 Nov;26(11):1378-1400. doi: 10.1111/tmi.13672. Epub 2021 Sep 13.
About 18% of urban households in Nigeria depend on packaged sachet water as the primary source of drinking water. This review assessed microbial contamination of these products with an emphasis on total coliforms and the faecal indicator bacteria (FIB) - Escherichia coli (E. coli) and thermotolerant coliforms (TTC).
PubMed/Medline, African Index Medicus, AfroLib, Global Health Library, Embase and the ISI Web of Science databases were searched to identify original research published up to October 2020. The literature findings were synthesised narratively in line with the review objectives. To assess prevalence of microbial contamination, a random effects meta-analysis, was also conducted using the R metafor package in RStudio. The protocol for this review is registered on PROSPERO with reference number CRD 42019128474.
Fifty-two of 429 studies were identified for inclusion. At 53.27%, contamination prevalence was higher for total coliforms (95% CI: 39.05-66.98, I = 81%, p < 0.01, 42 studies) than FIB (12.38%, 95% CI: 7.92-18.85, I = 61%, p < 0.01, 33 studies) suggesting that treatment failure is a major contributor to the poor microbial quality reported in the included studies. Within the FIB group, the prevalence of contamination with E. coli was 13.30% (95% CI: 8.23-20.80, I = 65%, p < 0.01, 27 studies) versus 6.24% (95% CI: 1.12-28.06, I = 72%, p < 0.01, six studies) for TTCs. Other microbial contaminants reported were Pseudomonas aeruginosa, Klebsiella and Enterococcus faecalis and these showed multidrug antibiotic resistance.
The findings of this review highlight the need for improved regulatory oversight with more stringent monitoring of the microbial quality of sachet water products in Nigeria.
尼日利亚约有 18%的城市家庭依赖包装的袋装水作为主要饮用水源。本综述评估了这些产品的微生物污染情况，重点是总大肠菌群和粪便指示菌（FIB）-大肠杆菌（E. coli）和耐热大肠菌群（TTC）。
检索了 PubMed/Medline、非洲医学索引、AfroLib、全球卫生图书馆、Embase 和 ISI Web of Science 数据库，以确定截至 2020 年 10 月发表的原始研究。根据综述目的，以叙述性方式综合文献结果。为了评估微生物污染的流行率，还使用 RStudio 中的 R metafor 包进行了随机效应荟萃分析。本综述的方案已在 PROSPERO 上注册，参考号为 CRD42019128474。
从 429 项研究中确定了 52 项进行纳入。总大肠菌群（95%CI：39.05-66.98，I=81%，p<0.01，42 项研究）的污染流行率为 53.27%，高于 FIB（12.38%，95%CI：7.92-18.85，I=61%，p<0.01，33 项研究），这表明处理失败是导致所纳入研究报告的微生物质量较差的主要原因。在 FIB 组中，大肠杆菌污染的流行率为 13.30%（95%CI：8.23-20.80，I=65%，p<0.01，27 项研究），而耐热大肠菌群的流行率为 6.24%（95%CI：1.12-28.06，I=72%，p<0.01，6 项研究）。报告的其他微生物污染物包括铜绿假单胞菌、克雷伯菌和粪肠球菌，这些细菌表现出多药抗生素耐药性。
本综述的结果强调需要加强监管监督，更严格地监测尼日利亚袋装水产品的微生物质量。
