Daba Chala, Berhanu Leykun, Desye Belay, Berihun Gete, Geto Abebe Kassa
Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Dessie Health Science College, Dessie, Ethiopia.
PLoS One. 2025 Jan 3;20(1):e0310731. doi: 10.1371/journal.pone.0310731. eCollection 2025.
Drinking contaminated water is a significant cause of mortality and morbidity in Sub-Saharan Africa, where access to safe drinking water is limited. Although numerous studies have investigated the bacteriological quality of drinking water in Ethiopia, their findings have been inconsistent and varied, hindering the implementation of effective water quality monitoring. Moreover, there is a lack of nationwide assessment of the bacteriological quality of drinking water in Ethiopia. Therefore, this systematic review and meta-analysis aimed to determine the bacteriological quality of drinking water and its associated factors in Ethiopia.
An international electronic database, including PubMed, Science Direct, Global Health, CINAHL, African Journals Online, HINARI, and Google Scholar was employed to retrieve the relevant articles. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA) guidelines. A random-effects model was used to estimate the pooled effect size, and the Egger regression model was employed using STATA 14 software to assess potential publication bias.
A total of 26 studies involving 7,962 water samples met the eligibility criteria for meta-analysis. The pooled prevalence of at least one bacteriological contamination of drinking water was 52.26% (95%CI: 39.09-65.43), with extreme heterogeneity (I2 = 99.7%; p-value < 0.001). The pooled prevalence of total and fecal coliform in drinking water was 49.55% (95% CI: 34.88-64.23) and 44.27% (95%CI: 34.36-54.19), respectively. 14.13% of the water source was at a very high sanitary risk level (unfit for drinking), with significant heterogeneity (I2 = 94.1%, p< 0.001). The absence of household-level water treatment (OR = 3.3; 95%CI: 1.28-5.32) and drawing water using dipping methods (OR = 4.52; 95%CI: 1.71-7.34) were determinant factors for bacteriological contamination of drinking water.
We found that the bacteriological quality of drinking water did not comply with the World Health Organization and Ethiopia's standard guidelines for drinking water, which call for urgent intervention. One out of seven water sources was at a high sanitary risk level, which could increase the risk of infectious disease in the country. The absence of household-level water treatment and drawing water using dipping was a significant factor in the bacteriological quality of drinking water. Based on these findings, the water supply and sewerage authority should prioritize regular monitoring of the bacteriological quality of drinking water.
在撒哈拉以南非洲，饮用受污染的水是导致死亡和发病的一个重要原因，该地区安全饮用水的获取有限。尽管众多研究调查了埃塞俄比亚饮用水的细菌学质量，但其研究结果并不一致且各不相同，这阻碍了有效水质监测的实施。此外，埃塞俄比亚缺乏对全国饮用水细菌学质量的评估。因此，本系统综述和荟萃分析旨在确定埃塞俄比亚饮用水的细菌学质量及其相关因素。
使用包括PubMed、Science Direct、Global Health、CINAHL、African Journals Online、HINARI和谷歌学术在内的国际电子数据库检索相关文章。该研究遵循系统综述和荟萃分析方案的首选报告项目（PRISMA）指南。采用随机效应模型估计合并效应量，并使用STATA 14软件采用Egger回归模型评估潜在的发表偏倚。
共有26项涉及7962个水样的研究符合荟萃分析的纳入标准。饮用水至少存在一种细菌污染的合并患病率为52.26%（95%置信区间：39.09 - 65.43），存在极端异质性（I² = 99.7%；p值 < 0.001）。饮用水中总大肠菌群和粪大肠菌群的合并患病率分别为49.55%（95%置信区间：34.88 - 64.23）和44.27%（95%置信区间：34.36 - 54.19）。14.13%的水源处于非常高的卫生风险水平（不适于饮用），存在显著异质性（I² = 94.1%，p < 0.001）。缺乏家庭层面的水处理（比值比 = 3.3；95%置信区间：1.28 - 5.32）和采用舀取方式取水（比值比 = 4.52；95%置信区间：1.71 - 7.34）是饮用水细菌污染的决定性因素。
我们发现，饮用水的细菌学质量不符合世界卫生组织和埃塞俄比亚的饮用水标准指南，这需要紧急干预。每七个水源中就有一个处于高卫生风险水平，这可能会增加该国传染病的风险。缺乏家庭层面的水处理和采用舀取方式取水是饮用水细菌学质量的一个重要因素。基于这些发现，供水和污水处理部门应优先定期监测饮用水的细菌学质量。
