Assessment of current water, sanitation, and hygiene (WASH) practices in the third and ninth districts of N'Djamena, Chad.

Access to safe drinking water, sanitation, and hygiene in Chad's cities, especially N'Djamena, is a persistent and significant challenge. This study aimed to assess current practices in water, sanitation, and hygiene in N'Djamena's third and ninth districts. We surveyed 395 households, conducted water source identification, and analyzed seven water samples at the National Water Laboratory. Temperature, ammonium, total coliforms, and aerobic flora values exceeded World Health Organization (WHO) guidelines. Ammonium and temperature averaged 0.7 mg/L and 30.1-31.93 °C, respectively. Bacterial contamination (>100 MPN/100 mL) exceeded the WHO's 0 MPN/100 mL guidelines, rendering the water unfit for consumption. Survey results indicate that 78.7% use hand pumps, 21.1% have tap water access, and 0.2% rely on rivers for water. Regarding toilets, 92.8% have traditional models, 2.9% have modern facilities, and 4.3% practice open defecation. 95% dispose of untreated wastewater into nature, with only 5% using septic tanks. For solid waste, 72% use illegal dumpsites, 18% rely on public services, and 10% burn waste. Finally, 95.5% of households wash their hands with clean water and soap after using the toilet. It is crucial to treat drinking water and implement proper hygiene and sanitation measures to safeguard the population's health in the studied area.

Characterization of dumpsite waste of different ages in Ghana.

Open dumping of municipal solid waste is a common practice in developing countries including Ghana and it creates major problems in many municipalities and towns in the countries, and therefore, the dumpsites need to be reclaimed or decommissioned after years of dumping. However, it becomes challenging to infer from the results of studies from other part of the world for dumpsites in Ghana since they may have different waste characteristics. Therefore, this study sought to characterize the dumpsite waste with different age groups from urban city and small town to ascertain the impacts of aging of deposited waste on waste fractions, it also assessed the waste components at different depths within the same and different age groups in both small-town and urban dumpsites; for waste deposited more than 5 years (Zone A), 2-4 years (Zone B), and less than 6 months (Zone C) in Bono region, Ghana. Waste (100 kg) was taken at surface, 0.5 m, 1.0 m and 1.5 m and reduced to 50 kg using coning and quartering method; dried, segregated and analyzed. Plastics waste (24.5-28.1%) increased with age at urban, and increased (5.4-8.5%) with depth at small town dumpsite. Plastic waste was second to Decomposed organic matter (DOM) at both dumpsites. The metal (<1.0%) at all depths in all age groups for both sites. DOM fine particle sizes (FPS) decreased with depth, 26.8% (surface waste) and 14.4% (1.5 m depth), at both dumpsites. Statistically significant effects of age on plastics, metal, DOM-CPS, DOM-FPS (p < 0.05) at urban dumpsite. However, at small town dumpsite, effect of age was statistically significant on only DOM-CPS and DOM-FPS (p < 0.05). The pH, EC, and TDS for both dumpsites decreased with increasing age, and increased with depth. The study provides relevant scientific findings for stakeholders to develop policy framework for dumpsite decommissioning or reclamation.

Assessment of the Knowledge, Prevalence, and Control Strategies of Malaria Among Households in Sunyani Municipality, Bono Region, Ghana.

Background: Malaria remains a global public health concern for centuries. The study assessed the knowledge, prevalence and control strategies of malaria among households in the Sunyani Municipality, Bono Region, Ghana. Method: A simple random sampling method was used to administer semi-structured questionnaires to the respondents (n = 422). STATA version 14.0 was used to analyse the data and the results were presented in charts, graphs, and tables. Result: The study shows that the knowledge level of malaria, its vector of transmission and mosquitoes breeding sites among the respondents was quite high. Among the respondents, 43% reported to have been infected by malaria once in a year and 94% indicated that, their relatives have been infected with malaria parasites previously. Also, majority, 65% of the respondents selected environmental management and sanitation (EMS), followed by settlement (building houses) away from wetlands, 20.0% as alternative vector control methods to be employed to supplement the core vector control methods in the Municipality. Further, majority, 69% of the respondents indicated that enforcement of environmental sanitation bye-laws will compel residents to clean their environment, and this is likely to eliminate most mosquito breeding sites, whiles 46% called on Government to support, and employ more Environmental Health Officers and Sanitary Labourers, and adequately resource them to work effectively. Conclusion: Health authorities in the Sunyani Municipality must intensified education on malaria at all levels with the aim to influence the attitudes of households towards its prevention and control. Central and Local Government must employ more Environmental Health Officers, and empower and adequately resourced them to strictly enforce the environmental sanitation bye-laws. Malaria control authorities in the study area must consider employing environmental management and sanitation (EMS) and application of larvicides for mosquito larval control as alternative/supplementary malaria prevention and control methods to compliments the current core vector control methods.

Health-care waste management practices: The case of Ho Teaching Hospital in Ghana.

Approximately 15% of wastes generated in hospitals is hazardous. Improper handling of this waste renders the remaining fraction infectious which is perilous to the health of hospital workers, patients, visitors and even communities. Sufficient data on medical waste management practices particularly in low-income countries such as Ghana is required for effective monitoring and policy making. This study sought to assess the waste generation rates, waste management practices, frequency of sharp injuries and the knowledge of health-care workers on waste management guidelines in Ho Teaching Hospital in Ghana. Data was collected through observations and questionnaire administration from 100 health-care workers. The results revealed that the total amount of wastes generated was 1.70kg/patient/day (490.62 kg/day) comprising of 57.48%, 33.98% and 8.54% of general, infectious and hazardous wastes respectively. Further investigations showed that 52% of the health-care workers knew about the existence of a hospital waste management policy and 89% attested that they had received training on medical waste management. The existing waste management committee was however, non-functional. Waste segregation at source and the use of color-coded waste receptacles were not strictly followed. Contaminated general wastes were landfilled whiles hazardous wastes were either incinerated or buried. Only 11% of the waste handlers were always completely dressed in personal protective equipment and about 77% of the waste handlers always sustained sharp injuries. Incentivizing the waste management team to ensure strict adherence to a waste management plan would improve waste management at the hospital.

Leaving no disease behind: The roadmap to securing universal health security and what this means for the surveillance of infectious diseases in Ghana as a precedent for sub-Saharan Africa.

INTRODUCTION: Ghana is the first country in sub-Saharan Africa (SSA) to aim for universal health coverage (UHC). Based on Ghana's UHC system, the accessibility and distribution of healthcare facilities were evaluated for 2020. Projecting into 2030, this study aimed at providing geographical information data for guiding future policies on siting required healthcare facilities. Ghana as a precedent for SSA was evaluated and proposed to "leave no disease behind" in the surveillance of infectious diseases (IDs). This is to reinforce the sustainable development goals (SDG) 3 agenda on health that underpins monitoring equity in "leaving no one behind." METHODS: Geospatial accessibility, travel time data, and algorithms were employed to evaluate the universality and accessibility of healthcare facilities, and their future projections to meet UHC by 2030. Healthcare facilities as surveillance sites were compared to community-based surveillance to identify which would be more applicable as a surveillance system to leave no disease behind in Ghana. FINDINGS: Ghana has 93.8%, 6.1% and 0.1% as primary, secondary and tertiary healthcare facilities respectively. It has 26.1% of healthcare facilities remaining to meet the SDG 3 health target by 2030. In terms of providing quality healthcare, 29.3% and 67.2% of the additional required healthcare facilities for optimal allocation and achieving the UHC target need to be secondary and tertiary respectively. In assessing the broad spectrum of IDs studied from 2000 to 2020, an average of 226 IDs were endemic or potentially endemic to Ghana. The majority of the studies carried out to identify these IDs were done through community-based surveillance. CONCLUSION: Establishing community-based surveillance sites to leave no disease behind and also providing the required healthcare facilities to reinforce leaving no one behind will enhance the universal health security of Ghana as a precedent for SSA.

Environmental Management and Sanitation as a Malaria Vector Control Strategy: A Qualitative Cross-Sectional Study Among Stakeholders, Sunyani Municipality, Ghana.

Background: For centuries malaria infection remains a public health burden globally as well as in the Sunyani Municipality. This exploratory qualitative study aimed to assess the prospects of environmental management and sanitation (EMS) as a malaria vector control strategy among key stakeholders involved in the prevention and control of malaria in Sunyani Municipality, Ghana. Method: We used an exploratory qualitative study and a designed focus group discussion (FGD) guide (with specific research questions) to solicit opinions and/or views among Malaria Control Focal Persons, Environmental Health Officers (Health Inspectors), and Honourable Assembly Members. Data were collected between December 2019 and February 2020. The responses were analyzed according to the specific research questions. Result: Findings from this study shows that high government support and/or political will by investing in environmental sanitation infrastructure, creating the enabling environment for strict enforcement of environmental sanitation bye-laws by Environmental Health Officers/Health Inspectors, effective and efficient collaboration among key stakeholders and organization of communal labor activities is likely to help reduce the majority of the mosquito breeding sites. Conclusion: The prospects of environmental management and sanitation (EMS) as a vector control strategy, look promisingly very high, pertinent, and workable and a likelihood game changer of winning the fight against malaria due to the residual transmission that is happening outdoors. However, EMS can be employed as a supplementary method to the current core vector control methods if the following conditions and bottlenecks are addressed and in place: (a) Effective collaboration among key stakeholders at all levels; (b) Adequate allocation of funds to the Environmental Health and Sanitation Department; (c) Enactment of robust educational campaigns across all educational levels and via different media; (d) Recognition, empowerment, and adequate resourcing of Environmental Health Officers; (e) Adherence to the building regulations to prevent encroachment of natural wetlands; (f) Revision of fees/fines and prosecution of sanitary offenders; (g) Enactment of an Environmental Sanitation Day (ESD), and establishment of the Environmental Health and Sanitation Fund (EHSF).

Manganese, Iron, Lead, and Zinc Levels and Haematological Profile among Welders in Bibiani Anhwiaso Bekwai District, Ghana.

Welders are exposed to metal ions or oxides through direct contact at occupational sites or indirectly through uptake from contaminated dust or air. This study was a case-control study designed to assess the levels of some heavy metals and the hematological profile of welders (cases) as compared to nonwelders (controls) from Bibiani Anhwiaso Bekwai District of Ghana, comparatively to determine whether their values are within acceptable international range. A quantitative-based survey using structured questionnaires was used to collect demographic data from purposively selected welders (n = 40) and nonwelders (n = 40) from the study area. Five (5 mL) blood samples were collected from the study participants and analyzed for blood cell count as well as levels of Mn, Fe, Pb, and Zn. There were no significant differences in the Mn, Zn, and Fe levels between the welders and nonwelders (p=0.431, 0.53 vs. 0.23 mg/L, p=0.05, 0.41 vs. 0.15, p=0.886, 1.82 vs. 1.11). The level of Pb was, however, significantly lower among welders compared to the nonwelders (p=0.016, 0.09 < 0.3 mg/L). The total white blood cell count did not differ significantly between welders and nonwelders (p=0.365, 5.16 vs. 4.85 × 109/L). However, the mixed cell fraction was significantly higher among welders compared to nonwelders (p=0.027, 0.34 × 109/L > 0.28 × 109/L). Red blood cell count and indices showed no significant differences between the welders and nonwelders. Hemoglobin levels in welders were, however, higher (14.47 g/dL) but this was not statistically significant compared to their nonwelder counterparts (13.85 g/dL). It was concluded from the study that welders in Bibiani Anhwiaso Bekwai District of the Western Region of Ghana had elevated levels of Pb in their bodies. This was associated with an increase in mixed white blood cell fraction platelets. However, the recorded levels were within the accepted physiological limits suggesting that the heavy metal exposure of welders had no clinically pathological significance.

Inhibition of ammonia and hydrogen sulphide as faecal sludge odour control in dry sanitation toilet facilities using plant waste materials.

On-site dry sanitation facilities, although cheaper than wet sanitation systems, suffer from high malodour and insect nuisance as well as poor aesthetics. The high odour deters users from utilizing dry sanitation toilets as an improved facility leading to over 20% open defecation in Sub-Saharan Africa. To address this malodour concern, this study first assessed odour levels, using hydrogen sulphide (H2S) and ammonia (NH3) as indicators, on two dry sanitation facilities named T1 and T2. The potential of using biomass (sawdust, rice husk, moringa leaves, neem seeds), ash (coconut husk, cocoa husk) or biochar (sawdust, rice husk, bamboo) as biocovers to remove or suppress odour from fresh faecal sludge (FS) over a 12-day period was investigated. Results showed that the odour levels for H2S in both T1 (3.17 ppm) and T2 (0.22 ppm) were above the threshold limit of 0.05 ppm, for unpleasantness in humans and vice versa for NH3 odour levels (T1 = 6.88 ppm; T2 = 3.16 ppm; threshold limit = 30 ppm limit). The biomasses exhibited low pH (acidic = 5-7) whereas the biochars and ashes had higher pHs (basic = 8-13). Basic biocovers were more effective at H2S emission reduction (80.9% to 96.2%) than acidic biocovers. The effect of pH on suppression of NH3 was determined to be statistically insignificant at 95% confidence limit. In terms of H2S and NH3 removal, sawdust biochar was the most effective biocover with odour abatement values of 96.2% and 74.7%, respectively. The results suggest that biochar produced from locally available waste plant-based materials, like sawdust, can serve as a cost-effective and sustainable way to effectively combat odour-related issues associated with dry sanitation facilities to help stop open defecation.

Conceptual Behaviour Underpinning the Occurrence of Nonfaecal Matter in Faecal Sludge in Some Urban Communities, Ghana.

Faecal sludge (FS) management is pertinent to the achievement of sustainable development goal 6.2 around the world; yet it is constrained by urbanisation challenges, waste management complexities, and defective attitudes. These deny communities of the plausible supply of resources from FS. This paper assesses the perception underpinning the occurrence of nonfaecal matter in FS in Ghana. Primary data were obtained from 400 respondents in four communities in Brong Ahafo and Greater Accra Regions of Ghana, using a structured questionnaire. Data were analysed by using STATA software version 15. Chi-square test and multiple logistic regression were conducted on all independent variables and statistical significance was accepted at p < 0.05. The study identified the following as the most perceived frequently disposed nonfaecal matter into FS: sanitary pads and diapers (38.5%), fabrics/rags (23.2%), toilet rolls (20.8%), razor/shaving sticks (10.3%), and others (7.2%). Gender, state of toilet facility (roof or unroofed), presence of container for collecting other types of waste in the toilet room, and state of container in toilet room either covered or uncovered were the factors found to be significantly associated with the disposal of solid waste (SW) into FS at 95% confidence level. The fear of exposing used sanitary materials for rituals, the use of fabric as an alternative to toilet rolls, and the desire to conceal aborted pregnancies from the public were some of the reasons alluded to the disposal acts. Education and awareness campaigns on proper SW disposal practices, appropriate use of toilet facilities, and the resource potentials of FS were found to be the best way forward to discourage indiscriminate disposal of SW into FS.

Biting rates and relative abundance of Simulium flies under different climatic conditions in an onchocerciasis endemic community in Ghana.

BACKGROUND: Knowledge of the relative abundance and biting rates of riverine blackflies (vectors of onchocerciasis) is essential as these entomological indices affect transmission of the disease. However, transmission patterns vary from one ecological zone to another and this may be due to differences in species of blackfly vectors and the climatic conditions in the area. This study investigated the effects of climate variability on the relative abundance and biting rates of blackflies in the Tanfiano community (Nkoranza North District, Bono East Region, Ghana). Such information will help to direct policy on effective timing of the annual mass drug administration of ivermectin in the area. METHODS: The study employed human landing collections and locally built Esperanza window traps to collect blackflies from March 2018 to February 2019. The relative abundance and biting rates of the Simulium vectors as well as the monthly climatic conditions of the study area were monitored. Correlation analysis and Poisson regression were used to establish the relationships between the variables. RESULTS: The relative abundance and biting rates of the Simulium vectors were highest in the drier months of March, April and August, characterized by high temperatures, low humidity, longer hours of sunshine and stronger winds. The rainy months of May, June and July, characterized by low temperatures, high humidity, few hours of sunshine and weaker winds, had relatively low blackfly abundance and biting activity. Correlation analysis showed that only temperature was significantly, positively correlated with the relative abundance of blackflies (r = 0.617, n = 12, P = 0.033) and monthly biting rates (r = 0.612, n = 12, P = 0.034). A model to predict relative abundance and monthly biting rates using climatological variables was developed. CONCLUSIONS: This study demonstrated that Simulium species in the study area preferred higher temperature, lower humidity and rainfall, more hours of sunshine and relatively stronger winds for survival. It is thus recommended that for the study district and others with similar climatological characteristics, mass drug administration of ivermectin should take place in April and September when the abundance of vectors has begun to decline after peaking.

Ellucidating the incidence and the prevalence of Schistosomiasis spp infection in riparian communities of the Bui dam.

The flow rate of rivers are affected when modifications are made for the benefit of mankind. Some man-made alterations carried out include dam construction. The aim of this study was to investigate the health impact of the Bui dam with respect to the prevalence and awareness level of schistosomiasis in a typical damming environment. The study was conducted in 4 riparian communities within the dam catchment area. A cross-sectional study design was employed to interview 350 individuals. Urine and stool samples were also collected from 386 participants. Results of the study showed that, knowledge of schistosomiasis was significantly greater in close communities (99.47%) than their far counterparts (50.29%) (p > 0.001; OR = 172). Schistosomiasis infection rate in the close communities (32.57%) were significantly greater in far communities (7.23%; p ≤ 0.0001). The overall prevalence of 82 (21.1%) was recorded for Schistosoma haematobium and 64 (16.1%) for Schistosoma mansoni. A significantly high prevalence of S. haematobium (43.3%) was found in the age group 15-24 with no prevalence reported for age group 5-9 (Close communities) (p = 0.012). When the same age group was further examined for S. mansonii, group 5-9 recorded a prevalence of 0% with age group 10-14 showing a high prevalence of 26.1% (p = 0.047). From the study, it was concluded that, though awareness level of Schistosomiasis knowledge on the cause, mode of transmission and symptoms were high, they were ignorant on personal preventive strategies. In addition, the study also revealed that, S. haematobium was more prevalent among inhabitants living closer to the Bui dam with children less than 14 years of age being the worst affected.

Prevalence of onchocerciasis and associated clinical manifestations in selected hypoendemic communities in Ghana following long-term administration of ivermectin.

BACKGROUND: Onchocerciasis is a neglected tropical disease which is still of immense major public health concern in several areas of Africa and the Americas. The disease manifests either as ocular or as dermal onchocerciasis with several symptoms including itching, nodules, skin thickening, visual impairment and blindness. Ivermectin has been an efficient microfilaricide against the causative agent of the disease (Onchocerca volvulus) but reports from some areas in Africa suggest the development of resistance to this drug. The aim of this study was to determine the prevalence of onchocerciasis and associated clinical conditions frequently associated with the disease in three endemic communities in Ghana which have been subjected to 18 to 20 rounds of mass drug administration of ivermectin. This was to help determine whether or not onchocerciasis persists in these communities. METHODS: A cross-sectional study design was adopted. Three communities (Tanfiano, Senya and Kokompe) in the Nkoranza North District of Ghana where mass drug administration of ivermectin had been ongoing for more than two decades were selected for the study. The population was randomly sampled and 114 participants recruited for the study based on the eligibility criteria. The study participants were examined for the presence of parasites and clinical manifestations of onchocerciasis following established protocols. RESULTS: The study showed that the prevalence of microfilaria in the Tanfiano, Senya, Kokompe communities were 13.2, 2.4, and 2.9%, with nodule prevalence being 5.3, 4.9 and 14.3% respectively. Females in the study communities had a higher prevalence of microfilaria carriers (5.17%) relative to males (2.44%), but this difference was not statistically significant (p = 0.2800, unpaired t test). The most frequent clinical manifestation observed in this study among all participants was dermatitis (25.4%), followed by visual impairment & nodules (7.9% each) and then by blindness (4.4%). CONCLUSION: The study showed that despite several years of mass drug administration with ivermectin, infection with onchocerciasis and the commonly associated clinical manifestations of the disease still persist in the study communities. This calls for a greater urgency for research and development aimed at discovering new or repurposed anti-filarial agents which will augment ivermectin if global onchocerciasis eradication targets are to be achieved.

A Perspective Analysis of Dams and Water Quality: The Bui Power Project on the Black Volta, Ghana.

Large dams play an important role in promoting economic and social development in many countries. However, the construction of such dams can have a detrimental effect on the environment. The aim of this study was to investigate perceptions of drinking water quality among inhabitants of selected communities within the Bui Dam environs. With the help of questionnaires, 100 respondents from communities "near to the dam" were randomly selected and interviewed. Their responses were compared with another 100 respondents selected from "far from the dam" communities. These were augmented with in-depth interviews, focus group discussion, and personal observation. Analysis of the results showed that, there were greater proportions (31%) of the participants who lived in "near communities" within the age category 20-25 compared to 19% of their "far communities" counterparts. There were significantly greater proportions of female respondents in the "near to the dam" (57%) compared to respondents in the "far from the dam" communities (52%). The study further showed that the perception of risk of consuming contaminated drinking water was more common among "far from the dam" communities (odds ratio = 4.57). The perception of the quality of water based on some physical properties was investigated as part of our study. Analysis of the results showed that significantly greater proportion of the "far from the dam" communities (35%) perceived their water had an objectionable smell compared to 7% of inhabitants of their other counterparts (p value = 0.001). The study further showed that significantly greater proportion of the study participants in the far from the communities perceived that their water had colour (65%) and they did not drink water from any other source (63%) apart from their stream. The study demonstrated that generally, inhabitants within the study communities perceived the construction of the Bui Power Project has negatively affected their drinking water quality.

The Search for an Efficient Black Fly Trap for Xenomonitoring of Onchocerciasis.

Onchocerciasis is a neglected tropical disease that has plagued mankind for decades with pathologies that involve the eyes and the skin. The WHO and the global health community have earmarked the disease for global elimination by 2045. However, as control programmes shift focus from reduction of the burden of the disease to elimination, new tools and strategies may be needed to meet targets. Monitoring Onchocerca volvulus larvae in the black fly vectors is an important tool needed to monitor disease dynamics and certify elimination. For decades, human landing collections have been the sole means of acquiring vectors for monitoring of the disease. This procedure has been plagued with ethical concerns and sometimes the inability to harvest enough black flies needed to carry out effective monitoring. Since the 1960s, the WHO recognized the need to replace human landing collections but relatively few field studies have designed and tested alternative traps. This review article systematically discusses some of the key traps tested, their successes, and their challenges. It is the aim of the review to direct research and development focus to the most successful and promising vector traps which could potentially replace the human landing collections.

Needs assessment to strengthen capacity in water and sanitation research in Africa: experiences of the African SNOWS consortium.

BACKGROUND: Despite its contribution to global disease burden, diarrhoeal disease is still a relatively neglected area for research funding, especially in low-income country settings. The SNOWS consortium (Scientists Networked for Outcomes from Water and Sanitation) is funded by the Wellcome Trust under an initiative to build the necessary research skills in Africa. This paper focuses on the research training needs of the consortium as identified during the first three years of the project. METHODS: We reviewed the reports of two needs assessments. The first was a detailed needs assessment led by one northern partner, with follow-up visits which included reciprocal representation from the African universities. The second assessment, led by another northern partner, focused primarily on training needs. The reports from both needs assessments were read and stated needs were extracted and summarised. RESULTS: Key common issues identified in both assessments were supervisory skills, applications for external research funding, research management, and writing for publication in the peer-reviewed scientific literature. The bureaucratisation of university processes and inconsistencies through administration processes also caused problems. The lack of specialist laboratory equipment presented difficulties, particularly of inaccessibility through a lack of skilled staff for operation and maintenance, and of a budget provision for repairs and running costs. The lack of taught PhD modules and of research training methods also caused problems. Institutionally, there were often no mechanisms for identifying funding opportunities. On the other hand, grantees were often unable to understand or comply with the funders' financial and reporting requirements and were not supported by their institution. Skills in staff recruitment, retention, and performance were poor, as were performance in proposal and paper writing. The requirements for ethical clearance were often not known and governance issues not understood, particularly those required by funders. CONCLUSIONS: SNOWS believes that working with African universities to develop networks that support African-led research driven by the local context is an effective approach to develop and retain research skills needed to change policy and practice in water, sanitation, and hygiene in Africa.

Chemical drinking water quality in Ghana: water costs and scope for advanced treatment.

To reduce child mortality and improve health in Ghana boreholes and wells are being installed across the country by the private sector, NGO's and the Ghanaian government. Water quality is not generally monitored once a water source has been improved. Water supplies were sampled across Ghana from mostly boreholes, wells and rivers as well as some piped water from the different regions and analysed for the chemical quality. Chemical water quality was found to exceed the WHO guidelines in 38% of samples, while pH varied from 3.7 to 8.9. Excess levels of nitrate (NO(3)(-)) were found in 21% of the samples, manganese (Mn) and fluoride (F(-)) in 11% and 6.7%, respectively. Heavy metals such as lead (Pb), arsenic (As) and uranium (U) were localised to mining areas. Elements without health based guideline values such as aluminium (Al, 95%) and chloride (Cl, 5.7%) were found above the provisional guideline value. Economic information was gathered to identify water costs and ability to pay. Capital costs of wells and boreholes are about pound1200 and pound3800 respectively. The majority of installation costs are generally paid by the government or NGO's, while the maintenance is expected to be covered by the community. At least 58% of the communities had a water payment system in place, either an annual fee/one-off fee or "pay-as-you-fetch". The annual fee was between pound0.3-21, while the boreholes had a water collection fee of pound0.07-0.7/m(3), many wells were free. Interestingly, the most expensive water ( pound2.9-3.5/m(3)) was brought by truck. Many groundwater sources were not used due to poor chemical water quality. Considering the cost of unsuccessful borehole development, the potential for integrating suitable water treatment into the capital and maintenance costs of water sources is discussed. Additionally, many sources were not in use due to lack of water capacity, equipment malfunction or lack of economic resources to repair and maintain equipment. Those issues need to be addressed in combination with water quality, coordinated water supply provision and possible treatment to ensure sustainability of improved water resources.

Comparative performance studies of water lettuce, duckweed, and algal-based stabilization ponds using low-strength sewage.

A bench-scale continuous-flow wastewater treatment system comprising three parallel lines using duckweed (Spirodela polyrhiza), water lettuce (Pistia stratiotes), and algae (natural colonization) as treatment agents was set up to determine environmental conditions, fecal coliform profiles and general treatment performance. Each line consisted of four ponds connected in series fed by diluted sewage. Influent and effluent parameters measured included environmental conditions, turbidity, biochemical oxygen demand (BOD), chemical oxygen demand (COD), nitrate, nitrite, ammonia, total phosphorus, fecal coliforms, mosquito larvae, and sludge accumulations. Environmental conditions and fecal coliforms profiles were determined in the sediments (0.63 m), suspensions (0.35 m), and surfaces (0.1 m) of each pond. Acidic conditions were observed in the pistia ponds, neutral conditions in duckweed ponds, and alkaline conditions in algal ponds. Fecal coliforms log removals of 6, 4, and 3 were observed in algal, duckweed, and pistia ponds, respectively, in the final effluents, with die-off rates per pond of 2.7, 2.0, and 1.6. Sedimentation accounted for over 99% fecal coliform removal in most of the algal and pistia ponds. BOD removal was highest in the duckweed system, followed by pistia and algae at 95%, 93%, and 25%, respectively. COD removals were 65% and 59%, respectively, for duckweed and pistia, while COD increased in algal ponds by 56%. Nitrate removals were 72%, 70%, and 36%, respectively for duckweed, pistia, and algal ponds. Total phosphorus removals were 33% and 9% for pistia and duckweed systems, while an increase of 19% was observed in the algal treatment system. Ammonia removals were 95% in both pistia and duckweed and 93% in algal systems. Removals of total dissolved solids (TDS) were 70% for pistia, 15% for duckweed, and 9% for algae. Mosquito populations of 11,175/m(2), 3516/m(2), and 96/m(2) were counted in pistia, algal, and duckweed ponds, respectively. Low turbidity and low sludge accumulation characterized the macrophyte ponds. Performance in the removal of fecal coliforms in the algal-based treatment system and organic load removal in both macrophytes and algal-based treatment systems met the Ghana Environmental Protection Agency guideline values.

An analysis of the environmental health impact of the Barekese Dam in Kumasi, Ghana.

Although dams have beneficial effects, they are also acknowledged as having serious environmental repercussions if they are not properly managed. The objective of this work was to examine the impact of the Barekese Dam in Ghana on the health status of three riparian communities downstream against a control. The environmental health status of the communities was analysed with reference to traditional endemic communicable water-related diseases in the catchment area, which were identified as malaria, urinary schistosomiasis, infectious hepatitis, diarrhoeal diseases and scabies. Case-control study was then conducted in the three phases of the dam (pre-construction, at the end of the construction and in the late operational phases) to analyse the health status of the communities as a function of the phases of the dam. The results showed that the control community consistently had a much better health status than two of the riparian communities, which were closer to the dam in all the three phases. However, it had a better health status than the third riparian community, which was farthest downstream, only in the first two phases. This community maintained a fairly constant health status retrospectively and did not appear to have been affected by the presence of the dam. On contrary, the health status of the two communities in close proximity to the dam deteriorated in the late operational phase. The study therefore showed that there was a strong association between the presence of the dam and poorer health status of the downstream communities in close proximity to it.