WATER BORNE DISEASE, CAUSES AND PREVENTION

A SEMINAR PRESENTED TO THE DEPARTMENT OF PUBLIC HEALTH,

FACULTY OF HEALTH SCIENCES, NATIONA OPEN UNIVERSITY OF NIGERIA

JUNE, 2025

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 WATER BORNE DISEASE, CAUSES AND PREVENTION.

BY

1. OKAFOR NKECHI ESTHER NOU241757722

2. AJABA CHIAMAKA PERPETUA NOU241770786

3. EMMANUEL VIVIAN CHARLES NOU241741821

4. UDE NNEAMAKA RITA NOU241727325

5. CHINELO BENITA AJOGWU NOU173022612

Abstract
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Waterborne diseases represent a critical global public health challenge, especially in developing
countries where access to safe and clean water is limited. These diseases, caused by pathogenic
microorganisms transmitted through contaminated water, include cholera, typhoid fever,
dysentery, and hepatitis A, among others. The causes of waterborne diseases are multifactorial,
encompassing environmental contamination, poor sanitation, inadequate hygiene, and socio-
economic factors. Complications arising from these diseases range from acute dehydration to
chronic health issues and even death, disproportionately affecting vulnerable populations such as
children and immunocompromised individuals. Preventive strategies primarily focus on
improving water quality, sanitation infrastructure, hygiene education, and public health policies.
This paper critically reviews recent research on the causes, complications, and preventive
measures of waterborne diseases, emphasizing the importance of integrated water, sanitation, and
hygiene (WASH) interventions and community engagement. Ultimately, it advocates for
sustainable and innovative approaches to mitigate the burden of waterborne diseases globally.

Table of Contents

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i. Abstract
ii. Introduction
iii. Review of Related Literature
Causes of Waterborne Diseases
Complications of Waterborne Diseases
Prevention of Waterborne Diseases
iv. Conclusion
v. References

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 INTRODUCTION

Water is essential for life, yet ironically, water contaminated with pathogens and pollutants has

become a vehicle for disease transmission, affecting millions worldwide. Waterborne diseases

are illnesses caused by pathogenic microorganisms that are primarily transmitted in

contaminated water. These diseases constitute a major public health issue, particularly in low-

and middle-income countries where inadequate water supply, sanitation, and hygiene (WASH)

conditions prevail (World Health Organization [WHO], 2023).

According to the WHO (2023), approximately 2 billion people globally use drinking water

sources contaminated with feces, leading to an estimated 485,000 diarrheal deaths annually,

predominantly among children under five. The burden of waterborne diseases is exacerbated by

population growth, urbanization, climate change, and conflicts, all of which strain water

resources and sanitation systems (Prüss-Ustün et al., 2022).

Understanding the causes and consequences of waterborne diseases is fundamental to developing

effective prevention strategies. These diseases not only impose a health burden but also

economic costs due to loss of productivity, healthcare expenses, and long-term disabilities

(UNICEF & WHO, 2023). This seminar aims to provide a comprehensive overview of

waterborne diseases, dissecting their complex etiological factors, detailing their diverse and often

severe complications, and critically examining the array of established and emerging prevention

strategies. By synthesizing current scientific understanding and public health recommendations,

this paper seeks to underscore the imperative of integrated, multi-sectoral approaches to ensure

access to safe water, adequate sanitation, and improved hygiene, thereby contributing to the

global effort to mitigate the devastating impact of these preventable diseases.

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 REVIEW OF RELATED LITERATURE

* Causes of Waterborne Diseases

Waterborne diseases arise mainly due to the ingestion or contact with water contaminated by

pathogenic microorganisms. These include bacteria, viruses, protozoa, and helminths. The

primary causes can be categorized as follows:

Microbial Contamination

The most direct cause of waterborne diseases is the presence of microbial pathogens in drinking

or recreational water sources. Fecal contamination is a key factor, often stemming from human

and animal waste. Common pathogens include:

 Bacteria: Vibrio cholerae (cholera), Salmonella typhi (typhoid), Escherichia coli

(various diarrheal diseases), Shigella species (dysentery), Campylobacter spp.

 Viruses: Hepatitis A virus, Norovirus, Rotavirus.

 Protozoa: Giardia lamblia, Cryptosporidium spp.

 Helminths: Schistosoma species and other parasitic worms.

Recent studies have shown that microbial contamination in water sources is often linked to

inadequate sanitation infrastructure and poor waste management (Kumar et al., 2023; Li et al.,

2024).

Environmental Factors

Environmental degradation such as pollution from industrial effluents, agricultural runoff, and

open defecation directly contributes to the contamination of water bodies. Nutrient loading from

fertilizers increases microbial proliferation, while chemical pollutants can weaken immune

responses, making populations more susceptible to infections (Olatunji et al., 2022).

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Climate change further exacerbates the situation by altering rainfall patterns, increasing flooding

events that disperse contaminants, and causing droughts that concentrate pollutants in dwindling

water supplies (Stanke et al., 2023).

Socioeconomic and Behavioral Causes

Poverty, lack of education, and inadequate infrastructure are critical socioeconomic

determinants. Overcrowded urban slums and rural communities often lack access to piped water

and rely on untreated surface water or unprotected wells (UNICEF & WHO, 2023). Poor hygiene

practices such as insufficient handwashing and unsafe water storage compound the problem

(Rahman et al., 2024).

In conflict zones and displaced populations, disrupted sanitation systems create hotspots for

waterborne outbreaks (Ahmed et al., 2023).

* Complications of Waterborne Diseases

The complications arising from waterborne diseases extend far beyond the immediate acute

symptoms, often leading to chronic health issues, impaired development, and significant societal

burdens. The severity and nature of complications depend on the specific pathogen, the host's

immune status, age, nutritional status, and access to timely and appropriate medical care.

Diarrhea and Dehydration:

The Immediate Threat: The most ubiquitous and immediate complication of waterborne

diseases, particularly those caused by bacteria, viruses, and protozoa, is acute diarrhea. This

involves the frequent passage of loose or watery stools, often accompanied by abdominal

cramps, nausea, and vomiting. If not adequately managed, persistent diarrhea rapidly leads to

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dehydration, a state where the body loses more fluids and electrolytes than it takes in.

Dehydration can range from mild to severe, manifesting as:

 Mild to Moderate Dehydration: Symptoms include increased thirst, dry mouth, reduced

urine output, and sunken eyes.

 Severe Dehydration: A medical emergency characterized by lethargy, rapid and weak

pulse, low blood pressure, lack of urine, inability to drink, and in infants, a sunken

fontanelle. Without prompt rehydration therapy (oral rehydration salts or intravenous

fluids), severe dehydration can lead to hypovolemic shock, organ failure, and death. This

is particularly lethal for infants and young children, making diarrheal diseases a leading

cause of child mortality globally (Payment & Hunter, 2001).

Malnutrition and Weight Loss:

A Vicious Cycle: Repeated or chronic episodes of diarrheal illness significantly impair nutrient

absorption in the gut. The inflamed intestinal lining and rapid transit time prevent the adequate

uptake of essential vitamins, minerals, and macronutrients. This malabsorption, coupled with

loss of appetite during illness and increased metabolic demands of fighting infection, inevitably

leads to:

 Malnutrition: Children, who are still developing, are particularly vulnerable. Chronic or

recurrent diarrheal diseases contribute to various forms of malnutrition, including

stunting (low height-for-age), wasting (low weight-for-height), and micronutrient

deficiencies (e.g., iron, zinc, vitamin A).

 Weight Loss: Both children and adults experience significant weight loss, weakening the

body and depleting energy reserves.

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  Impaired Physical and Cognitive Development: In children, prolonged malnutrition

due to recurrent waterborne infections can irreversibly impair physical growth, brain

development, and cognitive function, impacting educational attainment and future

productivity. This creates a vicious cycle where malnutrition weakens the immune

system, making individuals more susceptible to future infections.

Increased Risk of Infections and Diseases:

Immune System Compromise: Waterborne infections can compromise the body's immune

system, making individuals more susceptible to other infectious diseases. The energy expended

fighting the initial waterborne pathogen, coupled with malnutrition, weakens the body's defenses.

This can lead to:

 Secondary Infections: Individuals may develop bacterial infections in other parts of the

body (e.g., pneumonia, sepsis) while recovering from a waterborne illness.

 Increased Vulnerability to Other Pathogens: A weakened immune system makes

individuals more susceptible to a broader range of infections, including respiratory

illnesses, malaria, or other endemic diseases.

 Exacerbation of Chronic Conditions: For individuals with pre-existing chronic

conditions (e.g., diabetes, cardiovascular disease), waterborne infections can exacerbate

their symptoms and lead to more severe outcomes. This is particularly true for

immunocompromised individuals, such as those with HIV/AIDS, cancer patients

undergoing chemotherapy, or organ transplant recipients, for whom common waterborne

pathogens like Cryptosporidium can cause life-threatening, protracted illness.

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Organ Damage and Systemic Complications

Some waterborne pathogens can cause direct damage to specific organs or lead to systemic

complications:

 Kidney Damage and Failure: Certain bacterial infections, notably those caused by

enterohemorrhagic E. coli (EHEC) strains (e.g., O157:H7), can lead to Hemolytic Uremic

Syndrome (HUS). HUS is a serious condition characterized by hemolytic anemia

(destruction of red blood cells), thrombocytopenia (low platelet count), and acute kidney

injury or failure, often requiring dialysis. Children are especially vulnerable to HUS.

 Liver Inflammation (Hepatitis): Hepatitis A, caused by the Hepatitis A virus (HAV)

transmitted through contaminated water, directly targets the liver, causing inflammation.

While often self-limiting, severe cases can lead to acute liver failure, especially in older

adults or those with pre-existing liver conditions.

 Neurological Complications: Although rare, some waterborne pathogens can cause

neurological issues. For instance, severe dehydration from cholera can lead to electrolyte

imbalances that affect brain function. Certain specific pathogens, like Naegleria fowleri

(the "brain-eating amoeba"), though rare, can cause primary amoebic

meningoencephalitis (PAM), a rapidly fatal brain infection acquired through nasal

exposure to contaminated warm freshwater.

 Reactive Arthritis: Some bacterial infections, such as those caused by Salmonella,

Shigella, or Campylobacter, can trigger reactive arthritis (formerly Reiter's syndrome), an

autoimmune condition causing joint pain, inflammation, and sometimes eye and urinary

tract issues, weeks after the initial infection.

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  Chronic Gastrointestinal Issues: Even after resolution of acute symptoms, some

individuals may experience post-infectious irritable bowel syndrome (PI-IBS) or other

chronic digestive issues following certain waterborne infections (e.g., giardiasis,

cryptosporidiosis).

Death:

The Ultimate Consequence: Ultimately, if left untreated or if treatment is delayed, the severe

complications of waterborne diseases—especially profound dehydration, multi-organ failure (as

in HUS), or overwhelming systemic infection (as in severe typhoid or cholera)—can lead to

death. The vast majority of these deaths are preventable with access to safe water, adequate

sanitation, proper hygiene, and timely medical intervention. The high mortality rates, particularly

among children in developing nations, underscore the urgent need for effective prevention and

control measures. The Centers for Disease Control and Prevention (CDC) consistently highlights

the fatality risk associated with severe waterborne infections (Centers for Disease Control and

Prevention, 2022).

*Prevention of Waterborne Diseases

Prevention strategies are multifaceted, requiring coordinated efforts across water supply,

sanitation, hygiene, education, and policy.

Safe Water Supply and Treatment

Ensuring access to safe and clean water is foundational. This includes:

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  Water treatment technologies: Chlorination, ultraviolet (UV) treatment, filtration, and

emerging technologies such as solar disinfection and membrane filtration have proven

effective in reducing pathogen loads (Nguyen et al., 2023).

 Point-of-use treatment: Household-level interventions like boiling, chlorination, and

ceramic filters help communities without centralized treatment (Sarkar et al., 2023).

Improved Sanitation and Waste Management

Proper disposal of human waste through sewage systems or pit latrines prevents fecal

contamination of water sources. Community-led total sanitation (CLTS) programs have shown

success in reducing open defecation (Garn et al., 2023).

Hygiene Promotion and Education

Handwashing with soap, safe food handling, and hygienic water storage are critical behaviors to

interrupt transmission. Health education campaigns leveraging schools, media, and community

groups enhance awareness and adoption (Wolf et al., 2024).

Policy and Infrastructure Investment

Sustainable control of waterborne diseases demands robust policies supporting WASH

infrastructure investments, monitoring water quality, and rapid outbreak response systems (WHO

& UNICEF, 2023).

Innovations and Future Directions

Recent advances include:

 Smart water quality sensors and IoT for real-time contamination detection.

 Community-based participatory approaches ensuring local ownership.

 Climate-resilient water systems designed to withstand environmental shocks (Bain et al.,

2023).

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 CONCLUSION AND RECOMMENDATIONS

Waterborne diseases remain a formidable challenge to global health, particularly in regions with

inadequate WASH infrastructure. Their causes are deeply rooted in microbial contamination,

environmental degradation, and socioeconomic disparities. The complications of these diseases

are profound, impacting individual health and societal development.

Prevention is achievable through integrated interventions that ensure safe water, improved

sanitation, hygiene promotion, and supportive policies. Emerging technologies and participatory

approaches hold promise for accelerating progress.

Addressing waterborne diseases requires sustained political will, investment, and community

engagement to realize the global goals of universal access to safe water and sanitation, ultimately

reducing the burden of disease and fostering healthier populations worldwide.

Recommendations

Based on the extensive review of literature and the global burden of waterborne diseases, the

following recommendations are proposed to effectively combat and prevent the spread of these

illnesses:

 Government and NGOs should prioritize expanding access to treated, piped water

systems, especially in underserved rural and peri-urban areas.

 Promote community-scale water purification systems such as solar disinfection, biosand

filters, and membrane filtration in resource-limited settings (Nguyen et al., 2023).

 Implement urban sanitation master plans that prioritize sewage collection and treatment

to prevent open discharge into water bodies.

 Use mass media and digital platforms to spread messages about the importance of

hygiene, especially during disease outbreaks.

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