ASSESSMENT OF DRINKING WATER QUALITY AND THE PREVALENCE WATERBORNE DISEASE IN THE KUMBA MUNICIPALITY

N°13. Janvier Février Mars 202

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Abstract

Background: This study seeks to e xamine the nexus between drinking water sources in the Kumba municipality and its related health implications vis-à-vis the recurrent incidences of waterborne diseases such as, Typhoid, Cholera, Diarrhea, Dysentery, Hepatitis A and malaria. 

Methods: The study adopted a purposive sampling technique in which surveys were conducted between the months of June to December 2022. 150 questionnaires were retrieved from the 210 administered to the affected population of kosala, Buea road and Mambanda.

Information for the study was collected using surveys, questionnaires, key informant interviews, the laboratory analysis of collected drinking water samples, researcher’s direct observation as well as from hospital reports on the prevalence of water borne diseases. Water samples from the nearby streams and wells which were communally used by the local population for drinking and five slaughterhouses within the affected areas were laboratory tested to determine alterations in their chemical, physical and microbiological characteristics. The collected water samples from all the streams and wells used for drinking were tested for changes in properties such as temperature, turbidity, EC, pH, TDS, TSS, Cl, SO42-, PO43-, NO3-, Fe, Na, BOD, COD, DO, E.coli and total coliform concentration. These results were then compared with the WHO regulations for water quality.

Results:    The results from the laboratory analysis of drinking water sources which were at the same time used by the surrounding abattoirs revealed significant alterations in the water quality parameters such as temperature, turbidity, EC, pH, TDS, TSS, Cl, SO42-, PO43-, NO3-, Fe, Na, BOD, COD, DO, E.coli and total coliform concentration. This is due to the channeling of untreated wastes into the different drinking water points as well as the inter-use of dirty utensils such as buckets from slaughterhouses to fetch water from the streams and wells which serve as drinking water sources for the local population. On the human health aspect, the results were later on compared with hospital data and they revealed that, the consumption of such contaminated water in the localities of Kosala, Mambanda, and Buea road negatively affected the local population because of the high incidences of Typhoid, Cholera, Diarrhea, Dysentery, Hepatitis A and malaria. 

Conclusion: The poor management of drinking water sources pollute streams significantly exposes the local population to lots of water borne diseases.  Efforts should be made to provide clean pipe borne water to the affected localities of Kumba as well as to ensure the proper management of wastes. 

Keywords: drinking water, quality, waterborne disease, Cholera, water quality

Résumé  

Contexte : Cette étude vise à examiner le lien entre les sources d'eau potable dans la municipalité de Kumba et leurs implications sur la santé, notamment en ce qui concerne les maladies hydriques récurrentes telles que la typhoïde, le choléra, la diarrhée, la dysenterie, l'hépatite A et le paludisme.

Méthodologie : L'étude a adopté une technique d'échantillonnage probabiliste, au cours de laquelle des enquêtes ont été menées de juin jusqu’à décembre 2022. Sur les 210 questionnaires distribués, 150 ont été récupérés auprès de la population affectée de Kosala, Buea Road et Mambanda. Les informations ont été recueillies à l'aide d'enquêtes, de questionnaires, d'entretiens avec des enquêtés clés, d'analyses en laboratoire des échantillons d'eau potable, d'observations directes du chercheur ainsi que des rapports hospitaliers sur la prévalence des maladies hydriques.

Des échantillons d'eau des ruisseaux et des puits avoisinants, lesquelles étaient communément utilisées par la population locale pour boire, ainsi que de cinq abattoirs situés dans les zones touchées, ont été testés en laboratoire pour déterminer les altérations de leurs caractéristiques chimiques, physiques et microbiologiques. Les échantillons d'eau prélevés des ruisseaux et des puits ont été testés pour des paramètres tels que la température, la conductivité électrique (CE), le pH, les solides dissous totaux (TDS), les solides en suspension totaux (TSS), le chlore (Cl), le sulfate (SO4²⁻), le phosphate (PO4³⁻), le nitrate (NO3⁻), le fer (Fe), le sodium (Na), la demande biologique en oxygène (DBO), la demande chimique en oxygène (DCO), l'oxygène dissous (OD), l'E.coli et la concentration totale de coliformes. Ces résultats ont ensuite été comparés aux normes de l'OMS en matière de qualité de l'eau.

Résultats : Les résultats des analyses en laboratoire des sources d'eau potable, qui étaient également utilisées par les abattoirs environnants, ont révélé des altérations significatives des paramètres de qualité de l'eau tels que la température, la turbidité, la CE, le pH, les TDS, les TSS, le Cl, le SO4²⁻, le PO4³⁻, le NO3⁻, le Fe, le Na, la DBO, la DCO, l'OD, l'E.coli et la concentration totale de coliformes. Ces altérations sont dues au déversement de déchets non traités dans les différents points d'eau potable ainsi qu'à l'utilisation d'ustensiles sales, tels que des seaux provenant des abattoirs, pour puiser l'eau des ruisseaux et des puits servant de sources d'eau potable à la population locale. Sur le plan de la santé humaine, les résultats comparés aux données hospitalières ont révélé que la consommation de cette eau contaminée dans les localités de Kosala, Mambanda et Buea Road a eu des répercussions négatives sur la population locale en raison de l'incidence élevée de la typhoïde, du choléra, de la diarrhée, de la dysenterie, de l'hépatite A et du paludisme.

Conclusion : La mauvaise gestion des sources d'eau potable et la pollution des ruisseaux exposent de manière significante la population locale à de nombreuses maladies hydriques. Des efforts doivent être fournis pour approvisionner de l'eau potable propre aux localités affectées de Kumba et pour assurer une gestion appropriée des déchets.

Mots-clés: eau potable, qualité, maladies d’origine hydrique, choléra, qualité de l’eau.

INTRODUCTION

Water is the most fundamental component required by humans for the existence and many other life forms (Levallois & Villanueva, 2019). The quality of water consumed by  humans is one of the principal determinants of human health(Li & Wu, 2019). In many countries of the developing world, the quality of drinking water, is undesirable. This is the root cause of many  waterborne diseases(Hasan et al., 2019).  In this regard, the World Health Organization estimates that about 10% of the world’s population lack standard access to quality drinking water(Organization, 2020). The lack of quality drinking water sources in many countries of the world goes against one of the world health organisation’s sustainable development goals(Organization, 2021).

Amid other diseases, the consumption of poor quality water causes waterborne infections such as Typhoid, Cholera, Diarrhea, Dysentery, Hepatitis A. it is estimated that, this kills about one million people each year  most of whom are children under the age of five (Ahmed et al., 2020).

In most developing countries to which cameroon belongs, little efforts are made to reduce the prevalence of water borne diseases through the extension/ provision of pipe borne water facilities in areas without such facilities this aggravates the prevalence of water borne diseases (Adelodun et al., 2021; Bidhuri & Jain, 2019; Grigg, 2019). It is estimates that ≥ 63% of the population of cameroon suffers from the water borne diseases (Ako et al., 2009).

From the above-mentioned facts, this study has as target to examine the drinking water sources and quality in the localities of kosala, Buea road and Mambanda which are all localities in the Kumba metropolis and to determine the pattern of waterborne infections. In the same light, water sources and quality will be correlated to, identify zones of water borne disease prevalence.

Material and methodsStudy site

The municipality of Kumba is located in Meme Division of the South West Region of Cameroon (figure 1.1) between latitude 4°38" north of the equator and longitude 9°27"east of the Greenwich Meridian it is bounded to the South by Fako Division, to the East by Ndian Division and to the West by Kupe Muananguba. It covers a surface area of about 8.213Km2(Sop & Njumba, 2022).

The Location of Kumba municipality in Meme Division South West Region of Cameroon.

Source: adapted from (Sop & Njumba, 2022)

This study was conducted within four quarters of the Kumba metropolis of the south west region of Cameroon. These localities are served by many health facilities but chiefly by the Kumba district hospital, the Baptist hospital, hope clinic in kosala, and fiango pharmacy as shown on figure 1.2. These health facilities provided all of the medical reports needed for this study. This was complemented by field realities.

The Location of health facilities in the Kumba municipality in Meme Division South West Region of Cameroon.

Source: (KCC, 2022)

The health facilities receive patients from the different quarters under study. The climate of Kumba is dominated by the equatorial type of high rainfall and high temperature. The mean annual temperatures fluctuate between 20°C to 300C with little monthly variation. The annual average rainfall is 2.625mm per year but it becomes higher towards the Eastern and Western borders. Two seasons can be distinguished; the long rainy season, which begins in March and ends in November. The wettest months are July and August and there are 256 rainy days. The short dry season starts from December to February (KCC, 2022). The highest point of the metropolis is in the North West and is represented by the Barombi Mountain 467m high and has a crater lake which lies to the West (Lake Barombi) (Tchamabé et al., 2015). The lowlaying topography makes it possible for the town to be constantly in the event of heavy rain fall. Generally, Kumba municipality is a junction town noted for its commercial activities and extensive cultivation of cocoa, a major cash crop in Cameroon. This has made the town a hub for population growth inhabitants of mostly farmers and business people from almost every ethnic group in Cameroon (Ako et al., 2009).

Data collection method

This study made use of data from primary sources. First of all, appropriately designed questionnaires were used to obtain information from the respondents on aspects such as their ages, family size, profession, revenue, sources of water collection for their different domestic uses such cooking and drinking and watering. Equally the questionnaires looked at the different methods used by the respondents to purify water, their opinions vis-à-vis water quality as well as the type of waterborne diseases they suffer from. A total of 150 questionnaires were filled and retrieved from the study areas. The respondents were largely parents predominantly women (mothers). The field surveys were conducted during the months of June to December 2022. The objective of this time frame was to have a clear picture of the possible degradation of the drinking water quality and the intervals of waterborne infections that ensure from the consumption of poor quality water.

Equally, during fieldwork since we intended to know how local slaughterhouses contaminate water source within the study area, water samples and GPS locations were collected from all streams and wells used by both the slaughterhouses and the local population. This was equally done for the upper course and down course sections of the streams where slaughterhouses wastes are discharged. The collection of water samples was done in the morning between 6:30am to 11:00 am at the point where slaughterhouse liquid wastes entered into a stream communally used by the slaughterhouses and the population, water samples were collected at depths of about 8 to 10cm and 2 meters away from the banks. This was done in a bid to get at a point where the stream maintained a constant flow. The collection was done before slaughtering for the discharge points and the downstream sections, during slaughtering and washing of carcass for the downstream and effluents discharge point. Water samples were collected in plastic bottles of 0.5ml and 1.5L containers. Before collection of the water samples, the plastic bottles were washed trice with the same sample water at the collection point. This was to avoid possible contamination from the containers used for storage of the sample. At the sample collection sites three different bottles were used to collect three water samples from each location. One set of bottles were used for the collection of upper course samples, another for the collection of liquid wastes at the slaughterhouse effluents discharge canals while the last set of bottles were used for the collection of downstream samples. Each collected sample were meant to be used for physicochemical and microbiological analysis. The samples were later on labelled with location, the date, the time and the kind of analysis to be done on the sample. The water samples were later on coded in relation to their Names, Location and Date to ease laboratory analysis.

The following laboratory analysis were conducted on the water samples.

1	Température (°C),	9	Phosphate(mg/l),
2	Turbidity(NTU),	10	Nitrate(mg/l),
3	Electrical Conductivity (µS/cm),	11	Iron (mg/l),
4	pH	12	Sodium(mg/l),
5	Total Dissolved Solids(mg/l),	13	Biological Oxygen Demand(mg/l),
6	Total Suspended Solids(mg/l),	14	Chemical Oxygen Demand (mg/l),
7	Chloride (mg/l),	15	Dissolved Oxygen (mg/l),
8	Sulphate (mg/l),	16	Escherichia coli and Total Coliform (cfu/100ml)

Source: field work, 2021

Once all the information and data were assembled, we proceeded to the treatment of the data in order to test the validity of the pre-conceived hypothesis. Quantitative data were mostly treated manually by using Microsoft Excel and analysed using Statistical Package for the Social Sciences (SPSS). Qualitative data and information were treated using ranking, cross tabulation as well as comparison. The results were presented in the form of, tables, cartographic presentation, bar charts, graphs, percentages and pictures for illustrations. The statistical analysis that were done included Pearson's chi square test with symmetric measures of phi and Cramer's V were used to examine the strength of association between the categorical variables i.e. drinking water sources and waterborne infections(Akoachere et al., 2019).

Résulta and discussion

Field survey

Field survey reveals that majority of the population 55.3% were female while 44.7% were male. This variation between the gender constitutions is just a sampling coincidence. Age wise, the participants ages ranged from 15 years and above, with the age group 25-29 years constituting 43.3% of the participants.

As far as the population level of education is concerned, field results reveals that, 60% of them were secondary school graduates, 16.7% were university graduates, 13.3% had primary education and 3.3% of the population had gotten non formal or vocational education, while 6% had no formal education.

Regarding the occupation of the participants, 33.3% of the respondents were traders, 26.7% were private sector employees, 16.7% were civil servant and another 16.7% performed other types of occupations.

Furthermore, field surveys also indicated that, 3.3% of the population indicated their income is    between 20.000-40.000F CFA, 18% of the participants indicated their average monthly income was between 40-80,000frs; 36.7% of them on average earn between 80-120,000frs; 27.3% earn between 160-200,000frs while 18% others on average earn 200,000frs and above. The above results conform with the findings of (AfDB, 2022)which maintains that, about 1.3 billion people (22% of the world’s population) in the developing world could be classed as low and middle income earners.

Field survey also reveals that, 49.7% of the population indicated that they get their water from public taps and 33.3% indicating they got water for domestic use from same wells used by slaughterhouses while 17% indicated they got water for domestic use from nearby streams/ rivers used by slaughterhouses. The results further reveals that, 66.6% of the respondents in all the study sites indicated they use the same streams, rivers and wells with nearby slaughterhouses as shown on Plate 1.1 in which an inhabitant of the kosala II neighbourhood fetches water for domestic use from the same stream used by the slaughterhouse for the discharge of their wastes and the washing of intestines (image A).

Plate 1.1: Fetching Water for Domestic Purposes (B) From the Same Stream

Used by Slaughterhouse for Wastes Discharge (A)

 Source: field work, 2021

In the same vein, Field survey also reveals that, 40.1% of the population indicated that, they use the water for bathing while 33.3% of the population indicated that, they used water gotten from water bodies they shared with slaughterhouses for washing, 13.3% of the respondents indicated that they used the water for watering and 13.3% indicated they used the water for drinking.

A further question of interest from the researcher was meant to investigate participants’ opinions on whether or not slaughterhouse waste disposals pose any problems in the community. To this effect the results reveals that, 66.7% of the respondents admitted that slaughterhouse waste disposal is a problem in their community.

With the respondents sources of water understood, we proceeded to know participants’ opinions on whether or not slaughterhouse activities in the nearby water bodies have any negative impact on their health. To this, 66.7% of the participants admitted that slaughterhouse poor disposal of wastes into the nearby water bodies affects those who used the water downstream or around the slaughterhouse facility. As shown on plate 1.2 (A and B), we observe slaughterhouse discharge untreated liquid wastes and wash intestines in the same water bodies used by the local communities.

Plate 1.2: Washing of Intestines and the Discharge of intestinal Wastes

into Nearby Water Bodies       

 Source: field work, 2021

Also, interview with the health personnel and the population within the affected quarters, they were  both asked to identify possible health problems they or any member of their household has experienced within the last two weeks, months or years the  results are as shown on table 1.2.

The results on table 1.1 shows respondents’ views on the health effects originating from the utilization of polluted water in the study sites. It shows that frequency of visits to hospitals and health care facilities in the study areas is on the increase because of poor slaughterhouse wastes management, consumption and domestic utilization of slaughterhouse wastes polluted water. The result indicates that 36.6% and 34.9% of the sampled population strongly agreed and agreed that their frequency of visits to hospitals and other health care facilities is on the increase, while 20.4% and 8.1% disagreed and strongly disagreed with the opinion. Base on this these results, the frequency of visits to hospitals and other health care facilities in the study sites is on the increase due to the habitation around such environments and the consumption of polluted water from the streams and wells shared with the slaughterhouses.

           We also probed from the respondents and the health personnel if the incidence of typhoid could be because of the consumption of polluted water in the study sites. The results shows that, 50.4% and 32.7% strongly agreed and agreed with the opinion while, 9.3% of the respondents strongly disagreed with the opinion. This goes to show that high incidence of typhoid in the study area may be because of their consumption of poor quality water from the wells, streams and rivers. This was further supported by the hospital data obtained from kumba district hospital and from the Baptist hospital (Table 6.4).    

The researcher went further to investigate whether the prevalence of cholera in the study area is related to the drinking of poor quality water. Result from interviews with the health personnel and the respondents’ shows that 49.6% and 34.2% of the sampled population strongly agreed and agreed with the view, while 10.6% and 5.7% strongly disagreed and disagreed with the opinion. The results on the prevalence of cholera in the study area is as presented on Table 6.5. This tends to suggest that incidence of cholera in the study area may be related to the poor management of wastes generally and slaughterhouse wastes in particular. This is because the shortages noticed in the provision of portable water causes the local population to fetch water from other doubtful sources such as the polluted streams and wells on images A and B plate 1.3 which are also water bodies used by slaughterhouses.

Plate 1.3: Collection of Water from Polluted Sources

source: field work, 2021

The results from the filed survey indicates that, the more the population within the affected environments drink/ make use of the water from the polluted wells and streams used by slaughterhouses, the more they significantly suffer from water borne and related diseases. To this effect the trend of some waterborne/water related diseases in the study area from the period of 2012 to 2022 has recorded significant changes over time as presented on table 1.2.

Table 1.2: Trend of Some Water Borne/Water Related Diseases in Kumba (2012-2022)

Year	Typhoid	Cholera	Dysentery	Hepatitis A	Malaria	Diarrhea
2012	817	12	15	19	10,906	50
2013	1,538	4	50	134	2,040	164
2014	3,097	5	34	37	3,575	380
2015	7,366	1	26	158	9,079	641
2016	529	4	200	94	4,668	2,407
2017	1000	4	152	105	20,315	6,371
2018	809	1	500	84	23,758	7,528
2019	608	3	460	11	11,086	3,146
2020	1,024	3	76	10	3,113	1,999
2021	60	15	550	782	30,855	5,788
2022	51	56	343	358	20,918	4,238

Sources: Kumba District and Baptist Hospitals, 2022

As shown on table 1.2, the trend of the prevalence of water borne/related diseases in the study from 2012 shows that malaria was the most prevalent. This was because the number of malaria cases recorded (10,906) significantly higher than the other diseases. Typhoid was next with 817 cases, followed by diarrhea (50 cases), cholera (12 cases), hepatitis A (19 cases) and dysentery (15 cases). This shows that water related disease (malaria) was the most highly recorded case, followed by typhoid (water born) disease. Malaria cases in 2013 dropped from 10,906 to 2,040 cases, but this could not be said about others. For instance, typhoid (which recorded the next highest case) increased from 817 to 1,538 in 2013. In the order of most recorded cases, diarrhea had the next case of 164. Hepatitis A was next with 134 cases followed by dysentery (50) and cholera (4 cases) was the least.

Contrastingly, malaria cases increased from 2,040 to 3,575. Similarly, typhoid with next highest case also increased from 1,538 in 2004 to 3,097. Diarrhea (380 cases) followed, and in that order by hepatitis A (37 cases), dysentery (34 cases) and least cases was cholera (4 cases). In 2015, malaria cases continued dominating and increasing with a sharp increase to 9,079. Malaria is followed in this order by typhoid (7,366 cases), diarrhea (641 cases), hepatitis (158 cases), cholera (1 case) and dysentery (26 cases). There were drops in the number of cases of these diseases in 2016 except in dysentery which increased from 26 in 2015 to 200 in 2016. Despite this increase, the incidence of malaria was still more than that of other disease (4,668 cases). Malaria is followed at a distance by diarrhea (2,407 cases), typhoid (529 cases), dysentery (200 cases), hepatitis (94 cases) and lastly by cholera (4 cases). The reported cases of these diseases increased in 2017 except for dysentery and cholera which decreased. Specifically, the cases were still most in malaria (20,315 cases) followed by diarrhea (6,371), typhoid (1000), dysentery (152), hepatitis was (105) and least was cholera (30). Malaria continued its increasing trend in 2018 by rising to 23,758 and it was followed by diarrhea (7,528), typhoid (809), dysentery (500 cases), hepatitis was (84 cases) and least was cholera (1 case).

 Year 2019 recorded a drop in trend for all the cases except malaria which still dominated with 11,068 cases and was followed in that order by diarrhea (3,146 cases), typhoid (608 cases), dysentery (460 cases), cholera (13 cases) and hepatitis (11 cases). In 2011, malaria continued its domination of the recorded cases of 3,113 and is followed at a distance by diarrhea (1,999 cases), typhoid (1,024 cases), cholera (3 cases), dysentery (76 cases) and the hepatitis (10 cases).                                                                                                                                                                                                                                                                                                

Meanwhile, 2021 recorded a drastic fall in the number of cases of typhoid from 1,024 in 2020 to only 60 cases in 2021. But cases of other diseases increased noticeably with malaria increasing from 3,113 cases in 2020 to 30,855 in 2021. On the other hand, the number of cases of malaria remained the highest and is followed by diarrhea (5,788 cases), hepatitis (782 cases), dysentery (550 cases), typhoid (60 cases) and the least cholera (56 cases).

Lastly, 2022 recorded a small increase only in the cases of cholera from 15 cases in 2021 to 136 cases in 2022. The same could not be said about other diseases as they moved down greatly. Precisely, malaria increased from 30,855 in 2021 to 20,918 in 2022, while, typhoid and hepatitis A decreased to 51 and 358 in 2022 respectively. Malaria dominated the number of recorded case in 2022 with 20,918 and it is followed in that order by diarrhea (4,238 cases), hepatitis A had (358 cases), dysentery had (343 cases), cholera had (56 cases) and lastly typhoid had (51 cases).

Analysis of water samples

It was observed that not all the water samples tested for the physicochemical and biological parameters were found in the permissible limits as prescribed by the World Health Organization (UNICEF, 2021) for drinking water and abnormalities were reported many of the samples. As such the final laboratory results revealed that, most of the water samples were found to be contaminated by large numbers of microbes and total coliforms E. coli and salmonella were detected in most of the collected water Samples. The laboratory results of the collected water samples are as shown on table 1.3.

The laboratory results also shows that, total coliforms and other harmful pathogens like E. coli were present in most of the water samples collected at points were he population fetched water from streams or wells used by slaughterhouses for the disposal of their wastes, washing of carcass of as a water collection source. These results raise concerns over the quality of water used by the population in the study areas for most of their domestic activities. The high presence of bacteria in the Water samples indicates contamination from animal waste. These bacteria may cause complications such as stomach cramps, occasional fever, bloody diarrhea, vomiting and respiratory problems, pneumonia, and urinary tract infections and when such contaminated water goes into food it may lead to food poisoning. Also, its presence in drinking water is a clue of other organisms that may cause fatal diseases. Based on these results, it can be held that, most of the streams and well water sources used by the population of mambanda, kosala, and Buea road neighbourhoods were infected by pathogenic organisms whose source could be traced to the poor discharge of slaughterhouse wastes and the use of dirty buckets to fetch water from wells used by the population. This makes such water sources not fit for domestic use.

To test for the consumption of water within collected from the wells and streams in the study area and the occurrence of water borne diseases the cross-tabulation and chi-square test was used. the results revealed a significant association between the drinking water sources and water borne infections in the study area (Table1.4). 

Table 1.4:  Cross Tabulation of poor slaughterhouse wastes disposal and health effects 

Water consumption * adverse effect on Health
	adverse effect on Health	Total
Yes	No
Slaughter waste disposal	Yes	Count	32	16	48
% Adverse effect on Health	32.0%	32.0%	32.0%
No	Count	68	34	102
% Adverse effect on Health	68.0%	68.0%	68.0%
Total	Count	100	50	150
% adverse effect on Health	100.0%	100.0%	100.0%

					Chi-Square Tests
	Value	df	Asymp. Sig. (2-sided)	Exact Sig. (2-sided)	Exact Sig. (1-sided)
Pearson Chi-Square	16.025	1	.005

Source: fieldwork, 2021

Based on the results, 68% of the population indicated that the consumption/ utilization of the water sources around them has adverse health effects on their health. The chi-square test value on table 6.8 is 16.025 with associated probability(P-Value) = .005 implies that there is a significant association between the consumption/ utilization of the water sources and the corresponding health impacts of the inhabitants of mambanda, kosala, and Buea road neighbourhoods in Kumba central. The P-value of 0.005 means that there is a 99% chance that sustainable management of slaughterhouse wastes will lead to both environmental and health benefits to the study area. Thus, our results signify that there is a high likelihood that proper slaughterhouse waste management will lead to positive health outcomes.

To verify the effect of poor quality water consumption on health. The Chi Square, Phi, Cramer's V and Contingency Coefficient tests were used. The findings are presented on the table below.

Table 1.5: Chi Square, Phi, Cramer's V and Contingency Coefficient tests of hypothesis four 

	Value	Approximate Significance
Nominal by Nominal	Chi Square	49.4	.0012
Phi	.316	.001
Cramer's V	.316	.001
Contingency Coefficient	.302	.000
N of Valid Cases	150

Source: field work, 2021

The table above provides the chi square and other related test like Phi and Cramer’s V. The results depict that the test is statistically significant: χ2(2) = 49.4, p < .0005. Therefore, we can conclude that there are statistically significant association between poor quality water consumption and community health. This reveals that as slaughterhouses poorly discharge their wastes into nearby water sources there is a corresponding increase, in the number of health complications community members. 

CONCLUSION

The Usage of the stream water for the direct discharge of slaughterhouse wastes exposes the inhabitants of the various study sites to a variety of health risks. This is because the unsustainable manner of discharging slaughterhouse wastes goes a long way to degrade water quality parameters such as Electrical conductivity, TDS, COD, Iron, pH, Phosphates, Temperature, Nitrates, BOD, DO, E. coli, Chlorides and Total coliform higher than the WHO recommended limits. This calls the attention of the affected population to be prudent with the usage of the water sources and for the butchers to ensure the sustainable discharge of wastes from slaughterhouses. If this is done, good health of the users and that of the ecosystem will be ensured.

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