Safety of packaged water distribution limited by household recontamination in rural Cambodia

Packaged water treatment schemes represent a growing model for providing safer water in low-income settings, yet post-distribution recontamination of treated water may limit this approach. This study evaluates drinking water quality and household water handling practices in a floating village in Tonlé Sap Lake, Cambodia, through a pilot cross-sectional study of 108 households, approximately half of which used packaged water as the main household drinking water source. We hypothesized that households purchasing drinking water from local packaged water treatment plants would have microbiologically improved drinking water at the point of consumption. We found no meaningful difference in microbiological drinking water quality between households using packaged, treated water and those collecting water from other sources, including untreated surface water, however. Households' water storage and handling practices and home hygiene may have contributed to recontamination of drinking water. Further measures to protect water quality at the point-of-use may be required even if water is treated and packaged in narrow-mouthed containers.