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1.1 Background of Study

Waterborne diseases are conditions caused by pathogenic micro-organisms that are transmitted in water. Disease can be spread while bathing, washing or drinking water, or by eating food exposed to infected water. Various forms of waterborne diarrheal disease are the most prominent examples and affect children in developing countries most dramatically. (Wikipedia,2018)

Worldwide, water-associated infectious diseases are a major cause of morbidity and mort. A conservative estimate indicated that 4.0% of global deaths and 5.7% of the global disease burden (in DALYs) were attributable to a small subset of water, sanitation, and hygiene (WSH) related infectious diseases including diarrheal diseases, schistosomiasis, trachoma, ascariasis, trichuriasis, and hookworm infections. Although unknown, the actual disease burden attributable to water-associated pathogens is expected to be much higher. A total of 1415 species of microorganisms have been reported to be pathogenic, among which approximately 348 are water-associated, causing 115 infectious diseases. Yet, their distribution and associated factors at the global scale remain largely unexplored. (WHO,2014)

Although the linkage between the hydrological cycle and infectious diseases has long been recognized, the underlying mechanisms shaping this relationship at global and regional scales are rarely characterized. Recent developments in hydrology and geo-spatial technology and increasing availability of spatial socio-environmental information provide an opportunity to explore this issue. Geospatial techniques (e.g. Geographic Information System, or GIS, and spatial analytical techniques) offer a means for developing and organizing spatially explicit information. For example, the availability of information on terrestrial surface water area from the Global Lakes and Wetland Database (Lehner B, Döll P,2010), could allow the exploration of the possible relationship between the availability of terrestrial surface water and distribution of water-associated diseases at the global scale.

According to the World Health Organization, waterborne diseases account for an estimated 3.6% of the total DALY (disability- adjusted life year) global burden of disease, and cause about 1.5 million human deaths annually. The World Health Organization estimates that 58% of that burden, or 842,000 deaths per year, is attributable to a lack of safe drinking water supply, sanitation and hygiene (WHO report,2012).

Microorganisms causing diseases that characteristically are waterborne prominently include protozoa and bacteria, many of which are intestinal parasites, or invade the tissues or circulatory system through walls of the digestive tract. Various other waterborne diseases are caused by viruses. (In spite of philosophical difficulties associated with defining viruses as "organisms", it is practical and convenient to regard them as microorganisms in this connection. (Wikipedia, 2018).

The Millennium Development Goal (MDG 7) on drinking-water was met globally in 2010. The target was to halve the proportion of the world’s population without sustainable access to safe water. The 48 least developed countries did not meet the target, but substantial progress has been made with 42 per cent of the current population in these countries gaining access to improved drinking-water sources since 1990. (WHO,Africa,2018)

Sharp geographic, sociocultural and economic inequalities persist, not only between rural and urban areas but also in towns and cities where people living in low-income, informal or illegal settlements usually have less access to improved sources of drinking-water than other residents.

Contaminated water and poor sanitation are linked to transmission of diseases such as cholera, diarrhoea, dysentery, hepatitis A, typhoid and polio. Absent, inadequate, or inappropriately managed water and sanitation services expose individuals to preventable health risks. This is particularly the case in health care facilities where both patients and staff are placed at additional risk of infection and disease when water, sanitation and hygiene services are lacking. Globally, 15% of patients develop an infection during a hospital stay, with the proportion much greater in low-income countries. (WHO, Africa,2018)

Inadequate management of urban, industrial and agricultural wastewater means the drinking-water of hundreds of millions of people is dangerously contaminated or chemically polluted. Some 842 000 people are estimated to die each year from diarrhoea as a result of unsafe drinking-water, sanitation and hand hygiene. But diarrhoea is largely preventable, and the deaths of 361 000 children aged under 5 each year could be avoided each year if these risk factors were addressed. Where water is not readily available, people may decide handwashing is not a priority, thereby adding to the likelihood of diarrhoea and other diseases. .(WHO,Africa,2018)

Diarrhoea is the most widely known disease linked to contaminated food and water but there are other hazards. Almost 240 million people are affected by schistosomiasis – an acute and chronic disease caused by parasitic worms contracted through exposure to infested water. (WHO, Africa,2018)

In many parts of the world, insects that live or breed in water carry and transmit diseases such as dengue fever. Some of these insects, known as vectors, breed in clean, rather than dirty water, and household drinking-water containers can serve as breeding grounds. The simple intervention of covering water storage containers can reduce vector breeding and may also have a co-benefit of reducing faecal contamination of water at the household level. (WHO,Africa,2018)

As the international authority on public health and water quality, WHO leads global efforts to prevent transmission of waterborne disease, advising governments on the development of health-based targets and regulations. (WHO, Africa,2018)

WHO produces a series of water quality guidelines, including on drinking-water, safe use of wastewater, and safe recreational water environments. The water quality guidelines are based on managing risks, and since 2004 the Guidelines for Drinking-water Quality included the promotion of Water Safety Plans to identify and prevent risks before water is contaminated. In 2015, WHO introduced the concept of Sanitation Safety Plans to support implementation of the wastewater guidelines. WHO works on promoting effective risk assessment and management practices among all groups, including suppliers of drinking water, wastewater treatment companies, farmers, communities and individuals. (WHO, Africa,2018)

Since 2014, WHO has been testing household water treatment products against WHO health-based performance criteria through the WHO International ‘Scheme’ to Evaluate Household Water Treatment Technologies. The aim of the Scheme is to ensure that products distributed protect users from the pathogens that cause diarrhoeal disease and to strengthen policy, regulatory, and monitoring mechanisms at the national level to support appropriate targeting and consistent and correct use of such products. (WHO, Africa,2018)

WHO works closely with UNICEF in a number of areas concerning water and health. For example, the integrated global action plan to end preventable child deaths from pneumonia and diarrhoea by 2025 (GAPPD) sets out several prevention and treatment targets, including achieving universal access to drinking water in health care facilities and homes by 2030. The means of implementation for the work in health care facilities cuts across several health areas, including quality universal health coverage, and the two agencies have established a work plan to incrementally work towards universal access at the facility, national and global level. .(WHO,Africa,2018)

1.2 Statement of Problem

The water problem in Nigeria has reached a crisis point. No day passes by without stories or news about cases of water borne diseases caused by chronic shortage of safe water. It is no longer news that this problem has remained hydra-headed despite colossal sums of money budgeted by past and present governments. For instance, in Lagos, about 90 per cent of the residents do not have daily access to clean and safe water (Vanguard,2016)

 Meeting the daily water needs of the average family in the city is a difficult task. Safe water is expensive and almost unaffordable for many.  Nationwide, more than half of Nigeria’s population has no access to clean water and more than two thirds leave in poor sanitary conditions (WHO,2013),.

 According to UNICEF Executive Director, Anthony Lake, millions of children in Nigeria and the world at large lack access to safe water which in return endangers their lives, undermines their health, and jeopardizes their future. For him, the water crisis will continue unless collective action is taken urgently (UNICEF,2015). Nigerians say he may have been proved right. Today, millions are groaning under the burden of unsafe drinking water.  It is also a common sight to see women and children moving about with buckets and jerry can in search of illusive safe water, this is major reason why “pure water” is largely consume by many household in Nigeria and the fact that the value of the pure water is relatively low when compare with it quality. Majority of Nigerians consume “pure water” because of the level of safety at low price, the purpose of search for quality water is the prevention of water borne diseases.

1.3 Purpose of the Study

The purpose of this study is to assess the awareness and prevention of water-borne diseases among adult in Sagbama Local Government Area in Bayelsa State. The study will look at Knowledge, awareness and prevention of water-borne diseases in Sagbama Local Government Area.

1.4 Research Objectives

The study will be guided with the following objectives;

1.To assess the Knowledge about water-borne diseases among adult in Sagbama local government area, Bayelsa state.

2. To assess the level of awareness about causes  of water-borne diseases among adult in Sagbama local government area, Bayelsa state.

3. To find out the preventive measures used to prevent  the occurrence/ reoccurrence of water-borne diseases in Sagbama local government area.

1.5 Research Questions

1.Do adults in Sagbama local government area know of water-borne diseases?

2. What is the awareness level about the cause of water-borne diseases among adult in Sagbama local government area, Bayelsa state?

3. What are the preventive measures on the occurrence\reoccurrence of water-borne diseases in Sagbama local government area?

1.6 Research Hypothesis

Ho1 There is no significant relationship between respondents level of education and the level of awareness  about water-borne diseases among adult.

Ho2; There is no significant relationship between respondent level of awareness and the level of  knowledge about preventive measures.

1.6 Significance of Study

The study will be of immense benefit to different stakeholders. The study will benefit rural dwellers especially those in slum educating them about preventive measures against water-borne diseases. The study will also be useful to medical practitioners especially the nurses on creating awareness on water-borne diseases and  preventive measures against the disease. The study will also contribute to existing scope of knowledge The study will be of immense benefit to local government authorities to formulate programmes and policies which will serve as medium in creating awareness, treatment and prevention of water-borne diseases.

1.7 Scope of Study

The study assesses the awareness and prevention of water-borne diseases among adults in Sagbama local government area in Bayelsa state. Adults  will interviewed in the study. Young and middle age adults between 18-55 years old will be  involved in the study..

1.8 Delimitation of Study

The study will be  delimitated to assessment and awareness of water-borne diseases among adults in Sagbama local government area in Bayelsa state. The study will also delimitated to young and middle age adults in the stuy.

1.9 Operational Definition of Terms

Awareness: Awareness implies knowing about, or be in cognizant about water borne diseases

Prevention: Prevention of water borne diseases are various ways of avoiding the contamination and increase in susceptibility to water borne diseases. These include use of safe by water treatment, avoiding careless dumping of solid and liquid waste

Water-borne Disease: Waterborne diseases are conditions caused by pathogenic micro-organisms that are transmitted in water. Disease can be spread while bathing, washing or drinking water, or by eating food exposed to infected water. (Wikipedia,2018)

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