Microbial Contamination of Drinking Water in Pakistan: Effects on Health, Evaluation Methods, and Public Health Implications

Background: Microbial contamination of drinking water is a major public health concern in Pakistan, contributing to the high prevalence of waterborne diseases due to inadequate sanitation, aging infrastructure, and limited use of modern detection techniques. Objective: This narrative review aimed to evaluate the microbial contamination of drinking water in Pakistan, focusing on key pathogens (E. coli, Salmonella spp., H. pylori, etc.), detection methods (culture-based and molecular), and associated health risks, with implications for surveillance and intervention strategies. Methods: This narrative review was based on literature retrieved from PubMed, Scopus, Google Scholar, and ScienceDirect (2010–2024), selecting studies on bacteriological water quality in Pakistan. Inclusion criteria involved original studies assessing microbial water contamination; reviews and irrelevant studies were excluded. Data was extracted and synthesized narratively. Ethical approval was not required as no human subjects were involved, but the review adhered to the Helsinki Declaration principles. Results: Analysis revealed a high frequency of E. coli (up to 67.8%), Salmonella spp. (54%), and Shigella spp. (63%) across urban and rural sources. Molecular methods (PCR/qPCR) offered higher sensitivity but remain underutilized. Conclusion: There is an urgent need for integrated microbial surveillance using advanced detection methods to prevent gastrointestinal diseases and antimicrobial resistance in Pakistan’s population.