Bacteriological quality of drinking water and associated factors in Alemwach refugee camp in Dabat District, Northwest Ethiopia

Access to safe drinking water is essential for preventing waterborne diseases and ensuring public health, particularly in refugee camps, where overcrowding and inadequate sanitation pose significant risks. Contaminated drinking water remains a major public health concern, contributing to outbreaks of diarrheal and other infectious diseases. This study assesses the bacteriological quality of drinking water from sources to the point of use and identifies associated factors influencing contamination in Alemwach Refugee Camp, Dabat District, Northwest Ethiopia. A laboratory-supported cross-sectional study was conducted among Alemwach refugees by collecting a total of 435 drinking water samples (10 samples from the reservoir, 2 samples from the public stand well, 1 sample from the deep well, and 422 samples from household storage containers) for bacteriological analysis. Additionally, data were collected from 422 respondents using structured interviewer-based questionnaires and through observation that assessed factors related to the bacteriological quality of drinking water. Binary and multiple logistic regression analyses were performed to find associated factors, and variables with a p-value of 0.05 were considered statistically significant variables. This study revealed that 33.3% of water samples from groundwater, 30% of water samples from reservoirs, and 78.9% of water samples from household storage drinking water were contaminated by fecal coliform. The sanitary risk score indicates a high-level risk score of 66.7% for groundwater sources and a 54.5% risk score for household storage containers, representing a medium risk score. Educational status, home-based water treatment practice, type of water storage container, cleanliness of water storage container, types of sanitation facility, and animal contact with households were significantly associated with bacteriological quality of drinking water quality at the point of use. This study reveals substantial fecal coliform contamination in drinking water, particularly at the household level, indicating a high risk of waterborne diseases in Alemwach Refugee Camp. The contamination is influenced by multiple factors, including household education, type of water storage container, type of sanitation facilities, home-based water treatment, animal contact, and container cleanliness. To improve drinking water quality, targeted interventions such as promoting safe water storage, enhancing household water treatment practices, improving sanitation infrastructure, and conducting community education programs on hygiene and water safety are recommended. Regular monitoring and risk assessment of water sources should also be strengthened to ensure sustainable access to safe drinking water.