Evaluating microbial health risks and perceptions on water accessibility, sanitation, and hygiene (WASH) and health: using the Johor River Basin as a case study

ABSTRACT Water security in the Johor River Basin (JRB) faces challenges, including the lack of holistic approaches in river water quality monitoring, underreporting of water quality and health data, and suboptimal wastewater management. This study evaluates the microbial water quality, specifically the levels of total coliforms and antimicrobial-resistant (AMR) coliforms within the JRB, their potential health risks on riverside inhabitants, and the perceptions of these inhabitants on water quality, water accessibility, sanitation, and hygiene (WASH), and health practices. Microbial assessments were conducted at 22 sites across the basin to identify coliform hotspots. A targeted focus study was conducted to analyse tap water consumed by local communities, and the perceptions and knowledge on WASH practices and health of 30 indigenous households were evaluated via validated questionnaires. Four hotspots consistently exhibit high coliform levels, with significant differences between wet and dry monsoon seasons. Tap water supplies of the communities contain high coliform levels, and there were inconsistencies with their perceptions of WASH and health practices. The findings of this study reveal the need for more holistic interdisciplinary approaches to screen river basins, inform the population, and mitigate the impacts that total and AMR coliforms have on the riverside inhabitants.