Flood-related WASH disruption, point-of-use drinking water contamination and diarrhoea among under-five children in flood-affected communities in Ebonyi State, Nigeria

Abstract

Abstract Background Flooding disrupts water, sanitation and hygiene (WASH) systems, increasing the risk of waterborne diseases among young children. This study examined the relationships between flood-related WASH disruption, drinking water contamination and diarrhoea among under-five children in flood-displaced communities in Ebonyi State, Nigeria. Methods A cross-sectional study was conducted among 600 households across six flood-displaced communities. Point-of-use drinking water samples were tested for Escherichia coli and total coliform. Chi-square tests and multivariable logistic regression were used to examine associations. Results Most households (69.5%) reported direct flood exposure and water access was disrupted in 59.7%. Escherichia coli contamination was detected in 48.5% of samples and total coliforms in 53.7%. The two-week prevalence of diarrhoea among under-five children was 23.3%. Contamination was uniformly high across communities (all p > 0.05). Water treatment method was significantly associated with Escherichia coli contamination ( p = 0.023). Multivariable analysis showed that a storage container observed to be covered during the household visit was the only significant predictor of diarrhoea (AOR = 2.01, 95% CI: 1.33–3.02, p = 0.001). Conclusion Microbial contamination was widespread across the study communities. Post-collection water handling and storage appeared to be more strongly associated with diarrhoea than water source. Integrated emergency WASH responses prioritising household water treatment, safe storage and sanitation are urgently needed in flood-affected communities.