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The study examined the effect of heat stress on the well-being of outdoor workers and their coping strategies. A cross-sectional survey study was conducted between September 2019 and December 2019 ...

Nosocomial infections are enhanced due to a flop in the infection control processes such as disinfection. The aim of this study was to assess long term effectiveness and the stability of disinfectants currently used within healthcare settings in Accra, Ghana against two indicator pathogens. Two locally produced and two imported disinfectants usually used in health care settings were obtained. The efficacy and long-term stability of the disinfectants was done using the in-use method, with identified microbial culture isolates of Pseudomonas aeruginosa and Staphylococcus aureus. Counts of both test organisms (Pseudomonas aeruginosa and Staphylococcus aureus) were over and above the 5 ≥ CFU recommended standard. All the disinfectants failed the test. However, contamination was observed to be higher in local disinfectants as compared to those imported. Furthermore, Enterobacter spp was isolated as contaminant from one imported disinfected and Proteus spp was also isolated from one local disinfectant. Interestingly, one of the imported disinfectants (Disinfectant I) showed more stability and was effective in the long term. All disinfectants did not pass the in-use test. However, disinfectants that are produced locally are more unstable and ineffective. Key words: Infections, disinfectants, drug stability, hospital, pathogens, contamination.

Antibiotics are very important in the fight against infectious disease caused by bacteria and other microbes for decades. Today microbes have developed ways to resist antimicrobial agents targeted at them. We sought to characterize and simultaneously detect virulence genes associated water-borne antibiotic resistant Escherichia coli, obtained from water sampled from ground and surface water sources. The Analytical Profile Index (API) was use for the identifications of E. coli isolates. The Kirby-Bauer disk diffusion method was employed for susceptibility testing. A DNA•STRIP molecular assay technology designed for detection of shiga toxin genes was used for the molecular characterization. E. coli isolates showed a high (32.99%), resistance to penicillin, and was highly susceptible (93.8%) to nitrofurantoin. E. coli was confirmed Polymerase Chain Reaction (PCR). None of the confirmed multidrug resistant E. coli isolate had genes for stx1 and stx2. However, the eae intimin virulence gene was found on 6% of the multidrug resistant E. coli isolates. It was concluded that E. coli has developed a very high resistance to the various antibiotics. Second, the genotype EHEC test based on the DNA•STRIP technology used in this study has proved to be efficient and reliable in the molecular characterization of the multi-drug resistant E. coli isolates. The DNA•STRIP Genotype EHEC technology test is therefore recommended for pathogenic E. coli detection and monitoring. There is also a need to revise strategies towards the multidrug resistance programme. Key words: DNA•STRIP Technology, Escherichia coli, polymerase chain reaction, drug resistance, water bourne.

Global warming is a serious threat to human existence. The relatively higher level of global warming in recent times poses higher health risks to humans, both directly and indirectly. The aim of the study was to investigate public knowledge of global warming and its effects on human health. A nationally representative survey of Ghanaian adults ( N = 1130 ) was conducted from November 1, 2018 to February 28, 2019. Results show that 84.4% of the respondents understood the meaning of global warming. Respondents’ perceived causes of global warming include natural processes, deforestation, act of the gods, burning of fossil fuel, and carbon dioxide (CO2) emission from vehicles and industries. The majority of the respondents (83.4%) indicated that global warming has an impact on human health, while 8.5% indicated that it does not. Majority (78.6%) of the respondents are willing to support efforts to reduce the intensity of global warming. Television (19.1%) and social media (18.6%) were the leading preferred methods for receipt of global warming information. These findings provide useful insights for policy directions. The Government of Ghana and other stakeholders in health should develop a communication strategy to increase and sustain publicity and education of the citizenry on global warming.

The control of infectious diseases is seriously threatened by the increase in the number of microorganisms resistant to antimicrobial agents. Antibiotic-resistant bacteria have also been identified in the water environment. A field study was performed sampling drinking water sources in seven districts of southern Ghana targeting boreholes, dams, hand-dug wells, and streams during baseflow conditions. Bacteria were isolated ( N = 110 ) from a total of 67 water samples to investigate their antimicrobial susceptibility and to determine their carriage of select antibiotic resistance genes. Bacterial identification was performed using conventional selective media methods and the analytical profile index (API) method. Antibiotic susceptibility tests were carried out using the Kirby–Bauer method. Results indicated that all water sources tested were of poor quality based on the presence of fecal indicator organisms. The most commonly occurring bacterium isolated from water was Klebsiella spp. ( N = 24 , 21.8%), followed by E. coli ( N = 23 , 20.9%). Gram-negative bacteria isolates were most commonly resistant to cefuroxime (24.5%), while the Gram-positives were most commonly resistant to meropenem (21.3%). The highest rates of bacterial resistances to more than one antibiotic were observed in Klebsiella spp. (30.0%) followed by E. coli (27.8%). PCR was used to detect the presence of a select antibiotic resistance genes in the Gram-negative isolates. The presence of blaNDM-1, sull, tet(O), and tet(W) were observed in isolates from all water sources. In contrast, ermF was not detected in any of the Gram-negative isolates from any water source. Most (28.7%) of the resistance genes were observed in E. coli isolates. Reducing microbial contamination of the various water sources is needed to protect public health and to ensure the sustainability of this resource. This further calls for education of the citizenry.

Obstetric fistula is a devastating complication caused by a prolonged and obstructed labor. It is estimated that about 2 million girls and women continue to live with obstetric fistula while between 50,000-100,000 women worldwide develop obstetric fistula each year. This condition continues to persist and remains a major problem in Ghana and other developing countries.To explore the challenges and post-surgery integration needs among rural women living with obstetric fistula.A critical exploratory research methodology based on phenomenology was used to conduct in-depth one-on-one interviews. A non-probability and purposive sampling were done to identify thirty-six (36) women between the ages of 25 and 65. The interviews were recorded electronically and transcribed verbatim. A systematic analysis of data was then done to identify and categorize emerging themes.The results from the study showed that those who lived with obstetric fistulae experienced psychosocial, physical and economic challenges. Dominant among the psychological challenges identified were disruptions in social relations, divorce and loss of baby through neonatal death. Physical challenges include rashes and sores, foot drop, incontinence of urine. Economically, these women lost their source of livelihood and were heavily dependent on other family members. Support from family was also found to be key towards the post-surgery integration of the women.Obstetric fistula is a dilapidating condition that needs to be addressed at the micro, mezzo and macro level. Based on the findings of the study, recommendations were made to improve emergency obstetric care for women especially for women living in rural communities.

Introduction. Personal hygiene is essential to the current paradigm shift towards predictive, preventive, and personalized medicine, which enables the prediction and prevention of infectious disease outbreaks. Objective. The aim of this paper was to evaluate the personal hygiene practices among university students aiming at providing a basis for preventive and predictive medical interventions and to make future efforts improve target interventions for young people. Methods. The study was conducted using a cross-sectional study. Validated instruments that related personal hygiene practices were used to obtain quantitative data from 412 tertiary students from seven universities in Accra, Ghana. The resulting data were analyzed with IBM-SPSS, version 23. Results. There were more female respondents (54.4%) in the study than male respondents (45.6%). Respondents between the age group of 19-24 years constituted majority (59.7%) of the respondents in the study. Respondents from urban areas exhibited good hygiene practice compared to those from urban residences. There was a significant association between residence and hygiene practice (χ2=17.8, P≤0.001). We also observed that those respondents within the upper class in society had a poor hygiene practice, compared to the Lower Class and Middle Class respondents. Lack of education (63.1%) was observed as the main barrier to personal hygiene among the respondents. Future of the society depends on the health of its youth. Conclusion. A significant number of students are not actively practicing good hygiene. There is a need for deployment of preventive medicine interventions targeted at young people. It calls for improvement in methods of hygiene education for young people in tertiary institutions and the inclusion of hygiene in school curricula.

Research has proven that pelletized sawdust fuel is a possible replacement for charcoal and firewood. However, the conventional coal pot does not correctly support the use of pelletized sawdust as ...

Healthcare professionals are the most vulnerable to stress among all occupational groups due to the nature of their work environment. The aim of this study is to determine the level of stress and associated factors among healthcare workers in Western Ghana. The study employed a cross-sectional design with self-administered questionnaires. The results show that 69.5% of the respondents were stressed. Prevalence of stress was higher among female respondents than males. We found that 40.4 % of respondents intend to change work as a result of stress faced at their work places. Respondents aged 56≥ were more (3.16) likely to be stressed than those in the other age groups. We found a significant association between age, marital status, workload and educational background and stress levels among the respondents. The management of these healthcare institutions and their stakeholders must adopt strategies to help health workers cope with the stress they encounter., Outdoor workers; Pollution; Health; Disease; Vulnerable.

Healthcare waste generation is an integral part of healthcare operations. Improper healthcare waste management and disposal can be detrimental to humans and the environment. The objective of this paper is to investigate the healthcare waste management practices, aiming to provide needed data to inform policy decisions. The study was conducted using a cross-sectional study. Quantitative data was obtained from 497 respondents who worked in 25 major healthcare facilities. Data was analyzed using (SPSS) version 23.0. Results indicated that 52.4% of respondents had knowledge about healthcare waste management. However, only 12% of the respondents were open to training in healthcare/biomedical waste management. Less than half of the respondent (47.5%) practiced waste segregation at the sources of generation. There were significantly more healthcare waste disposal materials available ( P = 0.001) in private than government and quasi-government hospitals. Based on the major findings of the study, we recommend that adequate training as well as Personal Protective Equipment (PPE’s) should be provided to healthcare professionals to improve healthcare waste management. Complacence in adhering to Healthcare waste disposal guideline must be addressed.

Across the tropical developing countries, smallholder farmers are confronted with various climate related risks that hinge on agricultural activities. Climate change is predicted to impact smallholder farmers and their livelihood, especially within and beyond this century. Several studies have examined the impact of drought and rainfall on smallholder farmers as climate change impact assessment. However, there is limited information on impacts and coping strategies of poor farmers to heat exposure at household and farm level in tropical developing countries. As global temperature is predicted to increase with robust impacts on farmers in African region due to poverty and low adaptive capacity, this study evaluates how farmers in Bawku East of Northern Ghana experience the impacts of heat stress and how they cope with it both at the household level and on the field of cultivation. Using household survey and focus group discussion, the authors elicited impacts and responses of heat exposure from 308 resident farmers in three selected farming communities in Bawku East to gauge their vulnerability to heat exposure. Even though farmers have various impacts and coping strategies to heat exposure, these are ineffective to prevent them from heat related morbidity and mortality at both household and farm level. The study recommends the need for government led intervention to assist farmers in their effort to cope with heat stress as global temperatures will exacerbate heat stress impacts on small holder farmers especially in African region., Risk; Climate; Exposure; Farmers. Heat; livelihood, Bawku East, Climate change, heat stress; Agricultural Science; Environmental Science; Health Sciences.

In the last few decades, nuclear energy has become an important source of energy because it is seen as a low intensity carbon energy alternative to reduce environmental pollution. However, nuclear energy has many hazards to both the environment and human life. This paper examined the status, opportunities, and challenges of nuclear electric power, with emphasis on issues of energy security, safety and occupational health implications for Sub-Sahara Africa and particularly Ghana. The findings of the review suggest that Ghana could be supported by the International community with technical and human competencies required to effectively develop and run a nuclear energy project. However, there is the need to have clear-cut health, regulatory, occupational health and safety policies and procedures for the nuclear programme. Further, maintaining and strengthening economic and political institutions for nuclear programme more specifically and the overall national economy will be critical for the success of the nuclear energy programme. This will obviously require first and foremost the passage of the occupational health and safety bill into law and its implementation to ensure safe and clean energy. Additionally, the review shows that nuclear power should not be seen as a substitute but a complement to other renewable energy sources to reduce energy poverty and promote sustainable development.

Food safety is critical for public health and economic development. The hospitality industry offers a variety of food services, led by food handlers with diverse background. The aim of this paper is to evaluate food safety knowledge and practices among food handlers in the Ghanaian hospitality sectors, with the purpose of informing public policy and improving food safety. A cross-sectional survey study was conducted between February and May 2019. Data were obtained from food handlers working in the Ghanaian hospitality industry (N = 306). The findings of the study indicate that most (52.9%) respondents who work in restaurants had knowledge about food safety principles. Lack of training and education was identified by 63.1% of the respondents as a major barrier to food safety. Interestingly, 75.8% of the respondents indicated that food safety practice is not the responsibility of the kitchen staff only. Diarrhea (35.95%), cholera (35.62%), and typhoid (27.42%) were identified as major diseases associated with improper handling of food. Only 65.69% of the respondents undergo annual medical screening at their workplaces. There is correlation between food safety practice and variables such as marital status, type of residence, age, and education level. Educational campaigns coupled with strict law enforcement should be put in place to ensure that food safety rules and guideline are effectively implemented in the hospitality food industry. Training programs should be organized for food vendors and other stakeholders in the food industry as well. Finally, there should be proactive supervision by local government officials to ensure that good sanitation and hygienic conditions are maintained within the food sectors.

The importance of road safety in the developmental agenda of a country cannot be overemphasized. It is essential for effective socioeconomic development. However, several countries in the developing world are confronted by several challenges relating to road safety, which are inadequately investigated. These challenges further aggravate the already heavily burdened health-care systems. The aim of this study is, therefore, to determine and analyse road safety issues in Ghana aimed at contributing to national policy development, stakeholder engagements, and public safety education campaigns on road traffic collision. A qualitative study by one-on-one interviews with individuals (n = 97) in road safety leadership positions was performed from November 2018 to February 2019. The interviews were audio-recorded and transcribed. Data analysis was conducted using a constant comparative methodology approach facilitated by Atlas.ti 8.0 software. Important road safety challenges that were identified by the respondents were categorized into six thematic areas, namely, institutional, executional, managerial and operational, attitudinal and behavioural, research, and financial and investment challenges. We recommend that the government and stakeholders alike should tackle these challenges by building a collaborative environment where everyone is involved in the process of developing and implementing strategies aimed at overcoming these challenges as they arise. There is also the need to address the epidemic carnage of road traffic injuries, many of which are preventable since they arise from human actions and inactions.

Health workers are prone to burnout, which can have an adverse effect on their person and the patients to whom care is offered. The goal of this paper was to assess the levels of burnout experienced by healthcare workers in Accra, Ghana. The study was conducted using the cross-sectional study design. Questionnaires were used to obtain data from 365 respondents who worked in 12 major healthcare facilities. Data obtained were analyzed with SPSS version 23. Majority of the respondents were females (56.7%) as against males (43.3%). The total score for all burnout variables among health worker groups ranged from good (71.50%), alarming (12.60%), acute crisis (6.02%), and burnout (9.90%). Among the health worker groups, nurses had the highest percentage score values for all burnout variables. There was an association between burnout and these sociodemographic characteristics: age (p<0.001), gender (p=0.003), educational qualification (p<0.001), occupation (p<0.001), years of work experience (p<0.001), marital status (p<0.001), and parenthood (having children) (p<0.001). It is recommended that measures should be put in place in Ghanaian hospitals to assess stress and burnout levels to ensure people who are going through such situations are properly cared and supported.

Air pollution has been a major challenge worldwide particularly in the developing world. Improper waste disposal and management may result in microbial air pollution. In advanced countries, landfill sites are far from neighborhoods; however, the opposite is observed for landfill sites in the developing world. In Accra, some landfill sites are 100 meters from neighborhoods. The aim of this study was to assess the microbial air quality and associated environmental health hazards of landfill sites in selected districts in the Greater Accra Region of Ghana. A random sampling method was employed to select sampling sites across the dry and wet seasons from landfills and their corresponding neighborhoods. Results obtained showed a higher total count (CFU/m3) of bacteria and fungi in the air at the landfill sites than neighborhoods. Statistically significant variation p<0.05 in bacterial and fungal concentrations over two seasons was found for both landfills and neighborhoods. However, bacterial concentrations were significantly higher than fungal concentrations p<0.05 across seasons for all locations. Staphylococcus epidermidis was the highest (15.6 %) occurring microbe at both landfill sites and neighborhoods. This was followed by Staphylococcus aureus (12.7%). Other bacteria and fungi of public health importance such as Pseudomonas aeruginosa, Escherichia coli, Aspergillus flavus, and Aspergillus niger were also isolated from the study sites, above the WHO recommended levels. In conclusion, the landfill waste disposal and its close proximity to neighborhoods as observed in this study pose a potential environmental health risk, with dire implications for public health and safety. The government must enact and implement policies to regulate waste management and to ensure public safety.

Air pollution has been a major challenge worldwide particularly in the developing world. It has dire implications for human health. Understanding the knowledge and behaviour of the populace is key to the development and implementation of necessary intervention programmes. The aim of this study was to assess the knowledge, attitudes, and perceptions of air pollution in the Accra, Ghana. The study employed a cross-sectional design to obtain quantitative data form 1404 respondents, and the results were analysed with SPSS version 23. There were more (54.1%) female respondents than males (45.9%) in the study. The majority (70.5%) of the respondents were aware of the haze (air pollution) and its adverse effects on health. There was however a significant relationship between the sociodemographics and air pollution awareness (P=0.01). There was also a correlation between residents’ age, educational level, length of stay, marital status, and knowledge/awareness rate of air pollution (P<0.05). Although the majority of the respondents are aware of air pollution and its relationship to their health, rates of awareness were low in some demographic groups like the elderly and the less educated. Therefore, nondiscriminatory policies should be formed toward the education and guidance of people to become knowledgeable about air pollution and related health challenges. Most of the residents admitted improving air quality is the responsibility of every citizen. The government should utilize this to form collaborative measure with the citizens for a more effective control of air pollution.

Background: Patient satisfaction represents a key marker for the quality of healthcare delivery and is critical for smooth functioning of the healthcare system. Aim: The aim of this study was to determine the levels of patient satisfaction with the quality of care they receive, and thus identify the key factors that influence patients’ overall satisfaction with healthcare. Setting: The study was conducted across seven healthcare facilities in Greater Accra region. Methods: The study employed a cross-sectional design to obtain data from 417 respondents between 01 November 2017 and 31 January 2018. Patient satisfaction within the context and setting of this study refers to the extent to which patients are happy with the healthcare services they receive. Statistical analysis was performed using Statistical Package for the social Sciences (SPSS) version 23. Results: Female patients constituted 66.7% of the respondents, while 33.3% were male patients. Most of the participants had health insurance coverage (95.2%). Overall, 69.5% of the patients were satisfied with the level of care, 29.3% were somewhat satisfied and 1.2% were not satisfied. Female patients (86.0%) were more satisfied with the level of care they received compared to male patients (61.9%). Majority of the female patients (87.8%) indicated that they were treated with courtesy and respect. However, more than a half (51.8%) of male patients indicated they were not treated with courtesy and respect. Patient satisfaction negatively correlated with social status and age of the patients. Conclusion: Measurement of patients’ satisfaction is important for healthcare delivery. It was clear from this study that there is still a gap in improving and managing patients’ satisfaction and expectation. All stakeholders must get involved to ensure timely and satisfactory healthcare delivery to all patients.

Globally, there are strategies to solve sustainability and health problems, but we continue to experience an increase in disease burden and environmental problems. This study applied a cross-sectional design to examine the perceived awareness on the environmental hazard-health nexus and the key factors that drive individuals WTP in environmental policy design in Accra, Ghana. Significant number of respondents, who reported of cases of air pollution and poor sanitation, revealed perceived relationship between these environmental problems and malaria, diarrhoea and respiratory tract infections. More respondents are willing to participate in environmental policy design, recommending a tripartite medium of engagement (i.e. group discussion, provision of information, and survey) as the ideal. Municipal Assembly and Polluters are the key trusted actors to provide environmental information and solve environmental problems, suggesting the desirability of Public-Private Partnerships (PPPs) to environmental related matters. Finally, education, age, gender, residence (urban or rural), prior existing health and environmental conditions, and length of stay influence WTP in environmental policy design. The odds to participate rises with the level of education while it decreases with age, suggesting the desire of younger generation to participate in environmental protection policy. Investing in the human capital capacity of the young people is crucial.

Social acceptance of nuclear energy is critical for its successful implementation. Ghana has decided to develop nuclear energy to augment its growing demand for electricity. The study assesses the level of public knowledge, perceptions, risk and policy support for nuclear power development among Ghanaians. A nationally representative survey of Ghanaian adults (N = 1128), aged 18 and older, was conducted from August 1 to 2018 to November 28, 2018. The findings of the study indicate that, 72% of respondents have knowledge of nuclear energy, however only 28% of the respondents were aware of Ghana’s nuclear development plan. We observed that about 51% of the respondents support Ghana’s nuclear development plan despite the low level of awareness. Most respondents showed concern for the safety and prospects of having nuclear energy, fully adopted in the country. Social risk investment was identified as the most significant risk associated with nuclear power development. Majority of the respondents were much more ‘interested’ in how nuclear energy will impact or affect people or communities should they adopt the technology or in case of accidents. These findings provide useful insights for nuclear energy adoption and policy directions in Ghana. The Government of Ghana and other major stakeholders of nuclear power technology should develop a communication strategy to increase and sustain publicity and education of Ghana’s nuclear power development plan to citizens.

The spread of antibiotic-resistant microorganisms in the environment is recognized widely as an important public health issue, with concerns about future ability to treat infectious diseases. The main risk to public health is that the resistance genes are transferred from environmental bacteria to human pathogens. Safe water is one of the most important needs in public health in the twenty first century. Radiation sensitivity (D10) is defined as the radiation dose (kGy) required to reduce the number of that microorganism by 10-fold. The aim of this paper is to determine the association between multiple antibiotic resistance and radiation sensitivity (D10).Four hundred and sixty four (464) water samples were collected for assessment. E. coli isolation and identification were done using API 20E, and a PCR based DNA STRIP technology that allows simultaneous detection of virulence genes and confirmation of E. coli isolates. Antibiotic susceptibility testing was also conducted using the Kirby-bauer method. Radiation sensitivity was done using a cobalt 60 source. Sixty-three percent (63%) of the multidrug resistant E. coli strains recorded a multiple antibiotic resistance (MAR) index value of >0.2. The mean radiation sensitivity (D10) of the E. coli isolates is 0.33±0.11 kGy. The study confirmed a high prevalence of multiple antibiotic resistances in E. coli isolates. Lastly, there is no association between multiple antibiotic resistant indexes and radiation sensitivity (D10) of antibiotic resistant E. coli. Keywords : Antibiotics, Escherichia coli, water-borne, multi drug resistant radiation, Sensitivity.

Water is a natural resource and is essential to sustain life. Poor drinking water quality is the cause of several diseases. The aim of this paper was to investigate bacteriological profile of water sources as a measure of disease risk, aimed at providing useful information towards rural water resources management. Five hundred and twenty bacterial isolates (520) were obtained from waters samples collected during the period of study. Majority of the Isolates (305) representing 58.65% of the total were obtained during the dry season, as against (205) representing 41.35% in the rainy season. There was a statistical differences (P> 0.05) of the microbes isolated seasonally. The highest occurring was Klebsiella spp. (9.83±6.99, P> 0.05) in the dry season and the least Shigella spp. P> 0.05. Furthermore dam water sources was observed to poses a high disease risk among the five water sources investigated, whiles borehole water sources possess a lower diseases risk. An alarming observation was the presences of bacteria of public health importance in the water sources. These included Shigella spp. (dysentery), Salmonella typhi (typhoid fever and acute diarrhoeal infection), Salmonella typhi (typhoid fever), and Vibrio cholerea (cholera). In a nutshell, to reduce the level of bacterial contamination of drinking water sources there should be an incessant education on issues such as: environmental awareness, (cultivation sanitation habits and ensure that their surroundings and water sources are not indiscriminately polluted), causes, modes of transmission and prevention of water and sanitation related diseases. Keywords: E. coli , water, Public health and disease

Monitoring the microbiological quality of drinking water relies largely on examination of indicator bacteria such as coliforms, Escherichia coli, and Pseudomonas aeruginosa. E. coli is a member of the faecal coliform group and is a more specific indicator of faecal pollution than other faecal coliforms. Two key factors have led to the trend toward the use of E. coli as the preferred indicator for the detection of faecal contamination, not only in drinking water, but also in other matrices as well: first, the finding that some faecal coliforms were non faecal in origin, and second, the development of improved testing methods for E. coli. The faecal coliform definition has also been revised to coincide better with the genetic make-up of its members and now includes newly identified environmental species. As a result, faecal coliforms are increasingly being referred to as thermotolerant coliforms. This, combined with improved detection methods for E. coli, has started a trend toward the use of E. coli in place of thermotolerant coliforms as a more reliable indicator of faecal pollution in drinking water. At present, E. coli appears to provide the best bacterial indication of faecal contamination in drinking water. This is based on the prevalence of thermotolerant (faecal) coliforms in temperate environments as compared to the rare incidence of E. coli, the prevalence of E. coli in human and animal faeces as compared to other thermotolerant coliforms, and the availability of affordable, fast, sensitive, specific and easier to perform detection methods for E. coli.