Employing CBPR to investigate function, utility, and longevity of household filters to improve potable water quality for indigenous peoples at Lake Atitlán, Guatemala: a pilot study with San Pedro de La Laguna

Abstract

Cyanobacterial blooms at Lake Atitlán in Guatemala threaten and compromise the livelihood and health of local residents. Indigenous Tz’utujil, Kaqchikel, and K’iche’ rely directly on lake water for drinking, bathing, cleaning, cooking, and fishing. Nonpoint source runoff and untreated wastewater pumped directly into the lake contribute to high fecal pathogen loads into source waters. Concurrent nutrient loading results in cyanobacterial blooms further compromising water quality. A lakeside municipality facing high rates of childhood gastrointestinal illness volunteered to engage in community-based participatory research (CBPR) to evaluate efficacy, utility, and longevity of filters in households. The filters consistently reduced the risk of coliforms and E. coli in household water drawn from the lake based on World Health Organization guidelines. Household surveys were simultaneously administered through a student leadership group regarding water usage, water quality, and community health. Filters demonstrated ability to reduce high loads of fecal indicators from source waters and ability to remove a cyanobacterial toxin (microcystin) at 10 µg/L in deionized water. Further studies are imperative to determine longevity of use in households and CBPR provides a powerful avenue to test efficacy of a possible intervention while engaging stakeholders and empowering community members with sustainable solutions.

Keywords

CBPR / Cyanobacterial blooms / Household filters / Clay vessel / Ceramic candle / Fecal indicators

References

[1] Ahmed MS, Raknuzzaman M, Akther H, Ahmed S. The role of cyanobacteria blooms in cholera epidemic in Bangladesh. J Appl Sci, 2007, 7: 1785-1789

[2] Albert J, Luoto J, Levine D. End-user preferences for and performance of competing POU water treatment technologies among the rural poor of Kenya. Environ Sci Technol, 2010, 44: 4426-4432

[3] Bailie RS, Carson BE, McDonald EL. Water supply and sanitation in remote indigenous communities-priorities for health development. Aust NZ J Public Health, 2004, 28: 409-414

[4] Balazs CL, Morello-Frosch R. The three R’s: how community based participatory research strengthens the rigor, relevance and reach of science. Environ Justice, 2013

[5] Barbour V, Clark J, Jones S, Peiperl L, Veitch E, Yamey G, Med P. Clean water should be recognized as a human right. PLoS Med, 2009

[6] Bentley C, Laubach H, Spalter J, Ginter E, Jensen L. Relationship of cryptosporidiosis to abdominal pain and diarrhea in Mayan Indians. Rev Inst Med Trop Sao Paulo, 2004, 46: 235-237

[7] Bielefeldt AR, Kowalski K, Summers RS. Bacterial treatment effectiveness of point-of-use ceramic water filters. Water Res, 2009, 43: 3559-3565

[8] Calderón Barrios M (2007) Municipal regional parks: a model of sustainable community development implemented in the Atitlan Lake watershed multiple-use reserve. Guatemala South America Conservation Region External Affairs Technical Publication 1:41–47

[9] Carpenter SR. Phosphorus control is critical to mitigating eutrophication. Proc Natl Acad Sci USA, 2008, 105: 11039-11040

[10] Casanova LM, Walters A, Naghawatte A, Sobsey MD. Factors affecting continued use of ceramic water purifiers distributed to tsunami-affected communities in Sri Lanka. Trop Med Int Health, 2012, 17: 1361-1368

[11] Chaudhuri M, Verma S, Gupta A. Performance evaluation of ceramic filter candles. J Environ Eng, 1994, 120: 1646-1651

[12] Clasen TF Interventions to improve water quality for preventing diarrhoea. Cochrane Database Syst Rev, 2015

[13] Clasen TF Interventions to improve water quality for preventing diarrhoea. Cochrane Database Syst Rev, 2015, 10: CD004794

[14] Conley DJ Controlling eutrophication: nitrogen and phosphorus. Science, 2009, 323: 1014-1015

[15] Corman J Nutrient dynamics and phytoplankton resource limitation in a deep tropical mountain lake. Inland Waters, 2015, 5: 371-386

[16] Dodds WK Eutrophication of U.S. freshwaters: analysis of potential economic damages. Environ Sci Technol, 2009, 43: 12-19

[17] Drobac D, Tokodi N, Simeunovic J, Baltic V, Stanic D, Svircev Z. Human exposure to cyanotoxins and their effects on health. Arhiv za higijenu rada i toksikologiju, 2013, 64: 119-130

[18] Ford TE, Hamner S. A perspective on the global pandemic of waterborne disease. Microb Ecol, 2015

[19] Fraser ED, Dougill AJ, Mabee WE, Reed M, McAlpine P. Bottom up and top down: analysis of participatory processes for sustainability indicator identification as a pathway to community empowerment and sustainable environmental management. J Environ Manag, 2006, 78: 114-127

[20] Funari E, Testai E. Human health risk assessment related to cyanotoxins exposure. Crit Rev Toxicol, 2008, 38: 97-125

[21] Gao C, Zhang T. Eutrophication in a Chinese context: understanding various physical and socio-economic aspects. Ambio, 2010, 39: 385-393

[22] Harvey TS. Cyanobacteria blooms: Maya peoples between the politics of risk and the threat of disaster. Med Anthropol, 2012, 31: 477-496

[23] Hoover E Indigenous peoples of North America: environmental exposures and reproductive justice. Environ Health Perspect, 2012, 120: 1645-1649

[24] Huang WJ, Cheng BL, Cheng YL. Adsorption of microcystin-LR by three types of activated carbon. J Hazard Mater, 2007, 141: 115-122

[25] Johansson P, Knox-Nicola P, Schmid K. The Waponahki tribal health assessment: successfully using CBPR to conduct a comprehensive and baseline health assessment of Waponahki tribal members. J Health Care Poor Underserved, 2015, 26: 889-907

[26] Johnson CRS, Kraemer Diaz AE, Arcury TA. What does it mean for something to be “scientific”? Community understandings of science, educational attainment, and community representation among a sample of 25 CBPR projects. Health Educ Behav, 2016

[27] Komárek J Polyphasic evaluation of Limnoraphis robusta, a water–bloom forming cyanobacterium from Lake Atitlán, Guatemala, with a description of Limnoraphis gen. nov. Fottea Olomouc, 2013, 13: 39-52

[28] Larimer C, Ostrowski N, Speakman J, Nettleship I. The segregation of silver nanoparticles in low-cost ceramic water filters. Mater Charact, 2010, 61: 408-412

[29] Laubach HE, Bentley CZ, Ginter EL, Spalter JS, Jensen LA. A study of risk factors associated with the prevalence of Cryptosporidium in villages around Lake Atitlan, Guatemala. Braz J Infect Dis Off Publ Braz Soc Infect Dis, 2004, 8: 319-323

[30] Laukkanen M, Ekholm P, Huhtala A, Pitkanen H, Kiirikki M, Rantanen P, Inkala A. Integrating ecological and economic modeling of eutrophication: toward optimal solutions for a coastal area suffering from sediment release of phosphorus. Ambio, 2009, 38: 225-235

[31] Lonczak HS, Thomas LR, Donovan D, Austin L, Sigo RL, Lawrence N, Suquamish T. Navigating the tide together: early collaboration between tribal and academic partners in a CBPR study. Pimatisiwin, 2013, 11: 395-409

[32] Loo SL, Fane AG, Krantz WB, Lim TT. Emergency water supply: a review of potential technologies and selection criteria. Water Res, 2012, 46: 3125-3151

[33] Mackey TK, Liang BA. Integrating biodiversity management and indigenous biopiracy protection to promote environmental justice and global health. Am J Public Health, 2012, 102: 1091-1095

[34] Mellor J, Abebe L, Ehdaie B, Dillingham R, Smith J. Modeling the sustainability of a ceramic water filter intervention. Water Res, 2014, 49: 286-299

[35] Michen B, Diatta A, Fritsch J, Aneziris C, Graule T. Removal of colloidal particles in ceramic depth filters based on diatomaceous earth. Sep Purif Technol, 2011, 81: 77-87

[36] Mintz E, Bartram J, Lochery P, Wegelin M. Not just a drop in the bucket: expanding access to point-of-use water treatment systems. Am J Public Health, 2001, 91: 1565-1570

[37] Mittelman AM, Lantagne DS, Rayner J, Pennell KD. Silver dissolution and release from ceramic water filters. Environ Sci Technol, 2015, 49: 8515-8522

[38] Morri RJ, Williams DE, Luu HA, Holmes CF, Andersen RJ, Calvert SE. The adsorption of microcystin-LR by natural clay particles. Toxicon Off J Int Soc Toxinol, 2000, 38: 303-308

[39] Murphy HM, McBean EA, Farahbakhsh K. A critical evaluation of two point-of-use water treatment technologies: can they provide water that meets WHO drinking water guidelines?. J Water Health, 2010, 8: 611-630

[40] Navichoc Sajquiy P (2007) Historia de San Pedro la Laguna, Sololá Maestria en Docencia Universitaria, Universidad de San Carols, Facultad de Humanidades, Escuela de Estudios Postgrados

[41] O’Donahoo FJ, Ross KE. Principles relevant to health research among indigenous communities. Int J Environ Res Public Health, 2015, 12: 5304-5309

[42] O’Fallon LR, Dearry A. Commitment of the National Institute of Environmental Health Sciences to community-based participatory research for rural health. Environ Health Perspect, 2001, 109(Suppl 3): 469-473

[43] O’Fallon LR, Dearry A. Community-based participatory research as a tool to advance environmental health sciences. Environ Health Perspect, 2002, 110(Suppl 2): 155-159

[44] Oyanedel-Craver V, Narkiewicz S, Genovesi R, Bradshaw A, Cardace D. Effect of local materials on the silver sorption and strength of ceramic water filters. J Environ Chem Eng, 2014, 2: 841-848

[45] Paerl HW, Huisman J. Climate. Blooms like it hot. Science, 2008, 320: 57-58

[46] Paerl HW, Huisman J. Climate change: a catalyst for global expansion of harmful cyanobacterial blooms. Environ Microbiol Rep, 2009, 1: 27-37

[47] Paerl HW, Fulton RS 3rd, Moisander PH, Dyble J. Harmful freshwater algal blooms, with an emphasis on cyanobacteria. Sci World J, 2001, 1: 76-113

[48] Paerl HW, Hall NS, Calandrino ES. Controlling harmful cyanobacterial blooms in a world experiencing anthropogenic and climatic-induced change. Sci Total Environ, 2011, 409: 1739-1745

[49] Pandit AB, Kumar JK. Clean Water for developing countries. Annu Rev Chem Biomol Eng, 2015, 6: 217-246

[50] Paul BD, Demarest WJ. Citizen participation overplanned: the case of a health project in the Guatemalan community of San Pedro la Laguna. Soc Sci Med, 1984, 19: 185-192

[51] Rasch ED. Transformations in citizenship: local resistance against mining projects in Huehuetenango (Guatemala). J Dev Soc, 2012, 28: 159-184

[52] Rejmánková E, Komárek J, Dix M, Komárkova J, Girón N. Cyanobacterial blooms in Lake Atitlan, Guatemala. Limnol Ecol Manag Inland Waters, 2011, 41: 296-302

[53] Reller ME A randomized controlled trial of household-based flocculant–disinfectant drinking water treatment for diarrhea prevention in rural Guatemala. Am J Trop Med Hyg, 2003, 69: 411-419

[54] Ren D, Colosi LM, Smith JA. Evaluating the sustainability of ceramic filters for point-of-use drinking water treatment. Environ Sci Technol, 2013, 47: 11206-11213

[55] Rhodes SD, Malow RM, Jolly C. Community-based participatory research: a new and not-so-new approach to HIV/AIDS prevention, care, and treatment. AIDS Educ Prev, 2010, 22: 173-183

[56] Richmond L. Incorporating indigenous rights and environmental justice into fishery management: comparing policy challenges and potentials from Alaska and Hawai’i. Environ Manag, 2013, 52: 1071-1084

[57] Roegner AF, Brena B, Gonzalez-Sapienza G, Puschner B. Microcystins in potable surface waters: toxic effects and removal strategies. J Appl Toxicol, 2014, 34: 441-457

[58] Russell BD, Connell SD. Eutrophication science: moving into the future. Trends Ecol Evol, 2009, 24: 527-528 author reply 528–529)

[59] Salimi Y Is community-based participatory research (CBPR) useful? A systematic review on papers in a decade. Int J Prev Med, 2012, 3: 386-393

[60] Saxton DI, Brown P, Seguinot-Medina S, Eckstein L, Carpenter DO, Miller P, Waghiyi V. Environmental health and justice and the right to research: institutional review board denials of community-based chemical biomonitoring of breast milk. Environ Health, 2015, 14: 90

[61] Schmidt WP, Cairncross S. Household water treatment in poor populations: Is there enough evidence for scaling up now?. Environ Sci Technol, 2009, 43: 986-992

[62] Schweitzer RW, Cunningham JA, Mihelcic JR. Hydraulic modeling of clay ceramic water filters for point-of-use water treatment. Environ Sci Technol, 2013, 47: 429-435

[63] Servi AT, Frey D, Kang PK, Murcott S (2013) A holistic optimization framework for improving ceramic pot filter performance. Paper presented at the IEEE 2013 global humanitarian technology conference, San Jose, CA, USA

[64] Simonis JJ, Basson AK. Evaluation of a low-cost ceramic micro-porous filter for elimination of common disease microorganisms. Phys Chem Earth, 2011, 36: 1129-1134

[65] Smith VH, Schindler DW. Eutrophication science: Where do we go from here?. Trends Ecol Evol, 2009, 24: 201-207

[66] Sobsey MD, Stauber CE, Casanova LM, Brown JM, Elliott MA. Point of use household drinking water filtration: a practical, effective solution for providing sustained access to safe drinking water in the developing world. Environ Sci Technol, 2008, 42: 4261-4267

[67] Spector AY. CBPR with service providers: arguing a case for engaging practitioners in all phases of research. Health Promot Pract, 2012, 13: 252-258

[68] Tobias JK, Richmond CA, Luginaah I. Community-based participatory research (CBPR) with indigenous communities: producing respectful and reciprocal research. J Empir Res Hum Res Ethics, 2013, 8: 129-140

[69] van der Laan H Bacteria and virus removal effectiveness of ceramic pot filters with different silver applications in a long term experiment. Water Res, 2014, 51: 47-54

[70] Weiss ES Sustaining CBPR partnerships to address health disparities in times of economic instability. J Health Care Poor Underserved, 2012, 23: 1527-1535

[71] Wilhelm SW The relationships between nutrients, cyanobacterial toxins and the microbial community in Taihu (Lake Tai), China. Harmful Algae, 2011, 10: 207-215

[72] Wright J, Gundry S, Conroy R. Household drinking water in developing countries: a systematic review of microbiological contamination between source and point-of-use. Trop Med Int Health, 2004, 9: 106-117

Funding

Blum Center for Developing Economies, University of California, Davis(PARA Research Grant)

United States Agency for International Development(USAID Cooperative Agreement No. AID-520-A-12-00001)