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Towards an Integrated Approach to Improve the Understanding of the Relationships Between Water-Borne Infections and Health Outcomes: Using Malaysia as a Detailed Case Study

Lookup NU author(s): Jia Yee Ho, Amanda Lavinya, Dominic Kay, Dr Cindy LeeORCiD, Ahmad Haikal Razmi, Professor Claire Walsh, Dr Michaela Goodson, Dr Jeyanthy Eswaran



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Copyright © 2022 Ho, Lavinya, Kay, Lee, Razmi, Walsh, Goodson and Eswaran. As in many low- and middle-income countries around the world, thousands of local communities in Southeast Asia rely on river water to sustain their livelihoods. However, poor water quality threatens the health of both humans and ecosystems. The aim of this review was to examine the available literature to investigate how health outcomes in Malaysia have been studied and reported as directly attributable to human infections from river water. Computer-aided searches from 10 electronic databases were undertaken, with searches limited to the English language and publication dates since January 2010. The literature search revealed that the predominant river water infections identified in Malaysia were bacterial (coliforms, Salmonella spp., typhoid, leptospirosis, melioidosis), viral (including dengue, hepatitis, enterovirus), parasitic infections including amoebiasis, giardiasis and cryptosporidiosis, helminth infections, Blastocystis infections and sarcocystosis. No studies were found that have attempted to evaluate the impact of water related infection on human health longitudinally. Moreover, the possibility of integrated water governance systems that could reduce infection and improve water quality, particularly for marginalized groups have not been discussed or studied. Several cross-sectional studies identified infections at a point in time, but large longitudinal data sets of water infection parameters and how they influence human health outcomes have not been reported. Using Malaysia as a demonstration case study, we suggest a number of recommendations based on using a systems approach to tackle the challenges involved in data collection and integration, which is central to the understanding, strategic planning and management of water-borne infections.

Publication metadata

Author(s): Ho JY, Lavinya AA, Kay DSW, Lee CIS, Razmi AH, Walsh CL, Goodson ML, Eswaran J

Publication type: Review

Publication status: Published

Journal: Frontiers in Water

Year: 2022

Volume: 4

Online publication date: 03/03/2022

Acceptance date: 31/01/2022

ISSN (electronic): 2624-9375

Publisher: Frontiers Media S.A.


DOI: 10.3389/frwa.2022.779860