Abstract
INTRODUCTION: Access to safe drinking water is crucial for health and survival, yet many developing countries face significant challenges in this regard. In West Africa, rapid urbanisation has outpaced efforts to improve access to potable water, compelling households to rely on private vendors for solutions, particularly through the growing market for sachet water. Widely consumed in Ghana, sachet water has become a convenient and affordable option, with over 37% of the population depending on it. However, concerns about its microbial safety persist, as studies indicate that sachet water often fails to meet necessary safety standards. This review consolidated existing research on microbial contaminants in sachet water, aiming to provide a representative overview of the microbial quality of sachet water in Ghana. METHOD: The systematic review followed the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. A thorough literature search was conducted across multiple databases, including PubMed, Web of Science, ScienceDirect, Scopus and the search engine Google Scholar, using relevant search terms. Eligible studies were identified based on established criteria, and data were subsequently extracted and analysed. RESULTS: A total of 28 studies published from 2003 to 2024 were selected for inclusion in this review. Notably, 96% of these studies reported bacteria from 17 different genera, while 11% examined parasites from 5 genera. Some studies (7%) investigated both types of contaminants. Overall, 2,276 sachet water samples were analysed, with 1,727 (76%) showing microbial contamination. Escherichia coli was the most identified bacteria, while Cyclospora cayetanensis and Cryptosporidium parvum were the most identified parasites. CONCLUSION: This study highlighted critical public health risks associated with sachet water in Ghana, particularly the presence of harmful bacteria and parasites. It is important to implement stricter manufacturing and sanitation standards and encourage safe handling practices to ensure the safety and quality of sachet water. Additionally, future research should focus on bridging existing gaps by investigating parasitic, viral, and fungal contaminants, to provide a holistic overview of the microbial contaminants in sachet water in Ghana.