PLOS One
Abstract
Using household-survey data across 25 low- and middle-income countries, this study examines how reported water-treatment practices relate to measured E. coli contamination in drinking-water sources and stored water. Many households are exposed to contaminated water, yet relatively few report treating it. Because contamination is invisible, households respond only modestly as measured contamination rises, with treatment increasing by a few percentage points rather than keeping pace with risk. The analysis also finds that reported treatment does not reliably mean stored water is free of E. coli. The study is observational and does not claim a causal treatment effect; it highlights the limits of relying on households to identify contamination and the need for stronger water-safety measures and monitoring.