The main purpose of this study was to implement cost-effective household water treatment systems in every household of Makwane Village for the reduction of diarrhoeal diseases. These household water treatment systems were constructed with locally available materials and consisted of the biosand zeolite-silver impregnated granular clay filters and the silver-impregnated porous pot filters. During the study period (April 2015 to September 2015), the entire village had 88 households with a population size of 480. Prior to the implementation, a survey was conducted and results revealed that 75% (360/480) of the Makwane residents suffered from diarrhoeal disease and the majority of the cases were reported in children that were less than five years of age. Out of the 480 participants, 372 (77.5%) from 70 households accepted the installation of the systems (intervention group) and 108 (25.5%) from 18 households were reluctant to use the systems (the control group). To date, in the intervention group, only 3.8% (14/372) of participants reported cases of diarrhoea. In the control group, 57.4% (62/108) participants reported cases of diarrhoea and most of the episodes of diarrhoea were reported in children of less than five years old (85%), followed by the group aged ≥56 years (75%). The findings of the current study unequivocally demonstrated that the BSZ-SICG and SIPP filters were able to reduce the incidence of diarrhoea by 96.2%. These findings further demonstrate the importance of household water treatment systems (HWTS) interventions in rural areas to bring about meaningful reductions in diarrhoeal diseases by providing safe potable water.

Background Campylobacter spp. are one of the most frequent causes of diarrhoeal disease in humans throughout the world. This study aimed at determining the prevalence and the genotypic distribution of Campylobacter spp. and their association with diarrhoea and child growth in children of less than the age of two in the Limpopo Province of South Africa. Methods A total of 4280 diarrheal and non-diarrheal stool samples were collected on a monthly basis from children recruited at birth and followed up to 24 months. All stool samples were screened for the presence Campylobacter antigen using ELISA technique after which CAH 16S primer was used on the positive samples to confirm the presence of Campylobacter. Subsequently, the PCR positive samples were further characterised using species specific primers for Campylobacter jejuni and Campylobacter coli. Results Campylobacter antigen was detected in 564/4280 (13.2%). Campylobacter was more commonly found in diarrheal stools (20.4%) compared to non-diarrheal stools (12.4%) with a statistically significant difference (χ2 = 7.345; p = 0.006). Throughout the year there were two main peaks of Campylobacter infection one in December- January and the second peak in June. The prevalence of Campylobacter increased with the age of the children up to 11 months after which the prevalence decreased. Out of 564 positive ELISA samples, 257 (45.6%) were confirmed to have 16S rRNA gene for Campylobacter spp. Furthermore, C. jejuni was found to be more prevalent (232/257) than C. coli (25/257) with a prevalence of 90.3% and 9.7%, respectively. Both C. jejuni and C. coli were significantly associated with diarrhea with statistical values of (χ2 = 22.224; p < 0.001) and (χ2 = 81.682; p < 0.001) respectively. Sequences generated from the analysis of hip gene confirmed the PCR positives samples were C. jejuni positive. Conclusions This study has delineated a high prevalence of Campylobacter spp. in the study cohort. Moreover, C. jejuni was found to be more prevalent than C. coli both of which were associated with diarrhea. These findings are of clinical and epidemiological significance.

Development of biofilms occurring on the inner surface of storage vessels offers a suitable medium for the growth of microorganisms and consequently contributes to the deterioration of treated drinking water quality in homes. The aim of this study was to determine whether the two point-of-use technologies (biosand zeolite silver-impregnated clay granular (BSZ-SICG) filter and silver-impregnated porous pot (SIPP) filter) deployed in a rural community of South Africa could inhibit the formation of biofilm on the surface of plastic-based containers generally used by rural households for the storage of their drinking water. Culture-based methods and molecular techniques were used to detect the indicator bacteria (Total coliforms, faecal coliform, E. coli) and pathogenic bacteria (Salmonella spp., Shigella spp. and Vibrio cholerae) in intake water and on the surface of storage vessels containing treated water. Scanning electron microscopy was also used to visualize the development of biofilm. Results revealed that the surface water source used by the Makwane community was heavily contaminated and harboured unacceptably high counts of bacteria (heterotrophic plate count: 4.4–4.3 Log10 CFU/100mL, total coliforms: 2.2 Log10 CFU/100 mL—2.1 Log10 CFU/100 mL, faecal coliforms: 1.9 Log10 CFU/100 mL—1.8 Log10 CFU/100 mL, E. coli: 1.7 Log10 CFU/100 mL—1.6 Log10 CFU/100 mL, Salmonella spp.: 3 Log10 CFU/100 mL -8 CFU/100 mL; Shigella spp. and Vibrio cholerae had 1.0 Log10 CFU/100 mL and 0.8 Log10 CFU/100 mL respectively). Biofilm formation was apparent on the surface of the storage containers with untreated water within 24 h. The silver nanoparticles embedded in the clay of the filtration systems provided an effective barrier for the inhibition of biofilm formation on the surface of household water storage containers. Biofilm formation occurred on the surface of storage plastic vessels containing drinking water treated with the SIPP filter between 14 and 21 days, and on those containing drinking water treated with the BSZ-SICG filter between 3 and 14 days. The attachment of target bacteria on the surface of the coupons inoculated in storage containers ranged from (0.07 CFU/cm2–227.8 CFU/cm2). To effectively prevent the development of biofilms on the surface of container-stored water, which can lead to the recontamination of treated water, plastic storage containers should be washed within 14 days for water treated with the SIPP filter and within 3 days for water treated with the BSZ-SICG filter.

The implementation of water and sanitation safety plans (WSSP) has the potential of greatly improving the challenge of resource-limited drinking-water supplies. However, the most effective tool to make WSSP successful is understanding of the factors that contribute to hindering the implementation of these plans, specifically in rural communities. This study therefore aimed at assessing the status of basic services and determining the factors that contribute to hampering the process of WSSP in rural communities. A survey was conducted between March 2020 and March 2021 in rural communities of the Vhembe District, Limpopo Province, South Africa. The overall results indicate that poverty, unemployment, lack of access to purified water, and inadequate sanitation facilities have resulted in waterborne diseases reported within the communities and have a major impact in hindering WSSP. Other barriers observed are inequality regarding financial power, absent and degrading water and sanitation infrastructures, and lack of protection and maintenance of natural water sources. Therefore, there is a need for community members to be educated on proper behavior and perceptions towards sanitation, including working hand-in-hand with different stakeholders, men and women from communities, and different cultures and religions to overcome these barriers, so that human disease associated with water supply, wastewater reuse, and sanitation in rural communities can be alleviated.

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