People living in rural areas still rely on the use of environmental water that is contaminated by human and animal activities. This study assessed the occurrence of human enteric pathogens in rivers that are used by rural communities Vhembe District of South Africa as a source of drinking water covering two seasons (winter and summer) over a one-year period. Water quality was assessed using physico characteristics and indicator organisms (total coliforms, E. coli, Clostridium perfringens). Pathogens tested included bacteria (Pathogenic E. coli, Salmonella-, Shigella- and Vibrio spp.), protozoa (Cryptosporidium- and Giardia spp.), and enteric viruses (Rota-, Noro-, Entero-, and Adenoviruses) while using published molecular protocols. The results showed that the indicator bacteria counts exceeded South African drinking water quality guideline limits and pathogenic E. coli was detected in the samples. No Shigella spp. were isolated, while Vibrio spp. and Salmonella spp. were present; parasites were detected in four rivers and Enteric viruses were predominantly detected in the winter season. The results indicated the poor condition of water and the potential health risks to consumers highlighting the need for implementing river catchment management strategies for continued sustainability in these rivers.

Infectious diarrhoea contributes to high morbidity and mortality in young children from sub-Saharan Africa. The aim of this study was to assess the prevalence of single and multiple diarrhoeal-causing pathogen combinations in children suffering from diarrhoea from rural and peri-urban communities in South Africa. A total of 275 diarrhoea stool specimens were collected between 2014 and 2016 from Hospitals and Primary Health Care clinics. The BioFire^® FilmArray^® Gastrointestinal panel was used to simultaneously detect 22 diarrhoea pathogens (viruses, bacteria, parasites) known to cause diarrhoea. A total of 82% (226/275) enteric pathogens were detected in the stool specimens. The two most detected bacterial, viral and parasitic pathogens each included: EAEC (42%), EPEC (32%), Adenovirus F40/41 (19%), Norovirus (15%), Giardia (8%) and Cryptosporidium (6%), respectively. Single enteric pathogen infections were recorded in 24% (65/275) specimens with EAEC, and Norovirus was found in 26% (17/65) and 14% (9/65) of the specimens, respectively. Multiple enteric pathogen combinations were recorded in 59% (161/275) of the stool specimens with 53% (85/161) containing two pathogens, 22% (35/161) containing three pathogens and 25% (41/161) containing four or more pathogens. The results from this study demonstrated the complex nature of pathogen co-infections in diarrhoeal episodes which could have an impact on treatment effectiveness.

Limited access to water and sanitation is a risk to health, dignity, and ability to engage in occupations. This article aims to: 1) discuss the current and historical factors affecting access to water and sanitation in rural South Africa, and 2) explore the occupational implications of water access, particularly for older adults and people with disability in rural South Africa. A literature review was carried out through searching JSTOR, Scopus, and MEDLINE databases and using framework analysis to interpret the retrieved documents. This paper also reports a thematic analysis of semi-structured interviews, conducted in 2012 in a rural area of South Africa. Environmental, political, social-economic and attitudinal factors were identified as impacting water access and occupation, in both the documentary analysis and the semi-structured interviews. Due to South Africa’s history, injustice has occurred in the forms of occupational apartheid and occupational deprivation. We argue that supply systems must enable people to easily access more water than is essential for survival, so that people can participate in meaningful and productive occupations. Therefore, access to water should be considered part of an occupational right. Recognising this right will be an integral step in ensuring that water supplies are improved to support better livelihoods, and to achieve economic and social empowerment, and quality of life for all, in line with many of the United Nations’ new Sustainable Development Goals.

Background: Water quality testing is dictated by microbial agents found at the time of sampling in reference to their acceptable risk levels. Human activities might contaminate valuable water resources and add to the microbial load present in water bodies. Therefore, the effects of human activities on the microbial quality of rivers collected from twelve catchments in the Vhembe District in South Africa were investigated, with samples analyzed for total coliform (TC) and Eschericha coli (E. coli) contents. Methods: Physical parameters and various human activities were recorded for each sampling site. The Quanti-Tray^® method was adopted for the assessment of TC and E. coli contents in the rivers over a two-year period. A multiplex polymerase chain (PCR) method was used to characterize the strains of E. coli found. Results: The microbial quality of the rivers was poor with both TC and E. coli contents found to be over acceptable limits set by the South African Department of Water and Sanitation (DWS). No significant difference (p > 0.05) was detected between TC and E. coli risks in dry and wet seasons. All six pathogenic E. coli strains were identified and Enteroaggregative E. coli (EAEC), atypical Enteropathogenic E. coli (a-EPEC) and Enterotoxigenic E. coli (ETEC) were the most prevalent E. coli strains detected (respectively, 87%, 86% and 83%). Conclusions: The study indicated that contamination in the majority of sampling sites, due to human activities such as car wash, animal grazing and farming, poses health risks to communities using the rivers for various domestic chores. It is therefore recommended that more education by the respective departments is done to avert pollution of rivers and prevent health risks to the communities in the Vhembe District.

To assess, within communities experiencing Ebola virus outbreaks, the risks associated with the disposal of human waste and to generate recommendations for mitigating such risks. A team with expertise in the Hazard Analysis of Critical Control Points framework identified waste products from the care of individuals with Ebola virus disease and constructed, tested and confirmed flow diagrams showing the creation of such products. After listing potential hazards associated with each step in each flow diagram, the team conducted a hazard analysis, determined critical control points and made recommendations to mitigate the transmission risks at each control point. The collection, transportation, cleaning and shared use of blood-soiled fomites and the shared use of latrines contaminated with blood or bloodied faeces appeared to be associated with particularly high levels of risk of Ebola virus transmission. More moderate levels of risk were associated with the collection and transportation of material contaminated with bodily fluids other than blood, shared use of latrines soiled with such fluids, the cleaning and shared use of fomites soiled with such fluids, and the contamination of the environment during the collection and transportation of blood-contaminated waste. The risk of the waste-related transmission of Ebola virus could be reduced by the use of full personal protective equipment, appropriate hand hygiene and an appropriate disinfectant after careful cleaning. Use of the Hazard Analysis of Critical Control Points framework could facilitate rapid responses to outbreaks of emerging infectious disease.

Most conventional water treatment plants are not sufficiently equipped to treat both intracellular and extracellular Microcystins in drinking water. However, the effectiveness of sodium hypochlorite in removing Microcystin in containers at the point-of-use is not yet known. This study aimed to assess point-of-use water container treatment using bleach or sodium hypochlorite (NaOCl) and to assess the health problems associated with microcystins. Thirty-nine percent (29 of 74) of the total selected households were randomly selected to receive and treat their stored container water with sodium hypochlorite. The level of microcystin in the container water was measured after 30 min of contact with sodium hypochlorite. Microcystin concentrations in both the blooming and decaying seasons were higher (mean 1.10, 95% CI 0.46–1.67 µg/L and mean 1.14, 95% CI 0.65–1.63 µg/L, respectively) than the acceptable limit of 1 µg/L in households that did not treat their water with NaOCl, whilst in those that did, there was a significant reduction in the microcystin concentration (mean 0.07, 95% CI 0.00–0.16 µg/L and mean 0.18, 95% CI 0.00–0.45 µg/L). In conclusion, sodium hypochlorite treatment decreased microcystin s to an acceptable level and reduced the related health problems.