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      Dramatic Reduction in Diarrhoeal Diseases through Implementation of Cost-Effective Household Drinking Water Treatment Systems in Makwane Village, Limpopo Province, South Africa

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          Abstract

          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.

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          Progress and barriers for the control of diarrhoeal disease.

          Discovery of intestinal sodium-glucose transport was the basis for development of oral rehydration solution, and was hailed as potentially the most important medical advance of the 20th century. Before widespread use of oral rehydration solution, treatment for diarrhoea was restricted to intravenous fluid replacement, for which patients had to go to a health-care facility to access appropriate equipment. These facilities were usually neither available nor reasonable to use in the resource-poor settings most affected by diarrhoea. Use of oral rehydration solution has stagnated, despite being effective, inexpensive, and widely available. Thus, diarrhoea continues to be a leading cause of child death with consistent mortality rates during the past 5 years. New methods for prevention, management, and treatment of diarrhoea-including an improved oral rehydration formulation, zinc supplementation, and rotavirus vaccines-make now the time to revitalise efforts to reduce diarrhoea mortality worldwide. Copyright 2010 Elsevier Ltd. All rights reserved.
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            Detection and characterization of diarrheagenic Escherichia coli from young children in Hanoi, Vietnam.

            Diarrhea continues to be one of the most common causes of morbidity and mortality among infants and children in developing countries. Escherichia coli is an emerging agent among pathogens that cause diarrhea. The development of a highly applicable technique for the detection of different categories of diarrheagenic E. coli is important. We have used multiplex PCR by combining eight primer pairs specific for enteroaggregative E. coli (EAEC), enteroinvasive E. coli (EIEC), enterohemorrhagic E. coli, enteropathogenic E. coli (EPEC), and enterotoxigenic E. coli (ETEC). This facilitates the identification of five different categories of diarrheagenic E. coli from stool samples in a single reaction simultaneously. The prevalences of diarrheagenic E. coli were 22.5 and 12% in the diarrhea group and the control group, respectively. Among 587 fecal samples from Vietnamese children under 5 years of age with diarrhea, this technique identified 132 diarrheagenic E. coli strains. This included 68 samples (11.6%) with EAEC, 12 samples (2.0%) with EIEC, 39 samples (6.6%) with EPEC, and 13 samples (2.2%) with ETEC. Among the 249 age-matched controls, 30 samples were positive for diarrheagenic E. coli. The distribution was 18 samples (7.2%) with EAEC, 11 samples (4.4%) with EPEC, and 1 sample (0.4%) with ETEC.
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              Reductions of E. coli, echovirus type 12 and bacteriophages in an intermittently operated household-scale slow sand filter.

              Point-of-use (POU) drinking water treatment technology enables those without access to safe water sources to improve the quality of their water by treating it in the home. One of the most promising emerging POU technologies is the biosand filter (BSF), a household-scale, intermittently operated slow sand filter. Over 500,000 people in developing countries currently use the filters to treat their drinking water. However, despite this successful implementation, there has been almost no systematic, process engineering research to substantiate the effectiveness of the BSF or to optimize its design and operation. The major objectives of this research were to: (1) gain an understanding of the hydraulic flow condition within the filter (2) characterize the ability of the BSF to reduce the concentration of enteric bacteria and viruses in water and (3) gain insight into the key parameters of filter operation and their effects on filter performance. Three 6-8 week microbial challenge experiments are reported herein in which local surface water was seeded with E. coli, echovirus type 12 and bacteriophages (MS2 and PRD-1) and charged to the filter daily. Tracer tests indicate that the BSF operated at hydraulic conditions closely resembling plug flow. The performance of the filter in reducing microbial concentrations was highly dependent upon (1) filter ripening over weeks of operation and (2) the daily volume charged to the filter. BSF performance was best when less than one pore volume (18.3-L in the filter design studied) was charged to the filter per day and this has important implications for filter design and operation. Enhanced filter performance due to ripening was generally observed after roughly 30 days. Reductions of E. coli B ranged from 0.3 log10 (50%) to 4 log10, with geometric mean reductions after at least 30 days of operation of 1.9 log10. Echovirus 12 reductions were comparable to those for E. coli B with a range of 1 log10 to >3 log10 and mean reductions after 30 days of 2.1 log10. Bacteriophage reductions were much lower, ranging from zero to 1.3 log10 (95%) with mean reductions of only 0.5 log10 (70%). These data indicate that virus reduction by BSF may differ substantially depending upon the specific viral agent.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                27 February 2018
                March 2018
                : 15
                : 3
                : 410
                Affiliations
                Department of Environmental, Water and Earth Sciences, Arcadia Campus, Tshwane University of Technology, P/B X 680, Pretoria 0001, South Africa; Bphumu@ 123456gmail.com (P.B.); monyatsil@ 123456tut.ac.za (L.M.-M.)
                Author notes
                [* ]Correspondence: moropengrc@ 123456tut.ac.za (R.C.M.); mombamnb@ 123456tut.ac.za (M.N.B.M.); Tel.: +27-12-382-6365 (M.N.B.M.); Fax: +27-12-382-6233 (M.N.B.M.)
                Author information
                https://orcid.org/0000-0002-3017-1287
                https://orcid.org/0000-0003-3537-0354
                Article
                ijerph-15-00410
                10.3390/ijerph15030410
                5876955
                29495483
                141fdf09-4aea-4952-a62d-b0a29c786043
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 16 January 2018
                : 20 February 2018
                Categories
                Article

                Public health
                diarrhoeal disease,hwts implementation,water and sanitation
                Public health
                diarrhoeal disease, hwts implementation, water and sanitation

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