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Open AccessArticle

Diarrhoeal Disease in Relation to Possible Household Risk Factors in South African Villages

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Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2028, South Africa
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Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2028, South Africa
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School of Public Health, University of the Witwatersrand, Johannesburg 2028, South Africa
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Natural Resources and the Environment, Council for Scientific and Industrial Research, Private Bag x395, Pretoria 0001, South Africa
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Environment and Health Research Unit, South African Medical Research Council, Pretoria 0084, South Africa
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Department of Geography, Geoinformatics and Meteorology, Private Bag X20, Hatfield, Pretoria 0028, South Africa
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(8), 1665; https://doi.org/10.3390/ijerph15081665
Received: 18 June 2018 / Revised: 27 July 2018 / Accepted: 3 August 2018 / Published: 6 August 2018
(This article belongs to the Section Environmental Health)
Diarrhoeal disease is a significant contributor to child morbidity and mortality, particularly in the developing world. Poor sanitation, a lack of personal hygiene and inadequate water supplies are known risk factors for diarrhoeal disease. Since risk factors may vary by population or setting, we evaluated the prevalence of diarrhoeal disease at the household level using a questionnaire to better understand household-level risk factors for diarrhoea in selected rural areas in South Africa. In a sub-sample of dwellings, we measured the microbial quality of drinking water. One in five households had at least one case of diarrhoea during the previous summer. The most widespread source of drinking water was a stand-pipe (inside yard) (45%) followed by an indoor tap inside the dwelling (29%). Storage of water was common (97%) with around half of households storing water in plastic containers with an opening large enough to fit a hand through. After adjusting for confounders, the occurrence of diarrhoea was statistically significantly associated with sourcing water from an indoor tap (Adjusted Odds Ratio (AOR): 2.73, 95% CI: 2.73, 1.14–6.56) and storing cooked/perishable food in non-refrigerated conditions (AOR: 2.17, 95% CI: 2.17, 1.44–3.26). The highest total coliform counts were found in water samples from kitchen containers followed by stand-pipes. Escherichia coli were most often detected in samples from stand-pipes and kitchen containers. One in four households were at risk of exposure to contaminated drinking water, increasing the susceptibility of the study participants to episodes of diarrhoea. It is imperative that water quality meets guideline values and routine monitoring of quality of drinking water is done to minimise diarrhoea risk in relevant rural communities. The security of water supply in rural areas should be addressed as a matter of public health urgency to avoid the need for water storage. View Full-Text
Keywords: diarrhoea; water quality; water storage; environmental health; South Africa diarrhoea; water quality; water storage; environmental health; South Africa
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Kapwata, T.; Mathee, A.; Le Roux, W.J.; Wright, C.Y. Diarrhoeal Disease in Relation to Possible Household Risk Factors in South African Villages. Int. J. Environ. Res. Public Health 2018, 15, 1665.

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