Waterborne pathogens present a significant threat to people living with the human immunodeficiency virus (PLWH). This study presents a randomized, controlled trial that evaluates whether a household-level ceramic water filter (CWF) intervention can improve drinking water quality and decrease days of diarrhea in PLWH in rural South Africa. Seventy-four participants were randomized in an intervention group with CWFs and a control group without filters. Participants in the CWF arm received CWFs impregnated with silver nanoparticles and associated safe-storage containers. Water and stool samples were collected at baseline and 12 months. Diarrhea incidence was self-reported weekly for 12 months. The average diarrhea rate in the control group was 0.064 days/week compared to 0.015 days/week in the intervention group (p < 0.001, Mann-Whitney). Median reduction of total coliform bacteria was 100% at enrollment and final collection. CWFs are an acceptable technology that can significantly improve the quality of household water and decrease days of diarrhea for PLWH in rural South Africa.

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Background: Most communities in developing countries rely on traditional medicines for the treatment of diseases. In South Africa, the Limpopo province, within the Lebowakgomo district, uses tuberous roots of Kirkia wilmsii, after infusion in water for the treatment of a wide range of diseases by Sotho communities. Materials and Methods:The main objective of the study was to assess the anti-microbial activity of separated aqueous components of the Kirkia wilmsii tuberous roots. The clear aqueous extracts that were obtained after a 0.45 µm membrane filtration (Millipore Millex-HV Hydrophillic PVDF filter), were then injected into a preparative high performance liquid chromatography instrument in which pure components, as shown by peaks, were collected and evaluated for anti-microbial activity against a range of microorganisms. Results: The eight separated components were obtained, out of which four components showed anti-microbial activity (AMA). The freeze dried components were re-dissolved in deionised water and then evaluated for AMA against Vibrio cholerae, Shigella dysenteriae, Aeromonas hydrophilia, Salmonella typhi Proteus mirabilis, Escherichia coli, Staphylococcus aureus, Candida albicans and Enterobacter aerogenes.Component one exhibited antimicrobial activity against Shigella dysenteriae, Aeromonas hydrophilia, Salmonella typhi, Proteus mirabilis, Escherichia coli and Staphylococcus aureus with a minimum inhibitory concentration (MIC), of 3.445 mg/ml. Component five was only active against Proteus mirabilis with a MIC of 0.08 mg/ml. Component 7, was active against Shigella dysenteriae, Staphylococcus aureus and Escherichia coli with a MIC of 0.365 mg/ml against both Shigella dysenteriae and Staphylococcus aureus and 0.091 mg/ml against Escherichia coli. Component 8, was active against Shigella, Aeromonas hydrophilia, Salmonella, Proteus mirabilis, Escherichia coli with a MIC of 155 mg/ml. Conclusion: Only four out of eight aqueous extracts showed AMA against both gram negative and positive bacteria and showed no AMA against Candida albicans, Enterobacter aerogenes and Vibrio cholerae. Therefore the Kirkia wilmsii plant root may be used as a broad spectrum antibiotic.

In the present study, the physical and chemical quality of several borehole water sources, used by rural schools in Greater Giyani Municipality, were assessed to determine their safety for human consumption. Atomic absorption spectroscopy and ion chromatography were used to determine the chemical quality of water sources. The pH of the water samples varied between 5.29 and 8.3 and tended to be lower in summer and higher in winter. The turbidity values varied between 6.17 and 44.7 NTU in some of the schools. High concentrations of magnesium and total hardness were obtained from all water sources. Calcium concentrations were high in some schools. Anions such as chloride and sulphate were within the recommended Department of Water Affairs and Forestry (DWAF) limits except for two sampling points. High concentrations of nitrates were obtained from all schools except in Nyanisi high school. There were no fluorides and phosphates from all schools. Heavy metals like arsenic, iron, cadmium and lead were within the recommended DWAF limits. The results obtained in this study indicate that the water from the studied boreholes is not suitable for human consumption based on hardness and nitrate content and may pose a serious threat to the health of the consumers and therefore calls for urgent intervention in order to reduce such chemicals and preserve the health of the children.

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