Democratic Republic of the Congo. 13. Appui à la Lutte contre l'Oppression faite à l'Enfant et à la femme (ALOE), Uvira, Democratic Republic of the Congo. 14. Institut Supérieur des Techniques Médicales (ISTM) de Bukavu, Bukavu, Democratic Republic of the Congo.
This study evaluates the performance of commercial reverse osmosis (RO) and nanofiltration (NF) membranes for the removal of metal ions from synthetic water and surface water carried from the north-west of Lake Tanganyika in the city of Uvira, in the east of the Democratic Republic of Congo. Metal ion analyses were performed by the standardized ICP-MS and ICP-OES methods. The RO membrane showed higher metal ion rejection in high-concentration solutions (synthetic samples) prepared in the laboratory as well as in low-concentration samples from real raw water collected near Lake Tanganyika. Rejection levels were higher than 98% for Cr3+, Pb2+, Cd2+, As3+, Ni2+, and Sb+3 ions in the synthetic solutions, and 99.2, 98.8, 98.6, 99.2, 98.4, and 98.8%, respectively, in the real samples. The concentrations of metals in the permeate varied depending on the feed concentration and were 0.15 to 1.02 mg/L, 0.33 to 22 mg/L, and 0.11 to 22 mg/L in RO, NF90, and NF270 membranes, respectively. Regarding the NF membranes, the rejection of Cr, Ni, and Cd ions was interesting: 98.2, 97.8, and 92.3%, respectively. However, it was lower for Pb, As, and Sb ions: 76.9, 52.5 and 64.1%, respectively. The flux of NF was 329 to 375 L/m2.h, much higher than for RO membranes, which had a flux of 98 to 132 L/m2.h. The studied membranes are thus a feasible solution to remove the studied metals from real water sources at low concentrations since they meet the standards of the World Health Organization on specific values assigned to chemicals from industrial sources and human habitation areas where these ions are present in drinking water.
Introduction Diarrhoeal disease remains a leading cause of mortality and morbidity worldwide. Cholera alone is estimated to cause 95,000 deaths per year, most of which occur in endemic settings with inadequate water access. Whilst a global strategy to eliminate cholera by 2030 calls for investment in improved drinking water services, there is limited rigorous evidence for the impact of improved water supply on endemic cholera transmission in low-income urban settings. Our protocol is designed to deliver a pragmatic health impact evaluation of a large-scale water supply intervention in Uvira (Democratic Republic of the Congo), a cholera transmission hotspot. Methods/design A stepped-wedge cluster randomised trial (SW-CRT) was designed to evaluate the impact of a large-scale drinking water supply intervention on cholera incidence among the 280,000 inhabitants of Uvira. The city was divided into 16 clusters, where new community and household taps will be installed following a randomised sequence over a transition period of up to 8 weeks in each cluster. The primary trial outcomes are the monthly incidence of “confirmed” cholera cases (patients testing positive by rapid detection kit) and of “suspected” cholera cases (patients admitted to the cholera treatment centre). Concurrent process and economic evaluations will provide further information on the context, costs, and efficiency of the intervention. Discussion In this protocol, we describe a pragmatic approach to conducting rigorous research to assess the impacts of a complex water supply intervention on severe diarrhoeal disease and cholera in an unstable, low-resource setting representative of cholera-affected areas. In particular, we discuss a series of pre-identified risks and linked mitigation strategies as well as the value of combining different data collection methods and preparation of multiple analysis scenarios to account for possible deviations from the protocol. The study described here has the potential to provide robust evidence to support more effective cholera control in challenging, high-burden settings. Trial registration This trial is registered on clinicaltrials.gov (NCT02928341, 10th October 2016) and has received ethics approval from the London School of Hygiene and Tropical Medicine (8913, 10603) and from the Ethics Committee from the School of Public Health, University of Kinshasa, Democratic Republic of the Congo (ESP/CE/088/2015).
Introduction. Diarrhoeal disease remains a leading cause of mortality and morbidity worldwide. Cholera alone is estimated to cause 95,000 deaths per year, most of which occur in endemic settings with inadequate water access. Whilst a global strategy to eliminate cholera by 2030 calls for investment in improved drinking water services, there is limited rigorous evidence for the impact of improved water supply on endemic cholera transmission in low-income urban settings. Our protocol is designed to deliver a pragmatic health impact evaluation of a large-scale water supply intervention in Uvira (Democratic Republic of the Congo), a cholera transmission hotspot. Methods/Design.A stepped-wedge cluster randomised trial (SW-CRT) was designed to evaluate the impact of a large-scale drinking water supply intervention on cholera incidence among the 280,000 inhabitants of Uvira. The city was divided into 16 clusters, where new community and household taps will be installed following a randomised sequence over a transition period of up to 8 weeks in each cluster. The primary trial outcomes are the monthly incidence of “confirmed” cholera cases (patients testing positive by rapid detection kit) and of “suspected” cholera cases (patients admitted to the cholera treatment centre). Concurrent process and economic evaluations will provide further information on the context, costs and efficiency of the intervention. Discussion.In this protocol, we describe a pragmatic approach to conducting rigorous research to assess the impacts of a complex water supply intervention on severe diarrhoeal disease and cholera in an unstable, low-resource setting representative of cholera-affected areas. In particular, we discuss a series of pre-identified risks and linked mitigation strategies as well as the value of combining different data collection methods and preparation of multiple analysis scenarios to account for possible deviations from the protocol. The study described here has the potential to provide robust evidence to support more effective cholera control in challenging, high-burden settings. Trial registration. This trial is registered on clinicaltrials.gov (NCT02928341, 10th October 2016, https://clinicaltrials.gov/ct2/show/NCT02928341) and has received ethics approval from the London School of Hygiene and Tropical Medicine (8913, 10603) and from the Ethics Committee from the School of Public Health, University of Kinshasa, Democratic Republic of the Congo (ESP/CE/088/2015).
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