A scoping study on the prevalence of Escherichia coli and Enterococcus species in harvested rainwater stored in tanks

Rainwater harvesting (RWH) is a relatively inexpensive technology that has the potential to provide safe water in communities where conventional technologies are difficult to implement. In this study, the microbiological quality of rainwater harvested from rooftops and ground-surface runoff was evaluated based on the concentrations of Escherichia coli, total coliforms and enterococci. Samples were collected from 15 roof-harvested rainwater (RHRW) tanks, 4 ground-surface runoff rainwater harvesting (GRWH) tanks, 3 rivers and 1 spring water source in the Eastern Cape Province of South Africa, and 14 RHRW tanks in Gauteng Province. In the Eastern Cape Province E. coli and enterococci were detected in 7 and 4 of the 15 RHRW tanks, respectively. Enterococci were detected only from one river whereas E. coli was detected in all three rivers; in spring water neither enterococci nor E. coli were detected. Samples from GRWH tanks were positive for E. coli and enterococci in 2 and 3 of the 4 tanks, respectively. In Gauteng Province, E. coli, coliforms and enterococci were detected from 6, 6 and 9 of the 14 rainwater tanks, respectively. On average, E. coli and enterococci were detected in 44.8% of the RHRW tanks, although enterococci concentrations were several times higher than those for E. coli. We further evaluated the significance of urban pigeons as the likely sources of contamination by isolating 156 enterococci from 30 pigeon faecal samples and 208 enterococci from RHRW samples collected from Gauteng Province. Matrix-assisted laser desorption ionisation identification of the various enterococci revealed 4 species – E. faecalis (20.5%), E. mundtii (20.51%), E. faecium (23.1%) and E. casseliflavus (17.3%) – to be dominant in faecal samples, whereas E. casseliflavus (34.6%) and E. mundtii (33.2%) were dominant in RHRW.Keywords: rainwater harvesting, contamination, indicator bacteria, health risk

Independent and combined effects of improved water, sanitation, and hygiene, and improved complementary feeding, on child stunting and anaemia in rural Zimbabwe: a cluster-randomised trial.

BACKGROUND: Child stunting reduces survival and impairs neurodevelopment. We tested the independent and combined effects of improved water, sanitation, and hygiene (WASH), and improved infant and young child feeding (IYCF) on stunting and anaemia in in Zimbabwe. METHODS: We did a cluster-randomised, community-based, 2 × 2 factorial trial in two rural districts in Zimbabwe. Clusters were defined as the catchment area of between one and four village health workers employed by the Zimbabwe Ministry of Health and Child Care. Women were eligible for inclusion if they permanently lived in clusters and were confirmed pregnant. Clusters were randomly assigned (1:1:1:1) to standard of care (52 clusters), IYCF (20 g of a small-quantity lipid-based nutrient supplement per day from age 6 to 18 months plus complementary feeding counselling; 53 clusters), WASH (construction of a ventilated improved pit latrine, provision of two handwashing stations, liquid soap, chlorine, and play space plus hygiene counselling; 53 clusters), or IYCF plus WASH (53 clusters). A constrained randomisation technique was used to achieve balance across the groups for 14 variables related to geography, demography, water access, and community-level sanitation coverage. Masking of participants and fieldworkers was not possible. The primary outcomes were infant length-for-age Z score and haemoglobin concentrations at 18 months of age among children born to mothers who were HIV negative during pregnancy. These outcomes were analysed in the intention-to-treat population. We estimated the effects of the interventions by comparing the two IYCF groups with the two non-IYCF groups and the two WASH groups with the two non-WASH groups, except for outcomes that had an important statistical interaction between the interventions. This trial is registered with ClinicalTrials.gov, number NCT01824940. FINDINGS: Between Nov 22, 2012, and March 27, 2015, 5280 pregnant women were enrolled from 211 clusters. 3686 children born to HIV-negative mothers were assessed at age 18 months (884 in the standard of care group from 52 clusters, 893 in the IYCF group from 53 clusters, 918 in the WASH group from 53 clusters, and 991 in the IYCF plus WASH group from 51 clusters). In the IYCF intervention groups, the mean length-for-age Z score was 0·16 (95% CI 0·08-0·23) higher and the mean haemoglobin concentration was 2·03 g/L (1·28-2·79) higher than those in the non-IYCF intervention groups. The IYCF intervention reduced the number of stunted children from 620 (35%) of 1792 to 514 (27%) of 1879, and the number of children with anaemia from 245 (13·9%) of 1759 to 193 (10·5%) of 1845. The WASH intervention had no effect on either primary outcome. Neither intervention reduced the prevalence of diarrhoea at 12 or 18 months. No trial-related serious adverse events, and only three trial-related adverse events, were reported. INTERPRETATION: Household-level elementary WASH interventions implemented in rural areas in low-income countries are unlikely to reduce stunting or anaemia and might not reduce diarrhoea. Implementation of these WASH interventions in combination with IYCF interventions is unlikely to reduce stunting or anaemia more than implementation of IYCF alone. FUNDING: Bill & Melinda Gates Foundation, UK Department for International Development, Wellcome Trust, Swiss Development Cooperation, UNICEF, and US National Institutes of Health.The SHINE trial is funded by the Bill & Melinda Gates Foundation (OPP1021542 and OPP113707); UK Department for International Development; Wellcome Trust, UK (093768/Z/10/Z, 108065/Z/15/Z and 203905/Z/16/Z); Swiss Agency for Development and Cooperation; US National Institutes of Health (2R01HD060338-06); and UNICEF (PCA-2017-0002)

Severe acute malnutrition promotes bacterial binding over proinflammatory cytokine secretion by circulating innate immune cells.

Children with severe acute malnutrition (SAM) have high infectious mortality and morbidity, implicating defects in their immune defenses. We hypothesized that circulating innate immune cells from children (0 to 59 months) hospitalized with SAM in Zambia and Zimbabwe (n = 141) have distinct capacity to respond to bacteria relative to adequately nourished healthy controls (n = 92). SAM inpatients had higher neutrophil and monocyte Escherichia coli binding capacity but lower monocyte activation and proinflammatory mediator secretion in response to lipopolysaccharide or heat-killed Salmonella typhimurium than controls. Among SAM cases, wasting severity was negatively associated with cytokine secretion, children with HIV had lower monocyte activation, and the youngest children released the least myeloperoxidase upon stimulation. Inpatient bacterial binding capacity and monocyte activation were associated with higher odds of persistent SAM at discharge, a risk factor for subsequent mortality. Thus, SAM shifts innate immune cell function, favoring bacterial containment over proinflammatory activation, which may contribute to health deficits after discharge

Spatial and temporal variations in pollution indicator bacteria in the lower Vaal River, South Africa

The aim of this study was to evaluate the spatial and temporal variation of microbiological parameters of the Lower Vaal River, with emphasis on the Staphylococci population. River water concentrations of Staphylococci, heterotrophic, total coliforms, fecal coliforms and Streptococci groups of sanitary indicator bacteria were monitored. Results indicated significant contamination from agricultural land use inputs and municipal waste applications. Significant temporal and spatial variation was observed in response to the varying river discharge. Higher microbial concentrations were detected during high river discharge whereas during low river discharge both low and high microbial concentrations were detected. The varying responses associated with river discharge helped to identify the importance of different sources of contamination in the catchment and the mechanisms transferring them. The overall impact of contamination on the water quality of the Vaal River could have potentially serious public health risks but also provide valuable data for integrated water resource managemen