The Epidemiology and cost of treating Diarrhoea in South Africa. Volume 1: Prevalence of Diarrheagenic pathogens in water sources in the Vhembe District of the Limpopo Province.

Contaminated water can lead to waterborne disease outbreaks (Levy, 2015). Water is a vehicle for the transmission of pathogenic bacteria, viruses and parasites to humans, which cause waterborne illnesses such as diarrhoea (Lewin et al., 2007; Samie et al., 2009; Batabyal et al., 2013; Mobasa et al., 2017). Multiple routes of transmission on exposure as well as some multiple infectious and non-infectious diarrhoea pathogens make it difficult to impossible to accurately identify the specific pathogen(s) responsible for a specific diarrhoea episode (Levy, 2015). Several studies have shown that it is not always possible to make an association between water quality and diarrhoea (Gundry et al., 2004). Even if a water sample is collected from a household storage container on a specific day and moment, this does not guarantee that this water caused the diarrhoea seen in the child or any other member of the household. Many factors within a household and environment could be responsible for a diarrhoea episode (Gundry et al., 2004). Prevention of water pollution requires effective and continuous monitoring of physical, chemical and microbiological parameters to ascertain the possible risks associated with water from a particular source (Chandra et al., 2006). This is however not done regularly in developing countries due to limited or non-existing resources, which results in some diarrheal outbreaks going unnoticed (Zamxaka et al., 2004). In South Africa, almost 80% of the population still depend on surface water and groundwater as their main source of water for domestic purposes. This water is stored in various types of container without any treatment (Venter, 2001). As a result, many vulnerable people in rural and peri-urban communities are exposed to waterborne pathogens (Smith et al., 2006). There are very few studies and reports on waterborne diarrhoea in the rural communities in the Vhembe region and it is highly possible that some diarrhoea cases go unreported. A possible link between diarrhoea and water quality in the Vhembe region has been established (Bessong et al., 2009). Therefore, continuous monitoring of water quality is necessary to assess the possible risks associated with water sources used in the rural communities in the Vhembe region.