An Integrated Approach to Hygiene, Sanitation, and Storage Practices for Improving Microbial Quality of Drinking Water Treated at Point of Use: A Case Study in Makwane Village, South Africa.

This study assessed the impact of sanitation practices, hygienic and storage conditions on the quality of drinking water treated at point-of-use in Makwane Village. Subsequent to implementation of low-cost Household Water Treatment Devices which are the biosand filter with zeolite-silver (BSZ-SICG) and silver-impregnated porous pot (SIPP) filters in Makwane village, a structured questionnaire was designed to collect the following information: age of caretakers, number of children under the age of five, water storage conditions, sanitation amenities, and hygiene practices. Water quality from the sources to household level was assessed using culture-based and molecular techniques. The results revealed a significant association between the presence of Escherichia coli in treated drinking water with the age group of caregivers and the number of children ofless than the age of five [OR (95% CI) = 8.4737 (0.147-3.3497), p = 0.0141923 and OR (95% CI) = 9.1667 (0.1848-3.0159); p = 0.0165830, respectively]. Moreover, significant association was noted between hygiene practices (washing of hands with/without soap) and water quality in storage containers [OR (95% CI) = 16.000 (0.6763-3.9495), p = 0.0000125]. These findings further prove that there is still a dire need for reconsidering hygiene education in rural areas as the health benefits of water treated at point of use (POU) coupled with safe-storage condition interventions might not be guaranteed without proper hygiene. The results further highlighted the importance of washing hands in improving microbial quality of drinking water, which is the key factor for fighting against infectious diseases.