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Resource-limited communities throughout the developing world face significant environmental health problems related to the myriad of coliform sources within those communities. This study comprehensively investigated contamination sources and the biological and chemical mechanisms sustaining them in two adjacent communities in rural Limpopo, South Africa. An 8-month study was conducted of household () and source water quality, measurements of biofilm layers on the inside of household water storage containers and water transfer devices, and also hand-based coliforms and hand-washing effectiveness. A 7-day water container incubation experiment was also performed to determine the biological and chemical changes that occur in a household water storage container independent of human interference. Results indicate that household drinking water frequently becomes contaminated after collection but before consumption (197 versus 1,046 colony-forming ; ; ). The most important contamination sources include biofilm layers on the inside of storage containers ( colony-forming ; ), hands ( colony-forming ; ), and coliform regrowth resulting from high assimilable organic carbon (AOC) levels during storage. A maximum specific growth rate, , of was determined for total coliform bacteria on AOC, and a high correlation between AOC concentrations and the growth potential of total coliform bacteria was observed. These results support the implementation of point-of-use water treatment and other interventions aimed at maintaining the safe water chain and preventing biological regrowth. [ABSTRACT FROM AUTHOR]

Researchers have long studied the causes and prevention strategies of poor household water quality and early childhood diarrhea using intervention-control trials. Although the results of such trails can lead to useful information, they do not capture the complexity of this natural/engineered/social system. We report on the development of an agent-based model (ABM) to study such a system in Limpopo, South Africa. The study is based on four years of field data collection to accurately capture essential elements of the communities and their water contamination chain. An extensive analysis of those elements explored behaviors including water collection and treatment frequency as well as biofilm buildup in water storage containers, source water quality, and water container types. Results indicate that interventions must be optimally implemented in order to see significant reductions in early childhood diarrhea (ECD). Household boiling frequency, source water quality, water container type, and the biofilm layer contribution were deemed to have significant impacts on ECD. Furthermore, concurrently implemented highly effective interventions were shown to reduce diarrhea rates to very low levels even when other, less important practices were suboptimal. This technique can be used by a variety of stakeholders when designing interventions to reduce ECD incidences in similar settings. [ABSTRACT FROM AUTHOR]