title: Contribution of water pollution from inadequate sanitation and housing quality to diarrheal disease in low-cost housing settlements of Cape Town, South Africa.
abstract: OBJECTIVE
  We investigated the effects of failing sanitation, poor housing conditions, and fecal pollution in runoff water on the health-particularly the incidence of diarrheal disease-of residents of low-cost housing settlements in Cape Town, South Africa.
  
  
  METHODS
  In November 2009, we conducted a cross-sectional survey with structured interviews in 4 communities (n = 336 dwellings; 1080 persons). We used Colilert defined-substrate technology to determine Escherichia coli levels in runoff water samples taken from the study communities.
  
  
  RESULTS
  Almost 15% of households disposed of soiled products in storm water drains and 6% disposed of soiled products in the street. In only 26% of the dwellings were toilets washed daily. Approximately 59% of dwellings lacked a tap near the toilet for hand washing, and 14% of respondents suffered 1 or more attacks of diarrhea in the 2 weeks preceding their interview. E.coli counts of runoff environmental water samples ranged from 750 to 1 580 000 000 per 100 milliliters.
  
  
  CONCLUSIONS
  A holistic and integrated approach is needed to improve housing quality and sanitation among Cape Town's low-income citizens.
authors.affiliation: Division of Community Health, Dept of Interdisciplinary Health Sciences, Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa. govender.thashlin@gmail.com
authors.forename: Thashlin
authors.initials: T
authors.lastname: Govender
authors.forename: Jo M
authors.initials: JM
authors.lastname: Barnes
authors.forename: Clarissa H
authors.initials: CH
authors.lastname: Pieper
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D002648:Child; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006798:Housing; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000706:statistics & numerical data*; D012499:Sanitation / Q000592:standards; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014865:Waste Disposal, Fluid; D014871:Water Microbiology; D014876:Water Pollution / Q000009:adverse effects*; D055815:Young Adult