title: Ceramic water filters impregnated with silver nanoparticles as a point-of-use water-treatment intervention for HIV-positive individuals in Limpopo Province, South Africa: a pilot study of technological performance and human health benefits.
abstract: Waterborne pathogens present a significant threat to people living with the human immunodeficiency virus (PLWH). This study presents a randomized, controlled trial that evaluates whether a household-level ceramic water filter (CWF) intervention can improve drinking water quality and decrease days of diarrhea in PLWH in rural South Africa. Seventy-four participants were randomized in an intervention group with CWFs and a control group without filters. Participants in the CWF arm received CWFs impregnated with silver nanoparticles and associated safe-storage containers. Water and stool samples were collected at baseline and 12 months. Diarrhea incidence was self-reported weekly for 12 months. The average diarrhea rate in the control group was 0.064 days/week compared to 0.015 days/week in the intervention group (p < 0.001, Mann-Whitney). Median reduction of total coliform bacteria was 100% at enrollment and final collection. CWFs are an acceptable technology that can significantly improve the quality of household water and decrease days of diarrhea for PLWH in rural South Africa.
authors.affiliation: Department of Civil and Environmental Engineering, University of Virginia, PO Box 400742, 351 McCormick Road, Thornton Hall, Rm. B228, Charlottesville, VA 22908, USA.
authors.forename: Lydia Shawel
authors.initials: LS
authors.lastname: Abebe
authors.affiliation: Department of Civil and Environmental Engineering, University of Virginia, PO Box 400742, 351 McCormick Road, Thornton Hall, Rm. B228, Charlottesville, VA 22908, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: Smith
authors.affiliation: Department of Civil Engineering, University of Rhode Island, Bliss Hall 213, Kingston, RI 02881, USA.
authors.forename: Sophia
authors.initials: S
authors.lastname: Narkiewicz
authors.affiliation: Department of Civil Engineering, University of Rhode Island, Bliss Hall 213, Kingston, RI 02881, USA.
authors.forename: Vinka
authors.initials: V
authors.lastname: Oyanedel-Craver
authors.affiliation: Department of Public Health Sciences, Public Health Sciences Hospital West, University of Virginia, PO Box 800717, 3181, Charlottesville, VA, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Conaway
authors.affiliation: Department of Microbiology, University of Venda, Department of Chemistry, University of Venda, Private Bag X5050, Thohoyandou 0950, Limpopo Province, South Africa.
authors.forename: Alukhethi
authors.initials: A
authors.lastname: Singo
authors.affiliation: Department of Microbiology, University of Venda, Department of Chemistry, University of Venda, Private Bag X5050, Thohoyandou 0950, Limpopo Province, South Africa.
authors.forename: Samie
authors.initials: S
authors.lastname: Amidou
authors.affiliation: Department of Microbiology, University of Venda, Department of Chemistry, University of Venda, Private Bag X5050, Thohoyandou 0950, Limpopo Province, South Africa.
authors.forename: Paul
authors.initials: P
authors.lastname: Mojapelo
authors.affiliation: Department of Medicine, University of Virginia, PO Box 801379, Charlottesville, VA, USA E-mail: rd8v@virginia.edu.
authors.forename: Julia
authors.initials: J
authors.lastname: Brant
authors.affiliation: Department of Medicine, University of Virginia, PO Box 801379, Charlottesville, VA, USA E-mail: rd8v@virginia.edu.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Dillingham
mesh_terms: D000328:Adult; D002516:Ceramics / Q000627:therapeutic use; D003457:Cryptosporidiosis / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control; D003458:Cryptosporidium / Q000302:isolation & purification; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology / Q000469:parasitology / Q000517:prevention & control*; D060766:Drinking Water / Q000032:analysis* / Q000382:microbiology / Q000469:parasitology; D004755:Enterobacteriaceae / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D005243:Feces / Q000382:microbiology / Q000469:parasitology; D005260:Female; D005374:Filtration / Q000379:methods*; D006679:HIV Seropositivity / Q000453:epidemiology / Q000821:virology; D006801:Humans; D008297:Male; D053768:Metal Nanoparticles / Q000737:chemistry*; D008875:Middle Aged; D010865:Pilot Projects; D060888:Real-Time Polymerase Chain Reaction; D012424:Rural Population; D012834:Silver / Q000737:chemistry; D013019:South Africa / Q000453:epidemiology; D018508:Water Purification / Q000379:methods*; D060753:Water Quality; D055815:Young Adult
chemical_list: D060766:Drinking Water; D012834:Silver