Department of Microbiology, University of Venda, Thohoyandou, South Africa.
Research Office, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
BMC Fam Pract. 2021 Jan 4;22(1):8. doi: 10.1186/s12875-020-01346-z.
South Africa has unique and diverse social and economic factors that have an impact on the provision of basic water, sanitation, hygiene and waste management infrastructure and practices at health care facilities in ensuring patient safety and prevent the spread of diseases.
The aim of this study was to evaluate water, sanitation and hygiene access and standards at 50 government owned public health care clinics in the rural region of the Vhembe district of South Africa during 2016/2017, using self-observation, an observation checklist, record reviews and interviews with clinic managers. Water quality from all available water sources on the clinic compound was analysed for Total coliform and E. coli counts using the Colilert Quanti-tray/2000 system. The prevalence of pathogenic diarrhea causing E. coli strains was established using multiplex-Polymerase Chain Reaction.
The health care clinics in the Vhembe District generally complied with the basic WASH services guidelines according to the World Health Organisation. Although 80% of the clinics used borehole water which is classified as an improved water source, microbiological assessment showed that 38% inside taps and 64% outside taps from the clinic compounds had TC counts higher than guideline limits for safe drinking. Similarly, EC counts above the guideline limit for safe drinking water were detected in 17% inside taps and 32% outside taps from the clinic compounds. Pathogenic EAEC, EPEC, ETEC and EHEC strains were isolated in the collected water samples. Although improved sanitation infrastructures were present in most of the clinics, the sanitary conditions of these toilets were not up to standard. Waste systems were not adequately managed. A total of 90% of the clinics had hand washing basins, while only 61% of the clinics had soap present and only 64% of the clinics had adequate signs and posters reminding the staff, care givers and patients to wash their hands.
Various WASH aspects within the primary health care system in South Africa needs to be improved and corrected. A more rigorous system that is inclusive of all role players in the WASH sectors, with regular monitoring and training sessions, should be used.
南非具有独特且多样化的社会和经济因素，这些因素对医疗保健设施提供基本的水、环境卫生和废物管理基础设施和实践产生影响，以确保患者安全和防止疾病传播。
本研究旨在评估南非 Vhembe 地区 50 家政府拥有的公立医疗保健诊所 2016/2017 年期间的水、环境卫生和个人卫生设施的获取情况和标准，使用自我观察、观察检查表、记录审查和与诊所经理面谈的方法。使用 Colilert Quanti-tray/2000 系统分析诊所大院中所有可用水源的总大肠菌群和大肠杆菌计数。使用多重聚合酶链反应确定致病腹泻引起的大肠杆菌菌株的流行率。
Vhembe 区的医疗保健诊所普遍符合世界卫生组织的基本 WASH 服务指南。尽管 80%的诊所使用的是被归类为改良水源的水井水，但微生物评估显示，诊所大院内部水龙头的 38%和外部水龙头的 64%的 TC 计数高于安全饮用水的指南限值。同样，诊所大院内部水龙头的 17%和外部水龙头的 32%的 EC 计数超过安全饮用水的指南限值。在采集的水样中分离出致病性 EAEC、EPEC、ETEC 和 EHEC 菌株。尽管大多数诊所都存在改良的卫生基础设施，但这些厕所的卫生条件不符合标准。废物系统管理不善。90%的诊所都有洗手盆，而只有 61%的诊所提供肥皂，只有 64%的诊所提供足够的标志和海报提醒工作人员、护理人员和患者洗手。
南非初级卫生保健系统的各种 WASH 方面需要改进和纠正。应采用更严格的系统，包括 WASH 部门的所有利益相关者，并定期进行监测和培训。
