Background: Some rural African communities residing along rivers use the untreated river water for domestic
purposes, making them vulnerable to waterborne diseases such as diarrhea.
Methods: We determined water use practices and water quality, relating them to prevalence of diarrhea in
communities along the Boro-Thamalakane-Boteti river system, northern Botswana. A total of 452 households were
interviewed and 196 water samples collected show during February, May, September, and December 2012 in
settlements of Boro, Maun, Xobe, Samedupi, Chanoga, and Motopi. Information was sought on water use practices
(collection, storage, and handling) and diarrheal experience using questionnaires. Water quality was assessed for
physicochemical and microbiological parameters using portable field meters and laboratory analysis, respectively.
Results: All (100 %) of the river water samples collected were fecally contaminated and unsuitable for domestic use
without prior treatment. Samples had
Escherichia coli
(
E. coli) and fecal streptococci levels reaching up to 186 and
140 CFU/100 ml, respectively. Study revealed high dependence on the fecally contaminated river water with low
uptake of water treatment techniques. Up to 48 % of households indicated that they experience diarrhea, with
most cases occurring during the early flooding season (May). Nonetheless, there was no significant relationship
between river water quality and households’ diarrheal experience across studied settlements (
p > 0.05). Failure to
treat river water before use was a significant predictor of diarrhea (
p = 0.028).
Conclusions: Even though the river water was unsafe for domestic use, results imply further recontamination of
water at household level highlighting the need for simple and affordable household water treatment techniques.
