Hospital-acquired Legionnaires¡¦ Disease (LD) is a bacterial pneumonia caused by the genus of Legionella. It is an opportunistic pathogen with the characteristic of widespread distribution in the environment. Its source of infection associates with potable water systems. Proactively culturing hospital water supply for Legionella as a strategy for prevention of nosocomial LD has been widely adopted in other countries. Nosocomial LDs has been hardly reported in Taiwan. In addition, environmental cultures of Legionella in potable water systems in hospitals have not been systematically implemented. Thus, the purpose of the research is to confirm if LD presents in the hospital in Taiwan, and developing risk management strategy in hospital-acquired LD. To practice one-year prospective surveillance program for LD, we choose a military hospital in Southern Taiwan, collecting the specimens from the nosocomial and community-acquired pneumonia patients for legionella investigations. In the meanwhile, we collect water samples for hospital epidemiological investigation every 3 months. Isolated Legionella pneumophila is serotyped and analyzed by pulsed-field gel electrophoresis. From Nov 1, 2006 to Oct 30, 2007, within 54 cases of nosocomial and 300 cases of community-acquired pneumonia, only one case of nosocomial LD was found. Environmental investigations detected L. pneumophila in 17(20.7%) of the 84 water samples, of which 82.4% (14/17) belonged to serogroup 1. The result demonstrated the infection source of the only positive case of nosocominal pneumonia is the potable water supply system of another hospital. In conclusion: 1. The infection source of nosocomial LD is the potable water supply system of the hospital. 2. The positive rate of distal outlets for L. pneumophila is a reasonable and reliable indicator in risk management for nosocomial LD. 3. Uncovered cases of nosocomial LD will be found in prospective clinical surveillance for LD. Suggestions: 1. Routine water-quality monitoring should be added in environmental water culture for L. pneumophila in the institution, such as hospital, nursing home, hotel, restaurant, SPA, swimming pool, hot spring, school, army, etc. 2. We advise that government health department carries out national surveillance for hospital water environment in determining the risk of hospital-acquired LD. 3. Education and training program need to be provided for medical staffs in the diagnostic skills of nosocomial LD to avoid misdiagnosing and delaying the treatment.

En la actualidad, la cobertura de agua potable en el país aún es insuficiente, sobre todo en las zonas rurales del país; de manera similar este problema se presenta en las zonas periurbanas de Lima. Tal como en La Rinconada de Pamplona Alta que se encuentra ubicada en el distrito San Juan de Miraflores, el cual no cuenta con servicio básico de agua potable, el abastecimiento de este recurso se realiza mediante camiones cisterna y son almacenados en tanques, bidones, baldes, etc. Es por ello, que la presente investigación plantea una propuesta de diseño del sistema de abastecimiento de agua potable para la zona de estudio, para lo cual se toma en consideración que el caudal requerido será brindado por SEDAPAL. Debido a que la topografía de la zona de estudio presenta pendientes pronunciadas es necesario utilizar válvulas reductoras de presión, cuya localización se realiza a través de la aplicación del Algoritmo Genético Multiobjetivo, el cual en su codificación incluye el uso del Epanet Programmer’s Toolkit, que viene a ser una biblioteca dinámica (DLL) de funciones que permite a los programadores personalizar el motor de cálculo de EPANET para sus necesidades específicas. En ese sentido, el método utilizado plantea una propuesta de mejora en el proceso de diseño del sistema de abastecimiento de agua potable en La Rinconada de Pamplona Alta del distrito de San Juan de Miraflores. Para lo cual, se utilizó el programa EPANET en la simulación y cálculo hidráulico de la red de distribución por ser un programa de comprobada eficacia y de uso libre. Por otro lado, el resultado del análisis hidráulico de los proyectos de agua potable que se realizan en el país tanto por métodos manuales iterativos o con ayuda de programas de simulación, muchas veces no cumplen con las exigencias del rango de presiones admisibles establecido por el Reglamento Nacional de Edificaciones, lo cual se traduce por un lado en costos de cumplir programas de mantenimiento que suplan estas deficiencias y por otro lado posibles roturas de tuberías o fugas de agua debido a altas presiones. Es por ello que se busca cumplir con los requisitos exigidos por las normas de diseño y a la vez brindar una adecuada presión de servicio, para lo cual se hace uso del Algoritmo Genético Multiobjetivo en el diseño de la red para la zona de estudio, lo cual conllevaría a un ahorro en los costos de operación y mantenimiento. Finalmente el diseño propuesto para el sistema de abastecimiento de agua potable en La Rinconada de Pamplona Alta está conformado por el reservorio RAP-1 que abastece mediante una línea de aducción a cuatro zonas de presión y el reservorio RRP-3 que abastece por otra línea de aducción a tres zonas de presión debido a que la topografía presenta desniveles considerables. Adicionalmente, con el uso de un subprograma incluido en el Algoritmo Genético Multiobjetivo se logró asignar los caudales de demanda de manera automática en todos los nodos de la red de distribución contribuyendo a la mejora en el proceso de diseño mediante el programa EPANET. / At present, the coverage of drinking water in the country is still insufficient, especially in rural areas of the country; similarly, this problem occurs in the peri-urban areas of Lima. Such as the La Rinconada area of Pamplona Alta which is located in the San Juan de Miraflores district that does not have a basic potable water service, the supply of this resource is done by tank trucks and stored in tanks, drums, buckets, etc. It is for this reason that the present investigation proposes a design proposal for the potable water supply system for the study area, for which it is taken into consideration that the required flow will be provided by SEDAPAL. Because the topography of the study area presents steep slopes, it is necessary to use pressure reducing valves, which are localized through the application of the Multiobjective Genetic Algorithm, which in its coding includes the use of the Epanet Programmer's Toolkit, which comes to be a dynamic library (DLL) of functions that allows programmers to customize the EPANET calculation engine for their specific needs. In this sense, the method used proposes a proposal for improvement in the design process of the potable water supply system in La Rinconada de Pamplona Alta in the district of San Juan de Miraflores. For which, the EPANET program was used in the simulation and hydraulic calculation of the distribution network as it is a program of proven effectiveness and free use. On the other hand, the result of the hydraulic analysis of drinking water projects carried out in the country either by iterative manual methods or with the help of simulation programs, often does not meet the requirements of the range of admissible pressures established by the Regulation. National Building, which translates on the one hand in costs of carrying out maintenance programs that supply these deficiencies and on the other hand possible pipe breaks or water leaks due to high pressures. That is why it seeks to meet the requirements of the design standards and at the same time provide adequate service pressure, for which the Multiobjective Genetic Algorithm is used in the design of the network for the study area, which it would lead to savings in operation and maintenance costs. Finally, the proposed design for the drinking water supply system in La Rinconada de Pamplona Alta is made up of the RAP-1 reservoir that supplies four pressure zones through an adduction line and the RRP-3 reservoir that supplies another line of water. adduction to three pressure zones because the topography presents considerable differences in level. Additionally, with the use of a subprogram included in the Multiobjective Genetic Algorithm, it was possible to assign the demand flows automatically in all nodes of the distribution network contributing to the improvement in the design process through the EPANET program. / Tesis

The continuous population growth and the notable development of the mining industry have resulted in challenges for potable water supply in South Africa. The ever-increasing number of people migrating to urban areas has resulted in the demand of potable water supply in South Africa. Water is regarded as a human basic right which is promulgated by the recent amendment of the potable water service provisioning Water Services Act 108 of 1997 and the National Water Act 36 of 1998. The afore-mentioned Acts started a process to address the imbalance that existed during the apartheid regime. (The apartheid regime essentially had one objective initially, namely the control of (black, coloured and Indian) people in order to protect white privilege). It was meant to separate people of different races).The Acts were formulated to address the equal distribution of national resource for all South Africans. Mogwase Township in Moses Kotane Local Municipality is undergoing continuous growth with several mining areas being developed. Consequently, the supply of potable water has been a challenge in the area. It is, therefore, in the interest of the researcher to investigate the management of potable water supply in Mogwase Township with the aim of suggesting improved service delivery by the Moses Kotane Local Municipality. Water is now recognised as a scarce resource that belongs to all South Africans. The provision of potable water by the water services authorities (WSAs) is an important basic service that faces a number of challenges, such as the use of outdated infrastructure, namely: pipelines from the Vaalkop Dam, the lack of skilled and knowledgeable people, improper planning, and the booming population that place overt pressure on the demand for effective and efficient service delivery. This research was undertaken to investigate how Moses Kotane Local Municipality which obtains its potable water supply from Vaalkop Dam can improve the supply of water in a more effective, efficient, equitable, economic and sustainable manner through improved co-operative governance and integrated water resource management (IWRM). The qualitative and quantitative research designs were used to conduct the research, which included a literature review, semi-structured interviews, data sampling and scientific analysis of the responses. The researcher arrived at logical conclusions and S.M.A.R.T. (Simple, Measureable, and Achievable Realistic Timebound) recommendations with regard to all aspects related to the future management of potable water supply in Mogwase Township. / MA (Development and Management), North-West University, Potchefstroom Campus, 2015

The continuous population growth and the notable development of the mining industry have resulted in challenges for potable water supply in South Africa. The ever-increasing number of people migrating to urban areas has resulted in the demand of potable water supply in South Africa. Water is regarded as a human basic right which is promulgated by the recent amendment of the potable water service provisioning Water Services Act 108 of 1997 and the National Water Act 36 of 1998. The afore-mentioned Acts started a process to address the imbalance that existed during the apartheid regime. (The apartheid regime essentially had one objective initially, namely the control of (black, coloured and Indian) people in order to protect white privilege). It was meant to separate people of different races).The Acts were formulated to address the equal distribution of national resource for all South Africans. Mogwase Township in Moses Kotane Local Municipality is undergoing continuous growth with several mining areas being developed. Consequently, the supply of potable water has been a challenge in the area. It is, therefore, in the interest of the researcher to investigate the management of potable water supply in Mogwase Township with the aim of suggesting improved service delivery by the Moses Kotane Local Municipality. Water is now recognised as a scarce resource that belongs to all South Africans. The provision of potable water by the water services authorities (WSAs) is an important basic service that faces a number of challenges, such as the use of outdated infrastructure, namely: pipelines from the Vaalkop Dam, the lack of skilled and knowledgeable people, improper planning, and the booming population that place overt pressure on the demand for effective and efficient service delivery. This research was undertaken to investigate how Moses Kotane Local Municipality which obtains its potable water supply from Vaalkop Dam can improve the supply of water in a more effective, efficient, equitable, economic and sustainable manner through improved co-operative governance and integrated water resource management (IWRM). The qualitative and quantitative research designs were used to conduct the research, which included a literature review, semi-structured interviews, data sampling and scientific analysis of the responses. The researcher arrived at logical conclusions and S.M.A.R.T. (Simple, Measureable, and Achievable Realistic Timebound) recommendations with regard to all aspects related to the future management of potable water supply in Mogwase Township. / MA (Development and Management), North-West University, Potchefstroom Campus, 2015

The birth of a non-racial democracy in South Africa brought many challenges such as the supply of potable water to all societies irrespective of their colour or even location. Migration of people from rural to urban has increased the demand of potable water supply in many areas that were previously neglected by the former Apartheid regime. The increase of the human population in urban or developing areas of South Africa will therefore imply that various public services such as potable water supply, proper housing, electricity supply, schooling and basic health facilities should be provided in an efficient, effective and economic manner. As the resident of Khuma Township, the researcher has a keen interest in the management of potable water supply in this area, inter alia, the nature and extent of the physical environment and the efficiency and effectiveness of a potable water supply as a means of improving service delivery by the Matlosana Local Municipality to Khuma Township. The area has the history of gold mining and the majority of the people from other rural areas and neighbouring states moved into this area and were later joined by their families. This resulted in an increase in the population to a point where people were placed in dangerous areas such as underlying dolomite and along the Koekemoer spruit. For example, extension 6 is known to experience sinkholes due to underground mining activities and the underline dolomite rock. The population has increased in Khuma Township to such an extent that a shortage of potable water supply is been experienced. Khuma Township had one water reservoir for the past 40 years and Matlosana Local Municipality did not improve or developed infrastructure related to potable water supply to be able to cater for the increasing population of this area. An empirical study was conducted in among the residents of Khuma Township, Matlosana Local Municipality and role-players in the management of potable water supply. From this study, it was evident that the supply of potable water in Khuma Township is insufficient, and there was poor communication, cooperation and participation between Matlosana Local Municipality and the residents of Khuma Township. The ineffective management of potable water supply in Khuma Township by the Matlosana Local Municipality as well as ignoring the significance of settling people in a safe area that is free from water pollution, sinkholes and underlying dolomite rock left a lot to be desired. The researcher arrived at logical conclusions and recommendations with regard to all aspects related to future management of potable water supply in Khuma Township. / M Development and Management, North-West University, Potchefstroom Campus, 2014

The birth of a non-racial democracy in South Africa brought many challenges such as the supply of potable water to all societies irrespective of their colour or even location. Migration of people from rural to urban has increased the demand of potable water supply in many areas that were previously neglected by the former Apartheid regime. The increase of the human population in urban or developing areas of South Africa will therefore imply that various public services such as potable water supply, proper housing, electricity supply, schooling and basic health facilities should be provided in an efficient, effective and economic manner. As the resident of Khuma Township, the researcher has a keen interest in the management of potable water supply in this area, inter alia, the nature and extent of the physical environment and the efficiency and effectiveness of a potable water supply as a means of improving service delivery by the Matlosana Local Municipality to Khuma Township. The area has the history of gold mining and the majority of the people from other rural areas and neighbouring states moved into this area and were later joined by their families. This resulted in an increase in the population to a point where people were placed in dangerous areas such as underlying dolomite and along the Koekemoer spruit. For example, extension 6 is known to experience sinkholes due to underground mining activities and the underline dolomite rock. The population has increased in Khuma Township to such an extent that a shortage of potable water supply is been experienced. Khuma Township had one water reservoir for the past 40 years and Matlosana Local Municipality did not improve or developed infrastructure related to potable water supply to be able to cater for the increasing population of this area. An empirical study was conducted in among the residents of Khuma Township, Matlosana Local Municipality and role-players in the management of potable water supply. From this study, it was evident that the supply of potable water in Khuma Township is insufficient, and there was poor communication, cooperation and participation between Matlosana Local Municipality and the residents of Khuma Township. The ineffective management of potable water supply in Khuma Township by the Matlosana Local Municipality as well as ignoring the significance of settling people in a safe area that is free from water pollution, sinkholes and underlying dolomite rock left a lot to be desired. The researcher arrived at logical conclusions and recommendations with regard to all aspects related to future management of potable water supply in Khuma Township. / M Development and Management, North-West University, Potchefstroom Campus, 2014

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