Aim: The aim of this project was to find the level of oral health literacy of parents of preschool age children regarding their child’s oral health. The primary objective was to improve the oral health status of preschoolers and to prevent early childhood caries. Methods: 117 participants (parents of preschoolers) completed a self-administered oral health literacy questionnaire. Data obtained from the study was analysed using a statistical package (SPSS). Firstly, descriptive analysis was undertaken generating tables and graphs of sociodemographic variables. Later, associations between oral health literacy and sociodemographic variables were identified and also relation between parents’ oral health literacy and their attitude towards water fluoridation in Christchurch was identified using bivariate and multivariate analysis. Psychometric analysis was generated to test validity and reliability of the oral health literacy questionnaire. Results: In the total sample, 38% of participants had poor oral health literacy regarding their child’s oral health. The results also indicated that there were associations present between parents’ oral health literacy and socio-demographic variables such as ethnicity, education and family income. Nearly half of the parents opted for water fluoridation in Christchurch. A strong association between parents’ oral health literacy and their attitude towards water fluoridation was identified. In the total sample, 40% of parents were not aware of need for first dental visit before the school age. Reliability was good for the developed oral health literacy instrument. Conclusions: This study of parents’ oral health literacy in Christchurch, New Zealand identified association of oral health literacy and socio-demographic variables which gives future guidance to improving oral health status of New Zealand children. The relation 6 between parents’ oral health literacy and their attitude towards water fluoridation was shown in this study. This result might be used in future water fluoridation surveys. Future studies are needed to examine health care provider’s perspective in improving parents’ oral health literacy and to tailor more effective public health interventions to improve parents’ oral health literacy.

Text in Afrikaans / Die tydruimtelike variasie in die fluoriedinhoud vannatuurlike drinkwater en in die voorkoms van tandfluorose, die verband tussen hierdie veranderlikes asook hulle kovariasie is op 'n hoe resolusievlak in geselekteerde endemiese gebiede ondersoek. Die drie studiegebiede verskil grootliks van mekaar wat sommige fisies- en menslik-geografiese kenmerke betref, maar ondergrondse water was oral die belangrikste bron van drinkwater. Ioonspesifieke analise en laboratoriumtegnieke is gebruik om die fluoriedinhoud van die drinkwater uit 517 bronne te bepaal. Die tande van 3 068 kinders is klinies en fotografies ondersoek. Die erkende Tooth Fluorosis Index en die indeks van Dean is gebruik om die voorkoms van fluorose te beskryf. Grafiese tegnieke, beskrywende statistieke en nieparametriese analise van variansietoetse is gebruik om die voorkoms en tydruimtelike variasiepatrone van die sleutelveranderlikes in elke studiegebied, asook die verskillende ruimtelike eenhede binne die studiegebiede, te beskryf. Die verband tussen die sleutelveranderlikes asook hul intra- en interareale kovariasie is ontleed. Daar is gevind dat die fluoriedinhoud van die ondergrondse water in die Pilanesberg- en Hammanskraal-studiegebied relatief hoog tot hoog is en die in die Vrystaat-studiegebied relatief laag. Ruimtelike veranderlikheid met groot verskille oor klein afstande kenmerk die fluoriedinhoud van ondergrondse water ongeag die gesteentes waaruit dit onttrek word. Middelwaardes bied ontoereikende beskrywings van die fluoriedgehalte van die drinkwater. Die skep van nuwe drinkwaterbronne veroorsaak langtermynvariasie in die fluoriedinhoud van die beskikbare drinkwater. Fluoroseprevalensie in die studiegebiede bet van 62% tot 87% gewissel, met meer ernstige aantasting in die Pilanesberg- en Hammanskraal-gebied as in die Suid-Vrystaat. Beduidende intra-areale ruimtelike variasie is 'n wesenlike kenmerk van die voorkoms van fluorose in al drie studiegebiede. In alle gevalle het die variasiepatroon in die fluoriedinhoud van die drinkwater die in die voorkoms van fluorose slegs gedeeltelik verklaar. Sporadiese en/of periodieke kortstondige blootstelling aan hoe fluoriedkonsentrasies lei tot emstige aantasting ten spyte van die gereelde gebruik van water met 'n laefluoriedinhoud. Ligte fluorose ontwikkel geredelik in assosiasie met <0,5 mgF-/l en matige fluorose in assossiasie met 0,5-0,7 mgF-/l, die optimum konsentrasieinterval vir fluoridasie in Suid-Afrika. / The spatiotemporal variation in the fluoride content of natural drinking water and the occurrence of dental fluorosis, the relation between these variables as well as their covariation were investigated at a high resolution level in selected endemic areas. Groundwater was the most important source of drinking water in all three study areas, but they differed markedly in respect of some physical and human geographical characteristics. Ion specific analysis and laboratory techniques were used to determine the fluoride content of the water from 517 sources. The teeth of 3 068 children were examined clinically and photographically. The fluorosis was scored according to the Tooth Fluorosis Index and Dean's classification. Graphical techniques, descriptive statistics and nonparametric analysis of variance were used to describe the occurrence and variation patterns of the key variables in the different spatial units is each study area. The relation between the variables as well as their intra and interareal covariation were analysed. The fluoride content of the groundwater in the Pilanesberg and Hammanskraal areas was relatively high to high; in the southern Free State it was relatively low. Spatial variability and significant differences over small distances typify the fluoride content of the groundwater, irrespective of the aquifer. Central statistics inadequately describe the fluoride quality of the natural drinking water. The development of new water sources causes long term variation in the fluoride content of the available drinking water. Fluorosis prevalence varied form 62% to 87%, with more severe fluorosis in Pilanesberg and Hammanskraal than in the southern Free State. Significant intra-areal spatial variation is an attribute of fluorosis in all three study areas. In all cases the variation pattern in the fluoride content of the drinking water partly explained the spatial pattern in the occurrence of fluorosis. Sporadic and/or periodic brief exposure to high fluoride concentrations leads to severe fluorosis despite regul~ usage of water with a low fluoride content. Mild fluorosis readily develops in association with <0,5 mgF-1~ and medium fluorosis in association with 0,5-0,7 mgF-/l, the optimum concentration interval for fluoridation in South Africa. / Geography / D. Phil. (Geografie)

Vibrio infections remain a serious threat to public health. In the last decade, Vibrio disease outbreaks have created a painful awareness of the personal, economic, societal, and public health costs associated with the impact of contaminated water in the aquatic milieu. This study was therefore designed to assess the prevalence of Vibrio pathogens in the final effluents of wastewater treatment plants (WWTPs) in the Eastern Cape Province, as well as their abilities to survive the treatment processes of the activated sludge system either as free cells or as plankton-associated entities in relation to the physicochemical qualities of the effluents. Three wastewater treatment facilities were selected to represent typical urban, sub-urban and rural communities, and samples were collected monthly from August 2007 to July 2008 from the final effluent, discharge point, 500 meter upstream and downstream of the discharge points and analysed for physicochemical parameters, Vibrio pathogens prevalence and their antibiogram characteristics using both culture based and molecular techniques. Physicochemical parameters measured include pH, temperature, electrical conductivity, salinity, turbidity, total dissolved solid (TDS), dissolved oxygen (DO), chemical oxygen demand (COD), nitrate, nitrite and orthophosphate levels. Unacceptably high levels of the assayed parameters were observed in many cases for COD (<10 - 1180 mg/l), nitrate (0.08 - 13.14 mg NO3- as N/l), nitrite (0.06 - 6.78 mg NO2- as N/l), orthophosphate (0.07-4.81 mg PO43- as P/l), DO (1.24 - 11.22 mg/l) and turbidity (2.04 -159.06 NTU). Temperature, COD and nitrite varied significantly with season (P < 0.05), while pH, EC, salinity, TDS, COD, and nitrate all varied significantly with sampling site (P < 0.01; P < 0.05). In the rural wastewater treatment facility, free-living Vibrio densities varied from 0 to 3.45 × 101 cfu ml-1, while the plankton-associated Vibrio densities vary with plankton sizes as follows: 180 μm (0 – 4.50 × 103 cfu ml-1); 60 μm (0 – 4.86 × 103 cfu ml-1); 20 μm (0 – 1.9 × 105 cfu ml-1). The seasonal variations in the Vibrio densities in the 180 and 60 μm plankton size samples were significant (P < 0.05), while the 20 μm plankton size and free-living vibrios densities were not. Molecular confirmation of the presumptive vibrios isolates revealed V. fluvialis (36.5 percent), as the predominant species, followed by V. vulnificus (34.6 percent), and V. parahaemolyticus (23.1 percent), and V. metschnikovii (5.8 percent) (detected using only API 20 NE), suggesting high incidence of pathogenic Vibrio species in the final effluent of the wastewater facility. Correlation analysis suggested that the concentration of Vibrio species correlated negatively with salinity and temperature (P < 0.001 and P < 0.002 respectively) as well as with pH and turbidity (P < 0.001), in the final effluent. Population density of total Vibrio ranged from 2.1 × 101 to 4.36 × 104 cfu ml-1 and from 2.80 ×101 to 1.80 × 105 cfu ml-1 for the sub-urban and urban communities treatment facilities respectively. Vibrio species associated with 180 μm, 60 μm, and 20 μm plankton sizes, were observed at densities of 0 - 1.36 × 103 cfu ml-1, 0 - 8.40 × 102 cfu ml-1 and 0 - 6.80 × 102 cfu ml-1 respectively at the sub-urban community‘s WWTP. In the urban community, counts of culturable vibrios ranged from 0 - 2.80 × 102 cfu ml-1 (180 μm); 0 - 6.60 × 102 cfu ml-1 (60 μm) and 0 -1.80 × 103 cfu ml-1 (20 μm). Abundance of free-living Vibrio species varied between 0 and the orders of 102 and 103 cfu ml-1 in the sub-urban and urban communities WWTPs respectively. Molecular confirmation of the presumptive vibrios isolates revealed the presence of V. fluvialis (41.38 percent), V. vulnificus (34.48 percent), and V. parahaemolyticus (24.14 percent) in the sub-urban community effluents. In the urban community V. fluvialis (40 percent), V. vulnificus (36 percent), and V. parahaemolyticus (24 percent) were detected. There was no significant correlation between Vibrio abundance and season, either as free-living or plankton-associated entities, while Vibrio species abundance correlated positively with temperature (r = 0.565; P < 0.01), salinity and dissolved oxygen (P < 0.05). Turbidity and pH showed significant seasonal variation (P < 0.05) in both locations. The Vibrio strains showed the typical multi-antibiotic-resistance of an SXT element. They were resistant to sulfamethoxazole (Sul), trimethoprim (Tmp), cotrimoxazole (Cot), chloramphenicol (Chl) and streptomycin (Str), as well as other antibiotics such as ampicillin (Amp), penicillin (Pen), erythromycin (Ery), tetracycline (Tet), nalidixic acid (Nal), and gentamicin (Gen). The antibiotic resistance genes detected includes dfr18 and dfrA1 for trimethoprim; tetA, strB, floR, sul2 blaP1, for tetracycline, streptomycin, chloramphenicol, sulfamethoxazole and β-lactams respectively. A number of these genes were only recently described from clinical isolates, demonstrating genetic exchange between clinical and environmental Vibrio species. This study revealed that there was an adverse impact on the physicochemical characteristics of the receiving watershed as a result of the discharge of inadequately treated effluents from the wastewater treatment facilities. The occurrence of Vibrio species as plankton-associated entities confirms the role of plankton as potential reservoir for this pathogen. Also the treated final effluents are reservoirs of various antibiotics resistance genes. This could pose significant health and environmental risk to the biotic component of the environment including communities that rely on the receiving water for domestic purposes and may also affect the health status of the aquatic milieu in the receiving water. There is need for consistent monitoring programme by appropriate regulatory agencies to ensure compliance of the wastewater treatment facilities to regulatory effluent quality standards.

MENVSC / Department of Ecology and Resource Management / See the attached abstract below

MESHWR / Department of Hydrology and Water Resources / Siloam, a village in the Northern province of South Africa has groundwater reportedly characterised by concentration of fluoride greater than 1.5 mg/L permissible limit. Regional investigation has been done to determine the possible fluoride sources in the northern province of South Africa, but no localised investigation has been documented. The World Health Organization and South Africa National Standard permissible limit is 1.5 mg/L for a duration of time. Therefore, this study focuses on investigating the sources of fluoride in the groundwater of Siloam village in response to reported high incidences (80%) of dental fluorosis in Siloam village. This study also elaborates more on the hydrochemical and geochemical processes favouring the release of fluoride into the groundwater of Siloam village. Two (2) surface rocks, one (1) surface clay deposit, twelve (12) borehole cuttings and four (4) groundwater samples were used for this study. Temperature, total dissolved solids (TDS), conductivity (EC) and pH of the groundwater were determined using a combined multimeter because these parameters are proxy indicators of geogenic influence on groundwater fluoride concentration. Total fluoride in the groundwater samples and the leachates obtained during a leaching experiment were determined using Ion Chromatograph (IC) and Fluoride Ion Selective Electrode (FISE). X-ray fluorescence spectrometry is the most preferred method for rock analysis by earth scientists because it is faster and does not require ambiguous training on the part of the analyst, therefore, it is mostly the standard methods used in whole rock chemistry. Elemental composition and mineralogy were determined using X-ray Fluorescence (XRF) and X-ray diffraction (XRD), respectively. Clay, greywacke, argillaceous sedmients and basalt were analysed. Results obtained indicated that the groundwater fluoride concentration ranges from 3.92 to 4.95 mg/L, which are far above the WHO permissible limit and South African standard. Insitu temperature reading obtained ranges from 25 to 48°C thus classifying the groundwater to be hot and tepid. The groundwater pH ranges from 8.1 to 9.1 which indicates an alkaline water condition. The groundwater conductivity ranges from 330 to 730 μS/cm while the Total dissolved solids ranges from 130.12 to 423.07 mg/L. Groundwater proxy indicators showed geologic sources to be responsible for the high fluoride concentration in the groundwater of Siloam village. Hydrochemical investigation revealead that the mineralisation of groundwater in Siloam village is as a result of rock water interaction and the process of groundwater enrichment is through base ion exchange and reverse ion exchange. The dominant water type in the village was identified to be Na-Cl water type and the abundance of sodium (Na) is due to the heavy weathering of plagioclase of the parent rocks. Total fluoride content of the rocks and soils of the village ranges from 10 to 2000 mg/L. The leachable fluoride, however, ranged in concentration from 0.27 to 14.88 mg/L under induced temperature v and 0.05 to 10.40 mg/L without temperature. Mineralogical investigation revealed the abundance of smectite clay, which is known for its enrichment and leaching of fluoride into groundwater sources, thus, the research question and assumption about the possible source of fluoride and the assumption that fluoride increases downwards towards the aquifer were answered. Leaching experiments identified the main contributors of fluoride to groundwater in Siloam village as smectite clays and the muscovite present in the sandstone, greywacke and basalt. Time based leaching experiment, geochemical modelling and dating of different hydrogeological unit was recommended / NRF

MENVSC / Department of Ecology and Resource Management / Some boreholes in South Africa which serve as a source of drinking water for rural communities are reported to have high fluoride concentration, much above the WHO guideline of 1.5 mg/L. This study aimed at activating aluminosilicate clay soil mechanochemically, modifying aluminosilicate clay soil with Al-oxide and fabricating porous ceramic granules using Al-oxide modified mechanochemically activated aluminosilicate clay soil/ mechanochemically activated clay soil/ corn starch and evaluating their performances in defluoridation of groundwater. The raw clay materials were mechanochemically activated for 5, 10, 15 and 30 minutes for physicochemical transformation of the solid aggregate. The morphology of the samples showed the honeycomb structure. The surface area analyses of samples using Brunauer–Emmett–Teller (BET) gave the highest surface area of 50.5228 m2/g at 30 min activation time. Hence, the optimum activation time was 30 min. The Fourier Transform Infrared (FT-IR) analysis showed increase in the absorbance of FT-IR by Si-O-H groups at 510 cm-1 with increasing milling time. This is evidence that more surface Si-O-H groups were available at higher particle surface area that would be necessary to interact with fluoride. X-ray diffraction (XRD) analyses revealed that, at 30 minutes milling time, the peak broadening is intensified whereas the reflection peak intensities decreased. The X-ray fluorescence spectrometry (XRF) results for 30 minutes milling time showed that silica and alumina were the highest components in the clay soil. Using the activated clay in batch defluoridation of fluoride-spiked water, a maximum fluoride removal of 41% was achieved at a pHe of 2.41. The initial fluoride concentration was 9 mg/L while the sorbent dosage was 0.6 g/100 mL and the contact time being 30 minutes. The adsorption data fitted to both Langmuir and Freundlich isotherms. The adsorption data fitted only the pseudo-second-order kinetic, showing chemisorption. Optimization of Al3+ concentration for modification was carried out by modifying the mechanochemical activated aluminosilicate clay soil with different concentrations of Al3+ from which the optimum modification was achieved with 1.5 M. Characterisation studies on the Al-oxide modified mechanochemically activated aluminosilicate clay soil by SEM, BET, FT-IR, XRD and XRF, analyses were carried out to determine the resultant changes in physicochemical properties of the adsorbent owing to modification. The SEM image of Al-oxide modified mechanochemically activated clay soil showed many small pores and honey-comb structure on the surface of different images. The BET surface area and the BDH adsorption cumulative area of the Al-oxide modified mechanochemically activated v aluminosilicate clay soil were more than double those for the raw clay soil. There was also an increase in pore volume of the Al-oxide modified mechanochemically activated aluminosilicate clay soil. The FT-IR spectra showed that there was increase in the absorbance by the Si-OH, H-O-H, Al-O-H and Si-O-Al. The equilibrium pH of solution was higher than the point-of-zero charge (pHpzc) implying that fluoride removal occurred at solution pH > pHpzc where the net surface charge of the mechanochemically activated clay aluminosilicate soil was negative.The efficiency of 1.5 M Al-oxide modified aluminosilicate clay soil to remove fluoride from water was studied and found to be 96.5 % at pHe 6.86, contact time of 30 minutes and dosage of 0.3 g/100 mL for 10 mg/L fluoride solution at 200 rpm shaking speed. The result shows that Al-oxide modified mechanochemically activated aluminosilicate clay soil is effective for defluoridation. The adsorption data fitted to both Langmuir and Freundlich isotherms. The adsorption data fitted only the pseudo-second-order kinetic, showing chemisorption. Al-oxide modified mechanochemically activated aluminosilicate clay soil was tested for fluoride removal on field water and the percentage fluoride removal was 96.5 % at the dosage of 0.6 g/100 mL with the pHe of 6.48. The optimum Al-oxide modified mechanochemically activated aluminosilicate clay soil/ mechanochemically activated clay soil/ corn starch mixing ratio for fabrication of porous ceramic granules was determined by varying ratios and temperature. The optimum ratio found was 20:5:1.The porous ceramic granules were characterised using SEM, BET, FT-IR, XRD and XRF. SEM analysis showed that the porous ceramic granules have the porous structure of the organic foam template. The porous ceramic granule showed an increase in pore surface area and volume as compared to mechanochemically activated aluminosilicate clay soil. The FT-IR showed the presence of a strong broad bending and stretching vibrations band at about 993 cm-1 which shows the presence of Si–O–Si bonds. Mineralogical characterisation showed the presence of quartz, albite, horneblende and microcline as the main minerals of the calcined porous ceramic granules. The major oxides of the porous ceramic granules as shown by XRF analysis were SiO2, Al2O3, MnO and Na2O. The porous ceramic granules reduced the concentrations of fluoride in the water from 10 to 3.31 mg/L. The optimum adsorption capacity was 0.6648 mg/g at a pHe of 6.32 and the percentage fluoride removal was 66.9 % at an adsorbent dosage of 1.0063 g/100 mL and a temperature of 600 ⁰C. The porous ceramic granules were tested for fluoride removal on field water and the percentage fluoride removal was 45.4 % at the dosage of 1.0009 g/100 mL with the pHe of 7.87. Mechanochemically activated aluminosilicate clay soil showed higher adsorption capacity at acidic pH, therefore it is recommended that future work should focus on improving their adsorption capacity at wider range of pH. The porous ceramic granules can also be evaluated in column dynamic flow experiments.

MENVSC / Department of Ecology and Resource Management / Fluoride is one of the anionic contaminants which is found in excess in groundwater because of geochemical reaction or anthropogenic activities such as the disposal of industrial wastewaters. Among various methods used for defluoridation of water such as precipitation, ion-exchange processes, membrane processes, the adsorptions process is widely used. It offers satisfactory results and seems to be a more attractive method for the removal of fluoride in terms of cost, simplicity of design and operation. In this work, the preparation of clay polymer nanocomposites (CPNCs) used in defluoridation began by modifying the original natural Mukondeni clay to render the layered silicate miscible with the chosen polymer, microcrystalline cellulose. Clay polymer nanocomposites (CPNCs) were synthesized using the melt intercalation method. Mukondeni black clay with microcrystalline cellulose as polymers was melt mixed at 220 °C for 10 minutes in an extruder for exfoliation of the resulting composite. Physicochemical characteristics and mineralogical characteristics of the CPNC was determined using XRD, XRF, BET, FTIR and SEM. Batch adsorption experiments were conducted to determine the efficiency of CPNCs in defluoridation of groundwater. The pH, EC, TDS and fluoride concentration of field water was determined using the CRISON MM40 multimeter probe and the Orion versastar fluoride selective electrode for fluoride concentration. Elemental analysis revealed that CPNC 1:1 is mainly characterized of cellulose, Quartz and Albatite as the major minerals with traces of Montmorillonite, Ednite and Magnesium as minor minerals constituting CPNC 1:1. The structure of 1:4 CPNC was partially crystalline and partially amorphous showing increased cellulose quantity (1:4 clay to cellulose) as compared 1:1 CPNC, 1:2 CPNC and 1:3 CPNC. Maximum adsorption of fluoride was attained in 10 minutes using 0.5g of 1:4 CPNC removed 22.3% of fluoride. The initial fluoride concentration for the collected field groundwater was 5.4 mg/L, EC 436 μS/cm, and TDS 282 mg/L. The regeneration potential of CPNCs was evaluated through 3 successive adsorption desorption cycles. Fluoride removal decreased after the first cycle for all ratios of CPNCs, a continued decreased can be observed following the second cycle. CPNC 1:2 decreased from 9.32 % at the 1st cycle to 2.84 % and 0.56 % on the 2nd and 3rd cycle respectively. CPNC 1:4 decreased from 8.22 % at the 1st cycle to 4.80 % and 0.72 % on the 2nd and 3rd cycle respectively. The fluoride-rich Siloam groundwater had a slightly alkaline pH of 9.6. iv The low adsorptive characteristic displayed by all 4 CPNCs can be deduced from the BET analysis that revealed low surface area, pore volume, and pore size, it is evident from the BET analysis that less fluoride will be absorb as adsorption sites will be limited. Based on the findings of this study, recommendations are designing of correct preparation techniques to obtain nanocomposites with desirable properties, polymer melting points and evaporation point of the binder should be taken into consideration. / NRF