**Author details**

Several episodes of disease outbreaks such as diarrhea and cholera have been reported in various provinces of South Africa with wastewater effluents as the major contributor. In 2004, Mail and Guardian [62] reported a cholera outbreak in Delmas region of Mpumalanga Province of South Africa where 380 cases of diarrhea and 30 cases of typhoid fever were recorded. Similarly, sickness and death were recorded in KwaZulu‐Natal and Eastern Cape Provinces of South Africa where sewage spills occurred on surface water sources [53, 63]. South Africa suffered a cholera outbreak in 2003 when 3901 cases were reported in Mpumalanga Province, the Eastern Cape Province, and Kwazulu‐Natal Province, and 45 deaths were confirmed. In 2004, 1773 cases of cholera were reported in Mpumalanga's Nkomazi region, which borders Mozambique, and 29 people died. Also in the same year, 738 people were diagnosed with cholera in the Eastern Cape Province, of which 4 died [63]. And 260 more cases were reported in the North West Province of which two people died. In early 2014, a diarrhea outbreak was reported in Limpopo province [64]. Forty‐five people were admitted to hospital for treatment after contracting diarrhea. In almost all the cases stated above, the use of contaminated water as a source of domestic water was implicated to be the major cause of the epidemics. Several studies have shown that wastewater effluents still contain high amount of fecal coliforms which do not conform, to the 1000 cfu/100 mL in the DWA guideline for wastewater discharge [6, 31, 38, 39, 58, 59, 65].

Surface water will remain as an alternative source of water to meet domestic water demand mostly in rural areas of the world if potable water is not supplied on a regular basis. Wastewater effluents should be treated efficiently so as not to pose a health risk to the users of surface water resources. The major cause for the failing state of wastewater treatment facilities in South Africa as well as other developing countries includes inadequate coverage of wastewater treatment facilities in both urban and rural areas, poor operational state of wastewater infrastructure, design weaknesses, expertise, corruption, insufficient funds allocated for wastewater treatment, overloaded capacities of existing facilities, and inefficient monitoring for compliance with recommended guidelines. Enforcement of water and environmental laws must be in place to protect the environment and the health of numerous people that still depend on surface water as

**4. Conclusion**

410 Water Quality

**Acronyms**

their major source of water supply.

WWTP Wastewater treatment plant WWTF Wastewater treatment facilities

COD Chemical oxygen demand BOD Biochemical oxygen demand WHO World Health Organization DWAF Department of Water Affairs

DO Dissolved oxygen

Joshua N. Edokpayi\* , John O. Odiyo and Olatunde S. Durowoju

\*Address all correspondence to: Joshua.Edokpayi@Univen.ac.za

Department of Hydrology and Water Resources, School of Environmental Sciences, University of Venda, Thohoyandou, South Africa
