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24 July 2023 | Story André Damons | Photo Supplied
Tyla Baker
Tyla Baker, a postgraduate student in the Department of Microbiology and Biochemistry at the University of the Free State (UFS).

Yeast and other filamentous fungi, which pose a great risk to the health of immune-compromised or suppressed individuals, can be found in various drinking water sources such as ground, spring, surface, and tap water. These opportunistic pathogens may cause severe to fatal infections and can range from superficial to bloodstream or systemic infections.

This is according to Tyla Baker, a postgraduate student in the Department of Microbiology and Biochemistry at the University of the Free State (UFS). She is studying for her MSc degree in Microbiology under the supervision Prof Carlien Pohl-Albertyn, National Research Forum (NRF) SARChI Research Chair in Pathogenic Yeasts. Prof Jacobus Albertyn and Dr Jolly Musoke are her co-supervisors.

Baker says the fungi in the water highlights that current water treatment processes are not efficient in their removal from water destined for household use. “These infections may not be harmful to people with healthy immune systems, but do pose a great risk to the health of immune-compromised or suppressed individuals. 

Definite possibility to contract fungal infections from polluted water 

“As the number of people with immune systems that are less functional (e.g. premature babies, elderly persons, people with cancer, diabetes or other serious diseases, HIV+ persons, transplant patients) increases, the number of people at risk of fungal infection also increases,” says Baker.

According to Baker, a previous study done in Brazil has identified yeast in bottled mineral water as well as municipally supplied tap water. The potential risk to contract fungal infections from polluted water sources is a definite possibility but more research is required to fully understand and determine the level of risk and the extent of its effects, she says. In the context of Mangaung, it is a concern that untreated water from sewage works as well as other sewage often leaks into the environment (as evidenced by numerous recent articles in local newspapers). These waters are potential carriers of large numbers of pathogens (including pathogenic yeasts/fungi) that may increase the risk to people coming into contact with it.

Baker says there is a good chance people are consuming these kinds of micro-organisms daily, considering that yeast and other filamentous fungi can also form biofilms inside pipes and spread as the impact of water flow dislodges these cells. “People will not even be aware that they are consuming these micro-organisms, some fungi are considered nuisance microbes and may cause a change in the smell and taste of water which may act as an indicator that the water is contaminated, but tests would be needed to confirm this,” she says.

The effects of consuming these fungi are still a grey area of research since the full extent of the consumption of yeast is still unknown, but there are studies being conducted to elucidate the full impact of this occurrence, says Baker. The risk depends on the immune status of the person, the specific species of yeast/fungus ingested, and the number of cells/spores ingested.

Culture-dependent and independent methods

 “It is important to know that many pathogenic yeasts and other fungi are opportunistic pathogens, meaning they infect individuals whose immune systems are compromised due to various reasons such as illness (HIV/AIDS, cancer, TB etc.), undergoing organ transplants or even something as simple as using antimicrobial agents such as antibiotics. 

“Taking this into account, along with the HIV/AIDS statistics in South Africa, which has a prevalence rate of 13,7% with approximately 8,2 million people in 2021 living with HIV, these individuals are more susceptible to infection by these opportunistic pathogens. Some of these pathogenic yeasts are also multidrug resistant or show resistance to readily available antifungals, such as fluconazole, which hinders the ability of healthcare professionals to efficiently treat infections to avoid fatal/severe outcomes,” explains Baker.  

For her studies, she will be testing for fungi in water by using a combination of culture-dependent and independent methods to try and identify yeast present in wastewater. Baker says culture-dependent techniques will include culturing (growing) yeast on an appropriate medium while culture-independent techniques will include more intricate molecular work in the form of a multiplex PCR (polymerase chain reaction) which will enable her to identify an array of pathogenic yeasts present in samples.

According to Baker, people can stay safe by boiling water before drinking it, although temperatures above 100°C are required to kill most harmful microbes. Regular cleaning of shower heads and faucets help to prevent build-up which may act as a surface to which fungi will attach to and grow. Another way to stay safe is to maintain and regularly inspect water filters for damage and avoid contact with untreated sewage.

News Archive

Higher than expected prevalence of dementia in South African urban black population
2010-09-22

 Prof. Malan Heyns and Mr Rikus van der Poel

Pilot research done by University of the Free State (UFS) indicates that the prevalence of dementia, of which Alzheimer’s disease is only one of the causes, is considerably higher than initially estimated. Clinical tests are now underway to confirm these preliminary findings.

To date it has been incorrectly assumed that dementia is less prevalent among urban black communities. This assumption is strongly disputed by the findings of the current study, which indicates a preliminary prevalence rate of approximately 6% for adults aged 65 years and older in this population group. Previous estimates for Southern Africa have been set at around 2,1%.

The research by the Unit for Professional Training and Services in the Behavioural Sciences (UNIBS) at the UFS and Alzheimer’s South Africa is part of the International 10/66 Dementia Research Group’s (10/66 DRG) initiative to establish the prevalence of dementia worldwide.

Mr Rikus van der Poel, coordinator of the local study, and Prof. Malan Heyns, Principal Investigator, say worldwide 66% of people with dementia live in low and middle income countries. It is expected that it will rise to more than 70% by 2040, and the socio-economic impact of dementia will increase accordingly within this period. 21 September marks World Alzheimer’s Day, and this year the focus is on the global economic impact of dementia. Currently, the world wide cost of dementia exceeds 1% of the total global GDP. If the global cost associated with dementia care was a company, it would be larger than Exxon-Mobil or Wal-Mart.

The researchers also say that of great concern is the fact that South Africa’s public healthcare system is essentially geared toward addressing primary healthcare needs, such as HIV/Aids and tuberculosis. The adult prevalence rate of HIV was 18,1% in 2007. According to UNAIDS figures more than 5,7 million people in South Africa are living with HIV/Aids, with an estimated annual mortality of 300 000. In many instances the deceased are young parents, with the result that the burden of childcare falls back on the elderly, and in many cases elderly grandparents suffering from dementia are left without children to take care of them. “These are but a few reasons that highlight the need for advocacy and awareness regarding dementia and care giving in a growing and increasingly urbanized population,” they say.

Low and middle income countries often lack epidemiological data to provide representative estimates of the regional prevalence of dementia. In general, epidemiological studies are challenging and expensive, especially in multi-cultural environments where the application of research protocols relies heavily on accurate language translations and successfully negotiated community access. Despite these challenges, the local researchers are keen to support advocacy and have joined the international effort to establish the prevalence of dementia through the 10/66 DRG.

The 10/66 DRG is a collective of researchers carrying out population-based research into dementia, non-communicable diseases and ageing in low and middle income countries. 10/66 refers to the two-thirds (66%) of people with dementia living in low and middle income countries, and the 10% or less of population-based research that has been carried out in those regions.

Since its inception in 1998, the 10/66 DRG has conducted population based surveys in 14 catchment areas in ten low and middle income countries, with a specific focus on the prevalence and impact of dementia. South Africa is one of seven LAMICs (low and medium income countries) where new studies have been conducted recently, the others being Puerto Rico, Peru, Mexico, Argentina, China and India.

Mr Van der Poel says participating researchers endeavour to conduct cross-sectional, comprehensive, one-phase surveys of all residents aged 65 and older within a geographically defined area. All centres share the same core minimum dataset with cross-culturally validated assessments (dementia diagnosis and subtypes, mental disorders, physical health, anthropometry, demographics, extensive non-communicable risk factor questionnaires, disability/functioning, health service utilization and caregiver strain).

The local pilot study, funded by Alzheimer’s South Africa, was rolled out through an existing community partnership, the Mangaung University of the Free State Community Partnership Programme (MUCPP).

According to Mr Van der Poel and Prof. Heyns, valuable insights have been gained into the myriad factors at play in establishing an epidemiological research project. The local community has responded positively and the pilot phase in and of itself has managed to promote awareness of the condition. The study has also managed to identify traditional and culture-specific views of dementia and dementia care. In addition, existing community-based networks are being strengthened, since part of the protocol will include the training and development of family caregivers within the local community in Mangaung.

“Like most developing economies, the South African population will experience continued urbanization during the next two decades, along with increased life expectancy. Community-based and residential care facilities for dementia are few and far between and government spending will in all probability continue to address the high demands associated with primary healthcare needs. These are only some of the reasons why epidemiological and related research is an important tool for assisting lobbyists, advocates and policymakers in promoting better care for those affected by dementia.”

Media Release
Issued by: Mangaliso Radebe
Assistant Director: Media Liaison
Tel: 051 401 2828
Cell: 078 460 3320
E-mail: radebemt@ufs.ac.za  
21 September 2010

 

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