Prevalence and pattern of waterborne parasitic infections in eastern Africa: A systematic scoping review

Assessment of the potential occurrence of Cryptosporidium species in various water sources in Sharqia Governorate, Egypt

Cryptosporidium species are enteric apicomplexan parasites associated with diarrhoeal disease in humans and animals globally. Waterborne outbreaks resulting from contamination with the infective oocysts are common worldwide. Updated reports on waterborne protozoal infections are needed to identify emerging pathogens and susceptible populations. Therefore, this study aimed to assess the current profile of Cryptosporidium contamination of various water sources in Sharqia Governorate, Northeastern Egypt. For this purpose, eighty samples were collected from five different water types (canal, tap, tank, filtered, and groundwater), distributed in four major cities (El-Hessenia, Fakous, Zagazig, and Belbies) in Sharqia Governorate. All water samples were examined using conventional microscopy, ELISA, and real-time PCR (RT-PCR) techniques. Based on microscopic analysis, the Cryptosporidium protozoan was identified in 25% of the tested water samples. The RT-PCR assay has allowed for the quantification of Cryptosporidium oocysts in different types of water. Canal water exhibited the highest Cryptosporidium contamination levels (mean = 85.15 oocysts/L), followed by water tanks (mean = 12.031 oocysts/L). The study also provided a comparative evaluation of ELISA and RT-PCR for the diagnosis of Cryptosporidium infection. RT-PCR performed better than ELISA in terms of analytical accuracy (97.50% vs. 86.25%) and specificity (100% vs. 83.33%). However, ELISA showed a higher sensitivity (95.00% vs. 90.00%) for Cryptosporidium recovery. Our findings could serve as a platform for further investigations into the potential risks associated with water contamination in Sharqia Governorate.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12639-024-01675-1.

Awareness towards urinary schistosomiasis and its relation with active infection among primary school pupils and students in North Kordofan state, Sudan 2022

Objectives

This study intends to evaluate the prevalence of active Schistosomiasis in school children, as well as their awareness, attitude, and behavior towards the illness in El-Rahad province.

Methods

This facility-based analytical cross-sectional study among 495 primary school children aged seven to 13 in five villages; Structured and pre-tested questionnaires were used to collect the data in face-to-face interviews, in addition, urine samples were collected from each pupil and then assessed microscopically for S. Haematobium eggs Presence. Data was analyzed using SPSS version 25.0.

Results

A total of 424 primary school students participated in the study. Almost all the students (96%) had poor knowledge about urinary schistosomiasis. In general, 100% of the students had poor practices. Attitude revealed that females have lower chance of having the infection than their male counterparts. About 27% (n = 115) of them had active urinary schistosomiasis infection at the time of the study.

Conclusion

The study revealed poor level of awareness and knowledge, positive attitude, and poor practices among primary school students. There was also high level of active infection among participants.

Burden of neglected tropical diseases and access to medicine and diagnostics in Ethiopia: a scoping review

BACKGROUND

More than 1.7 billion people are affected by neglected tropical diseases (NTDs) worldwide. Forty percent of the NTD-affected people live in Africa with the poorest, most vulnerable, and hard to reach geographical areas. The NTDs cause significant social and economic burden and deepen marginalization and stigmatization. The World Health Organization's current roadmap for NTD aims to prevent, control, eliminate, or eradicate 20 tropical diseases. Ethiopia experiences a high burden of these diseases, but current access to diagnostics, medicine, and/or care has been little explored to inform the country's NTD strategic plan. The overall purpose of the scoping review was to map and characterize the burden of NTDs and challenges in access to diagnostics, medicine, and/or care in Ethiopia.

METHODS

A systematic search of evidence was conducted in PubMed, Cochrane Library, and Google Scholar from January 2000 until May 2022, without restrictions of language or study design. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review was followed for screening of studies. Key findings were extracted and narrated qualitatively.

RESULTS

The search resulted in 4532 articles, of which 105 met the inclusion criteria and were included in the scoping review under three themes: burden of NTDs, access to diagnostics, medicine and/or care, and key barriers. Although gains have been made in the prevention and control of NTDs in Ethiopia, the burden remains high, and progress in access to diagnostics, medicine/drugs, and/or care is very slow. Poverty, poor quality of life, and underfunding of NTD programs decelerate the process of NTD elimination program in the country.

CONCLUSIONS

The scoping review identified a considerable number of studies on the burden of NTDs in Ethiopia and strategies for diagnosis, treatment, and/or care; however, there is a paucity of evidence on the suitability and potential benefits of novel diagnostic technologies and medicines in the country. A regular review and analysis of such country-level evidence is important to inform the country NTDs roadmap and local implementation strategies.

Toward waterborne protozoa detection using sensing technologies

Drought and limited sufficient water resources will be the main challenges for humankind during the coming years. The lack of water resources for washing, bathing, and drinking increases the use of contaminated water and the risk of waterborne diseases. A considerable number of waterborne outbreaks are due to protozoan parasites that may remain active/alive in harsh environmental conditions. Therefore, a regular monitoring program of water resources using sensitive techniques is needed to decrease the risk of waterborne outbreaks. Wellorganized point-of-care (POC) systems with enough sensitivity and specificity is the holy grail of research for monitoring platforms. In this review, we comprehensively gathered and discussed rapid, selective, and easy-to-use biosensor and nanobiosensor technologies, developed for the early detection of common waterborne protozoa.

Climate change and human health in the Eastern Mediterranean and Middle East: Literature review, research priorities and policy suggestions

Human health is linked to climatic factors in complex ways, and climate change can have profound direct and indirect impacts on the health status of any given region. Susceptibility to climate change is modulated by biological, ecological and socio-political factors such as age, gender, geographic location, socio-economic status, occupation, health status and housing conditions, among other. In the Eastern Mediterranean and Middle East (EMME), climatic factors known to affect human health include extreme heat, water shortages and air pollution. Furthermore, the epidemiology of vector-borne diseases (VBDs) and the health consequences of population displacement are also influenced by climate change in this region. To inform future policies for adaptation and mitigation measures, and based on an extensive review of the available knowledge, we recommend several research priorities for the region. These include the generation of more empirical evidence on exposure-response functions involving climate change and specific health outcomes, the development of appropriate methodologies to evaluate the physical and psychological effects of climate change on vulnerable populations, determining how climate change alters the ecological determinants of human health, improving our understanding of the effects of long-term exposure to heat stress and air pollution, and evaluating the interactions between adaptation and mitigation strategies. Because national boundaries do not limit most climate-related factors expected to impact human health, we propose that adaptation/mitigation policies must have a regional scope, and therefore require collaborative efforts among EMME nations. Policy suggestions include a decisive region-wide decarbonisation, the integration of environmentally driven morbidity and mortality data throughout the region, advancing the development and widespread use of affordable technologies for the production and management of drinking water by non-traditional means, the development of comprehensive strategies to improve the health status of displaced populations, and fostering regional networks for monitoring and controlling the spread of infectious diseases and disease vectors.

Global occurrence of SARS-CoV-2 in environmental aquatic matrices and its implications for sanitation and vulnerabilities in Brazil and developing countries

This paper includes a systematic review of the SARS-CoV-2 occurrence in environmental aquatic matrices and a critical sanitation analysis. We discussed the interconnection of sanitation services (wastewater, water supply, solid waste, and stormwater drainage) functioning as an important network for controlling the spread of SARS-CoV-2 in waters. We collected 98 studies containing data of the SARS-CoV-2 occurrence in aquatic matrices around the world, of which 40% were from developing countries. Alongside a significant number of people infected by the virus, developing countries face socioeconomic deficiencies and insufficient public investment in infrastructure. Therefore, our study focused on highlighting solutions to provide sanitation in developing countries, considering the virus control in waters by disinfection techniques and sanitary measures, including alternatives for the vulnerable communities. The need for multilateral efforts to improve the universal coverage of sanitation services demands urgent attention in a pandemic scenario.

Prevalence of intestinal protozoan parasites among school children in africa: A systematic review and meta-analysis

Introduction

Parasitic infections, especially intestinal protozoan parasites (IPPs) remain a significant public health issue in Africa, where many conditions favour the transmission and children are the primary victims. This systematic review and meta-analysis was carried out with the objective of assessing the prevalence of IPPs among school children in Africa.

Methods

Relevant studies published between January 2000 and December 2020 were identified by systematic online search on PubMed, Web of Science, Embase and Scopus databases without language restriction. Pooled prevalence was estimated using a random-effects model. Heterogeneity of studies were assessed using Cochrane Q test and I² test, while publication bias was evaluated using Egger’s test.

Results

Of the 1,645 articles identified through our searches, 46 cross-sectional studies matched our inclusion criteria, reported data from 29,968 school children of Africa. The pooled prevalence of intestinal protozoan parasites amongst African school children was 25.8% (95% CI: 21.2%-30.3%) with E. histolytica/ dispar (13.3%; 95% CI: 10.9%-15.9%) and Giardia spp. (12%; 95% CI: 9.8%-14.3%) were the most predominant pathogenic parasites amongst the study participants. While E. coli was the most common non-pathogenic protozoa (17.1%; 95% CI: 10.9%-23.2%).

Conclusions

This study revealed a relatively high prevalence of IPPs in school children, especially in northern and western Africa. Thus, poverty reduction, improvement of sanitation and hygiene and attention to preventive control measures will be the key to reducing protozoan parasite transmission.

Pathogenic intestinal protozoan parasites (IPPs) remain a major public health concern. Studies have documented that, the prevalence rates of protozoan infections are quite high in developing regions, particularly Africa and children are the primary victims. Despite numerous studies have been conducted on IPPs in school children in African countries, data on the burden of these infections in African school children have not yet been synthesised. This systematic review and meta-analysis was conducted to provide continent-wide prevalence of IPPs amongst African school children. Our study found that about 25.8% of the children had one or more species of intestinal protozoan parasites in their faecal specimens. E. histolytica/ dispar and Giardia spp. were the most predominant parasites amongst the study participants. The relatively high prevalence estimate of IPPs amongst African children and the considerable variation in the disease prevalence over the years, between and within countries and regions clearly indicates the needs to improve sanitation and hygiene, paying more attention to preventive control measures as well as poverty reduction which are the key to reducing protozoan parasite transmission.

Cost Estimations of Water Pollution for the Adoption of Suitable Water Treatment Technology

This study analyzed the cost implications of using suitable technologies and the cost of inaction when addressing water pollution. This was achieved by developing three main models for the costs (model one) and benefits (model two and model three). The first model accounts for the operational costs of adopting suitable technologies, namely the use of diatomaceous earth for textile wastewater treatment. The second model analyzed the cost of inaction through analyzing the cost of treatment for water pollution-related diseases for the affected population. The occurrence and cost of treatment for three diseases, namely diarrhea, amoebiasis and bacterial infection, were used as indicators of water pollution in the area. The third model included the contingent valuation method (CVM) data on the willingness to pay for environmental restoration of the surveyed population. The benefit–cost ratio (BCR) of the resulting data from the three models were used to highlight the economic viability of the proposed project. A BCR of (0.67) for the cost of the proposed project versus the benefits of the project on human health using data from one hospital was obtained. There is a high possibility that the real BCR would increase if more data from other hospitals or other diseases were included. The results imply that the use of D.E can be considered a good candidate for treating wastewater. To thoroughly discuss the BCR of treating wastewater from one factory, the BCR of the proposed restoration project along River Sosiani, and the value of using DE as suitable technology, more studies are needed to evaluate the unaccounted costs and benefits for accurate economic estimations of the proposed project. The outcome of the study is a framework of numbers and figures that can be presented to decision makers and policy makers as critical information when making decisions.

Annual burden of disease in Nakaale, Karamoja: A descriptive, cross-sectional study

Even with global Sustainable Development Goals aimed at reducing poverty by reaching those furthest behind first and reducing inequalities within countries, regions like Karamoja continue to score low on many health indices. To understand the Karamoja context, we aimed to systematically describe the burden of disease in Nakaale, which is a hard-to-reach parish in Nakapiripirit District, through disaggregated data. This descriptive, cross-sectional study was conducted between January and December 2019. We relied on secondary data collected from all clients seen at Akisyon a Yesu Presbyterian Clinic's outpatient department in Nakaale. Data was extracted from Uganda's Health Management Information System records using Excel and exported to Stata for analysis. We labelled, categorised, and estimated frequencies and proportions for the variables. We estimated the means and medians for normally distributed or skewed variables respectively. A total of 14,685 observations, different diagnoses (n = 163) and residential locations or villages (n = 189) were extracted and included in the analysis. Nearly half (48.9%) of the clients were under the age of five years. Infectious diseases (42%), respiratory diseases (19%), and gastrointestinal and hepatic diseases (17%) were most commonly reported. While many clients (42%) reside in the sub-county where the health facility is located, a larger proportion (58%) came from further away, including 15% from outside of the local district. In conclusion, Akiyson a Yesu Presbyterian Clinic serves a very young population in a catchment area well beyond what is expected of a Health Centre II, in breadth of diagnoses, geographically, and in sheer numbers. Data gathered in this study will inform policy at the clinic, subcounty, and district levels enabling accurate health service delivery for the local context.

Design and assembly of a domestic water temperature, pH and turbidity monitoring system

Objective

The aim of this study was to design a domestic water temperature, pH and turbidity monitoring system that could constantly log temperature, pH and turbidity of water and give alerts in case the parameters are outside the acceptable limits for potable water.

Results

The system was designed, assembled and performed as expected. The study indicates that the proposed and designed system outperforms the existing manual monitoring system as it can constantly track and store changes in water quality. This could be used to prepare better treatment processes as well as identify problems in the water distribution system early enough.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-021-05578-9.

Physicochemical Quality of Water from Chuho Springs, Kisoro District, Uganda

In the current study, water from Chuho springs used as the main water source in Kisoro municipality, Uganda were assessed for their suitability as drinking water. The temperature, turbidity, conductivity, total dissolved solids, dissolved oxygen, biological oxygen demand, total hardness, total alkalinity, calcium, magnesium, phosphates, iron, copper, arsenic, chlorides and the fluoride content of the water samples were determined. Not all the parameters met World Health Organizations’ guidelines for drinking water. Temperature, dissolved oxygen and fluorides were outside the recommended limits of 15 ℃, 10-12 mg/L and 1.5 mg/L, respectively. Further studies should assess the microbiological and sanitary profile of the springs.

Food and waterborne parasites in Africa - threats and opportunities

This Special Issue (SI) was conceptualized on the basis that success in tackling foodborne and waterborne parasites (FBP and WBP) will contribute to achievement of seven of the United Nation's Sustainable Development Goals (SDGs). We chose to take a closer look at research on FBP and WBP in Africa, given that attaining these SDGs may be particularly challenging there. In this SI we present 7 articles that provide particular insights into FBP and WBP from different regions in Africa. The articles take different approaches. Three papers are reviews addressing "occurrence" (either widely, in terms of parasite and/or geography, or with focus on a specific parasite genus at a more regional level); all 3 articles emphasise the importance of a "One Health" approach regarding control and prevention of FBP and WBP, and the need for further research to fulfil the information gaps identified. Two articles then report on investigations regarding the knowledge and understanding of different communities in Africa regarding various FBP and WBP. These articles highlight lack of awareness among communities at risk, and also, perhaps of greater relevance, gaps in the knowledge of health workers regarding some FBP and WBP of public health importance. The final two articles are research articles regarding prevalence and occurrence of specific WBP, both as infections and in the environment. This SI, while limited in depth and scope, provides insights into some of the current challenges associated with FBP and WBP in Africa that might result in a lack of success regarding attainment of the previously mentioned seven SDGs. We anticipate significant advances in research on FBP and WBP in Africa, and hope that a future SI on the same topic may present a more positive picture regarding the current status and research achievements.