The impact of rainfall on drinking water quality in Antananarivo, Madagascar

Association between particulate matter (PM)2·5 air pollution and clinical antibiotic resistance: a global analysis

BACKGROUND

Antibiotic resistance is an increasing global issue, causing millions of deaths worldwide every year. Particulate matter (PM)2·5 has diverse elements of antibiotic resistance that increase its spread after inhalation. However, understanding of the contribution of PM2·5 to global antibiotic resistance is poor. Through univariate and multivariable analysis, we aimed to present the first global estimates of antibiotic resistance and burden of premature deaths attributable to antibiotic resistance resulting from PM2·5 pollution.

METHODS

For this global analysis, data on multiple potential predictors (ie, air pollution, antibiotic use, sanitation services, economics, health expenditure, population, education, climate, year, and region) were collected in 116 countries from 2000 to 2018 to estimate the effect of PM2·5 on antibiotic resistance via univariate and multivariable analysis. Data were obtained from ResistanceMap, European Centre for Disease Prevention and Control Surveillance Atlas (antimicrobial-resistance sources), and PLISA Health Information Platform for the Americas. Future global aggregate antibiotic resistance and premature mortality trends derived from PM2·5 in different scenarios (eg, 50% reduced antibiotic use or PM2·5 controlled to 5 μg/m3) were projected until 2050.

FINDINGS

The final dataset included more than 11·5 million tested isolates. Raw antibiotic-resistance data included nine pathogens and 43 types of antibiotic agents. Significant correlations between PM2·5 and antibiotic resistance were consistent globally in most antibiotic-resistant bacteria (R2=0·42-0·76, p<0·0001), and correlations have strengthened over time. Antibiotic resistance derived from PM2·5 caused an estimated 0·48 (95% CI 0·34-0·60) million premature deaths and 18·2 (13·4-23·0) million years of life lost in 2018 worldwide, corresponding to an annual welfare loss of US$395 (290-500) billion due to premature deaths. The 5 μg/m3 target of concentration of PM2·5 in the air quality guidelines set by WHO, if reached in 2050, was estimated to reduce antibiotic resistance by 16·8% (95% CI 15·3-18·3) and avoid 23·4% (21·2-25·6) of premature deaths attributable to antibiotic resistance, equivalent to a saving of $640 (580-671) billion.

INTERPRETATION

This analysis is the first to describe the association between PM2·5 and clinical antibiotic resistance globally. Results provide new pathways for antibiotic-resistance control from an environmental perspective.

FUNDING

National Natural Science Foundation of China, Fundamental Research Funds for the Central Universities, Zhejiang University Global Partnership Fund, and China Postdoctoral Science Foundation.

Fecal indicator bacteria diversity and decay in an estuarine mangrove ecosystem of the Xuan Thuy National Park, Vietnam

Mangroves are complex and dynamic ecosystems that are highly dependent on diverse microbial activities. In this study, laboratory experiments and field studies for fecal indicator bacteria (FIB) decay rates are carried out for the first time in the Xuan Thuy Mangrove Forest Reserve of Vietnam. Results show that there are significant differences in bacterial diversity in the water of mangrove areas that have been deforested compared to those which have been planted. The highest mean total coliform (TC) and Escherichia coli (EC) values were found in the natural mangroves (3,807±2,922 and 964±1133 CFU 100 ml^-1, respectively). The results indicated that the source of contamination and seasonal changes affect the abundance of fecal bacteria. These results were exceeding by far the safety guidelines for individual, non-commercial water supplies in most of the samples. In the planted mangrove sampling sites, the highest mean Fecal streptococci (FS) values of 1,520±1,652 CFU 100 ml^-1 were found. Microbial die-off rates were calculated over 5 days, and observed to be systematically higher for TC than for EC.

Associations between climate variables and water quality in low- and middle-income countries: A scoping review

Understanding how climate change will affect water quality and therefore, health, is critical for building resilient water services in low- and middle-income countries (LMICs) where the effect of climate change will be felt most acutely. Evidence of the effect of climate variables such as temperate and rainfall on water quality can generate insights into the likely impact of future climate change. While the seasonal effects on water quality are known, and there is strong qualitative evidence that climate change will impact water quality, there are no reviews that synthesise quantitative evidence from LMICs on links between climate variables and water quality. We mapped the available evidence on a range of climate exposures and water quality outcomes and identified 98 peer-reviewed studies. This included observational studies on the impact of temperature and rainfall events (which may cause short-term changes in contaminant concentrations), and modelling studies on the long-term impacts of sea level rise. Evidence on links between antecedent rainfall and microbiological contamination of water supplies is strong and relatively evenly distributed geographically, but largely focused on faecal indicator bacteria and on untreated shallow groundwater sources of drinking water. The literature on climate effects on geogenic contaminants was sparse. There is substantial research on the links between water temperature and cyanobacteria blooms in surface waters, although most studies were from two countries and did not examine potential effects on water treatment. Similarly, studies modelling the impact of sea level rise on groundwater salinity, mostly from south-Asia and the Middle East, did not discuss challenges for drinking water supplies. We identified key future research priorities based on this review. These include: more studies on specific pathogens (including opportunistic pathogens) in water supplies and their relationships with climate variables; more studies that assess likely relationships between climate variables and water treatment processes; studies into the relationships between climate variables and geogenic contaminants, including risks from heavy metals released as glacier retreat; and, research into the impacts of wildfires on water quality in LMICs given the current dearth of studies but recognised importance.

Community monitoring of coliform pollution in Lake Tanganyika

Conventional water quality monitoring has been done for decades in Lake Tanganyika, under different national and international programs. However, these projects utilized monitoring approaches, which were temporally limited, labour intensive and costly. This study examines the use of citizen science to monitor the dynamics of coliform concentrations in Lake Tanganyika as a complementary method to statutory and project-focused measurements. Persons in five coastal communities (Kibirizi, Ilagala, Karago, Ujiji and Gombe) were trained and monitored total coliforms, faecal coliforms and turbidity for one year on a monthly basis, in parallel with professional scientists. A standardized and calibrated Secchi tube was used at the same time to determine turbidity. Results indicate that total and faecal coliform concentrations determined by citizen scientists correlated well to those determined by professional scientists. Furthermore, citizen scientist-based turbidity values were shown to provide a potential indicator for high FC and TC concentrations. As a simple tiered approach to identify increased coliform loads, trained local citizen scientists could use low-cost turbidity measurements with follow up sampling and analysis for coliforms, to inform their communities and regulatory bodies of high risk conditions, as well as to validate local mitigation actions. By comparing the spatial and temporal dynamics of coliform concentrations to local conditions of infrastructure, population, precipitation and hydrology in the 15 sites (3 sites per community) over 12 months, potential drivers of coliform pollution in these communities were identified, largely related to precipitation dynamics and the land use.

Water quality and climate variability of urban and tourism areas in Thailand and northern Vietnam: correlations and possible influences on nearby coastal shrimp farms

This research explored the long-term relationships of climate parameters and coastal water quality nearby shrimp farms in two countries. In Thailand, two sampling points in canals located in Bangkok and Trang provinces were selected as the urban and tourism areas, respectively. In northern Vietnam, the canals located in Thai Binh and Quang Ninh provinces were used as the urban and tourism areas, respectively. The diurnal monitoring of water quality and weather was performed at each site to evaluate the relationships between climate and water quality, pollution load, and risk analysis. A questionnaire was also used to assess the climate and water exposure, vulnerability, and adaptability of each site. All data were ranked on a scale of 1 to 5 to integrate each factor. It was determined that the main water quality problem was fecal pollution. Notably, aquaculture farming in northern Vietnam is more vulnerable than in Thailand; however, Vietnam farmers were adaptable for climate variability.

Chemometrics Applied in the Development of a Water Quality Indicator System for the Brazilian Amazon

The objective of this work was to develop a method to calculate the water quality index (WQI) using chemometric methods. The study was carried out at the Curuá-Una hydroelectric power plant in the state of Pará in the Brazilian Amazon. Eight collection stations in four periods (winter, intermediate I, summer, and intermediate II) and 29 parameters were selected. Multivariate analysis was applied to the results to verify the quality of the data and to select the most sensitive variables to be used as indicators for the WQI calculation. The 10 parameters selected were E _h, dissolved oxygen, total dissolved solids, chlorophyll a, phosphate, Ba, Ca, Fe, Na, and Sn. The WQI proposed herein was effective in the classification of water quality for the periods analyzed.

Long-term trends in seasonality of mortality in urban Madagascar: the role of the epidemiological transition

Background: Seasonal patterns of mortality have been identified in Sub-Saharan Africa but their changes over time are not well documented.Objective: Based on death notification data from Antananarivo, the capital city of Madagascar, this study assesses seasonal patterns of all-cause and cause-specific mortality by age groups and evaluates how these patterns changed over the period 1976-2015.Methods: Monthly numbers of deaths by cause were obtained from death registers maintained by the Municipal Hygiene Office in charge of verifying deaths before the issuance of burial permits. Generalized Additive Mixed regression models (GAMM) were used to test for seasonality in mortality and its changes over the last four decades, controlling for long-term trends in mortality.Results: Among children, risks of dying were the highest during the hot and rainy season, but seasonality in child mortality has significantly declined since the mid-1970s, as a result of declines in the burden of infectious diseases and nutritional deficiencies. In adults aged 60 and above, all-cause mortality rates are the highest in the dry and cold season, due to peaks in cardiovascular diseases, with little change over time. Overall, changes in the seasonality of all-cause mortality have been driven by shifts in the hierarchy of causes of death, while changes in the seasonality within broad categories of causes of death have been modest.Conclusion: Shifts in disease patterns brought about by the epidemiological transition, rather than changes in seasonal variation in cause-specific mortality, are the main drivers of trends in the seasonality of all-cause mortality.