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Kohle S, Petersen TN, Vigre H, Johansson MHK, Aarestrup FM. Metagenomic analysis of sewage for surveillance of bacterial pathogens: A release experiment to determine sensitivity. PLoS One 2024; 19:e0300733. [PMID: 38753691 PMCID: PMC11098379 DOI: 10.1371/journal.pone.0300733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 03/04/2024] [Indexed: 05/18/2024] Open
Abstract
Accurate monitoring of gastro-enteric and other diseases in large populations poses a challenge for public health management. Sewage represents a larger population, is freely obtainable and non-subject to ethical approval. Metagenomic sequencing offers simultaneous, multiple-target analysis. However, no study has demonstrated the sensitivity of metagenomics for detecting bacteria in sewage. In this study, we spot-released 1013 colony-forming units (CFU) of Staphyloccus hyicus (non-pathogenetic strain 842J-88). The strain was flushed down a toilet into the sewer in the catchment area of a public wastewater treatment plant (WWTP), serving a population of 36,000 people. Raw sewage was continuously sampled at the WWTP's inlet over 30- and 60-minute intervals for a total period of seven hours. The experiment was conducted twice with one week in-between release days and under comparable weather conditions. For the metagenomics analyses, the pure single isolate of S. hyicus was sequenced, assembled and added to a large database of bacterial reference sequences. All sewage samples were analyzed by shotgun metagenome sequencing and mapped against the reference database. S. hyicus was identified in duplicate samples at both of two release days and these sequence fragment counts served as a proxy to estimate the minimum number of sick people or sensitivity required in order to observe at least one sick person at 95% probability. We found the sensitivity to be in the range 41-140 and 16-36 sick people at release days 1 and 2, respectively. The WWTP normally serves 36,000 people giving a normalized sensitivity in the range of one in 257 to 2,250 persons.
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Affiliation(s)
- Simon Kohle
- Research Group for Genomic Epidemiology, DTU-Food, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Thomas N. Petersen
- Research Group for Genomic Epidemiology, DTU-Food, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Håkan Vigre
- Research Group for Genomic Epidemiology, DTU-Food, Technical University of Denmark, Kongens Lyngby, Denmark
| | | | - Frank M. Aarestrup
- Research Group for Genomic Epidemiology, DTU-Food, Technical University of Denmark, Kongens Lyngby, Denmark
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2
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Lebu S, Gyimah R, Nandoya E, Brown J, Salzberg A, Manga M. Assessment of sanitation infrastructure resilience to extreme rainfall and flooding: Evidence from an informal settlement in Kenya. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2024; 354:120264. [PMID: 38354609 DOI: 10.1016/j.jenvman.2024.120264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/14/2024] [Accepted: 01/30/2024] [Indexed: 02/16/2024]
Abstract
Sanitation infrastructure can fail during heavy rainfall and flooding, allowing the release of fecal waste - and the pathogens it carries - into spaces where people live, work, and play. However, there is a scarcity of reliable frameworks that can effectively assess the resilience of such infrastructure to extreme rainfall and flooding events. The purpose of this study was to develop and apply a novel framework for assessing and ranking the resilience of sanitation infrastructure in informal settlements. A framework for assessing sanitation infrastructure resilience was developed consisting of 19 indicators that were categorized into three domains: physical infrastructure design (8 indicators), operations and management (5 indicators), and environmental factors (6 indicators). The framework was applied to data from 200 shared sanitation facilities in Kibera, Kenya, collected through transect walks, field observations, surveys, and sanitary risk inspections. Results indicate that sanitation infrastructure type impacts resilience. Toilet facilities connected to a piped sewer (r = 1.345, 95% CI: 1.19-1.50) and toilets connected to a septic system (r = 1.014, 95% CI: 0.78-1.25) demonstrated higher levels of resilience compared to latrines (r = 0.663, 95% CI: 0.36-0.97) and hanging toilets (r = 0.014, 95% CI: 0.30-0.33) on a scale ranging from 0 to 4. The key determinants of sanitation infrastructure resilience were physical design, functionality, operational and maintenance routines, and environmental factors. This evidence provides valuable insights for developing standards and guidelines for the design and safe siting of new sanitation infrastructure and encourages investment in sewer and septic systems as superior options for resilient sanitation infrastructure. Additionally, our findings underscore the importance for implementers and communities to prioritize repairing damaged infrastructure, sealing potential discharge points into open drains, and emptying filled containment systems before the onset of the rainy season.
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Affiliation(s)
- Sarah Lebu
- The Water Institute at UNC, Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, 4114 McGavran Hall, 135 Dauer Drive, Campus Box # 7431, NC 27599, Chapel Hill, NC, USA
| | - Rita Gyimah
- The Water Institute at UNC, Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, 4114 McGavran Hall, 135 Dauer Drive, Campus Box # 7431, NC 27599, Chapel Hill, NC, USA
| | - Erick Nandoya
- CFK Africa, P.O. Box 10763, Nairobi Postal Code: 00100 - GPO, Kenya
| | - Joe Brown
- The Water Institute at UNC, Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, 4114 McGavran Hall, 135 Dauer Drive, Campus Box # 7431, NC 27599, Chapel Hill, NC, USA; Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Aaron Salzberg
- The Water Institute at UNC, Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, 4114 McGavran Hall, 135 Dauer Drive, Campus Box # 7431, NC 27599, Chapel Hill, NC, USA
| | - Musa Manga
- The Water Institute at UNC, Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, 4114 McGavran Hall, 135 Dauer Drive, Campus Box # 7431, NC 27599, Chapel Hill, NC, USA; Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC 27599, USA.
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Ishtiaq F. Wastewater-based surveillance of vector-borne pathogens: a cautionary note. Trends Parasitol 2024; 40:93-95. [PMID: 38160180 DOI: 10.1016/j.pt.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
Diamond et al. recently identified malaria and dengue as high-priority diseases in wastewater surveillance for climate-change-driven shifts in pathogen dynamics. When employing wastewater surveillance for vector-borne pathogens it is essential to take into account the geographical context, pathogen biology, and the availability of sewage networks for meaningful interventions.
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Affiliation(s)
- Farah Ishtiaq
- Tata Institute for Genetics and Society, New InStem Building, GKVK Campus, Bellary Road, Bangalore 560065, India.
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Schaeffer J, Desdouits M, Besnard A, Le Guyader FS. Looking into sewage: how far can metagenomics help to detect human enteric viruses? Front Microbiol 2023; 14:1161674. [PMID: 37180249 PMCID: PMC10166864 DOI: 10.3389/fmicb.2023.1161674] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/03/2023] [Indexed: 05/16/2023] Open
Abstract
The impact of human sewage on environmental and food contamination constitutes an important safety issue. Indeed, human sewage reflects the microbiome of the local population, and a variety of human viruses can be detected in wastewater samples. Being able to describe the diversity of viruses present in sewage will provide information on the health of the surrounding population health and will help to prevent further transmission. Metagenomic developments, allowing the description of all the different genomes present in a sample, are very promising tools for virome analysis. However, looking for human enteric viruses with short RNA genomes which are present at low concentrations is challenging. In this study we demonstrate the benefits of performing technical replicates to improve viral identification by increasing contig length, and the set-up of quality criteria to increase confidence in results. Our approach was able to effectively identify some virus sequences and successfully describe the viral diversity. The method yielded full genomes either for norovirus, enterovirus and rotavirus, even if, for these segmented genomes, combining genes remain a difficult issue. Developing reliable viromic methods is important as wastewater sample analysis provides an important tool to prevent further virus transmission by raising alerts in case of viral outbreaks or emergence.
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Affiliation(s)
| | | | | | - Françoise S. Le Guyader
- Ifremer, Laboratoire de Microbiologie, U. Microbiologie Aliment Santé et Environnement, Nantes, France
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Tiwari A, Kurittu P, Al-Mustapha AI, Heljanko V, Johansson V, Thakali O, Mishra SK, Lehto KM, Lipponen A, Oikarinen S, Pitkänen T, Heikinheimo A. Wastewater surveillance of antibiotic-resistant bacterial pathogens: A systematic review. Front Microbiol 2022; 13:977106. [PMID: 36590429 PMCID: PMC9798455 DOI: 10.3389/fmicb.2022.977106] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
Infectious diseases caused by antibiotic-resistant bacterial (ARB) pathogens are a serious threat to human and animal health. The active surveillance of ARB using an integrated one-health approach can help to reduce the emergence and spread of ARB, reduce the associated economic impact, and guide antimicrobial stewardship programs. Wastewater surveillance (WWS) of ARB provides composite samples for a total population, with easy access to the mixed community microbiome. This concept is emerging rapidly, but the clinical utility, sensitivity, and uniformity of WWS of ARB remain poorly understood especially in relation to clinical evidence in sewershed communities. Here, we systematically searched the literature to identify studies that have compared findings from WWS of ARB and antibiotic resistance genes (ARG) with clinical evidence in parallel, thereby evaluating how likely WWS of ARB and ARG can relate to the clinical cases in communities. Initially, 2,235 articles were obtained using the primary search keywords, and 1,219 articles remained after de-duplication. Among these, 35 articles fulfilled the search criteria, and an additional 13 relevant articles were included by searching references in the primary literature. Among the 48 included papers, 34 studies used a culture-based method, followed by 11 metagenomics, and three PCR-based methods. A total of 28 out of 48 included studies were conducted at the single sewershed level, eight studies involved several countries, seven studies were conducted at national or regional scales, and five at hospital levels. Our review revealed that the performance of WWS of ARB pathogens has been evaluated more frequently for Escherichia coli, Enterococcus spp., and other members of the family Enterobacteriaceae, but has not been uniformly tested for all ARB pathogens. Many wastewater-based ARB studies comparing the findings with clinical evidence were conducted to evaluate the public health risk but not to relate with clinical evidence and to evaluate the performance of WWS of ARB. Indeed, relating WWS of ARB with clinical evidence in a sewershed is not straightforward, as the source of ARB in wastewater cannot be only from symptomatic human individuals but can also be from asymptomatic carriers as well as from animal sources. Further, the varying fates of each bacterial species and ARG within the sewerage make the aim of connecting WWS of ARB with clinical evidence more complicated. Therefore, future studies evaluating the performance of many AMR pathogens and their genes for WWS one by one can make the process simpler and the interpretation of results easier.
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Affiliation(s)
- Ananda Tiwari
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland,*Correspondence: Ananda Tiwari,
| | - Paula Kurittu
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Ahmad I. Al-Mustapha
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland,Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria,Department of Veterinary Services, Kwara State Ministry of Agriculture and Rural Development, Ilorin, Nigeria
| | - Viivi Heljanko
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Venla Johansson
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Ocean Thakali
- Department of Civil Engineering, University of Ottawa, Ottawa, ON, Canada
| | - Shyam Kumar Mishra
- School of Optometry and Vision Science, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Kirsi-Maarit Lehto
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Anssi Lipponen
- Expert Microbiology Unit, Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sami Oikarinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Tarja Pitkänen
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland,Expert Microbiology Unit, Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Annamari Heikinheimo
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland,Finnish Food Authority, Seinäjoki, Finland
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da Silva MG, Carniel ADS. Study of the correlation between Covid-19 cases and deaths and basic sanitation in Brazil: Is this a possible secondary route of virus transmission? JOURNAL OF HAZARDOUS MATERIALS ADVANCES 2022; 8:100149. [PMID: 36619828 PMCID: PMC9396440 DOI: 10.1016/j.hazadv.2022.100149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 02/01/2023]
Abstract
People with COVID-19 may excrete viable SARS-CoV-2 virus through urine and faeces, which has raised concerns about the possibility of transmission of COVID-19 via water contaminated or sewage. These concerns are especially exacerbated in underdeveloped countries like Brazil, where untreated sewage is usually discharged to surface water or soil. Because of that, a hypothesis emerged that was addressed in this study, which seeks to understand whether access to basic sanitation services can influence the proliferation of the virus. A correlation study was carried out between the cases of COVID-19 and the indicators of basic sanitation from all regions of Brazil. The results showed that there was a correlation only with the water supply indicator. A hypothesis that would explain the presented correlation would be the inefficiency of the water treatment systems in Brazil, not totally inactivating the virus, or possible contamination of the water distribution networks by sanitary sewage. In general, the data presented reinforce the need to expand and monitor basic sanitation services, especially to ensure the effective and efficient disinfection of drinking water. This monitoring could be useful for early warning surveillance of the spread of the virus.
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Lanrewaju AA, Enitan-Folami AM, Sabiu S, Edokpayi JN, Swalaha FM. Global public health implications of human exposure to viral contaminated water. Front Microbiol 2022; 13:981896. [PMID: 36110296 PMCID: PMC9468673 DOI: 10.3389/fmicb.2022.981896] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/05/2022] [Indexed: 01/08/2023] Open
Abstract
Enteric viruses are common waterborne pathogens found in environmental water bodies contaminated with either raw or partially treated sewage discharge. Examples of these viruses include adenovirus, rotavirus, noroviruses, and other caliciviruses and enteroviruses like coxsackievirus and polioviruses. They have been linked with gastroenteritis, while some enteric viruses have also been implicated in more severe infections such as encephalitis, meningitis, hepatitis (hepatitis A and E viruses), cancer (polyomavirus), and myocarditis (enteroviruses). Therefore, this review presents information on the occurrence of enteric viruses of public health importance, diseases associated with human exposure to enteric viruses, assessment of their presence in contaminated water, and their removal in water and wastewater sources. In order to prevent illnesses associated with human exposure to viral contaminated water, we suggest the regular viral monitoring of treated wastewater before discharging it into the environment. Furthermore, we highlight the need for more research to focus on the development of more holistic disinfection methods that will inactivate waterborne viruses in municipal wastewater discharges, as this is highly needed to curtail the public health effects of human exposure to contaminated water. Moreover, such a method must be devoid of disinfection by-products that have mutagenic and carcinogenic potential.
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Affiliation(s)
| | - Abimbola Motunrayo Enitan-Folami
- Department of Biotechnology and Food Science, Durban University of Technology, Durban, South Africa
- *Correspondence: Abimbola Motunrayo Enitan-Folami,
| | - Saheed Sabiu
- Department of Biotechnology and Food Science, Durban University of Technology, Durban, South Africa
| | - Joshua Nosa Edokpayi
- Water and Environmental Management Research Group, Engineering and Agriculture, University of Venda, Thohoyandou, South Africa
| | - Feroz Mahomed Swalaha
- Department of Biotechnology and Food Science, Durban University of Technology, Durban, South Africa
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8
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Godman B, Egwuenu A, Wesangula E, Schellack N, Kalungia AC, Tiroyakgosi C, Kgatlwane J, Mwita JC, Patrick O, Niba LL, Amu AA, Oguntade RT, Alabi ME, Ncube NBQ, Sefah IA, Acolatse J, Incoom R, Guantai AN, Oluka M, Opanga S, Chikowe I, Khuluza F, Chiumia FK, Jana CE, Kalemeera F, Hango E, Fadare J, Ogunleye OO, Ebruke BE, Meyer JC, Massele A, Malande OO, Kibuule D, Kapona O, Zaranyika T, Bwakura-Dangarembizi M, Kujinga T, Saleem Z, Kurdi A, Shahwan M, Jairoun AA, Wale J, Brink AJ. Tackling antimicrobial resistance across sub-Saharan Africa: current challenges and implications for the future. Expert Opin Drug Saf 2022; 21:1089-1111. [PMID: 35876080 DOI: 10.1080/14740338.2022.2106368] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Antimicrobial resistance (AMR) is a concern as this increases morbidity, mortality, and costs, with sub-Saharan Africa having the highest rates globally. Concerns with rising AMR have resulted in international, Pan-African, and country activities including the development of national action plans (NAPs). However, there is variable implementation across Africa with key challenges persisting. AREAS COVERED Consequently, there is an urgent need to document current NAP activities and challenges across sub-Saharan Africa to provide future guidance. This builds on a narrative review of the literature. EXPERT OPINION All surveyed sub-Saharan African countries have developed their NAPs; however, there is variable implementation. Countries including Botswana and Namibia are yet to officially launch their NAPs with Eswatini only recently launching its NAP. Cameroon is further ahead with its NAP than these countries; though there are concerns with implementation. South Africa appears to have made the greatest strides with implementing its NAP including regular monitoring of activities and instigation of antimicrobial stewardship programs. Key challenges remain across Africa. These include available personnel, expertise, capacity, and resources to undertake agreed NAP activities including active surveillance, lack of focal points to drive NAPs, and competing demands and priorities including among donors. These challenges are being addressed, with further co-ordinated efforts needed to reduce AMR.
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Affiliation(s)
- Brian Godman
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Abiodun Egwuenu
- AMR Programme, Nigeria Centre for Disease Control, Jabi, Abuja, Nigeria
| | - Evelyn Wesangula
- Patient and Health Workers Safety Division, AMR Focal Point, Ministry of Health, Nairobi, Kenya
| | - Natalie Schellack
- Department of Pharmacology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | | | - Joyce Kgatlwane
- Department of Pharmacy, University of Botswana, Gaborone, Botswana
| | - Julius C Mwita
- Department of Internal Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Okwen Patrick
- Effective Basic Services (eBASE) Africa, Bamenda, Cameroon, Africa
- Faculty of Health and Medical Sciences, Adelaide University, Adelaide, Australia
| | - Loveline Lum Niba
- Effective Basic Services (eBASE) Africa, Bamenda, Cameroon, Africa
- Department of Public Health, University of Bamenda, Bambili, Cameroon
| | - Adefolarin A Amu
- Pharmacy Department, Eswatini Medical Christian University, Mbabane, Eswatini
| | | | - Mobolaji Eniola Alabi
- School of Pharmaceutical Sciences, College of Health Sciences, University of Kwazulu-natal (UKZN), Durban, South Africa
| | - Nondumiso B Q Ncube
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Israel Abebrese Sefah
- Department of Pharmacy Practice, School of Pharmacy, University of Health and Allied Sciences, Volta Region, Ghana
| | - Joseph Acolatse
- Pharmacy Directorate, Cape Coast Teaching Hospital (CCTH), Cape Coast, Ghana
| | - Robert Incoom
- Pharmacy Directorate, Cape Coast Teaching Hospital (CCTH), Cape Coast, Ghana
| | - Anastasia Nkatha Guantai
- Department of Pharmacology & Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi, Kenya
| | - Margaret Oluka
- Department of Pharmacology & Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi, Kenya
| | - Sylvia Opanga
- Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, University of Nairobi, Nairobi, Kenya
| | - Ibrahim Chikowe
- Pharmacy Department, Kamuzu University of Health Sciences (KUHeS) (formerly College of Medicine), Blantyre, Malawi
| | - Felix Khuluza
- Pharmacy Department, Kamuzu University of Health Sciences (KUHeS) (formerly College of Medicine), Blantyre, Malawi
| | - Francis K Chiumia
- Pharmacy Department, Kamuzu University of Health Sciences (KUHeS) (formerly College of Medicine), Blantyre, Malawi
| | - Collins Edward Jana
- Division of Biochemistry, Biomedical Sciences Department, Kamuzu University of Health Sciences (KUHeS) (formerly College of Medicine), Blantyre, Malawi
| | - Francis Kalemeera
- Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| | - Ester Hango
- Department of Pharmacy Practice and Policy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| | - Joseph Fadare
- Department of Pharmacology and Therapeutics, Ekiti State University, Ado-Ekiti, Nigeria
- Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Olayinka O Ogunleye
- Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
- Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Bernard E Ebruke
- International Foundation Against Infectious Disease in Nigeria (IFAIN), Abuja, Nigeria
| | - Johanna C Meyer
- Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Amos Massele
- Department of Clinical Pharmacology and Therapeutics, Hurbert Kairuki Memorial University, Dar Es Salaam, Tanzania
| | - Oliver Ombeva Malande
- Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Child Health and Paediatrics, Egerton University, Nakuru, Kenya
- East Africa Centre for Vaccines and Immunization (ECAVI), Kampala, Uganda
| | - Dan Kibuule
- Department of Pharmacology & Therapeutics, Busitema University, Mbale, Tororo, Uganda
| | | | - Trust Zaranyika
- Department Of Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - Mutsa Bwakura-Dangarembizi
- Department of Paediatrics and Child Health, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | - Zikria Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy, The University of Lahore, Lahore, Pakistan
| | - Amanj Kurdi
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
- Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Pharmacology, College of Pharmacy, Hawler Medical University, Erbil, Iraq
- Center of Research and Strategic Studies, Lebanese French University, Erbil, Iraq
| | - Moyad Shahwan
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- College of Pharmacy and Health Science, Ajman University, Ajman, United Arab Emirates
| | | | - Janney Wale
- Independent consumer advocate, Brunswick, Australia
| | - Adrian J Brink
- Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- National Health Laboratory Services, Cape Town, South Africa
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Kilingo FM, Bernard Z, Hongbin C. Study of domestic wastewater treatment using Moringa oleifera coagulant coupled with vertical flow constructed wetland in Kibera Slum, Kenya. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:36589-36607. [PMID: 35064879 DOI: 10.1007/s11356-022-18692-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 01/12/2022] [Indexed: 06/14/2023]
Abstract
The domestic wastewater collection and treatment rate of Nairobi, Kenya are not high. The wastewater in the Kibera slum on the outskirts of the city that is directly discharged to the environment and pollution of the surrounding water body is a serious problem. This paper takes the domestic wastewater in the slum area as the research objective and researches on the wastewater characteristics, collection, and treatment, therefore providing the reference for the wastewater collection and treatment technology in the region. In this paper, domestic wastewater in the Kibera slum of Nairobi was sampled and investigated to find out the characteristics of wastewater discharged, the way of discharge of the household wastewater, and the management in this area. The study shows that there are differences in the concentration of main pollutants such as nutrients and organic matter in the wastewater from the household discharged to the residential river in the slum area. The domestic wastewater in this slum area contained a high concentration of nutrients such as nitrogen and phosphorus and other organics, total suspended solids (TSS), total coliforms and color, and with no treatment methods. Therefore, economic and feasible treatment technology needs to be developed. A pilot study was conducted on the treatment of domestic wastewater in the slum area by combining the seed extract of the natural plant Moringa oleifera as a coagulant and vertical flow constructed wetland (VFCW) at Tongji University, Shanghai, China. The VFCW system was efficient in chemical oxygen demand (COD), TSS, turbidity, total phosphorus (TP), and phosphates (PO4-P) removal, but the removal efficiency of nitrogen (total nitrogen (TN), ammonium nitrogen (NH4-N), and nitrate (NO3-N)) was poor, and the effluent pH reached the required discharge country's standard of the water. The average removal efficiencies for COD (79.99%), TSS (86.84%), turbidity (87.35%), TP (61.29%), PO4-P (65.66%), TN (14.11%), NH4-N (18.17%), and NO3-N (93%) were achieved by the treatment system. Furthermore, the removal efficiencies of pollutants such as TP, PO4-P, TN, and NH4-N were carried out by using the fruit extract of Moringa oleifera as raw material and zeolite as an auxiliary agent. The comprehensive effect of zeolite combined with VFCW and natural coagulant in the treatment of domestic wastewater was investigated. The COD removal efficiency was increased by (9%). TN by (46%), NH4-N by (67%), TP by (19%), and turbidity improved by (9%). In short, the domestic wastewater in the Kibera slum was collected and pretreated with natural plant coagulant, and then purified by vertical flow constructed wetland, which can not only significantly reduce the pollutant concentration but also basically meet the discharge standards. It is a low-cost sewage treatment technology suitable for poor areas.
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Affiliation(s)
- Flory Mkangombe Kilingo
- UNEP-TONGJI Institute of Environmental Science and Sustainable Development (IESD), Tongji University, Siping Road 1239, Shanghai, 200092, People's Republic of China
- The State Key Laboratory of Pollution Control and Resource Reuse, School of Environmental Sciences and Engineering, Tongji University, Shanghai, 200092, China
| | - Zulu Bernard
- UNEP-TONGJI Institute of Environmental Science and Sustainable Development (IESD), Tongji University, Siping Road 1239, Shanghai, 200092, People's Republic of China
- The State Key Laboratory of Pollution Control and Resource Reuse, School of Environmental Sciences and Engineering, Tongji University, Shanghai, 200092, China
| | - Chen Hongbin
- UNEP-TONGJI Institute of Environmental Science and Sustainable Development (IESD), Tongji University, Siping Road 1239, Shanghai, 200092, People's Republic of China.
- The State Key Laboratory of Pollution Control and Resource Reuse, School of Environmental Sciences and Engineering, Tongji University, Shanghai, 200092, China.
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10
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Chau KK, Barker L, Budgell EP, Vihta KD, Sims N, Kasprzyk-Hordern B, Harriss E, Crook DW, Read DS, Walker AS, Stoesser N. Systematic review of wastewater surveillance of antimicrobial resistance in human populations. ENVIRONMENT INTERNATIONAL 2022; 162:107171. [PMID: 35290866 PMCID: PMC8960996 DOI: 10.1016/j.envint.2022.107171] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 01/23/2022] [Accepted: 02/28/2022] [Indexed: 05/05/2023]
Abstract
OBJECTIVES We systematically reviewed studies using wastewater for AMR surveillance in human populations, to determine: (i) evidence of concordance between wastewater-human AMR prevalence estimates, and (ii) methodological approaches which optimised identifying such an association, and which could be recommended as standard. We used Lin's concordance correlation coefficient (CCC) to quantify concordance between AMR prevalence estimates in wastewater and human compartments (where CCC = 1 reflects perfect concordance), and logistic regression to identify study features (e.g. sampling methods) associated with high agreement studies (defined as >70% of within-study wastewater-human AMR prevalence comparisons within ±10%). RESULTS Of 8,867 records and 441 full-text methods reviewed, 33 studies were included. AMR prevalence data was extractable from 24 studies conducting phenotypic-only (n = 7), genotypic-only (n = 1) or combined (n = 16) AMR detection. Overall concordance of wastewater-human AMR prevalence estimates was reasonably high for both phenotypic (CCC = 0.85 [95% CI 0.8-0.89]) and genotypic approaches (CCC = 0.88 (95% CI 0.84-0.9)) despite diverse study designs, bacterial species investigated and phenotypic/genotypic targets. No significant relationships between methodological approaches and high agreement studies were identified using logistic regression; however, this was limited by inconsistent reporting of study features, significant heterogeneity in approaches and limited sample size. Based on a secondary, descriptive synthesis, studies conducting composite sampling of wastewater influent, longitudinal sampling >12 months, and time-/location-matched sampling of wastewater and human compartments generally had higher agreement. CONCLUSION Wastewater-based surveillance of AMR appears promising, with high overall concordance between wastewater and human AMR prevalence estimates in studies irrespective of heterogenous approaches. However, our review suggests future work would benefit from: time-/location-matched sampling of wastewater and human populations, composite sampling of influent, and sampling >12 months for longitudinal studies. Further research and clear and consistent reporting of study methods is required to identify optimal practice.
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Affiliation(s)
- K K Chau
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom.
| | - L Barker
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom.
| | - E P Budgell
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom.
| | - K D Vihta
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom.
| | - N Sims
- Department of Chemistry, Faculty of Science, University of Bath, Bath BA2 7AY, United Kingdom.
| | - B Kasprzyk-Hordern
- Department of Chemistry, Faculty of Science, University of Bath, Bath BA2 7AY, United Kingdom.
| | - E Harriss
- Bodleian Healthcare Libraries, University of Oxford, Oxford OX3 9DU, United Kingdom.
| | - D W Crook
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom; Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom.
| | - D S Read
- UK Centre for Ecology & Hydrology, Wallingford OX10 8BB, United Kingdom.
| | - A S Walker
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom; NIHR Oxford Biomedical Research Centre, Oxford OX4 2PG, United Kingdom.
| | - N Stoesser
- Nuffield Department of Medicine, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom; Department of Microbiology/Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom.
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11
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Fu S, Yang Q, Sheng Y, Wang Q, Wu J, Qiu Z, Lan R, Wang Y, Liu Y. Metagenomics combined with comprehensive validation as a public health risk assessment tool for urban and agricultural run-off. WATER RESEARCH 2022; 209:117941. [PMID: 34920315 DOI: 10.1016/j.watres.2021.117941] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/13/2021] [Accepted: 12/04/2021] [Indexed: 06/14/2023]
Abstract
Early detection of emerging and life-threatening pathogens circulating in complex environments is urgently required to combat infectious diseases. This study proposed a public health risk assessment workflow with three stages, pathogen screening, pathogen genotyping, and risk assessment. In stage one, pathogens were screened with metagenomic sequencing, microfluidic chip, and qPCR. In stage two, pathogens were isolated and genotyped with multi-locus sequence typing (MLST) or conventional PCR. Finally, virulence genes from metagenomic data were assessed for pathogenicity. Two regions (Donggang and Zhanjiang) with potential public health concerns were selected for evaluation, each of which comprised of one urban and one farming wastewater sampling location. Overall, metagenomic sequencing reflected the variation in the relative abundance of medically important bacteria. Over 90 bacterial pathogens were monitored in the metagenomic dataset, of which 56 species harbored virulence genes. In Donggang, a pathogenic Acinetobacter sp. reached high abundances in 2018 and 2020, whereas all pathogenic Vibrio spp. peaked in October 2019. In Zhanjiang, A. baumanni, and other Enterobacteriaceae species were abundantly present in 2019 and 2020, whereas Aeromonas and Vibrio spp. peaked in November-2017. Forty species were subsequently isolated and subtyped by MLST, half of which were prevalent genotypes in clinical data. Additionally, we identified the African Swine Fever Virus (ASFV) in water samples collected in 2017, ahead of the first reported ASFV outbreak in 2018 in China. RNA viruses like Hepatitis A virus (HAV) and Enterovirus 71 (EV71) were also detected, with concentrations peaking in April 2020 and April 2018, respectively. The dynamics of HAV and EV71 were consistent with local epidemic trends. Finally, based on the virulence gene profiles, our study identified the risk level in wastewater of two cities. This workflow illustrates the potential for an early warning of local epidemics, which helps to prioritize the preparedness for specific pathogens locally.
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Affiliation(s)
- Songzhe Fu
- College of Marine Science and Environment, Dalian Ocean University, Dalian, China; Key Laboratory of Environment Controlled Aquaculture (KLECA), Ministry of Education, Dalian 116023, China.
| | - Qian Yang
- Center for Microbial Ecology and Technology (CMET), Ghent University, Coupure Links 653, Gent 9000, Belgium
| | - Yijian Sheng
- Laboratory for Marine Biology and Biotechnology, Qingdao National Laboratory for Marine Science and Technology, Qingdao, China; College of Food Science and Technology, Shanghai Ocean University, Shanghai 201306, China
| | - Qingyao Wang
- College of Marine Science and Environment, Dalian Ocean University, Dalian, China; Key Laboratory of Environment Controlled Aquaculture (KLECA), Ministry of Education, Dalian 116023, China
| | - Junmin Wu
- College of Marine Science and Environment, Dalian Ocean University, Dalian, China; Key Laboratory of Environment Controlled Aquaculture (KLECA), Ministry of Education, Dalian 116023, China
| | - Zhiguang Qiu
- School of Environment and Energy, Shenzhen Graduate School, Peking University, Shenzhen 518055, China
| | - Ruiting Lan
- School of Biotechnology and Biomolecular Sciences, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Yongjie Wang
- Laboratory for Marine Biology and Biotechnology, Qingdao National Laboratory for Marine Science and Technology, Qingdao, China; College of Food Science and Technology, Shanghai Ocean University, Shanghai 201306, China
| | - Ying Liu
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 150791, China
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12
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Development and evaluation of a molecular based protocol for detection and quantification of Cryptosporidium spp. In wastewater. Exp Parasitol 2022; 234:108216. [DOI: 10.1016/j.exppara.2022.108216] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 01/13/2022] [Accepted: 01/21/2022] [Indexed: 12/19/2022]
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13
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Taviani E, Pedro O. Impact of the aquatic pathobiome in low-income and middle-income countries (LMICs) quest for safe water and sanitation practices. Curr Opin Biotechnol 2021; 73:220-224. [PMID: 34492621 DOI: 10.1016/j.copbio.2021.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/10/2021] [Accepted: 08/18/2021] [Indexed: 11/03/2022]
Abstract
Microbial contamination of surface waters is of particular relevance in low-income and middle-income countries (LMICs) since they often represent the only available source of water for drinking and domestic use. In the recent years, a growing urbanization, profound demographic shifts and drastic climate events have greatly affected LMICs capacity to reach access to safe drinking water and sanitation practices, and to protect citizens' health from risks associated to the exposure and use of contaminated water. Detailed phylogenetic and microbiological information on the exact composition of pathogenic organisms in urban and peri-urban water is scarce, especially in rapidly changing settings of sub-Saharan Africa. In this review we aim to highlight how large-scale water pathobiome studies can support the LMICs challenge to global access to safe water and sanitation practices.
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Affiliation(s)
- Elisa Taviani
- Center for Biotechnology, University Eduardo Mondlane, Maputo, Mozambique.
| | - Olivia Pedro
- Center for Biotechnology, University Eduardo Mondlane, Maputo, Mozambique
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14
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Ferdinand AS, Kelaher M, Lane CR, da Silva AG, Sherry NL, Ballard SA, Andersson P, Hoang T, Denholm JT, Easton M, Howden BP, Williamson DA. An implementation science approach to evaluating pathogen whole genome sequencing in public health. Genome Med 2021; 13:121. [PMID: 34321076 PMCID: PMC8317677 DOI: 10.1186/s13073-021-00934-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 07/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pathogen whole genome sequencing (WGS) is being incorporated into public health surveillance and disease control systems worldwide and has the potential to make significant contributions to infectious disease surveillance, outbreak investigation and infection prevention and control. However, to date, there are limited data regarding (i) the optimal models for integration of genomic data into epidemiological investigations and (ii) how to quantify and evaluate public health impacts resulting from genomic epidemiological investigations. METHODS We developed the Pathogen Genomics in Public HeAlth Surveillance Evaluation (PG-PHASE) Framework to guide examination of the use of WGS in public health surveillance and disease control. We illustrate the use of this framework with three pathogens as case studies: Listeria monocytogenes, Mycobacterium tuberculosis and SARS-CoV-2. RESULTS The framework utilises an adaptable whole-of-system approach towards understanding how interconnected elements in the public health application of pathogen genomics contribute to public health processes and outcomes. The three phases of the PG-PHASE Framework are designed to support understanding of WGS laboratory processes, analysis, reporting and data sharing, and how genomic data are utilised in public health practice across all stages, from the decision to send an isolate or sample for sequencing to the use of sequence data in public health surveillance, investigation and decision-making. Importantly, the phases can be used separately or in conjunction, depending on the need of the evaluator. Subsequent to conducting evaluation underpinned by the framework, avenues may be developed for strategic investment or interventions to improve utilisation of whole genome sequencing. CONCLUSIONS Comprehensive evaluation is critical to support health departments, public health laboratories and other stakeholders to successfully incorporate microbial genomics into public health practice. The PG-PHASE Framework aims to assist public health laboratories, health departments and authorities who are either considering transitioning to whole genome sequencing or intending to assess the integration of WGS in public health practice, including the capacity to detect and respond to outbreaks and associated costs, challenges and facilitators in the utilisation of microbial genomics and public health impacts.
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Affiliation(s)
- Angeline S Ferdinand
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia.
- Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
| | - Margaret Kelaher
- Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Courtney R Lane
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Anders Gonçalves da Silva
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Norelle L Sherry
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Susan A Ballard
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Patiyan Andersson
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Tuyet Hoang
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Justin T Denholm
- Victorian Tuberculosis Program, Melbourne Health, Melbourne, Australia
- Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | | | - Benjamin P Howden
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Deborah A Williamson
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia.
- Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.
- Department of Microbiology, Royal Melbourne Hospital, Melbourne, Australia.
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15
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De R. Mobile Genetic Elements of Vibrio cholerae and the Evolution of Its Antimicrobial Resistance. FRONTIERS IN TROPICAL DISEASES 2021. [DOI: 10.3389/fitd.2021.691604] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Vibrio cholerae (VC) is the causative agent of the severe dehydrating diarrheal disease cholera. The primary treatment for cholera is oral rehydration therapy (ORT). However, in case of moderate to severe dehydration, antibiotics are administered to reduce morbidity. Due to the emergence of multidrug resistant (MDR) strains of VC routinely used antibiotics fail to be effective in cholera patients. Antimicrobial resistance (AMR) is encoded in the genome of bacteria and is usually acquired from other organisms cohabiting in the environment or in the gut with which it interacts in the gut or environmental niche. The antimicrobial resistance genes (ARGs) are usually borne on mobile genetic elements (MGEs) like plasmids, transposons, integrons and SXT constin. Horizontal gene transfer (HGT) helps in the exchange of ARGs among bacteria leading to dissemination of AMR. In VC the acquisition and loss of AMR to many antibiotics have been found to be a dynamic process. This review describes the different AMR determinants and mechanisms of resistance that have been discovered in VC. These ARGs borne usually on MGEs have been recovered from isolates associated with past and present epidemics worldwide. These are responsible for resistance of VC to common antibiotics and are periodically lost and gained contributing to its genetic evolution. These resistance markers can be routinely used for AMR surveillance in VC. The review also presents a precise perspective on the importance of the gut microbiome in the emergence of MDR VC and concludes that the gut microbiome is a potential source of molecular markers and networks which can be manipulated for the interception of AMR in the future.
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16
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Silva RR, Ribeiro CJN, Moura TR, Santos MB, Santos AD, Tavares DS, Santos PL. Basic sanitation: a new indicator for the spread of COVID-19? Trans R Soc Trop Med Hyg 2021; 115:832-840. [PMID: 33547895 PMCID: PMC7928698 DOI: 10.1093/trstmh/traa187] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/06/2020] [Accepted: 12/22/2020] [Indexed: 12/13/2022] Open
Abstract
Background Basic sanitation could be a potential indicator of the spread of coronavirus disease-2019 (COVID-19) and, in this context, space-time patterns are important tools with which to elucidate the spread of disease and identify risk factors. The aim of this study was to assess a possible association between basic sanitation indices and COVID-19 rates in all the 5570 municipalities of Brazil and its spatial distribution. Methods Data of COVID-19 cases registered in Brazil from 28 February until 31 May 2020 and independent variables associated with basic sanitation were included. Results High incidence rates were significantly associated with precarious water service index (0–25% coverage) and offstandard faecal coliforms index for tap water (5–50% and 75–100% of samples tested). A significant association between high mortality rates and sewage collection (0–25% coverage)/treatment (25–50% coverage) indices was also verified. In addition, clusters with significant spatial autocorrelation were identified mainly in the North and Northeast regions for mortality and incidence rates (high-high risk areas) and for offstandard faecal coliforms index. Those regions are considered the poorest in Brazil, presenting with low incomes, human agglomerations, as well as a poor basic sanitation system, which also hinder the implementation of COVID-19-preventative measures. Conclusions A precarious basic sanitation infrastructure could potentially be associated with the high transmission of severe acute respiratory syndrome coronavirus-2 in Brazil.
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Affiliation(s)
- Renata R Silva
- Health Sciences Postgraduate Program, Federal University of Sergipe, Rua Cáudio Batista, s/n, Palestina, CEP 49060-108, Aracaju, Sergipe, Brazil
| | - Caique J N Ribeiro
- Department of Nursing, Federal University of Sergipe, Av. Governador Marcelo Déda, 13, Centro, CEP 49 400-000, Lagarto, Sergipe, Brazil
| | - Tatiana R Moura
- Department of Morphology, Federal University of Sergipe, Av. Marechal Rondom, s/n, Jardim Rosa Elze, CEP 49 100-000, São Cristóvão, Sergipe, Brazil
| | - Márcio B Santos
- Department of Morphology, Federal University of Sergipe, Av. Marechal Rondom, s/n, Jardim Rosa Elze, CEP 49 100-000, São Cristóvão, Sergipe, Brazil
| | - Allan D Santos
- Department of Nursing, Federal University of Sergipe, Av. Governador Marcelo Déda, 13, Centro, CEP 49 400-000, Lagarto, Sergipe, Brazil
| | - Débora S Tavares
- Department of Health Education, Federal University of Sergipe, Av. Governador Marcelo Déda, 13, Centro, CEP 49 400-000, Lagarto, Sergipe, Brazil
| | - Priscila L Santos
- Department of Health Education, Federal University of Sergipe, Av. Governador Marcelo Déda, 13, Centro, CEP 49 400-000, Lagarto, Sergipe, Brazil
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17
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Mthethwa NP, Amoah ID, Reddy P, Bux F, Kumari S. A review on application of next-generation sequencing methods for profiling of protozoan parasites in water: Current methodologies, challenges, and perspectives. J Microbiol Methods 2021; 187:106269. [PMID: 34129906 DOI: 10.1016/j.mimet.2021.106269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 01/23/2023]
Abstract
The advancement in metagenomic techniques has provided novel tools for profiling human parasites in environmental matrices, such as water and wastewater. However, application of metagenomic techniques for the profiling of protozoan parasites in environmental matrices is not commonly reported in the literature. The key factors leading to the less common use of metagenomics are the complexity and large eukaryotic genome, the prevalence of small parasite populations in environmental samples compared to bacteria, difficulties in extracting DNA from (oo)cysts, and limited reference databases for parasites. This calls for further research to develop optimized methods specifically looking at protozoan parasites in the environment. This study reviews the current workflow, methods and provide recommendations for the standardization of techniques. The article identifies and summarizes the key methods, advantages, and limitations associated with metagenomic analysis, like sample pre-processing, DNA extraction, sequencing approaches, and analysis methods. The study enhances the understanding and application of standardized protocols for profiling of protozoan parasite community from highly complexe samples and further creates a resourceful comparison among datasets without any biases.
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Affiliation(s)
- N P Mthethwa
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban 4000, South Africa; Department of Community Health Studies, Faculty of Health Sciences, Durban University of Technology, Durban 4000, South Africa
| | - I D Amoah
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban 4000, South Africa
| | - P Reddy
- Department of Community Health Studies, Faculty of Health Sciences, Durban University of Technology, Durban 4000, South Africa
| | - F Bux
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban 4000, South Africa
| | - S Kumari
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban 4000, South Africa.
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18
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Upfold NS, Luke GA, Knox C. Occurrence of Human Enteric Viruses in Water Sources and Shellfish: A Focus on Africa. FOOD AND ENVIRONMENTAL VIROLOGY 2021; 13:1-31. [PMID: 33501612 PMCID: PMC7837882 DOI: 10.1007/s12560-020-09456-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 12/16/2020] [Indexed: 05/02/2023]
Abstract
Enteric viruses are a diverse group of human pathogens which are primarily transmitted by the faecal-oral route and are a major cause of non-bacterial diarrhoeal disease in both developed and developing countries. Because they are shed in high numbers by infected individuals and can persist for a long time in the environment, they pose a serious threat to human health globally. Enteric viruses end up in the environment mainly through discharge or leakage of raw or inadequately treated sewage into water sources such as springs, rivers, dams, or marine estuaries. Human exposure then follows when contaminated water is used for drinking, cooking, or recreation and, importantly, when filter-feeding bivalve shellfish are consumed. The human health hazard posed by enteric viruses is particularly serious in Africa where rapid urbanisation in a relatively short period of time has led to the expansion of informal settlements with poor sanitation and failing or non-existent wastewater treatment infrastructure, and where rural communities with limited or no access to municipal water are dependent on nearby open water sources for their subsistence. The role of sewage-contaminated water and bivalve shellfish as vehicles for transmission of enteric viruses is well documented but, to our knowledge, has not been comprehensively reviewed in the African context. Here we provide an overview of enteric viruses and then review the growing body of research where these viruses have been detected in association with sewage-contaminated water or food in several African countries. These studies highlight the need for more research into the prevalence, molecular epidemiology and circulation of these viruses in Africa, as well as for development and application of innovative wastewater treatment approaches to reduce environmental pollution and its impact on human health on the continent.
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Affiliation(s)
- Nicole S Upfold
- Department of Biochemistry and Microbiology, Rhodes University, Grahamstown, 6140, South Africa
| | - Garry A Luke
- Centre for Biomolecular Sciences, School of Biology, Biomolecular Sciences Building, University of St Andrews, North Haugh, St Andrews, Scotland, KY16 9ST, UK
| | - Caroline Knox
- Department of Biochemistry and Microbiology, Rhodes University, Grahamstown, 6140, South Africa.
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19
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Muirhead A, Zhu K, Brown J, Basu M, Brinton MA, Costa F, Hayat MJ, Stauber C. Zika Virus RNA Persistence in Sewage. ENVIRONMENTAL SCIENCE & TECHNOLOGY LETTERS 2020; 7:659-664. [PMID: 37293193 PMCID: PMC10249660 DOI: 10.1021/acs.estlett.0c00535] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Despite substantial advances in knowledge and understanding about Zika virus (ZIKV), limitations in surveillance for this mainly asymptomatic infection constrain attempts to characterize the epidemiological distribution of the virus. Monitoring of fecal waste streams including sewage offers opportunities to track the spread of arboviruses such as ZIKV, known to be present in fecal waste and urine. To demonstrate the feasibility of ZIKV RNA detection in sewage, we examined viral RNA decay in sewage from a local wastewater treatment plant. We added ZIKV (MEX 1-44) to unpasteurized sewage and stored the samples at 4°C, 25°C or 35°C for one month. We extracted nucleic acids from the mixture using a QiaAmp Minelute Virus Spin Kit and measured ZIKV RNA using a TaqPath Zika Virus Kit. We found no appreciable decline in ZIKV RNA detection at 4°C during the month. We estimate that 90% decay of detectable ZIKV RNA occurred after 21 days at 25°C and after 8.5 days at 35°C. Our preliminary work suggests ZIKV RNA can remain detectable in sewage over a range of temperatures and that sewage provides a cost-effective, community diagnostic tool that deserves further investigation as a novel epidemiologic surveillance approach.
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Affiliation(s)
- Aaron Muirhead
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Kevin Zhu
- Civil and Environmental Engineering, School of Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Joe Brown
- Civil and Environmental Engineering, School of Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Mausaumi Basu
- Department of Biology, College of Arts and Sciences, Georgia State University, Atlanta, GA, USA
| | - Margo A Brinton
- Department of Biology, College of Arts and Sciences, Georgia State University, Atlanta, GA, USA
| | - Federico Costa
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, BR
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz/MS, Salvador, Bahia, BR
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Matthew J Hayat
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Christine Stauber
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
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20
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Odih EE, Afolayan AO, Akintayo I, Okeke IN. Could Water and Sanitation Shortfalls Exacerbate SARS-CoV-2 Transmission Risks? Am J Trop Med Hyg 2020; 103:554-557. [PMID: 32524953 PMCID: PMC7410451 DOI: 10.4269/ajtmh.20-0462] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
SARS-CoV-2, the etiologic agent of COVID-19, is shed in stool. SARS coronaviruses have been detected in wastewater during outbreaks in China, Europe, and the United States. In this perspective, we outline the risk fecal shedding poses at locations without safely managed sanitation, as in most of Nigeria where we work. We believe that feco-oral transmission could occur if community transmission becomes high and sustained in densely populated cities without proper sanitation in Nigeria and many other African and Asian settings. In the absence of basic sanitation, or where existing sanitation is not safely managed, groundwater, which is often drawn up from wells and boreholes for drinking and household use, can become contaminated with enteric bacteria and viruses from fecal matter. Endemic and epidemic transmission of multiple feco-oral pathogens via this route continues to be documented in areas without safely managed sanitation, and, therefore, the risk of SARS-CoV-2 transmission needs to be evaluated, tracked, and forestalled in such settings. We suggest that fecal matter from treatment facilities and recovered patients should be carefully and properly disposed. Furthermore, environmental surveillance of SARS-CoV-2 in wastewater and accumulated human waste, as well as efforts to mitigate the virus’ entry into unprotected household water sources, should be a priority part of the COVID-19 response in settings without safely managed sanitation for the duration of the pandemic.
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Affiliation(s)
- Erkison E Odih
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Ayorinde O Afolayan
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - IfeOluwa Akintayo
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Iruka N Okeke
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
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Aarestrup FM, Woolhouse MEJ. Using sewage for surveillance of antimicrobial resistance. Science 2020; 367:630-632. [DOI: 10.1126/science.aba3432] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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