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Makgoba L, Abrams A, Röösli M, Cissé G, Dalvie MA. DDT contamination in water resources of some African countries and its impact on water quality and human health. Heliyon 2024; 10:e28054. [PMID: 38560195 PMCID: PMC10979284 DOI: 10.1016/j.heliyon.2024.e28054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/13/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
Dichlorodiphenyltrichloroethane (DDT) usage has been prohibited in developed nations since 1972 but is exempted for use in indoor residual spraying (IRS) in developing countries, including African countries, for malaria control. There have been no previous reviews on DDT residues in water resources in Africa. The study aimed to provide a review of available research investigating the levels of DDT residues in water sources in Africa and to assess the consequent human health risks. A scoping review of published studies in Africa was conducted through a systematic electronic search using PubMed, Web of Science, EBSCO HOST, and Scopus. A total of 24 articles were eligible and reviewed. Concentrations of DDT ranged from non-detectable levels to 81.2 μg/L. In 35% of the studies, DDT concentrations surpassed the World Health Organization (WHO) drinking water guideline of 1 μg/L in the sampled water sources. The highest DDT concentrations were found in South Africa (81.2 μg/L) and Egypt (5.62 μg/L). DDT residues were detected throughout the year in African water systems, but levels were found to be higher during the wet season. Moreover, water from taps, rivers, reservoirs, estuaries, wells, and boreholes containing DDT residues was used as drinking water. Seven studies conducted health risk assessments, with two studies identifying cancer risk values surpassing permissible thresholds in water sampled from sources designated for potable use. Non-carcinogenic health risks in the studies fell below a hazard quotient of 1. Consequently, discernible evidence of risks to human health surfaced, given that the concentration of DDT residues surpassed either the WHO drinking water guidelines or the permissible limits for cancer risk in sampled drinking sources within African water systems. Therefore, alternative methods for malaria vector control should be investigated and applied.
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Affiliation(s)
- Lethabo Makgoba
- Centre for Environmental and Occupational Health Research, School of Public Health, University of Cape Town, Health Sciences Faculty, Observatory, Cape Town, 7925, South Africa
| | - Amber Abrams
- Future Water Research Institute, University of Cape Town, Cape Town, 7700, South Africa
| | - Martin Röösli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland
- University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Guéladio Cissé
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland
- University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Mohamed Aqiel Dalvie
- Centre for Environmental and Occupational Health Research, School of Public Health, University of Cape Town, Health Sciences Faculty, Observatory, Cape Town, 7925, South Africa
- Future Water Research Institute, University of Cape Town, Cape Town, 7700, South Africa
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Martin JA, Hendershot AL, Saá Portilla IA, English DJ, Woodruff M, Vera-Arias CA, Salazar-Costa BE, Bustillos JJ, Saénz FE, Ocaña-Mayorga S, Koepfli C, Lobo NF. Anopheline and human drivers of malaria risk in northern coastal, Ecuador: a pilot study. Malar J 2020; 19:354. [PMID: 33008438 PMCID: PMC7532652 DOI: 10.1186/s12936-020-03426-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/23/2020] [Indexed: 11/28/2022] Open
Abstract
Background Understanding local anopheline vector species and their bionomic traits, as well as related human factors, can help combat gaps in protection. Methods In San José de Chamanga, Esmeraldas, at the Ecuadorian Pacific coast, anopheline mosquitoes were sampled by both human landing collections (HLCs) and indoor-resting aspirations (IAs) and identified using both morphological and molecular methods. Human behaviour observations (HBOs) (including temporal location and bed net use) were documented during HLCs as well as through community surveys to determine exposure to mosquito bites. A cross-sectional evaluation of Plasmodium falciparum and Plasmodium vivax infections was conducted alongside a malaria questionnaire. Results Among 222 anopheline specimens captured, based on molecular analysis, 218 were Nyssorhynchus albimanus, 3 Anopheles calderoni (n = 3), and one remains unidentified. Anopheline mean human-biting rate (HBR) outdoors was (13.69), and indoors (3.38) (p = 0.006). No anophelines were documented resting on walls during IAs. HBO-adjusted human landing rates suggested that the highest risk of being bitten was outdoors between 18.00 and 20.00 h. Human behaviour-adjusted biting rates suggest that overall, long-lasting insecticidal bed nets (LLINs) only protected against 13.2% of exposure to bites, with 86.8% of exposure during the night spent outside of bed net protection. The malaria survey found 2/398 individuals positive for asymptomatic P. falciparum infections. The questionnaire reported high (73.4%) bed net use, with low knowledge of malaria. Conclusion The exophagic feeding of anopheline vectors in San Jose de Chamanga, when analysed in conjunction with human behaviour, indicates a clear gap in protection even with high LLIN coverage. The lack of indoor-resting anophelines suggests that indoor residual spraying (IRS) may have limited effect. The presence of asymptomatic infections implies the presence of a human reservoir that may maintain transmission.
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Affiliation(s)
- James A Martin
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Allison L Hendershot
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Iván Alejandro Saá Portilla
- Centro de Investigación Para La Salud en América Latina, Facultad de Ciencias Exactas Y Naturales, Pontificia Universidad Católica del Ecuador, Calle San Pedro Y Pambahacienda, 170530, Nayón, Ecuador
| | - Daniel J English
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Madeline Woodruff
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Claudia A Vera-Arias
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.,Centro de Investigación Para La Salud en América Latina, Facultad de Ciencias Exactas Y Naturales, Pontificia Universidad Católica del Ecuador, Calle San Pedro Y Pambahacienda, 170530, Nayón, Ecuador
| | - Bibiana E Salazar-Costa
- Centro de Investigación Para La Salud en América Latina, Facultad de Ciencias Exactas Y Naturales, Pontificia Universidad Católica del Ecuador, Calle San Pedro Y Pambahacienda, 170530, Nayón, Ecuador
| | - Juan José Bustillos
- Centro de Investigación Para La Salud en América Latina, Facultad de Ciencias Exactas Y Naturales, Pontificia Universidad Católica del Ecuador, Calle San Pedro Y Pambahacienda, 170530, Nayón, Ecuador
| | - Fabián E Saénz
- Centro de Investigación Para La Salud en América Latina, Facultad de Ciencias Exactas Y Naturales, Pontificia Universidad Católica del Ecuador, Calle San Pedro Y Pambahacienda, 170530, Nayón, Ecuador
| | - Sofía Ocaña-Mayorga
- Centro de Investigación Para La Salud en América Latina, Facultad de Ciencias Exactas Y Naturales, Pontificia Universidad Católica del Ecuador, Calle San Pedro Y Pambahacienda, 170530, Nayón, Ecuador.
| | - Cristian Koepfli
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Neil F Lobo
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA
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Tugume A, Muneza F, Oporia F, Kiconco A, Kihembo C, Kisakye AN, Nsubuga P, Deogratias S, Yeka A. Effects and factors associated with indoor residual spraying with Actellic 300 CS on malaria morbidity in Lira District, Northern Uganda. Malar J 2019; 18:44. [PMID: 30791906 PMCID: PMC6383239 DOI: 10.1186/s12936-019-2681-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 02/14/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Indoor residual spraying (IRS) with Actellic 300 CS was conducted in Lira District between July and August 2016. No formal assessment has been conducted to estimate the effect of spraying with Actellic 300 CS on malaria morbidity in the Ugandan settings. This study assessed malaria morbidity trends before and after IRS with Actellic 300 CS in Lira District in Northern Uganda. METHODS The study employed a mixed methods design. Malaria morbidity records from four health facilities were reviewed, focusing on 6 months before and after the IRS intervention. The outcome of interest was malaria morbidity defined as; proportion of outpatient attendance due to total malaria, proportion of outpatient attendance due to confirmed malaria and proportion of malaria case numbers confirmed by microscopy or rapid diagnostic test. Since malaria morbidity was based on count data, an ordinary Poisson regression model was used to obtain percentage point change (pp) in monthly malaria cases before and after IRS. A household survey was also conducted in 159 households to determine IRS coverage and factors associated with spraying. A modified Poisson regression model was fitted to determine factors associated with household spray status. RESULTS The proportion of outpatient attendance due to malaria dropped from 18.7% before spraying to 15.1% after IRS. The proportion of outpatient attendance due to confirmed malaria also dropped from 5.1% before spraying to 4.0% after the IRS intervention. There was a decreasing trend in malaria test positivity rate (TPR) for every unit increase in month after spraying. The decreasing trend in TPR was more prominent 5-6 months after the IRS intervention (Adj. pp = - 0.60, P-value = 0.015; Adj. pp = - 1.19, P-value < 0.001). The IRS coverage was estimated at 89.3%. Households of respondents who were formally employed or owned any form of business were more likely to be unsprayed; (APR = 5.81, CI 2.72-12.68); (APR = 3.84, CI 1.20-12.31), respectively. CONCLUSION Coverage of IRS with Actellic 300 CS was high and was associated with a significant decline in malaria related morbidity 6 months after spraying.
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Affiliation(s)
- Abdulaziz Tugume
- Department of Epidemiology and Biostatistics, College of Health Sciences, School of Public Health, Makerere University, P.O.BOX, 7072, Kampala, Uganda.
| | - Fiston Muneza
- Department of Epidemiology and Biostatistics, College of Health Sciences, School of Public Health, Makerere University, P.O.BOX, 7072, Kampala, Uganda
| | - Frederick Oporia
- Department of Disease Control and Environmental Health, College of Health Sciences, School of Public Health, Makerere University, Kampala, Uganda
| | - Arthur Kiconco
- Department of Disease Control and Environmental Health, College of Health Sciences, School of Public Health, Makerere University, Kampala, Uganda
| | | | - Angela Nakanwagi Kisakye
- Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda.,African Field Epidemiology Network, Kampala, Uganda
| | | | - Sekimpi Deogratias
- Department of Disease Control and Environmental Health, College of Health Sciences, School of Public Health, Makerere University, Kampala, Uganda
| | - Adoke Yeka
- Department of Disease Control and Environmental Health, College of Health Sciences, School of Public Health, Makerere University, Kampala, Uganda
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Tukei BB, Beke A, Lamadrid-Figueroa H. Assessing the effect of indoor residual spraying (IRS) on malaria morbidity in Northern Uganda: a before and after study. Malar J 2017; 16:4. [PMID: 28049475 PMCID: PMC5209922 DOI: 10.1186/s12936-016-1652-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 12/15/2016] [Indexed: 11/29/2022] Open
Abstract
Background Indoor residual spraying (IRS) is known to reduce malaria transmission. In northern Uganda, a high endemic area, IRS has been implemented since 2006. Limited data however, exists on the effect of IRS on the malaria burden. This study sought to assess the effect of IRS on malaria morbidity in the high intensity area of northern Uganda. Retrospective routine data from ten health facilities in three districts which had received at least five rounds of IRS in northern Uganda was analysed. The primary outcome of interest was malaria morbidity, measured by the slide positivity rate (SPR). Descriptive statistics were used to describe the malaria morbidity stratified by age and sex. The average change in the malaria morbidity, measured by the SPR was assessed according to time, measured as calendar months. A fixed-effects linear regression model was used which included a polynomial function of time and controlled for malaria seasonality and variations between districts/facilities. Results The total out-patient department attendance in the ten health facilities for the study period was 2,779,246, of which 736,034 (26.5%) malaria cases were diagnosed with 374,826 (50.9%) cases of under 5 years and an overall SPR of 37.5%. The percentage point (p.p.) changes in SPR according to time measured as calendar months following IRS, revealed a decreasing trend in malaria morbidity in the first 3 months following each round of IRS. The highest percentage point decrease in the SPR was observed in the second month following IRS (9.5 p.p., CI −17.85 to −1.16, p = 0.026), among patients above 5 years. The SPR decline however waned by the fourth month following IRS, with an increase in the SPR of 8.4 p.p. at district level by the sixth month, p = 0.510. Conclusion The study results show that IRS was associated with a significant reduction in malaria morbidity in northern Uganda in the first 3 months following IRS. The malaria reduction however waned by the fourth month following IRS. Electronic supplementary material The online version of this article (doi:10.1186/s12936-016-1652-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Betty Bawuba Tukei
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.
| | - Andy Beke
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Héctor Lamadrid-Figueroa
- Division of Reproductive Health, Research Center for Population Health, National Institute of Public Health (INSP), Cuernavaca, Mexico
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