Razak Seidu

Quantification of the health risk associated with wastewater reuse in Accra, Ghana: a contribution toward local guidelines

Quantitative Microbial Risk Assessment (QMRA) models with 10,000 Monte Carlo simulations were applied to ascertain the risks of rotavirus and Ascaris infections for farmers using different irrigation water qualities and consumers of lettuce irrigated with the different water qualities after allowing post-harvest handling. A tolerable risk (TR) of infection of 7.7 x 10(-4) and 1 x 10(-2) per person per year were used for rotavirus and Ascaris respectively. The risk of Ascaris infection was within a magnitude of 10(-2) for farmers accidentally ingesting drain or stream irrigation water; approximately 10(0) for farmers accidentally ingesting farm soil and 10(0) for farmers ingesting any of the irrigation waters and contaminated soil. There was a very low risk (10(-5)) of Ascaris infection for farmers using pipe-water. For consumers, the annual risks of Ascaris and rotavirus infections were 10(0) and 10(-3) for drain and stream irrigated lettuce respectively with slight increases for rotavirus infections along the post-harvest handling chain. Pipe irrigated lettuce recorded a rotavirus infection of 10(-4) with no changes due to post harvest handling. The assessment identified on-farm soil contamination as the most significant health hazard.

Comparative assessment of the bacterial communities associated with Aedes aegypti larvae and water from domestic water storage containers

BackgroundDomestic water storage containers constitute major Aedes aegypti breeding sites. We present for the first time a comparative analysis of the bacterial communities associated with Ae. aegypti larvae and water from domestic water containers.MethodsThe 16S rRNA-temporal temperature gradient gel electrophoresis (TTGE) was used to identify and compare bacterial communities in fourth-instar Ae. aegypti larvae and water from larvae positive and negative domestic containers in a rural village in northeastern Thailand. Water samples were cultured for enteric bacteria in addition to TTGE. Sequences obtained from TTGE and bacterial cultures were clustered into operational taxonomic units (OTUs) for analyses.ResultsSignificantly lower OTU abundance was found in fourth-instar Ae. aegypti larvae compared to mosquito positive water samples. There was no significant difference in OTU abundance between larvae and mosquito negative water samples or between mosquito positive and negative water samples. Larval samples had significantly different OTU diversity compared to mosquito positive and negative water samples, with no significant difference between mosquito positive and negative water samples. The TTGE identified 24 bacterial taxa, belonging to the phyla Proteobacteria, Firmicutes, Actinobacteria, Bacteroidetes and TM7 (candidate phylum). Seven of these taxa were identified in larval samples, 16 in mosquito positive and 13 in mosquito negative water samples. Only two taxa, belonging to the phyla Firmicutes and Actinobacteria, were common to both larvae and water samples. Bacilli was the most abundant bacterial class identified from Ae. aegypti larvae, Gammaproteobacteria from mosquito positive water samples, and Flavobacteria from mosquito negative water samples. Enteric bacteria belonging to the class Gammaproteobacteria were sparsely represented in TTGE, but were isolated from both mosquito positive and negative water samples by selective culture.ConclusionsFew bacteria from water samples were identified in fourth-instar Ae. aegypti larvae, suggesting that established larval bacteria, most likely acquired at earlier stages of development, control the larval microbiota. Further studies at all larval stages are needed to fully understand the dynamics involved. Isolation of enteric bacteria from water samples supports earlier outcomes of E. coli contamination in Ae. aegypti infested domestic containers, suggesting the need to further explore the role of enteric bacteria in Ae. aegypti infestation.

Cost-effectiveness of options for reducing health risks in areas where food crops are irrigated with treated or untreated wastewater

In this article the authors draw from a comparative assessment of different interventions, examining their costs, risk-reduction potential and cost-effectiveness. They consider a case study in Ghana, using an approach that integrates quantitative microbial risk assessment (QMRA), disability-adjusted life years (DALYs) and cost-effectiveness analysis. Most practices appear highly cost-effective, although only a few are likely to avert more than 80% of the DALY burden. As compliance will always be a challenge, the results support the need for a multi-barrier risk-management approach that, where possible, combines treatment and non-treatment interventions.

Relationship between Aedes aegypti production and occurrence of Escherichia coli in domestic water storage containers in rural and sub-urban villages in Thailand and Laos

In a cross-sectional survey in one rural and one suburban village each in Thailand and Laos the relationship between Aedes aegypti production and Escherichia coli contamination in household water storage containers was investigated. Entomological and microbiological surveys were conducted in 250 and 239 houses in Thailand and Laos, respectively. Entomological indices across all four villages were high, indicating a high risk for dengue transmission. Significantly more Ae. aegypti pupae were produced in containers contaminated with E. coli as compared to those that were not, with the odds of Ae. aegypti infested containers being contaminated with E. coli ranging from two to five. The level of E. coli contamination varied across container classes but contamination levels were not significantly associated with the number of pupae produced. We conclude that the observed relationship between Ae. aegypti production and presence of E. coli in household water storage containers suggests a causal relationship between dengue and diarrheal disease at these sites. How this relationship can be exploited for the combined and cost-effective control of dengue and diarrheal diseases requires further research.

Diarrhea and dengue control in rural primary schools in Colombia: study protocol for a randomized controlled trial

BackgroundDiarrheal diseases and dengue fever are major global health problems. Where provision of clean water is inadequate, water storage is crucial. Fecal contamination of stored water is a common source of diarrheal illness, but stored water also provides breeding sites for dengue vector mosquitoes. Poor household water management and sanitation are therefore potential determinants of both diseases. Little is known of the role of stored water for the combined risk of diarrhea and dengue, yet a joint role would be important for developing integrated control and management efforts. Even less is known of the effect of integrating control of these diseases in school settings. The objective of this trial was to investigate whether interventions against diarrhea and dengue will significantly reduce diarrheal disease and dengue entomological risk factors in rural primary schools.Methods/designThis is a 2×2 factorial cluster randomized controlled trial. Eligible schools were rural primary schools in La Mesa and Anapoima municipalities, Cundinamarca, Colombia. Eligible pupils were school children in grades 0 to 5. Schools were randomized to one of four study arms: diarrhea interventions (DIA); dengue interventions (DEN); combined diarrhea and dengue interventions (DIADEN); and control (C). Schools were allocated publicly in each municipality (strata) at the start of the trial, obviating the need for allocation concealment. The primary outcome for diarrhea is incidence rate of diarrhea in school children and for dengue it is density of adult female Aedes aegypti per school. Approximately 800 pupils from 34 schools were enrolled in the trial with eight schools in the DIA arm, nine in the DEN, eight in the DIADEN, and nine in the control arms. The trial status as of June 2012 was: completed baseline data collections; enrollment, randomization, and allocation of schools. The trial was funded by the Research Council of Norway and the Lazos de Calandaima Foundation.DiscussionThis is the first trial investigating the effect of a set of integrated interventions to control both dengue and diarrhea. This is also the first trial to study the combination of diarrhea-dengue disease control in school settings.Trial registrationCurrent Controlled Trials ISRCTN40195031

Modeling the die-off of E. coli and Ascaris in wastewater-irrigated vegetables: implications for microbial health risk reduction associated with irrigation cessation

This study assessed the die-off of Escherichia coli (E. coli) and Ascaris suum on lettuce (Great Lakes 118) and cabbage (Brassica oleracea var capitata) in wastewater-irrigated fields using comparative mathematical die-off models. The study revealed that none of the survival curves of E. coli and A. suum was best fitted with the log-linear model, indicating that the classical first-order kinetic approach is inadequate in many cases. The biphasic die-off model best described the die-off of E. coli on lettuce (kmax1 = 2.62 day(-1) and kmax2 = 0.22 day(-1)) and cabbage (kmax1 = 1.06 day(-1) and kmax2 = 0.53 day(-1)). The die-off of A. suum on lettuce was best described by the biphasic model (kmax1 = 0.48 day(-1) and kmax2 = 0.01 day(-1)) and best described by log linear + tail (kmax = 0.44) on cabbage. A comparative health risk assessment associated with the consumption of lettuce showed significant underestimation of the number of days of irrigation cessation required to achieve E. coli O157:H7 and Ascaris tolerable annual infection risk when using biphasic die-off rates compared with other die-off rates. The study stresses the need to test different die-off models as inputs for quantitative microbial risk assessment (QMRA) particularly for interventions associated with health risk reduction.

Contribution of Wastewater Irrigation to Soil Transmitted Helminths Infection among Vegetable Farmers in Kumasi, Ghana

Wastewater irrigation is associated with several benefits but can also lead to significant health risks. The health risk for contracting infections from Soil Transmitted Helminths (STHs) among farmers has mainly been assessed indirectly through measured quantities in the wastewater or on the crops alone and only on a limited scale through epidemiological assessments. In this study we broadened the concept of infection risks in the exposure assessments by measurements of the concentration of STHs both in wastewater used for irrigation and the soil, as well as the actual load of STHs ova in the stool of farmers and their family members (165 and 127 in the wet and dry seasons respectively) and a control group of non-farmers (100 and 52 in the wet and dry seasons, respectively). Odds ratios were calculated for exposure and non-exposure to wastewater irrigation. The results obtained indicate positive correlation between STH concentrations in irrigation water/soil and STHs ova as measured in the stool of the exposed farmer population. The correlations are based on reinfection during a 3 months period after prior confirmed deworming. Farmers and family members exposed to irrigation water were three times more likely as compared to the control group of non-farmers to be infected with Ascaris (OR = 3.9, 95% CI, 1.15–13.86) and hookworm (OR = 3.07, 95% CI, 0.87–10.82). This study therefore contributes to the evidence-based conclusion that wastewater irrigation contributes to a higher incidence of STHs infection for farmers exposed annually, with higher odds of infection in the wet season.

Long-term hygienic barrier efficiency of a compact on-site wastewater treatment system.

The long-term use of a filter-based, on-site wastewater treatment system increases nutrient discharge to receiving waters and may reduce its hygienic barrier efficiency. The main purpose of this research was to assess the hygienic barrier efficiency and the associated health risks of an on-site system that had exceeded its 5-yr design capacity with respect to phosphorus (P) removal. The system was investigated for bacteria and virus removal and assessed with respect to potential health risks in relation to reuse of effluent for irrigation. The system consists of a septic tank, a pressure-dosed vertical flow biofilter, and an up-flow filter unit with lightweight clay aggregates. The total P concentration in the effluent had increased gradually from initially <0.1 mg P L(-1) during the first 2 yr of operation to 1.8 mg P L(-1) after 5.3 yr. Escherichia coli was used as an indicator organism for fecal bacteria removal, whereas bacteriophages phiX174 and Salmonella typhimurium phage 28B (S.t. 28B) were used to model enteric virus removal. An overall decrease in E. coli removal occurred from a complete (approximately 5.6 log10) reduction during the first 3 yr of operation to 2.6 log10 reduction. The removal amounts of the bacteriophages phiX174 and S.t. 28B were 3.9 and 3.7 log10, respectively. Based on removal of S.t. 28B, the risks of rotavirus infection and disease for the investigated scenarios were above the acceptable level of 10(-4) and 10(-3), respectively, as defined by the World Health Organization.

Evaluating the Trend and Extreme Values of Faecal Indicator Organisms in a Raw Water Source: A Potential Approach for Watershed Management and Optimizing Water Treatment Practice

This study demonstrates the use of microbial load time series, through trend and extreme event analysis, to evaluate the effectiveness of watershed management strategies and to understand the probabilistic behaviour of extreme events. Heterotrophic plate count (HPC), Clostridium perfringens, intestinal enterococci, Escherichia coli, and coliform bacteria, were monitored from 1999 to 2012 at Nedre Romerike Vannverk (NRV) drinking water treatment plant, which takes its source water from Glomma River, Norway. Mann-Kendall test, Seasonal Mann-Kendall test, and Sen’s Slope Estimator were used for trend analysis over years and also seasonal trends were examined through linear regression. Mann-Kendall test results show a decreasing trend for all indicator microorganisms except Escherichia coli. Seasonal trend analysis results also indicate that Clostridium perfringens during autumn and intestinal enterococci during spring have a significantly decreasing trend. An increasing trend was observed for all pathogens during the summer season. Trend analysis results offer insights and crucial perspective for policy makers and planners to evaluate the existing watershed management strategies. Moreover, extreme microbial load events in the raw water was analysed using the POT method to estimate return levels of extreme indicator microbial load corresponding to selected return periods. It is of importance to calculate the return period of extreme microbial load events for the purpose of designing optimal pathogen barriers and performing risk analysis.

Virus removal by unsaturated wastewater filtration: effects of biofilm accumulation and hydrophobicity.

Enhanced treatment of septic tank effluent can improve the hydraulic function and performance of infiltration systems and constructed wetlands. By intermittent spray application of septic tank effluent onto a coarse-grained filter media, an unsaturated flow regime beneficial for pathogen removal is created. A column filtration study showed an increase in PRD-1 removal by time of operation with corresponding biofilm accumulation in the filter material. The same increased removal was observed for 1 mum polystyrene beads, irrespective of their hydrophilic/hydrophobic surface properties. A control experiment with sorption of 1 mum hydrophobic and hydrophilic polystyrene beads to different glass surfaces with hydrophobic and hydrophilic properties indicate that mechanisms other than hydrophobic interactions may govern the rate of attachment to the filter media. For a given volumetric flow-rate in the columns, the presence of biofilm altered the hydrodynamic characteristics and this resulted in increased retention time and particle removal.