Quantification of microbial risks to human health caused by waterborne viruses and bacteria in an urban slum
Quantification of microbial risks to human health caused by waterborne viruses and bacteria in an urban slum
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DOI：
10.1111/jam.12368
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发表时间：
2014-02-01
影响因子：
4
通讯作者：
Lens, P. N. L.
中科院分区：
文献类型：
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作者：
Katukiza, A. Y.;Ronteltap, M.;Lens, P. N. L.
目的 确定坎帕拉（乌干达）Bwaise III（撒哈拉以南非洲的一个典型贫民窟）水源病毒和细菌的微生物风险程度。方法和结果进行定量微生物风险评估（QMRA），以确定坎帕拉（乌干达）Bwaise III 的各种暴露途径带来的水源病原体微生物风险的程度。这是基于泉水、自来水、地表水、灰水和污染土壤样品中大肠杆菌 O157:H7、沙门氏菌、轮状病毒 (RV) 和人类腺病毒 F 和 G (HAdV) 的浓度。总疾病负担为每年每 1000 人 680 个伤残调整生命年 (DALY)。造成疾病负担最高的是暴露于开放排水渠道的地表水（39%），其次是暴露于三级排水沟中的灰水（24%）、储存容器（22%）、未受保护的泉水（8%）、受污染的土壤（7%）和自来水（002%）。平均估计感染百分比最高的是大肠杆菌 O157:H7 (41%)，其次是 HAdV (32%)、RV (20%) 和沙门氏菌。 (7%)。此外，贫民窟出水口地表水中HAdV感染风险最高为1，自来水中大肠杆菌O157:H7感染风险最低为271x10(-6)。结论结果表明，贫民窟环境受到污染，除自来水外，Bwaise III贫民窟各暴露途径的疾病负担远高于WHO可容忍风险参考水平。 每人每年 1x10(-6) 伤残调整生命年 (DALY)。 研究的意义和影响 本研究的结果为政府、地方当局和非政府组织制定措施决策提供指导，根据接触源将感染风险和疾病负担降低 10(2) 至 10(5)，以实现预期的健康影响。通过对人类排泄物和灰水进行可持续管理，再加上家庭和社区层面的卫生意识宣传活动中的风险沟通，可以降低感染风险。这些数据还为进行战略投资以改善城市贫民窟的卫生条件提供了基础。
Aims To determine the magnitude of microbial risks from waterborne viruses and bacteria in Bwaise III in Kampala (Uganda), a typical slum in Sub-Saharan Africa.Methods and Results A quantitative microbial risk assessment (QMRA) was carried out to determine the magnitude of microbial risks from waterborne pathogens through various exposure pathways in Bwaise III in Kampala (Uganda). This was based on the concentration of Escherichia coli O157:H7, Salmonella spp., rotavirus (RV) and human adenoviruses F and G (HAdV) in spring water, tap water, surface water, grey water and contaminated soil samples. The total disease burden was 680 disability-adjusted life years (DALYs) per 1000 persons per year. The highest disease burden contribution was caused by exposure to surface water open drainage channels (39%) followed by exposure to grey water in tertiary drains (24%), storage containers (22%), unprotected springs (8%), contaminated soil (7%) and tap water (002%). The highest percentage of the mean estimated infections was caused by E.coli O157:H7 (41%) followed by HAdV (32%), RV (20%) and Salmonella spp. (7%). In addition, the highest infection risk was 1 caused by HAdV in surface water at the slum outlet, while the lowest infection risk was 271x10(-6) caused by E.coli O157:H7 in tap water.Conclusions The results show that the slum environment is polluted, and the disease burden from each of the exposure routes in Bwaise III slum, with the exception of tap water, was much higher than the WHO reference level of tolerable risk of 1x10(-6) DALYs per person per year.Significance and Impact of the Study The findings of this study provide guidance to governments, local authorities and nongovernment organizations in making decisions on measures to reduce infection risk and the disease burden by 10(2) to 10(5) depending on the source of exposure to achieve the desired health impacts. The infection risk may be reduced by sustainable management of human excreta and grey water, coupled with risk communication during hygiene awareness campaigns at household and community level. The data also provide a basis to make strategic investments to improve sanitary conditions in urban slums.