The use of quantitative microbial risk assessment to estimate the health risk from viral water exposures in sub-Saharan Africa : a review

Show simple item record Van Abel, Nicole Taylor, Maureen B. 2018-01-29T07:30:14Z 2018
dc.description.abstract Access to microbiologically safe water is not a reality for many people throughout Sub-Saharan Africa where there is widespread occurrence of viruses in water sources. Exposure to this water can lead to adverse health risks including diarrhoeal disease. To a limited extent in Sub-Saharan Africa, the quantification of the human health risk associated with exposure to virally contaminated water has been done through the use of quantitative microbial risk assessment (QMRA). To understand the scope of the information available on this region, two systematic reviews were done to collect previously published literature from Sub-Saharan Africa on (1) prevalence and quantification of viral contamination in water and (2) QMRAs assessing the risk from exposure to water contaminated by viruses. The results of the 2 reviews were then summarised including, for the QMRAs, exposure and dose-response assumptions, input parameters, and risk outcomes. The results found the prevalence of 10 viruses (1-100%) in drinking, ground, irrigation, surface, and waste waters from eight countries with South Africa having the most information on water contamination by viruses. Quantified viral concentration data was reported for ∼50% of the papers, for 6 viruses (entero-, human adeno-, noro-, rota-, sapo- and Hepatitis A virus), and ranged from (10−4-1011 viruses/liter). Additionally, 22 QMRAs were identified for 6 viruses (entero-, human adeno-, noro-, rota-, coxsackie B, and Hepatitis A virus) from 4 countries demonstrating that QMRA has not been used extensively in this region. The majority of these QMRAs concluded that the risk of infection, illness, or Disability Adjusted Life Year (DALY) was exceptionally high and in excess of acceptable risk limits indicating a public health concern. In conclusion, water is contaminated with viruses, risk from exposure to viruses in water was extremely high for these 4 Sub-Saharan Africa countries, and QMRA is not a widely adopted methodology. Finally, some QMRA limitations were observed such as the need for more viral concentration data, collection of site- or region-specific exposure data, application of commonly used dose-response models, addressing susceptible populations such those with human immunodeficiency virus (HIV) infection in the risk characterisation, and access to free software. en_ZA
dc.description.department Medical Virology en_ZA
dc.description.department School of Health Systems and Public Health (SHSPH) en_ZA
dc.description.embargo 2018-12-15
dc.description.librarian hj2018 en_ZA
dc.description.sponsorship Dr Nicole van Abel acknowledges a postdoctoral fellowship from the University of Pretoria and Rand Water Chair in Public Health, Faculty of Health Sciences, University of Pretoria. This study was funded, in part, by the Rand Water Chair in Public Health. en_ZA
dc.description.uri en_ZA
dc.identifier.citation Nicole Van Abel , Maureen B Taylor , The use of Quantitative Microbial Risk Assessment to estimate the health risk from viral water exposures in Sub-Saharan Africa: A review, Microbial Risk Analysis (2017), doi: 10.1016/j.mran.2017.12.001. NYP. en_ZA
dc.identifier.issn 2352-3522
dc.identifier.other 10.1016/j.mran.2017.12.001
dc.language.iso en en_ZA
dc.publisher Elsevier en_ZA
dc.rights © Published by Elsevier B.V. All rights reserved. Notice : this is the author’s version of a work that was accepted for publication in Microbial Risk Analysis. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. A definitive version was subsequently published in Microbial Risk Analysis, vol. x, no. y, pp. z-zz, 2018. doi : 10.1016/j.mran.2017.12.001. en_ZA
dc.subject Quantitative microbial risk assessment (QMRA) en_ZA
dc.subject Water en_ZA
dc.subject Enteric viruses en_ZA
dc.subject Sub-Saharan Africa en_ZA
dc.subject South Africa (SA) en_ZA
dc.title The use of quantitative microbial risk assessment to estimate the health risk from viral water exposures in sub-Saharan Africa : a review en_ZA
dc.type Postprint Article en_ZA

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