Inadequate wastewater management in Dhaka’s major hospitals: A socio-technical systems analysis of leadership, policy, and technological challenges

PLOS Water, Journal Year: 2025, Volume and Issue: 4(1), P. e0000270 - e0000270

Published: Jan. 8, 2025

Unsafe hospital wastewater (HWW) is a significant concern, especially in low-and middle-income countries (LMICs) where the health impact often underreported. Socio-technical systems (STS) theory, which examines interplay between social and technical elements within complex systems, widely used developed but rarely applied LMIC hospitals. STS theory was employed to evaluate aspects of HWW treatment management Dhaka City, alongside comprehensive assessment WWT processes. A mixed-methods approach used, combining quantitative (structured observations) qualitative interviews. Structured observations assessed availability functionality selected The fieldworkers conducted 30 key-informant interviews across 13 hospitals, including 21 respondents from government nine private were cleaners, key professionals, public works department (PWD) engineers. We also analyzed relevant reports policies. Among hospitals surveyed, 10 had some form system, while remaining three lacked any infrastructure. Of those with WWT, seven utilized anaerobic baffled reactors septic tanks. Interviews revealed that authorities prioritize patient care medical equipment maintenance over limited understanding among staff regarding WWT. PWD-engineers reported frequent shortages bureaucratic delays, affecting efficiency system repairs desludging. Our study identified gaps use adequate technologies, poor knowledge, many disrepair, leading hazardous liquid being discharged directly into environment. highlighted need for policy formulation regulation, leadership, financing, assistance, capacity building. Addressing these issues comprehensively can lead safer more sustainable practices HCFs, ultimately benefiting

Language: Английский

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Multi-scale wastewater surveillance at a Bangkok tertiary care hospital: A potential sentinel site for real-time COVID-19 surveillance at hospital and national levels

PLOS Global Public Health, Journal Year: 2025, Volume and Issue: 5(4), P. e0004256 - e0004256

Published: April 8, 2025

Wastewater-based epidemiology is a valuable tool for population-level pathogen surveillance, complementing clinical methods. While most sampling focuses on municipal wastewater treatment plants, emerging evidence suggests collected from hospital settings can lead to targeted interventions. To investigate surveillance in further, we tracked the presence and concentration of SARS-CoV-2 RNA across multi-scale sample sites within large, public tertiary care Bangkok, Thailand. From July 2022 May 2023, weekly samples (n=392) were various including non-clinical facilities, as well hospital’s plant. Influent at center yielded consistent detection all sites, with 26 samples. Despite varied building usage patterns, significant moderate negative correlations found 90% (9/10) between RT-PCR cycle threshold values case data national reports. Targeting specific buildings distinct trends, indicating their potential offer complementary insights into viral shedding transmission among sub-populations campus. Our findings suggest that wastewater-based reflects broader community disease which may be especially useful regions limited coverage. Large hospitals could serve effective cost-efficient sentinel future monitoring, guiding health actions.

Language: Английский

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SARS-CoV-2 surveillance in medical and industrial wastewater—a global perspective: a narrative review

Environmental Science and Pollution Research, Journal Year: 2023, Volume and Issue: 30(23), P. 63323 - 63334

Published: March 29, 2023

Language: Английский

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Wastewater early warning system for SARS-CoV-2 outbreaks and variants in a Coruña, Spain

Environmental Science and Pollution Research, Journal Year: 2023, Volume and Issue: 30(32), P. 79315 - 79334

Published: June 7, 2023

Abstract Wastewater-based epidemiology has been widely used as a cost-effective method for tracking the COVID-19 pandemic at community level. Here we describe COVIDBENS, wastewater surveillance program running from June 2020 to March 2022 in treatment plant of Bens A Coruña (Spain). The main goal this work was provide an effective early warning tool based help decision-making both social and public health levels. RT-qPCR procedures Illumina sequencing were weekly monitor viral load detect SARS-CoV-2 mutations wastewater, respectively. In addition, own statistical models applied estimate real number infected people frequency each emerging variant circulating community, which considerable improved strategy. Our analysis detected 6 waves with concentrations between 10 3 RNA copies/L. system able anticipate outbreaks during 8–36 days advance respect clinical reports and, emergence new variants such Alpha (B.1.1.7), Delta (B.1.617.2), Omicron (B.1.1.529 BA.2) 42, 30, 27 days, respectively, before did. Data generated here helped local authorities managers give faster more efficient response situation, also allowed important industrial companies adapt their production situation. wastewater-based developed our metropolitan area (Spain) served powerful combining monitoring over time.

Language: Английский

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Inadequate sanitation in healthcare facilities: A comprehensive evaluation of toilets in major hospitals in Dhaka, Bangladesh

PLoS ONE, Journal Year: 2024, Volume and Issue: 19(5), P. e0295879 - e0295879

Published: May 22, 2024

Background Lack of access to functional and hygienic toilets in healthcare facilities (HCFs) is a significant public health issue low- middle-income countries (LMICs), leading the transmission infectious diseases. Globally, there lack studies characterising toilet conditions estimating user-to-toilet ratios large urban hospitals LMICs. We conducted cross-sectional study 10-government two-private explore availability, functionality, cleanliness, ratio Dhaka, Bangladesh. Methods From Aug-Dec 2022, we undertook infrastructure assessments selected hospitals. observed all recorded attributes intended users, including sex, disability status, patient status (in-patient/out-patient/caregiver) and/or staff (doctor/nurse/cleaner/mixed-gender/shared). Toilet functionality was defined according criteria used by WHO/UNICEF Joint-Monitoring Programme HCFs. cleanliness assessed, considering visible feces on any surface, strong fecal odor, presence flies, sputum, insects, rodents, solid waste. Results Amongst 2875 toilets, 2459 (86%) were observed. Sixty-eight-percent government hospital 92% private functional. Only 33% 56% clean. A high hospitals’ outpatients service (214:1) compared inpatients (17:1). User-to-toilet also (94:1) wards (19:1). 3% had bins for menstrual-pad disposal <1% disabled people. Conclusion percentage unclean coupled with hinders achievement SDG 2030 risks poor infection-control. Increasing number usable, clean proportion users crucial. The findings suggest an urgent call attention ensure basic sanitation Dhaka’s policy makers should allocate resources adequate maintenance staff, along leadership administrators.

Language: Английский

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Exposure of adult zebrafish (Danio rerio) to SARS-CoV-2 at predicted environmentally relevant concentrations: Outspreading warns about ecotoxicological risks to freshwater fish

The Science of The Total Environment, Journal Year: 2023, Volume and Issue: 880, P. 163269 - 163269

Published: April 5, 2023

Language: Английский

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Monitoring SARS-CoV-2 variants in wastewater of Dhaka City, Bangladesh: approach to complement public health surveillance systems

Human Genomics, Journal Year: 2023, Volume and Issue: 17(1)

Published: July 7, 2023

Wastewater-based epidemiological surveillance has been considered a powerful tool for early detection and monitoring of the dynamics SARS-CoV-2 its lineages circulating in community. This study is aimed to investigate complexity infection Dhaka city by examining genetic variants wastewater. Also, seeks determine connection between variations detected clinical testing those found wastewater samples.Out 504 samples tested RT-qPCR, 185 (36.7%) positive viral RNA. The median log10 concentration N gene copies/Liter (gc/L) was 5.2, ORF1ab 4.9. To further reveal diversity SARS-CoV-2, ten with real-time RT-PCR cycle threshold (Ct) values ranging from 28.78 32.13 were subjected whole genome sequencing using nanopore technology. According clade classification, sequences grouped into 4 clades: 20A, 20B, 21A, 21J, Pango lineage, B.1, B.1.1, B.1.1.25, B.1.617.2, coverage 94.2 99.8%. Of them, 70% belonged followed 10% 21J. Lineage B.1.1.25 predominant Bangladesh phylogenetically related India, USA, Canada, UK, Italy. Delta variant (B.1.617.2) first identified at beginning May 2021. In contrast, we that it community September 2020.Environmental useful temporal spatial trends existing emerging infectious diseases supports evidence-based public health measures. findings this supported use wastewater-based epidemiology provided baseline data environment Dhaka, Bangladesh.

Language: Английский

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Modeled and measured SARS-CoV-2 virus in septic tank systems for wastewater surveillance

Journal of Water and Health, Journal Year: 2023, Volume and Issue: 21(9), P. 1242 - 1256

Published: Sept. 1, 2023

Abstract SARS-CoV-2 wastewater surveillance (WWS) at treatment plants (WWTPs) can reveal sewered community COVID-19 prevalence. For unsewered areas using septic tank systems (STSs) or holding tanks, how to conduct WWS remains unexplored. Here, two large STSs serving Zuma Beach (Malibu, CA) were studied. Supernatant and sludge concentrations from the directly-sampled parameterized a dynamic solid–liquid separation, mass balance-based model for estimating infection rate of users. Pumped septage before hauling upon WWTP disposal was also sampled assessed. Most (96%) STS samples contained N1 N2 genes, with exceeding supernatant increasing depth while correlating total suspended solids (TSS). The trucked genes which decayed (coefficients: 0.09–0.29 h−1) but remained detectable. Over approximately 5 months starting in December 2020, modeled prevalence estimations among users ranged 8 18%, mirroring larger metropolitan area first 2 months. approaches herein inform public health intervention augment conventional that: (1) user rates communal tanks are estimable (2) pumped hauled be assayed infer where disease is spreading areas.

Language: Английский

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Monitoring SARS-CoV-2 RNA in wastewater from a shared septic system and sub-sewershed sites to expand COVID-19 disease surveillance

Journal of Water and Health, Journal Year: 2024, Volume and Issue: 22(6), P. 978 - 992

Published: April 12, 2024

ABSTRACT Wastewater-based epidemiology has expanded as a tool for collecting COVID-19 surveillance data, but there is limited information on the feasibility of this form within decentralized wastewater systems (e.g., septic systems). This study assessed SARS-CoV-2 RNA concentrations in samples from system servicing mobile home park (66 households) and two pumping stations serving similarly sized (71 larger (1,000 neighborhood nearby sewershed over 35 weeks 2020. Also, raw hospital same was sampled. The had highest detection frequency (39/39 days) mean concentration (2.7 × 107 gene copies/person/day N1) among four sampling sites. N1 N2 copies were highly correlated across (Pearson's r = 0.93, p &lt; 0.0001). In neighborhood, new cases reported every week during period; however, we detected 12% corresponding samples. results suggest that infrastructure can be used continuous monitoring infections.

Language: Английский

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Fecal sludge treatment and concomitant resource recovery

Elsevier eBooks, Journal Year: 2024, Volume and Issue: unknown, P. 427 - 451

Published: Jan. 1, 2024

Language: Английский

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