Implementation of quantitative microbial risk assessment (QMRA) for public drinking water supplies: Systematic review

Owens, Christopher E. L.; Angles, Mark; Cox, Peter; Byleveld, Paul M.; Osborne, Nicholas J.; Rahman, Bayzidur

doi:10.1016/j.watres.2020.115614

Cited by 66 publications

(49 citation statements)

References 83 publications

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“…The literature revealed that the 8% of the total E. coli is pathogenic, so the E. coli dose was multiplied by 0.08, in order to estimate the dose of pathogenic E. coli, as has been done elsewhere [28,29]. Campylobacter and Rotavirus were also predicted, using the E. coli to pathogenic ratio [19,29]. From each school's drinking-water source at the point of use, 1500 mL of drinking water was collected in a sterile bag.…”

Section: Hazard Identificationmentioning

confidence: 99%

“…In another study in Pakistan, only one out of 14 water-filtration plants were meeting national water-quality standards. Both of these studies recommended periodic water-quality monitoring from national water-quality-monitoring authorities, to ensure safe drinking water at the point of use [8,16].Quantitative Microbial Risk Assessment (QMRA) is a tool to estimate the risk of an adverse effect, such as illness, infection, and/or death from exposure to waterborne, airborne, or foodborne pathogens [17][18][19][20]. The QMRA model uses measures of microorganisms in the environment as inputs to calculate associated risks as outputs.…”

mentioning

confidence: 99%

“…Quantitative Microbial Risk Assessment (QMRA) is a tool to estimate the risk of an adverse effect, such as illness, infection, and/or death from exposure to waterborne, airborne, or foodborne pathogens [17][18][19][20]. The QMRA model uses measures of microorganisms in the environment as inputs to calculate associated risks as outputs.…”

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confidence: 99%

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Quantitative Microbial Risk Assessment of Drinking Water Quality to Predict the Risk of Waterborne Diseases in Primary-School Children

Ahmed

Wong

Chua

et al. 2020

IJERPH

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Primary-school children in low- and middle-income countries are often deprived of microbiologically safe water and sanitation, often resulting in a high prevalence of gastrointestinal diseases and poor school performance. We used Quantitative Microbial Risk Assessment (QMRA) to predict the probability of infection in schoolchildren due to consumption of unsafe school water. A multistage random-sampling technique was used to randomly select 425 primary schools from ten districts of Sindh, Pakistan, to produce a representative sample of the province. We characterized water supplies in selected schools. Microbiological testing of water resulted in inputs for the QMRA model, to estimate the risks of infections to schoolchildren. Groundwater (62%) and surface water (38%) were identified as two major sources of drinking water in the selected schools, presenting varying degrees of health risks. Around half of the drinking-water samples were contaminated with Escherichia coli (49%), Shigella spp. (63%), Salmonella spp. (53%), and Vibrio cholerae (49%). Southern Sindh was found to have the highest risk of infection and illness from Campylobacter and Rotavirus. Central and Northern Sindh had a comparatively lower risk of waterborne diseases. Schoolchildren of Karachi were estimated to have the highest probability of illness per year, due to Campylobacter (70%) and Rotavirus (22.6%). Pearson correlation was run to assess the relationship between selected pathogens. V. cholerae was correlated with Salmonella spp., Campylobacter, Rotavirus, and Salmonella spp. Overall, the risk of illness due to the bacterial infection (E. coli, Salmonella spp., V. cholerae, Shigella, and Campylobacter) was high. There is a dire need for management plans in the schools of Sindh, to halt the progression of waterborne diseases in school-going children.

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Section: Hazard Identificationmentioning

confidence: 99%

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confidence: 99%

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Quantitative Microbial Risk Assessment of Drinking Water Quality to Predict the Risk of Waterborne Diseases in Primary-School Children

Ahmed

Wong

Chua

et al. 2020

IJERPH

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“…Quantitative microbial risk assessment is a scientific model to measure risks such as the probability of an adverse effect including illness, infection, and/or death (mortality) due to exposure to a pathogen (22)(23)(24). The QMRA model starts with determining the concentration of the pathogen (HAV) in the environment (water) as input to calculate the associated risk as output.…”

Section: Introductionmentioning

confidence: 99%

“…The QMRA model starts with determining the concentration of the pathogen (HAV) in the environment (water) as input to calculate the associated risk as output. Studies have estimated the risk of various infections based on exposure to various doses of fecal coliforms as an indicator pathogen (22,23). Various studies used the indicator-to-pathogen ratio such as the ratios of E. coli to Rotavirus and E. coli to Campylobacter.…”

Section: Introductionmentioning

confidence: 99%

Estimation of Hepatitis A Virus Infection Prevalence Through Drinking Water Supply of Primary Schools of Sindh, Pakistan

et al. 2020

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Background: Hepatitis A Virus (HAV) is among the main endemic human enteric viral diseases that directly or indirectly affect children's performance at primary schools in low-income countries. Limited information is available on the presence of HAV, with particular reference to drinking water supplies of primary schools in Sindh, Pakistan. Objectives: The present study estimated the risk of HAV infection through drinking water sources using Quantitative Microbial Risk Assessment (QMRA) in primary schools of Sindh, Pakistan. Methods: The QMRA model was applied to estimate the potential health risks of HAV using indicator organisms, i.e., fecal coliforms. Microbial analysis was conducted using a membrane filtration method. The exponential dose-response model was used to calculate the probability of infection. Results: The highest daily risk of HAV infection for schoolchildren was calculated as 35.0 per 10,000 schoolchildren in Karachi district with an annual risk of 66%, whereas the lowest risk was 3.0 per 10,000 schoolchildren in Larkana with 7.8% of the annual risk. The mortality risk due to HAV ranged from 4.0 to 29 deaths per 10,000 children per year. Conclusions: Overall, the drinking water quality of primary schools of Sindh was found very poor. The estimated daily and annual risks of hepatitis A to primary school children were moderate to high. To halt enteric virus transmission through drinking water sources, there is a dire need to invest in the provision of comprehensive water sanitation and hygiene facilities at schools.

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Metagenomic sequencing combined with flow cytometry facilitated a novel microbial risk assessment framework for bacterial pathogens in municipal wastewater without cultivation

Wang

et al. 2023

iMeta

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Implementation of quantitative microbial risk assessment (QMRA) for public drinking water supplies: Systematic review

Cited by 66 publications

References 83 publications

Quantitative Microbial Risk Assessment of Drinking Water Quality to Predict the Risk of Waterborne Diseases in Primary-School Children

Quantitative Microbial Risk Assessment of Drinking Water Quality to Predict the Risk of Waterborne Diseases in Primary-School Children

Estimation of Hepatitis A Virus Infection Prevalence Through Drinking Water Supply of Primary Schools of Sindh, Pakistan

Metagenomic sequencing combined with flow cytometry facilitated a novel microbial risk assessment framework for bacterial pathogens in municipal wastewater without cultivation

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