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Author Notes:

Institute for Sustainable Futures, University of Technology Sydney, 235 Jones St, Ultimo, NSW 2007, Australia.

Nuhu Amin: Conceptualization, Methodology, Validation, Formal analysis, Data curation, Writing – original draft, Review & editing, Visualization, Supervision. Rehnuma Haque: Conceptualization, Methodology, Formal analysis, Writing – review & editing, Supervision. Md. Ziaur Rahman: Conceptualization, Formal analysis, Data curation, Writing – original draft, Writing – review & editing, Supervision. Mohammed Ziaur Rahman: Laboratory analysis of SARS-COV-2 RT PCR, review & editing. Zahid Hayat Mahmud: Laboratory analysis of E. coli, Writing – review & editing. Rezaul Hasan: Securing of Government approval, Writing – review & editing. Md. Tahmidul Islam: Conceptualization, Writing – review & editing. Protim Sarker: Investigation, Writing – review & editing. Supriya Sarker: Securing of Government approval, Writing – review & editing. Shaikh Daud Adnan: Investigation, Writing – review & editing. Nargis Akter: Investigation, Writing – review & editing. Dara Johnston: Conceptualization, Investigation, Writing – review & editing. Mahbubur Rahman: Investigation, Writing – review & editing. Pengbo Liu: Laboratory analysis of SARS-COV-2 RT PCR, review & editing. Yuke Wang: Data analysis, review & editing. Tahmina Shirin: Investigation, Writing – review & editing. Mahbubur Rahman: Conceptualization, Methodology, Investigation, Project Administration, Writing – review & editing. Prosun Bhattacharya: Conceptualization, Methodology, Investigation, validation, Writing – supervision, review & editing.

We would like to convey our gratitude to the Directorate General of Health Services (DGHS) under Bangladesh's Ministry of Health and Family Welfare (MoHFW) for providing approval and necessary support to conduct the research. We acknowledged the Director, Hospital and Clinic Sections, DGHS, for his strong leadership and continuous support in collecting samples and conducting the study in selected COVID-19 and non-CVID19 hospitals. We are also thankful to the Directors, doctors, and support staff of six selected hospitals for their permission and support during sample and data collection, interviewing, and effective implementation at the facility. We are also indebted to icddr,b COVID-19 frontline workers who contributed immensely to conducting field activities to make this study successful in the bleak pandemic. In addition, support from Mohammadpur, Wari councillor offices, and study participants are praiseworthy to combat a pandemic as responsible citizens. The authors are also thankful to Professor Christine L. Moe from Emory University for her careful edits before submission.

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Research Funding:

We sincerely thank the Swiss Agency for Development and Cooperation (SDC) and United Nations Children's Fund (UNICEF) [PD Ref. No.: BGD/PCA201840/HPD2020375] for the funding support and technical collaboration to achieve the study goal. icddr,b is also grateful to the governments of Bangladesh, Canada, Sweden, and the United Kingdom for providing core/unrestricted support.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Environmental Sciences
  • Environmental Sciences & Ecology
  • SARS-CoV-2
  • Viral RNA
  • Hospital wastewater
  • Wastewater-based epidemiology
  • Hospital sanitation facilities
  • Faecal contamination
  • Bangladesh
  • ESCHERICHIA-COLI
  • SURFACE-WATER
  • HYGIENE
  • VIRUS
  • HANDS

Dependency of sanitation infrastructure on the discharge of faecal coliform and SARS-CoV-2 viral RNA in wastewater from COVID and non-COVID hospitals in Dhaka, Bangladesh

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Journal Title:

SCIENCE OF THE TOTAL ENVIRONMENT

Volume:

Volume 867

Publisher:

, Pages 161424-161424

Type of Work:

Article | Final Publisher PDF

Abstract:

The detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA in wastewater can be used as an indicator of the presence of SARS-CoV-2 infection in specific catchment areas. We conducted a hospital-based study to explore wastewater management in healthcare facilities and analyzed SARS-CoV-2 RNA in the hospital wastewater in Dhaka city during the Coronavirus disease (COVID-19) outbreak between September 2020–January 2021. We selected three COVID-hospitals, two non-COVID-hospitals, and one non-COVID-hospital with COVID wards, conducted spot-checks of the sanitation systems (i.e., toilets, drainage, and septic-tank), and collected 90 untreated wastewater effluent samples (68 from COVID and 22 from non-COVID hospitals). E. coli was detected using a membrane filtration technique and reported as colony forming unit (CFU). SARS-CoV-2 RNA was detected using the iTaq Universal Probes One-Step kit for RT-qPCR amplification of the SARS-CoV-2 ORF1ab and N gene targets and quantified for SARS-CoV-2 genome equivalent copies (GEC) per mL of sample. None of the six hospitals had a primary wastewater treatment facility; two COVID hospitals had functional septic tanks, and the rest of the hospitals had either broken onsite systems or no containment of wastewater. Overall, 100 % of wastewater samples were positive with a high concentration of E. coli (mean = 7.0 log10 CFU/100 mL). Overall, 67 % (60/90) samples were positive for SARS-CoV-2. The highest SARS-CoV-2 concentrations (median: 141 GEC/mL; range: 13–18,214) were detected in wastewater from COVID-hospitals, and in non-COVID-hospitals, the median SARS-CoV-2 concentration was 108 GEC/mL (range: 30–1829). Our results indicate that high concentrations of E. coli and SARS-CoV-2 were discharged through the hospital wastewater (both COVID and non-COVID) without treatment into the ambient water bodies. Although there is no evidence for transmission of SARS-CoV-2 via wastewater, this study highlights the significant risk posed by wastewater from health care facilities in Dhaka for the many other diseases that are spread via faecal oral route. Hospitals in low-income settings could function as sentinel sites to monitor outbreaks through wastewater-based epidemiological surveillance systems. Hospitals should aim to adopt the appropriate wastewater treatment technologies to reduce the discharge of pathogens into the environment and mitigate environmental exposures.

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© 2023 Elsevier B.V. All rights reserved.

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