WATERBORNE PATHOGENS
OF CONCERN IN
DEVELOPING COUNTRIES:
with Special Reference to Libya
Prof. Khalifa Sifaw Ghenghesh
Dep...
INTRODUCTION
 Drinking

water is a major source of
microbial pathogens in developing
countries.
 Waterborne disease caus...
WATERBORNE PATHOGENS IN
DEVELOPING COUNTRIES
BACTERIA
Microorganism
Major disease
--------------------------------------------------------------------------Salmonella ...
ENTERIC VIRUSES
Enteroviruses
Polio viruses
Coxsackie A & B
Other enteroviruses

Poliomyelitis
Aseptic meningitis
Encephal...
PROTOZOA & HELMINTHS
Balantidium coli

Balantidosis (dysentery)

Cryptosporidium parvum

Cryptosporidiosis
(gastroenteriti...
Causative Agents of Childhood Diarrhea in Libya
% positive
Agent
Tripoli
Benghazi
Zliten
---------------------------------...
Bacteriological Quality of Drinking Water
in Libya
Type of
No
% positive for
Water
tested
E. coli
Aeromonas
--------------...
Outbreaks of waterborne disease in England and Wales from
1991 to 2000
Cause

Number of
Number
Outbreaks
of cases
--------...
Recreational contact with surface water
Viral gastroenteritis

1

7

Swimming pool contact
Cryptosporidium
23
337
--------...
Outbreaks of waterborne disease in Tripoli
1992-2004
Number of
outbreaks

Number
of cases

-------------------------------...
Some Concerns Regarding Waterborne
Pathogens
 Efficacy

of treatment (filtration and
chlorination) and the use of E. coli...
Emerging Waterborne Issues


Rapid urbanization of humans in developing
regions:




Places further stress on inadequat...
What We Should Do?
A

combination of both monitoring of
water quality and epidemiological
surveillance.
 A comprehensive...
CONCLUSION


Despite our efforts, waterborne pathogens will
always be a major issue for human health, and
particularly so...
Waterborne Pathogens in Developing Countries
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Waterborne Pathogens in Developing Countries

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Waterborne Pathogens in Developing Countries

  1. 1. WATERBORNE PATHOGENS OF CONCERN IN DEVELOPING COUNTRIES: with Special Reference to Libya Prof. Khalifa Sifaw Ghenghesh Dept. of Medical Microbiology, Faculty of Medicine Tripoli - Libya
  2. 2. INTRODUCTION  Drinking water is a major source of microbial pathogens in developing countries.  Waterborne disease cause more than 2 million deaths and 4 billion cases of diarrhea annually.  9 out of 10 deaths are in children and virtually all of the deaths are in developing countries
  3. 3. WATERBORNE PATHOGENS IN DEVELOPING COUNTRIES
  4. 4. BACTERIA Microorganism Major disease --------------------------------------------------------------------------Salmonella typhi Typhoid fever S. paratyphi Paratyphoid fever Other Salmonella Salmonellosis Shigella spp. Bacillary dysentery (Shigellosis) Vibrio cholerae Cholera Diarrheagenic E. coli Gastroenteritis Yersinia enterocolitica Gastroenteritis Campylobacter jejuni Gastroenteritis Aeromonas spp. Gastroenteritis Various mycobacteria Pulmonary illness
  5. 5. ENTERIC VIRUSES Enteroviruses Polio viruses Coxsackie A & B Other enteroviruses Poliomyelitis Aseptic meningitis Encephalitis Rotavirus Gastroenteritis Adenoviruses Hepatitis A & E viruses Upper respiratory and gastrointestinal illness Infectious hepatitis Norovirus Gastroenteritis
  6. 6. PROTOZOA & HELMINTHS Balantidium coli Balantidosis (dysentery) Cryptosporidium parvum Cryptosporidiosis (gastroenteritis) Entamoeba histolytica Amoebic dysentery Giardia lamblia Giardiasis (gastroenteritis) Ascaris lumbricoides Ascariosis
  7. 7. Causative Agents of Childhood Diarrhea in Libya % positive Agent Tripoli Benghazi Zliten -------------------------------------------------------------------------------------------------Single 41 35 44 Multiple 19 6 12 Rotavirus 32 24 27 Salmonella 11 7 14 Shigella 6 5 4 Enteropathogenic E. coli 11 8 ND E. coli O157 7 ND ND Campylobacter 6 2 ND Yersinia enterocolitica 0.6 0 ND Aeromonas 15 0 6 Cryptosporidium ND ND 13 Giardia lamblia ND ND 1 Entamoeba histolytica ND ND 12
  8. 8. Bacteriological Quality of Drinking Water in Libya Type of No % positive for Water tested E. coli Aeromonas ---------------------------------------------------------------------Well 1000 37 49 Fasghia 56 27 73 Majin 62 ND 60 From Mosques 50 14 18 Mineral 216 0 0
  9. 9. Outbreaks of waterborne disease in England and Wales from 1991 to 2000 Cause Number of Number Outbreaks of cases --------------------------------------------------------------------------------------------------------Public water supplies: Cryptosporidium 23 2837 Campylobacter 1 281 Gastroenteritis 1 229 Total 25 3347 Private water supplies: Campylobacter Mixed Campylobacter and Cryptosporidium Cryptosporidium Gastroenteritis Giardia E. coli O157 Total 8 1 178 43 3 2 1 1 16 74 81 31 14 421
  10. 10. Recreational contact with surface water Viral gastroenteritis 1 7 Swimming pool contact Cryptosporidium 23 337 --------------------------------------------------------------------------------------------------------Overall total 65 4112
  11. 11. Outbreaks of waterborne disease in Tripoli 1992-2004 Number of outbreaks Number of cases -------------------------------------------------------------------------------Public water supplies: Shigella sonnei 1 >1500 Private water supplies: Shigella flexneri 1 6
  12. 12. Some Concerns Regarding Waterborne Pathogens  Efficacy of treatment (filtration and chlorination) and the use of E. coli as a fecal indicator:  Chlorine-resistant parasitic protozoa • Oocysts of Cryptosporidium parvum  Various enteric viruses  Important to match the appropriate indicator for the group of pathogen(s) of interest.
  13. 13. Emerging Waterborne Issues  Rapid urbanization of humans in developing regions:   Places further stress on inadequate water supply and sanitation. Climate change:  A change in the distribution of rainfall • Heavy rain fall • Flooding  Greater extremes in global weather patterns • Major waterborne outbreaks typically follow large storm events in developing countries  Evolution of new pathogens
  14. 14. What We Should Do? A combination of both monitoring of water quality and epidemiological surveillance.  A comprehensive public health surveillance strategy seems the most efficient approach to better understand and control the impact of water quality on gastrointestinal disease.
  15. 15. CONCLUSION  Despite our efforts, waterborne pathogens will always be a major issue for human health, and particularly so in developing countries

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