PROJECTS

UB visit to UniQ, Port au Prince // Monitoring Water Contamination

The first activity of the proposed collaboration project inter-university was completed with a three-week stay (July 2011) of two collaborators of the Laboratory of Viral Contamination of Water and Food form the University of Barcelona to University of Quisqueya (Port-au-Prince, Haiti).

The objectives of the visit were:

– Meeting with counterpart teams participating in the project: Laboratory Analysis of Water Quality (LAQUE) to define the study that we propose for monitoring viral contamination in the capital and perform the first part of the analysis to obtain a baseline.

– Make education and training for students UniQ about “Microbiology of water: the risks of viral contamination”

Attached final report of the visit:
PDF en català
PDF en français

Final Reports // Hepatitis E

After the finalization of the study, we present the final results with several adapted reports to achieve maxim dissemination:

- Final Report, communicate at field level for government agencies and other international organizations working in the region. PDF in french

- Manuscript complete, report of the study, presentation for Master’s dissertation. PDF in spanish

- The scientific paper published in a scientific journal (Journal of Water and Health. Impact Factor: 1.64.) PDF in english

Introduction // Monitoring Water Contamination

Title of the project: Implementation of concentration methods and detection of viral indicators of faecal contamination in water to the Laboratoire de Qualité de l’Eau et de l’environnment, LAQUE, Université Quisqueya, Haiti.
Place: Haiti
Participants: University of Barcelona, Université de Quisqueya and Intermon Oxfam
Period of the project: 01/06/2011 to 01/06/2012
Sources of funding: Intermon Oxfam (10000 euros) et Universitat de Barcelona (4500 euros)
Personal involved: Laura Guerrero, Marta Rusiñol, Marçal Trigo, Rosina Girones and Silvia Bofill.

Objective:
The waste-water is the main source of pathogenic microorganisms that are transmitted by the fecal-oral route. Microbial contamination of the environment represents public health risk through the exposure or consumption of water and / or contaminated food. Despite the great importance of contamination by pathogenic bacteria, it is also necessary to consider the risks associated with the presence of viral pathogens that are more resistant than bacteria to treatment of filtration and other disinfection methods used and which are responsible of important diseases.
The list of virus pathogens in the waters of human consummation includes human adenovirus, polyomavirus, enterovirus, norovirus, rotavirus, astrovirus, hepatitis A and hepatitis E among others.
The diseases caused by viral infections are commonly associated with adenovirus and dangerous hepatitis A and E in adult individuals.
Other viral infections, including severe gastroenteritis in children and the elderly are generally associated with infections caused by rotavirus, adenovirus and norovirus.
The conventional indicators of bacteria (Escherichia coli and fecal coliform) traditionally used to monitor water quality and food are not a good model to predict the presence of viruses and protozoan parasites (Gerber et al 1979;. Griffin et al. 2003;. Pina et al, 1998). Viruses are more stable in the environment than traditional indicators of bacteria.
Virological surveillance of the environment is a complex process because of the difficulty of identifying low levels of virus in large volumes of dispersed sample. The detection of viruses in environmental samples therefore requires specific techniques of concentration and recovery of virus in these samples and specific detection techniques. In recent years have developed methods based on polymerase chain reaction (PCR) for detection of viruses in the environment.
The laboratory of viral contaminants from water and food led by Dr. Girones, including Dr. Bofill, calling this cooperation project, in part since 1997 has developed methods of concentration and detection of viruses and virus of different indicators the human and animal fecal contamination in environmental samples (http://www. ub.edu / microbiology / virology).
Currently, the research group is funded by Oxfam to undertake a project based on the use of ceramic filters for microbiological decontamination of water for consumption in Petit Goave, Haiti. These projects complement each other, as the study of viruses in drinking water sources as a reference for assessing the impact of the implementation of ceramic filters in the region.

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Introduction // Ceramic Filters

Project title: Improved low-cost ceramic water filters introduction in rural areas around Petit Goâve (Haiti)
Location of the action: Haiti
Lead manager and partners: Intermon Oxfam and University of Barcelona (coordinators)
Dates: 01/02/2011 to 01/02/2013
Donors: Intermon Oxfam (IO)
Amount contributed:
IO: 158000 euros
Personal Involved: Laura Guerrero, Alberto Ibañez, Marçal Trigo, Josep Mates and Rosina Girones

Objectives and results of the action:
Interventions to treat and to maintain the microbiological quality of the house water by Household Water Treatments (HWT) are between the most promising approaches to reduce the health impact of waterborne diseases. To assure the access to these technological solutions will contribute to health benefits complemented with other reinforcements in water, sanitation and hygiene.
Among several house water disinfection technologies that have shown microbiological effectiveness, the ceramics water filters (CWF) have been promoted actively like methods of water treatment of house in populations with low resources showing a high impact in health in the long term (Hunter, 2009).
The CWF is a flower pot-shaped, gravity flow, porous ceramic filter device intended to treat drinking water on the household scale. Water is poured through the porous ceramic pot into a receiving container that stores treated water, with the treated water dispensed via a tap.
The production of ceramic water filtration devices at the local level in developing countries is made possible by the fact that the necessary materials and knowledge are widely available and relatively inexpensive, although adapting these to the production of a high quality, low-cost, economic and socially sustainable, and proven device to provide safe water and reduce diarrheal disease does require significant innovation and investment.
At the moment, more than 17 filter facilities has been established around the world by Potters for Peace, a NGO that give technical advice and assistance to local partners.
The most successful projects, Cambodia and Guatemala, have the common implementation plan of an NGO with health and marketing experience teaming with a group of potters/trained individuals to produce the filter.
The projects that have failed or stopped producing were those projects, where the facility is not integrated into the local networks, where the NGO focus was not health, and/or where there was no marketing capacity.
Previous experiences in Dominican Republic suggest that household-based water filters fabricated locally are acceptable by the population, and a portion of the population use the filters for at least 16 months after they received, purchasing their own replacement in many cases.
Field trials of the effectiveness of ceramic water filters in Cambodia over time showed a 46% reduction in diarrheal disease between filter users and non-users, a 2 log10 reduction average reduction of E.coli in drinking water (Brown and Sobsey, 2006).
The viral disinfection is still a remaining challenge that needs further research.
In recent investigations has been suggested that electric charges of the ceramic components could play an important role in the retention/inactivation of viruses presents in water (Brown, 2009).

Resources Development International in Cambodia (RDIC) now adds Laterite to its clay mix. Laterite, a material high in Fe oxides, the positive charges of the Fe oxides has demonstrated a removal action of the largely negatively charged viruses. Laboratory testing has shown a 1 log10 reduction in viruses (Brown, 2007).
However, this reduction might not be sufficient to protect consumers from viral infections.
In developing countries, gastroenteritis is a common cause of death in children < 5 years that can be linked to a wide variety of pathogens. Much of the gastroenteritis in children is caused by viruses belonging to four distinct families: rotaviruses, caliciviruses, astroviruses and adenoviruses. Recent estimates attribute 527 000 deaths in children less than five years of age to rotavirus diarrhoea annually. (MSF-Spain data about diarrhoea in Haiti)
More basic research on technologies is needed for viral removal to play major role in providing safe water.
In this project we will provide a platform for exchange and interaction between microbiological research and its sustainable application in developing countries; the provision of clean water to most vulnerable communities.

The proposal of our project is:

  • Evaluate the performance of different candidates of ceramic water filters and coatings against viral pathogens (surrogates and human pathogens). Local minerals in different concentrations at the clay mix will be tested in a pot-filter design.
    Models will be evaluated based on filtration flow, virological efficiency, ease of manufacture, availability of materials, final cost, contribution to artisan activity, and ease of distribution.
  • Those tests in laboratory will ensure a base line for a posterior field implementation.
  • The health impacts associated with using the technology will be evaluated using appropriate rigorous epidemiological methods (blinded, randomized trials).

‘KEYPOINTS’:

- The proven sustainability of the program in other experiences (ceramic water filters implementation at household level).
- The previous evaluation of different candidates in composition (local materials) in order to increase viral removal.
- The rigorous protocols of safety that will be taken to ensure the quality of the product.
- The extra benefit of providing jobs and supporting local enterprises.
- The evaluation of health impact of our program after implementation.
- To study the possibility of scaling-up within the country after program’s evaluation.

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Introduction // Hepatitis E

Project title: Environmental study in two settlements based in Eastern Chad: analysis of Human Adenovirus and Hepatitis E Virus in water sources. And an update of public health impact of HEV in the area.
Location of the action: Chad
Lead manager and partners: Intermon Oxfam and University of Barcelona (coordinators)
Dates: 01/06/2009 to 30/10/2010
Donors: Intermon Oxfam (IO), University of Barcelona (UB) and CyO,7
Amount contributed:
IO: 2000 euros, UB: 1200 euros, CyO,7: 1500 euros
Personal Involved: Laura Guerrero, Alberto Ibañez, Rosina Girones

Objectives and results of the action:
The project was possible thank to the collaboration between Intermon Oxfam and the Group of Environmental Virology of the University of Barcelona.
Intermon Oxfam expressed their preoccupation and interest by performing a detailed investigation that allowed them to prevent and contain the appearance of epidemic periods of Hepatitis E in Eastern Chad due to the impact in terms of health that presents in the region.
It seemed interesting to detect the virus in the atmosphere and identify the possible sources of contamination in the refugee camps where IO work since 2007. But for it we needed very sophisticated equipment that we could only find in a reference laboratory.
The Group of Environmental Virology of the UB has more then 25 years experience in research about detection and removal of virus in water. A collaborator from the laboratory went to the field where the study was conducted and samples were collected and shipped to the reference laboratory to be analysed.
Hepatitis E, caused by infection with hepatitis E virus (HEV), is a common cause of acute hepatitis in areas with poor sanitation. In 2003 the conflict in Darfur (Western Soudan) started obligating to thousands of victims to move westwards taking refugee in Eastern Chad.
An outbreak of HEV infection affected around 2000 people in Eastern Chad (Dar Sila) in 2004. Since then, more cases of Acute Jaundice Syndrome (AJS) have been reported in the district of Dar Sila.
The investigation conducted describes the incidence in the region of AJS in the last 5 years. Moreover, water samples from drinking-water sources were screened for enteric viruses to establish the potential circulation of waterborne hepatitis virus and faecal contamination in Goz Amir Refugee camp and Dogdoré site for Internal Displaced People (IDPs).
Review of medical surveillance data indicated that AJS outbreaks are more frequently detected during the rainy season, from May until October, although the incidence (cases/1000 people/year) has been substantially decreasing since the outbreaks that occurred in 2004.
This is the first time that the HEV isolation from water has been attempted in an unstable setting as the context in Eastern Chad with a timely screening of drinking-water. Although the number of samples collected is limited HEV was not detected in the environmental samples tested (water and donkey’s stools), in accordance with the absence of HEV cases during the specific period studied. However the presence of human adenoviruses in low levels in some of the water resources studied indicate that potential routes of faecal contamination for water-borne viruses may exist.
This research has been divulgated to all the humanitarian actors working in the region and the manuscript has been accepted in the Journal of Water and Health from IWA publishing (in press).

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