Pathogenic Parasite and Waterborne Diseases in Three Stations

Chapter 1 INTRODUCTION Background of the Study Rivers are the bodies of water bearing an immense biological importance. Though they contain only about 0. 0001% of the total amount of water in the world at any given time, rivers are vital carriers of water and nutrients to areas all around the earth, they are essential components of the hydrological cycle, for they act as drainage channels for surface water and they serve as habitat for various organisms (Hebert, 2011). With rapid increase of the country’s population and urbanization, bodies of water tremendously began to be polluted.This event commenced the contamination of drinking water as well as the widespread occurrence of waterborne diseases. Waterborne diseases are often caused by parasites which are directly transmitted through consuming contaminated drinking water. Any water reserve, infested with pathogenic parasites, used in the preparation of food can be considered as a source of foodborne disease and could be easi ly transmitted through consumption of the same pathogenic parasites. These diseases commonly affect the digestive tract as well as the other vital parts of the body that may be fatal to anyone especially those who are immunocompromised (WHO, 2004).Globally, waterborne diseases such as diarrhea accounts for 1. 5 million deaths annually according to the Centers for Disease Control and Prevention on its report in 2010. It is considered one of the most dangerous diseases that could be acquired in flowing water and is a major health problem for developing countries. Also, according to World Health Organization (WHO) on its report in 2004, diarrheal disease accounts for an estimated 4. 1% of the total Disability-adjusted Life Year (DALY) global burden of disease and is responsible for the deaths of 1. million people every year. It was estimated that 88% of that burden is attributable to unsafe water supply, sanitation and hygiene, and is mostly concentrated in children in developing count ries. Over the time – from 2004 up to the present – , rapid increase in population, urbanization, and industrialization reduce the quality of Philippine waters, especially in densely populated areas and regions of industrial and agricultural activities. The discharge of domestic and industrial wastewater and agricultural runoff has caused extensive pollution of the receiving ater-bodies. This effluent is in the form of raw sewage, detergents, fertilizer, heavy metals, chemical products, oils, and even solid waste. Each of these pollutants has a different noxious effect that influences human livelihood and translates into economic costs. Access to clean and adequate water remains an acute seasonal problem in urban and coastal areas in the Philippines. The National Capital Region (Metro Manila), Central Luzon, Southern Tagalog, and Central Visayas are the four urban critical regions in terms of water quality and quantity.The Government’s monitoring data indicates that just over a third or 36 percent of the country’s river systems are classified as sources of public water supply, up to 58 percent of groundwater sampled is contaminated with coliform and needs treatment, approximately 31 percent of illness monitored for a five-year period were caused by waterborne sources, and many areas are experiencing a shortage of water supply during the dry season. Nearly 2. 2 million metric tons of organic pollution are produced annually by domestic (48 percent), agricultural (37 percent), and industrial (15 percent) sectors.In the four water-critical regions, water pollution is dominated by domestic and industrial sources. Untreated wastewater affects health by spreading disease-causing parasites, makes water unfit for drinking and recreational use, threatens biodiversity, and deteriorates overall quality of life. Known diseases caused by poor water include gastro-enteritis, diarrhea, typhoid, cholera, dysentery and hepatitis. The number of water- related health outbreaks including deaths reported in newspapers is going up.However, awareness regarding the need for improved sanitation and water pollution control, reflected by the willingness-to-pay and connection to a sewerage system where they are easily available, is very low (Philippines: Environment Monitor, 2003; Greenpeace 2007). Davao City has been expanding and growing in terms of population, economy and industry. In this manner, more raw materials are being demanded by these different sectors and as a result destruction of the natural resources is inevitable. Davao river ranks number seven among the largest river basins in the Philippines.This is largest of the city’s nine principal watersheds. The river is the main natural reservoir of the aquifer in the city’s jurisdiction. Its length is about 143 kilometers. It has received domestic and industrial wastewater. Since the sewage systems have not yet been fully developed, the garbage has been discharge in to the river leading to a wide-scale contamination of Davao River (Pascua et. al. , 2011). At present, residents within Davao River unceasingly make use of the water for bathing and washing which may present various threats to them.Some use the river for livelihood e. g. sand quarrying and fishing and for recreational activities. But they are blinded by the fact that they can be infected by pathogenic parasites that would eventually lead to waterborne diseases. This study aims to determine the level of pathogenic parasites in the water. Having everyone in the community know the specific parasites present in the selected stations of Davao River – Bankerohan, Bucana and Magallanes – would eventually lead to a more effective prevention and disease control among the residents of the community.The goal of clean water for everyone has to be achieved in a growing population of a city. This study also aims to measure the level of waterborne diseases in Davao River. Through thi s study, we can help the people be oriented with the danger of using contaminated water from Davao River. Related Literature The importance of urban rivers and streams for urban ecology and quality of life in cities is an increasing concern worldwide. The present state of rivers is much dependent on the history and trends of the society in each country.In many situations water quality is still unsatisfying. Restoration of urban rivers is challenging because of intensive land use, danger of flooding and impacts of human activities for water quality and for the ecology of rivers (Jormola, 2008). Today about 50% of the global population are living in urban areas, placing one-third of their inhabitants into slums, and creating huge challenges to their environment and sanitation. Poor sanitation, poor treatments of waste water, as well as catastrophic floods introduce pathogenic bacteria into rivers, infecting and killing many people.The goal of clean water for everyone has to be achieve d with a still growing human population and their rapid concentration in large cities, often megacities. How long introduced pathogens survive in rivers and what their niches are remain poorly known but essential to control waterborne diseases in megacities. Biofilms are often niches for various pathogens because they possess high resistances against environmental stress. They also facilitate gene transfers of antibiotic resistance genes which become an increasing health problem.Beside biofilms, amoebae are carriers of pathogenic bacteria and niches for their survival (Abraham, 2011). The World Health Organization says that every year more than 3. 4 million people die as a result of water related diseases, making it the leading cause of disease and death around the world. Most of the victims are young children, the vast majority of whom die of illnesses caused by organisms that thrive in water sources contaminated by raw sewage (Berman, 2009). Waterborne Diseases Many illnesses, con taminants, and injuries can be water, sanitation, or hygiene-related.Waterborne diseases are caused by organisms that are directly spread through water. Water-related illnesses can be acquired due to lack of water for good hygiene and lack of sanitation. It is important to know how these diseases and contaminants affect humans where they are found, and how to reduce the chance getting ill or suffering injury. This will allow individuals to make informed decisions about water, hygiene, and sanitation-related activities (CDC, 2012). Parasitic Organisms Parasites may be present in food or in water and can be identified as causes of waterborne illness.They range in size, from tiny single-celled organisms to worms visible to the naked eye. Their lifecycle may also vary. While some parasites use a permanent host, others go through a series of developmental phases using different animal or human hosts. The illnesses they can cause range from mild discomfort to debilitating illness and poss ibly death (USDA, 2011). Parasites cause over 2 billion infections per year worldwide. In the immunocompromised host these infections generally represent reactivation of infection from donor or in the allograft recipient often long after the initial infection (Wiley, 2004).Inland and coastal surface waters can be contaminated by human waterborne zoonotic enteropathogens such as Cryptosporidium parvum, Giardia lamblia, Encephalitozoon intestinalis, E. hellem and Enterocytozoon bieneusi (Graczyket et. al, 2008). The aquatic ecosystem harbors many kinds of organisms. Some of these organisms are parasitic protozoa such as Cryptosporidium spp. and Giardia spp. , which have recently been recognized as important causes of water and food-borne disease outbreaks associated with fecal contamination (Doron, 2000; Karanis et al. , 2006).Cryptosporidium is a parasite commonly found in lakes and rivers, especially when the water is contaminated with sewage and animal wastes. There have been six m ajor outbreaks of cryptosporidiosis in the United States as a result of contamination of drinking water. One major outbreak in Milwaukee in 1993 affected over 400,000 persons. Cryptosporidial infection can thus be transmitted from fecally contaminated food and water, from animal-person contact, and via person-person contact. The probability of transmission from just a small amount of contamination is fairly high, since a recent study has determined that the 50% infective dose of C. arvum is only 132 oocysts for healthy persons with no previous serological immunity to cryptosporidiosis (Hannahs, G. 1995). Cryptosporidium is very resistant to disinfection, and even a well-operated water treatment system cannot ensure that drinking water will be completely free of this parasite. Cryptosporidium has caused several large waterborne disease outbreaks of gastrointestinal illness, with symptoms that include diarrhea, nausea, and/or stomach cramps (Freedrinkingwater. com, 2009). Cryptosporid iosis, a common finding in pediatric patients hospitalized for diarrhea in urban Manila, Republic of the Philippines.Urban areas, particularly in the developing countries, frequently experience severe overcrowding with concomitant diminished sanitation. This situation is conducive to the transmission of enteric pathogens. It would be reasonable to expect that cryptosporidium oocysts are readily passed from human-to-human, human-to-animal and animal-to-human hosts. In rural areas around the world, human cryptosporidiosis is putatively associated with close human-animal contact, as in the case of animal handlers and similar agricultural situations (Laxer, M. 2003).Giardia lamblia is the protozoan parasite responsible for the disease Giardiasis. Symptoms of acute Giardiasis include diarrhea, nausea, weight loss, malabsorption, abdominal cramps, flatulence, and anemia. The mode of transmission of Giardia is through fecal to oral route or ingestion of cysts. A person can become infected after accidentally swallowing the parasite; but cannot become infected through contact with blood. You can become infected with Giardia lamblia if you swallow contaminated recreational water. Recreational water such as in swimming pools, hot tubs, jacuzzis, fountains, lakes, rivers, prings, ponds, or streams that can be contaminated with sewage or feces from humans or animals (Vdresearch. com, 2008). The prevalence of Giardia and Cryptosporidium among 3,456 diarrheic patients corrected from May 2004 to May 2005 in the Philippines was determined. Of 133 (3. 8%) positive samples, 69 (2. 0%) were positive for Giardia and 67 (1. 9%) for Cryptosporidium. Three samples had co-infection with Giardia and Cryptosporidium. Luzon had the highest positive samples (5. 0%) followed by Mindanao (4. 9%), then Visayas (2. 2%). Giardia was most prevalent in Mindanao (3. 6%) while Cryptosporidium was most prevalent in Luzon (3. %). The prevalence of Giardia (2. 0%) among pediatric patients (0-18 years ) did not significantly differ from that (1. 9%) among adults (>18 years old). However, for Cryptosporidium, the prevalence (2. 9%) among pediatric patients was significantly higher compared to that (0. 2%) among adult patients. In the pediatric population, the highest percentage of patients with Giardia was the 5-9 year old age group, while that of Cryptosporidium was in the 0-4 year old group. The prevalence of Giardia, but not Cryptosporidium, was significantly higher in male than female adults (Natividad, F. 008). Amoebic dysentery (amoebiasis) which is the agent of Entamoeba histolytica is widely seen around the world. About 50 million people has become infected a year and eventually over 100,000 people lose their lives. Amoebiasis come into being in consequence of taken of quad-core mature cysts from water, foods, goods or hands by orally. E. histolytica trophozoites are placed into the colon mucosa and submucosa then forms a bloodymucus diarrhea table. It forms abscesses by m oving through blood to liver, lungs, brain and other tissues (Kaya, O. 2011).The infection is common in developing countries and predominantly affects individuals with poor socioeconomic conditions, nonhygienic practices, and malnutrition (Rivera, W. 1998). Related Studies Waterborne diseases are the most prevalent infectious diseases in the developing countries especially in new settlements along the river. Waterborne diseases occur worldwide, and outbreaks caused by the contamination of community water systems and accidental ingestion of recreational waters have the potential to cause disease in large numbers of consumers. Statistics on outbreaks linked to contaminated water have been vailable in the USA since 1920 (Craun 1986), and since 1971, the Centers for Disease Control (CDC), the US Environmental Protection Agency (USEPA), and the Council of State and Territorial Epidemiologists have maintained a collaborative surveillance system for collecting data pertaining to the occurr ence and causes of outbreaks of waterborne disease (Barwick et al. 2000; Lee et al. 2002). In Europe during 1986–96, 277 outbreaks associated with drinking and recreational water were reported from 16 European countries (Kramer et al. 2001). At least 325 water-associated outbreaks of parasitic protozoan disease have been reported.North American and European outbreaks accounted for 93% of all reports and nearly two-thirds of outbreaks occurred in North America. Over 30% of all outbreaks were documented from Europe, with the UK accounting for 24% of outbreaks, worldwide. Giardia duodenalis and Cryptosporidium parvum account for the majority of outbreaks (40. 6% and 165; 50. 8%, respectively), Entamoeba histolytica and Cyclospora cayetanensis have been the aetiological agents in nine (2. 8%) and six (1. 8%) outbreaks, respectively, while Toxoplasma gondii and Isospora belli have been responsible for three outbreaks each (0. %) and Blastocystis hominis for two outbreaks (0. 6%). Balantidium coli, the microsporidia, Acanthamoeba and Naegleria fowleri were responsible for one outbreak, each (0. 3%). Moreover, the occurrence of Giardia and Cryptosporidium (oo)cysts in recreational rivers from Malaysia was reported. It was carried out in water samples at two rivers, ‘Sungai Congkak’ and ‘Sungai Batu’, located in Selangor State. The occurrence of both Giardia lamblia and Cryptosporidium parvum (oo)cysts was higher in Sungai Congkak (50% or 15/30 and 10% or 3/30 respectively) than Sungai Batu (16% or 5/30 and 3. % or 1/30 respectively). The mean density of cysts/L was 0. 72 in Sungai Congkak and 0. 023 in Sungai Batu, and that of oocysts/L was 0. 023 in Sungai Congkak and 0. 0033 in Sungai Batu, showing that the occurrence of Giardia was higher and more frequent than Cryptosporidium in both rivers. On the other hand, the Giardia and Cryptosporidium (oo)cysts were more concentrated at the downstream station, followed by midstream and upst ream stations which might be due to human factors where settlements and recreation areas were located around and between midstream and downstream stations.Failure to meet basic human needs for water in China leads to waterborne diseases and preventable deaths, especially among children. The OECD Environmental Indicators in China report issued in July 2007 estimated 30,000 rural children die each year from diarrhea caused by polluted water (OECD, 2007). The World Health Organization reported an incidence of 108. 4 mortalities per 100,000 persons from diarrhea-related illness in China in 2002. In 2003, the National Statistics Office said diarrheal diseases ranked second among the top causes of morbidity in the Philippines with 615,692 cases recorded (World Bank, 2006).Diarrhea is considered a major cause of morbidity, especially in developing countries. In the Philippines, it was the leading cause of morbidity for the years 2001 and 2003, and the second in 2002 (National Statistics Of fice, 2006). Common causes of diarrhea are infections due to protozoa. These causative agents are either foodborne or waterborne. Among enteric protozoa, Giardia lamblia (syn. G. intestinalis or G. duodenalis) and Cryptosporidium spp. are the most commonly reported causes of water-borne diarrhea outbreaks (Natividad et al,2008).The protozoa G. lamblia was first reported in the Philippines in 1977 and since then has been identified as a common intestinal parasite. Studies done in Luzon, in various localities in the Visayas, and in the southern islands of Mindanao indicate wide distribution of Giardia in the Philippines. (Natividad et al, 2008). Stool examinations in the Philippines typically included the identification of the common etiologic agents of diarrheas such as G. lamblia and Cryptosporidium.According to the most recent nationwide survey of Giardia and Cryptosporidium provides basic information on the prevalence of these enteric protozoa in the Philippines. (Buerano et al, 2 008). The worsening water quality is related to incidence of waterborne diseases, and is likely to increase a negative impact of floods on human health. Example of this is an unusual flood that occurred in Marikina City, resulting in high mortality and morbidity rates due to gastroenteritis and other waterborne diseases (The Asian Disaster Preparedness Center, August 2008).The pollution of the surface water in Agusan River could cause a variety of contagious diseases. Those diseases could outbreak through several routes such as: infection by parasites (such as schistosome), which inhabit in the water and drinking of and/or contact with the polluted water river that may cause dysentery and diarrhea (Lomboy, 2011). Instead of developing Davao River as an economic resource, it is currently being used as a central septic tank according to the Davao River Conservation Coordinating Committee.A study conducted by the committee showed that about 11 drainage systems in the city are moving in to the Davao River (Manila Bulletin Publishing Corp. , 2004). Currently, Davao River has become a dumping site for garbage, biological wastes, chemical wastes and other pollutants carried by the residents and even people just within the area (Pascua et. al. , 2011). Thus, areas near or within the urbanized populace such as Bankerohan, Magallanes and Bucana, are considered polluted and may be the source of detrimental effects to those who live nearby. Conceptual FrameworkINDEPENDENT VARIABLEDEPENDENT VARIABLE Fig. 1 Conceptual Paradigm Showing the Relationship of Independent and Dependent Variables of the Study Presented in Fig. 1 above is the conceptual paradigm showing the independent variable, the pathogenic parasites and its levels on the three stations of Davao River namely Bankerohan, Magallanes and Bucana and is the subject of the study. The waterborne diseases and its levels would depend on what pathogenic parasites are found on the three stations of Davao River and is consid ered the dependent variable of the study.Statement of the Problem This study specifically aims to answer the following questions: 1. What is the level of pathogenic parasites in the following stations of Davao River: 1. Bankerohan? 2. Magallanes? 3. Bucana? 2. Is there a significant difference among the levels of pathogenic parasites? 3. What is the level of waterborne diseases in the following stations of Davao River: 1. Bankerohan? 2. Magallanes? 3. Bucana? 4. Is there a significant difference among the levels of waterborne diseases? 5.Is there a significant association between the level of pathogenic parasites and the level of waterborne diseases? Null Hypotheses 1. Hypothesis free 2. There is no significant difference among the levels of pathogenic parasites in the three stations of Davao River. 3. Hypothesis free 4. There is no significant difference among the levels of waterborne diseases in the three stations of Davao River. 5. There is no significant association between the level of pathogenic parasites and the level of waterborne diseases in the three stations of Davao River. Significance of the StudyThe results of this study would provide advantages to various fields namely: Government – They would be able to implement policies and ordinances regarding proper waste management and the dos and don’ts regarding the use of water from the river. The affected residents within the area would be supported and information dissemination within the community would be implemented. Environmental Groups and Agencies – Having been aware on the situation of the 3 stations of Davao River, they would be able to provide solutions to lessen its contamination and prevent increase on water pollution.Community – They would be given health awareness as well as the possible implementation of preventive measures and disease control. Teachers – This study would serve as an educational supplement and could be regarded as a learning material th at could give additional knowledge to those who would desire to conduct a study related to pathogenic organisms found in urbanized rivers. Students – This study could serve as a reference material for further researches. Definition of Terms Davao River. It is one of the largest rivers in the Philippines and the largest in Davao Region.It has a length of 143 kilometers. Salug River located in San Fernando, Bukidnon is its source and the mouth is located at the Davao Gulf. Bacteria. They are single-celled prokaryotic microscopic living organisms that could be pathogenic or likely to cause disease especially waterborne diseases since they could live in water and easily multiply. Parasite. It is an organism that lives in or on another organism (its host) and benefits by getting nutrients directly to its host. It is usually acquired through ingestion of contaminated food or water.Waterborne disease. It is a disease acquired by drinking water contaminated at its source or in the di stribution system, or by direct contact with environmental and recreational waters. It is a disease which results from infection with pathogenic microorganisms or chemical poisoning. Pathogenic microorganisms include viruses, bacteria, protozoans and helminthes. ———————– Waterborne diseases †¢ Bucana †¢ Magallanes †¢ Bankerohan Pathogenic Parasites †¢ Bucana †¢ Magallanes †¢ Bankerohan