Socio-economic and climate change impacts on rotavirus concentrations and its linked disease burden in Uganda's surface waters
Brief background and aims:
Rotavirus is a globally important waterborne pathogen causing high infant mortality and morbidity from gastroenteritis. In Uganda, 7% of all deaths in children below 5-years are due to rotavirus infections. The country’s low coverage of improved sanitation, improper fecal sludge disposal and wastewater treatment exacerbate rotavirus transmission via the fecal-oral route. To understand the role of sanitation systems on surface water pollution with rotavirus and its associated disease burden, this study aims to:
- develop a modelling framework to estimate rotavirus emissions (loads) and concentrations reaching surface water from sanitation systems in Uganda.
- develop a framework to estimate the relative risk and diarrheal disease burden for the different rotavirus exposure scenarios on case-by-case basis.
- study the impacts of socio-economic and climate change on modelled rotavirus output and the estimated disease burden.
The proposed modelling framework will be applicable to other fecally-excreted pathogens or locations, and can support decision making for sanitation improvement and the management of sanitation-related health outcomes.
To estimate rotavirus emissions, we will use an adapted process-based water quality model (the Global Water Pathogens – GloWPa), which factors associated diarrheal incidence, excretion rate, sanitation-type coverage and wastewater treatment-type removal. Emissions reaching surface water will be simulated for different age-groups, rural and urban populations. Afterward, we will couple loads with surface run-off across all 8 hydrological river basins in the country to estimate rotavirus concentrations in surface water. Run-off will be simulated from two physically-based hydrodynamic models. The risk of infection and burden of disease due the simulated concentrations will be developed from localized exposure cases, dose-response models and disease severity. Building each exposure case will include identifying the exposure pathways, exposure points, risk populations and exposure mechanisms with the help of the Water-K2P Project stakeholders in Uganda and from literature. Finally, scenarios for socio-economic development and climate change will be built to investigate their impacts on rotavirus concentrations and its associated disease burden.
This study is supported by the Global Water Pathogens Project, which piloted the Knowledge to Practice (Water K2P) Uganda chapter, themed: Utilizing the Global Water Pathogen Project (GWPP) to meet the SDGs.