research paper on water purification in philippines

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The Effectiveness of Home Water Purification Systems on the Amount of Fluoride in Drinking Water

Behrooz eftekhar, masoume skini, milad shamohammadi, jaber ghaffaripour, firoozeh nilchian.

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Correspondence: Nilchian F. Dental Students Research Center, Dept. of Dental Public Health, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran. Tel: +98-31-37922894 Email: [email protected]

Received 2014 Sep; Revised 2015 Apr; Accepted 2015 Jun.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/ ) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Statement of the Problem

Water purification systems for domestic use have drawn significant attention over the past few years. This can be related to the improvement of public health and concern for water contamination. 

The aim of this study was to evaluate whether home water purification systems eliminate the essential materials such as fluoride besides filtrating the heavy ions and other unwanted particles out of water.

Materials and Method

In this experimental study, six most frequently used commercial brands of water purifiers were evaluated and compared. Specimens were collected right before and after setting up the device, and 6 months later. Then, spectrophotometry (the Harrison device) was performed to compare fluoride clearance by each home water cleaner device.

Based on the data collected from all water purification devices in different locations, the amount of fluoride was significantly different before and right after using home water purifier and six months later ( p = 0.001 and p = 0.00, respectively).

The filtration of water significantly decreased its fluoride concentration. The fluoride content of purified water was approximately as much as zero in some cases.

Keywords: Water Purification, Fluoride, Spectrophotometry

Introduction

Fluoride is a natural element branched from Fluorine. This element can be found in all sorts of water and soil. Out of every kilogram of outer layer of earth, 0.3 gram is fluoride. Mineral waters have more amount of this element compared to other sources.( 1 )

About 60 years ago, Grand Rapids in Michigan State was the first city in which fluoride supplement was synthetically added to tap water. In US, adding fluoride to community water supplies of many cities has improved the oral health of millions of American citizens.( 2 )

Fluoridation of community water supplies is adding a specific amount of fluoride (0.7-1.2 ppm) to water in order to reduce the risk of dental caries. By 2002, almost 170 million Americans were provided with this privilege.( 3 )

Since most of the systemic fluoride is provided through tap water to population, many policies have been established to add fluoride to community water regarding its benefits for teeth and bones.( 4 )

In regions and countries that do not have water-fluoridation technology, there are natural supplements as previously mentioned. For example, Iran has many mineral water supplies that contain considerable amounts of fluoride. Amount of fluoride in natural mineral waters depends on weather conditions; the warmer the weather is, the higher the amount of fluoride can be detected. Mineral waters in southern regions that have warmer weather contain more fluoride. In Iran, the highest amount of fluoride has been found in southeast and northeast areas.

Water purification systems for domestic use have drawn much of attention over the past few years. This can be related to improvement of public health and concerns for water contamination. There are several types of home water purification systems that can be categorized into 3 different groups( 5 ) as filtered systems, systems using UV irradiation, and ion-exchange systems.

The aim of this study was to find out whether domestic water purification systems could eliminate the essential materials such as fluoride besides filtrating the heavy ions and other unwanted particles out of water.

In this study, 6 frequently used commercial brands of water purifiers in Ahwaz were compared. The commercial brands evaluated in the current study were CCK (Ceramic and Ceramic/Carbon Cartridges ; RTX-TS DLM filters, Korea), Soft Water (Ceramic Candles; Alpine TJ Series filters, W9332420, USA), Alkusar (Special media cartridges filters; PRB50-IN, USA), Puricom (Special media cartridges filters; Watts 4.5" x 10" Dual Housing, Korea), Water Safe (Granular Carbon Cartridges filters; LCV (Lead, Cysts, VOC's) (Carbon Block Filter Cartridges, Australia), and Aquafresh (Sediment String-Wound; Poly Spun and Pleated Washable Cartridges filters, K5520, USA). The main drinking water supply for Ahwaz is provided by governmental companies. After making arrangement with certain companies that supported these brands, the devices were setup in 6 different regions of Ahwaz. Samples were collected before and right after setting up the device. To reduce the errors and elevate the accuracy of the module, 5 samples were taken from each device. Another sample was collected from each single device 6 months later. A total of 64 samples were collected including 32 unfiltered (control) and 32 filtered samples of tap water (experimental) from 6 regions in Ahwaz. Fluoride sampling kits (Spands; EW-99574-08Hach ® Test Kits, USA) were used to test the amount of fluoride in sample waters. Samples were all collected in polyethylene sampling containers and were then coded. Spectrophotometry (AvaSpec-ULS2048L- USB2 UARS spectrometer, USA) was performed. In order to measure the characteristics of individual molecules, a mass spectrometer converted them to ions so that they could be moved about and manipulated by external electric and magnetic fields.

Atmospheric pressure was around 760 torr (mm of mercury). The pressure under which ions may be handled is roughly 10 -5 to 10 -8 torr (less than a billionth of an atmosphere). By varying the strength of the magnetic field, ions of different mass can be focused progressively on a detector fixed at the end of a curved tube and also under a high vacuum.

Latin alphabetic words were used to code each commercial device. Numbers were used for samples obtained before and after setting the device.( 6 )

The results were analyzed by using paired sample t-test, with alpha (ɑ) set at 0.05.

The amount of fluoride in water before and after using six brands of water purifier device is summarized in Table 1 .

The amount of fluoride before and after installing water purifier devices

Based on the data gathered from all water purification devices set in different regions, the level of fluoride was significantly different before and after using home water purifier ( p = 0.001). It was found that home water purifiers nearly eliminated fluoride from tap water. Table 2 represents the results of t-test.

Comparison of different study groups with t-test

* p< 0.05 is statistically significant.

Another round of sampling was done 6 months later from the same filters of home water purifier. Details are illustrated in Table 3 and 4.

The amount of fluoride in tap water after 6 months of using a water purification filter

Comparison of the study groups after six mounts with t-test

Fluoride absorption is mostly systemic or local; systemic absorption occurs through eating the element with food, water or fluoride pills, and local absorption by toothpastes and other fluoride-containing hygienic products. In many countries, the highest supply for fluoride absorption is systemic absorption through water consumption.( 6 ) In early 20 th century, the first attempts were made to fluoridate public water supplies, which eventually led to 40% decrease of dental caries in the target population.( 7 )Introduction of water fluoridation in the 1950-1960 and fluoride-containing dental products in the 1970 changed the situation. The main sources of fluoride in established market economies (EME) are drinking water, fluoridated salt, foods and beverages, baby cereals and formulas, fluoride supplements, toothpastes, mouth-rinses, and topical fluorides. Additionally, fluoride in water has a diffusion or halo effect; which means that the drinks and foods manufactured in fluoridated areas are also available to whole population including the residents of non-fluoridated areas.

Although adding fluoride to almost all oral hygienic products has restricted the effect of fluoride water (Halo effect), it is still common to fluoridate the city water supply.( 6 ) In many areas of the world, there is no systematic plan for fluoridation of community water and only the natural sources supply it. Therefore, sometimes the hardness of water and aggregation of different and sometimes poisonous elements drive the population to use bottled water or use home purification devices.

The findings of the present study revealed that all the 6 devices reduced the fluoride in tap water and most of them nearly eliminated it. Different home purification devices have been marketed each of which is claimed to eliminate certain kinds of elements from water.( 9 ) JK Mwabi et al. (2011) used 4 different filters to reduce the hardness and chemical contamination of water in poor villages in Africa, and reported that all of the four filters reduced the fluoride significantly. Bucket filter had the most significant effect and reduced fluoride element 99.9%. These results also indicated that fluoride was the most reduced element of all. Likewise, silver-impregnated porous pot (SIPP) filter reduced 90%-100% of elements.

Clasen et al. ( 5 ) in their study reported that 3 different home purification systems ,the ceramic candle gravity filter, iodine resin gravity filter, and iodine resin faucet filter, reduced bacterial contamination by four logs and decreased ions such as fluoride and arsenic, as well.

Moreover, there are certain methods to reduce the excessive amount of fluoride in the water. One of the best-known methods is absorption technique.( 7 ) Evaluation of 6 different commercial water purifiers has not been done in any other study; therefore, there is no similar study to compare the results exactly. More evaluations are suggested to be performed on home water purification systems, and more strategies should be devised to preserve the essential elements of tap water.

The current study found considerable differences between the amount of fluoride before and after filtration with home purification device; that is filtration significantly decreased the fluoride concentration even as much as 100% in some cases.

Conflict of Interest: None declared

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Cocopeat Effluent Water Filtration Systems in the Philippines: A Comparative Evaluation of Alternative Implementation Models

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Context & Problem Overview - There is a great necessity for improved sanitation practices in the developing world. Forty percent of the world’s population practice open defecation or lack adequate sanitation facilities. In urban areas throughout the developing world, where household and community toilets are available, 2.1 billion people use toilets connected to septic tanks that are not safely emptied or use other systems that discharge raw sewage into open drains or surface waters resulting in a greater incidence of waterborne diseases, poor drinking water quality, and contaminated water sources. In the Philippines, poor sanitation infrastructure and disease costs the economy $1.94 billion a year. Improved sanitation practices and infrastructure are difficult to implement and sustain. Public services, treatment systems, and sanitation practices in the developing world often require sufficient land, capital, and energy resources that are often scarce. Low cost, sustainable improvements and innovations, as well as local acceptance and ownership, are necessary to develop and implement alternative technologies that can help reuse waste, improve water treatment and improve overall quality of sanitation services. Researchers at Research Triangle Institute (RTI) International have developed and tested a secondary waste water treatment filter that can be appended to existing decentralized waste water treatment systems (DEWATS) and collection facilities. Using a cocopeat filter, the discarded dust and coir generated from coconut processing plants, an effective bio-filter unit can be constructed. This simple device can easily be connected to existing septic tanks or other primary treatment components to filter effluent waste water and meet national discharge standards. This filtration technology has the potential to improve health and positively impact sanitation services for urban poor communities. Although successful pilot programs have been launched through grant funding and self-financing, RTI would like to explore alternative implementation models to deliver this technology to a larger audience in the Philippines.

Policy Question - What implementation models could RTI International consider for scaling up cocopeat bio-filtration systems to improve access to safe water and sanitation in urban poor areas of the Philippines?

Data and Methodology - To assess and recommend potential implementation model options the following data and methodology was used: 1) Sanitation Sector Landscape Analysis – I conducted a literature review of the Philippines sanitation sector to assess the most significant institutional factors related to implementing DEWATS projects. 2) Case Study Analysis – I collected and reviewed relevant case studies related to DEWATS projects implemented in urban Philippines locations to determine key lessons learned, potential implementation models, and project financing structures. 3) Integrated Financial and Economic Analysis – From the financial and economic data collected in the case studies, I analyzed cocopeat filter technology system costs with comparable secondary treatment systems. Additionally, I analyzed potential cost distributions of a cocopeat filter system using four different implementation models.

Findings - 1) Cocopeat filter technology is a proven low cost, sustainable, and effective alternative to other secondary waste water treatment technology options with comparable efficiency. 2) The Community Participation model shows the most potential for mitigating institutional risks and constraints within the sanitation sector. 3) Efficient DEWATS implementation using a cocopeat filter has the potential to improve benefit to cost ratios (BCRs), reduce cost burdens on direct users, and introduce sanitation treatment systems to urban areas where space constraints are a key limiting factor.

Recommendations - RTI could pursue Community Participation models for implementing cocopeat filter DEWATS projects with support from local government units (LGUs) and NGOs. This model shows the most promise for mitigating institutional risks, promoting awareness of sanitation benefits, driving ownership by end users, and enabling technology adoption. Given that technical implementation, social marketing, and sanitation training expertise resides predominantly with NGOs, RTI should also continue to promote the benefits of cocopeat filter technology through these subject matter experts.

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Parsons, Seth (2014). Cocopeat Effluent Water Filtration Systems in the Philippines: A Comparative Evaluation of Alternative Implementation Models . Master's project, Duke University. Retrieved from https://hdl.handle.net/10161/8567 .

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A perception study of an integrated water system project in a water scarce community in the philippines.

1. Introduction

2. iws project in mulanay, 2.1. study area, 2.2. focus group discussion and social preparation, 2.3. site selection, 2.4. components of the integrated water system, 2.4.1. rainwater harvesting system (rwhs), 2.4.2. water treatment system (wts), 2.4.3. eco-toilet system (ets), 3. methodology, 3.1. research framework, variables, and hypotheses, 3.2. survey instrument, 3.3. measurement scale and measurement items, 3.4. data collection, 3.5. data analysis, 4. results and discussion, 4.1. demographic profile of valid respondents, 4.2. community water sources, 4.3. socio-economic considerations, 4.4. empirical findings on c-tam-tpb as pls–sem model, 4.5. discussion and research implications, 5. conclusions and recommendations, author contributions, acknowledgments, conflicts of interest.

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Ignacio, J.J.; Malenab, R.A.; Pausta, C.M.; Beltran, A.; Belo, L.; Tanhueco, R.M.; Promentilla, M.A.; Orbecido, A. A Perception Study of an Integrated Water System Project in a Water Scarce Community in the Philippines. Water 2019 , 11 , 1593. https://doi.org/10.3390/w11081593

Ignacio JJ, Malenab RA, Pausta CM, Beltran A, Belo L, Tanhueco RM, Promentilla MA, Orbecido A. A Perception Study of an Integrated Water System Project in a Water Scarce Community in the Philippines. Water . 2019; 11(8):1593. https://doi.org/10.3390/w11081593

Ignacio, Jonathan Jared, Roy Alvin Malenab, Carla Mae Pausta, Arnel Beltran, Lawrence Belo, Renan Ma. Tanhueco, Michael Angelo Promentilla, and Aileen Orbecido. 2019. "A Perception Study of an Integrated Water System Project in a Water Scarce Community in the Philippines" Water 11, no. 8: 1593. https://doi.org/10.3390/w11081593

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WATER QUALITY IN THE PHILIPPINES (2008-2015

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Translating National Policy to Improve Environmental Conditions Impacting Public Health Through Community Planning, 2018

The Philippines is an archipelagic country dominated by water and inland water sources. Water quality has been the subject of attention for the country and specifically, Mindanao Island, because of the role this natural resource plays in agriculture. Water supply and usage for the island and the nation are identified and discussed in relation to the scarcity of potable water. Potential threats and pollution hotspots bring forth the various health and environmental impact attributed to the water system accessibility, distribution, and quality. Strategies addressing water resources problems are taken into consideration side-by-side the numerous national laws, policies, standards, and guidelines in addressing water quality control and management. Therefore, the legal framework for various agencies to carry out these policies on quality control, usage, and water management are pivotal to recommendations on revision of certain provisions that rely on embedding local community involvement...

Access to safe drinking water is not only essential for the promotion and protection of public health but is a basic human right. Provision of safe water supply prevents the transmission of waterborne pathogens and reduces the exposure of individuals to chemical and physical hazards that could be ingested through contaminated drinking water. Diarrheas and other waterborne diseases still rank among the leading causes of illnesses in the country. It is apparent that continuous development or refinement of policies and programs geared towards minimizing the risk of contracting waterborne diseases should be supported to provide optimal health service for the population. Setting standards for drinking water establishes threshold limits for different impurities found in drinking water. These limits are intended to minimize risk and therefore prevent deleterious health repercussions that result from lifelong exposure to these impurities through consumption of water. The Department of Health is mandated to formulate standards to this effect. Chapter II (Water Supply), Section 9 of the Code on Sanitation of the Philippines states that " Standards for drinking water and their microbiological and chemical examinations, together with the evaluation of results, shall conform to the criteria set by the National Drinking Water Standards. " The government recognizes recent quality-related developments in the water supply sector in the country and elsewhere such as the following: 1. New information on many chemicals. As an outcome of evolving agricultural, industrial and even domestic practices, new chemicals find their way into the environment and contaminate drinking water sources 2. Proliferation of water refilling stations as alternative (or main) sources of drinking water. The quality of " processed " water from these stations may require distinct standards compared to the water from large water systems.

International Journal of Scientific & Technology Research, 2021

Mindanao Journal of Science and Technology, 2015

Journal of Advanced Research in Dynamical and Control Systems

InTech eBooks, 2012

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Journal of Water and Health, 2016

Ground Water, 2009

SIMI 2016, 2016

American Journal of Water Resources, 2015

Water intelligence online, 2013

International Letters of Natural Sciences

International Journal of Water Resources Development, 2019

… Microbial Safety of Drinking Water, 2003

International Journal of Clinical Medicine, 2016

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Municipal Water Quality Management in the Philippines’ Zamboanga Peninsula Region: An Assessment

28 Pages Posted: 7 Aug 2023

Emerissa Jane Tendero

International Register of Certificated Auditors (IRCA-Philippines)

Date Written: July 25, 2023

This study conducted an in-depth assessment of municipal water quality management in the Zamboanga Peninsula Region of the Philippines. It aims to identify the key challenges and opportunities in ensuring safe and sustainable water resources for local communities. Through a comprehensive analysis of actual water quality data obtained from the region's municipalities, this research sheds light on the existing state of water quality and the effectiveness of current management practices. The findings reveal alarming levels of water contamination in several areas, primarily attributed to industrial discharge, agricultural runoff, and inadequate wastewater treatment. The absence of efficient monitoring systems and inadequate enforcement of environmental regulations exacerbate the situation. However, the study also identifies promising practices in certain municipalities, where active community engagement and collaborative efforts with non-governmental organizations have led to notable improvements in water quality. This research serves as a valuable resource for policymakers, public administrators, and water management professionals seeking to enhance water quality in the region. By synthesizing real-world data, the study underscores the urgency of implementing evidence-based policies and participatory approaches to address the complex challenges of municipal water quality management effectively.

Keywords: municipal water quality, water contamination, water resources, Philippines, Zamboanga Peninsula, environmental regulations, community engagement, sustainable water management

Suggested Citation: Suggested Citation

Emerissa Jane Tendero (Contact Author)

International register of certificated auditors (irca-philippines) ( email ).

CPADS, Normal Road Baliwasan Zamboanga City, Zamboanga del Sur 7000 Philippines 09207256273 (Phone)

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An Investigatory Study of Water Filtration

• M. L. Ferrer
• C. Florentino
• D. L. Gabato
• E. F. Lacson
• D. N. Ventura
• Reynold R. Bangalisan, LPT, MRIEdr

Water filtration project is a process that can remove unwanted substances in water using materials such as pebbles, sand, and charcoal and turn it into water that can be used on everyday habits and can eventually be drunk. Charcoal is activated to remove chlorine. Pebble is used to trap and strain particles in the water. Sand is naturally occurring granular materials composed of finely divided rock and mineral particles. It is defined by size, being finer than gravel and coarser than silt. This study utilized a quantitative analysis method of research. It also utilized a questionnaire to test the level of acceptability of the water filtration process in terms of color, suspended particles, and usefulness and assessed by 5 Science Experts and 5 Science Teachers of Bestlink College of the Philippines. To determine the level of acceptability of the water filtration process, the researchers used a t-test to test the significant differences between the assessment of the Science Experts and Science Teachers at the level of significance of α= 0.01 and the degree of freedom of 8. The level of acceptability of the water filtration process in terms of color, suspended particles, and usefulness is moderately acceptable as assessed by the Science Experts and Science Teachers. There is no significant difference between the assessment of the Science Experts and Science Teachers on the level of acceptability of the water filtration process in terms of color, suspended particles, and usefulness. The Science Teachers said that the color and suspended particles were acceptable but it is not advisable for drinking. The Science Experts said that there are many tests that we need to conduct to know if it is potable and safe. The level of acceptability of the water filtration process is rejected. This study was connected to another study that used the same ingredients as pebbles, sand, and charcoal. This study was not as effective as we used normal charcoal to filtrate the water. Another study that used activated charcoal was reliable. The flaws of the study were acknowledged and the future researchers were advised to research more effective ingredients to filter the water.

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‘Malunggay’ studied as water filter

The humble “malunggay” (Moringa oleifera) could make waves when it comes to the Philippines’ water purification industry, thanks to a research initiative headed by a Manila university in partnership with a Canada-based Filipino educator.

Malunggay’s potential as a water filter is being tapped by a joint research project of De La Salle University (DLSU) on Taft Avenue in Manila, University of Waterloo in Canada and George Washington University in Washington, D.C.

The researchers hope to come up with a cheap and easy-to-use water filtration system that could provide water even to remote rural communities in the Philippines.

The Barangay Water Project uses malunggay seeds packed with an adsorbent, such as sand, carbonized rice husk or activated carbon, to create a “point-of-use biofilter that can either be used at home or in small communities, like a school, for purifying drinking water,” Canada-based Sheree Pagsuyoin, the project’s lead investigator, said in an e-mail interview.

Pagsuyoin is also an assistant professor of civil and environmental engineering at the University of Waterloo.

Canadian grant

The project is funded by a grant from Grand Challenges Canada, a government program that aids research on global health issues in Canada and developing countries.

Pagsuyoin, who secured the grant, got in touch with Raymond Tan, DLSU vice chancellor for innovation and research, to form and head the Philippine team that would work on the project.

Pagsuyoin said the team chose to develop a water biofilter because “water treatment technologies are much needed in many low-income regions, especially in rural areas.”

“But we also recognize that these technologies should be environmentally, economically and socially sustainable for them to be effective over the long term,” she added.

Filtering properties

“We chose moringa because it is already widely known in the Philippines for its many other uses. Thus it will be easier to introduce the concept,” said Pagsuyoin, who has worked on other water and sanitation projects in rural areas in the Philippines and South Africa.

Previous studies on the use of malunggay seeds for water purification showed that these had proteins containing antimicrobial and coagulant properties that can kill coliform and remove turbidity in water, she said.

The seeds, however, also produce other organic elements that affect long-term storage of the treated water.

“Our goal with the biofilter is to harness the [seeds’] proteins’ antimicrobial properties while eliminating these organics,” Pagsuyoin said.

She said she had yet to complete lab experiments and the filter’s final design in Canada with the help of a DLSU graduate student, engineer John Barajas.

Luis F. Razon, director of the DLSU Food and Water Institute and a member of the research team, likened the expected final product design to that of a Brita filter, which is small and cylindrical.

The filter, Razon said, would be packed with malunggay seeds and adsorbents. One would just need to pour the contaminated water through the filter to remove the impurities.

Razon said the DLSU team would test the malunggay biofilter in July or August in Mulanay, a small seaside municipality in the Bondoc Peninsula in Quezon province, where the university previously worked in other projects.

In August 2014, Razon headed focus group discussions with 150 to 200 Mulanay residents to find out their main concerns about drinking water.

“What stood out to me was how they described the taste of the water they fetched from local wells—matabsing, which means an acrid and sort of salty taste. They were also aware that there were harmful bacteria in the water and that they could get sick from drinking it,” Razon said.

“So aside from creating a biofilter [that] can take out the impurities, we have to make sure that the water will also taste good,” he added.

Mulanay’s water supply comes from a mountain spring that Razon said tested positive for E. coli bacteria. So far, the team has been unable to determine why the water source is contaminated, Razon said.

If all goes well with the product testing in Mulanay, Razon said, the team hoped to bring the filter to more rural communities in the country that need potable water.

Commercial production

Razon said the researchers were also studying the biofilter’s marketability. Joost Santos, an assistant professor at George Washington University, is heading the feasibility study on the commercial production of the malunggay biofilter, Razon said.

“Personally, if the biofilter would be commercialized, I think it would be better for quality control. But, of course, we won’t limit it to that. Another option would be for someone to make his own biofilter and use it to treat water, which he could then sell,” Razon said.

“There are other possible uses, say, during a storm, when people are in need of clean water, they can use the biofilter,” he said.

Community attitude

The success of the Barangay Water Project, however, won’t just depend on the filter’s effectiveness, but on the community’s attitude toward using the filter, Razon said. For one, the community would need to have a steady supply of malunggay, which Mulanay has.

“[From past experiences], I’ve come to recognize that intervention technologies designed to improve the water and health status of low-income communities must be integrated into the locals’ daily activities,” Pagsuyoin said.

“Moringa has many other uses and livelihood can stem from encouraging its cultivation,” she added.

“It’s easy to work with Mulanay [residents] because they have become so used to consultative work. They’re good at organizing themselves. It is easy to instruct them to form groups, work in teams,” Razon said.

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“It’s important that the community is organized, ready to receive the technology and willing to provide information. The local government has to be receptive,” he said.

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Review of bacterial and viral zoonotic infections transmitted by dogs

I ghasemzadeh.

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Correspondence to: Sh. Namazi, MD, PhD student, Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran, Phone: +98 76 33334275-6, Fax: +98 76 33331991, E-mail: [email protected]

Received 2015 Jul 28; Accepted 2015 Dec 15.

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Dogs are a major reservoir for zoonotic infections. Dogs transmit several viral and bacterial diseases to humans. Zoonotic diseases can be transmitted to human by infected saliva, aerosols, contaminated urine or feces and direct contact with the dog. Viral infections such as rabies and norovirus and bacterial infections including Pasteurella, Salmonella, Brucella, Yersinia enterocolitica, Campylobacter, Capnocytophaga, Bordetella bronchiseptica, Coxiella burnetii, Leptospira, Staphylococcus intermedius and Methicillin resistance staphylococcus aureus are the most common viral and bacterial zoonotic infections transmitted to humans by dogs. This review, focused on the mentioned infectious diseases by describing general information, signs and symptoms, transmission ways, prevention and treatment of the infection. As far as the infections are concerned, the increase of the knowledge and the awareness of dog owners and the general population regarding zoonotic infections could significantly mitigate zoonoses transmission and consequently their fatal complications.

Keywords: bacterial and zoonotic infections, viral infections, dogs, rabies, noroviruses

Introduction

It is estimated that over 60% of the western families own a pet. The majority of these households keep a dog. Dogs have been kept as pets for over 14 centuries. Many studies have confirmed the precious roles of pets in the human life. Evidence has shown that owning a pet can increase the activity of pet owners and consequently reduced serum cholesterol, low triglyceride levels, and fewer cardiovascular events [ 1 , 2 ]. Also, some other studies demonstrated that pet owners suffer from depression and mental stress less and have a higher self esteem compared to others. Although dogs have several positive effects on the psychosocial and psychical health of their owners, many diseases among humans are attributed to them [ 3 ]. Children and immunocompromised individuals are especially at an increased risk of developing zoonoses infections. Several studies demonstrated that domestic dogs have a dramatic role in developing zoonoses disease and hospitalization [ 4 , 5 ].

Regarding domestic dogs, the increase in the population of stray and semi domestic dogs in urban areas has increased the risk of zoonoses diseases. About 5 million people throughout the world are annually bitten by dogs. Many parasitic and zoonotic pathogens are transmitted by dogs [ 6 , 7 ]. This review focused on the most important viral and bacterial zoonotic diseases, which can be transmitted by dogs.

Rabies is a single strand RNA virus belonging to the Rhabdoviridae family. Rabies infection is an ancient disease with a high mortality rate in human and animal population. Based on the World Health Organization reports, annually between 30000 and 70000 deaths occurred throughout the world due to rabies infection [ 8 ]. Dogs are the major animal reservoirs for rabies infection. The majority of the infected patients in developing countries are infected by dog bites while, in developed countries, wild animals including raccoons, bats and foxes are the main cause for rabies transmission [ 9 ]. In a study in the United States, a rabies control program was conducted by using extensive vaccination in domestic dogs and reducing the rabies infection [ 8 ]. The incubation period for rabies varies between 4 days to several years depending on the location of the inoculating wound and the amount of induced viruses. Patients may present agitation, anxiety, confusion, hallucination, and hydrophobia. Post exposure prophylaxis with frequent doses of human rabies immunoglobulin (HRIG) within 14 days after the suspected dog bite can prevent the disease. Washing the wound with water and liquid soap can dramatically reduce the viral lead and consequently the probability of rabies infection [ 10 ].

Noroviruses

Noroviruses are a heterogeneous single strand RNA virus belonging to the Caliciviridae family. Noroviruses are the main cause of sporadic and epidemic gastroenteritis in humans [ 11 ]. This virus can affect humans of all ages. The virus can be found in the gastrointestinal tract and consequently in the feces or diarrhea of the infected dogs. It can be transmitted from contaminated food or water to humans and the infection can rapidly spread in the human population by fecal oral rate. Serum therapy should be considered for patients with acute gastroenteritis [ 12 ].

Pasteurella

Pasteurella species are Gram-negative coccobacilli, which were primarily found in animals. Pasteurella spp are normal flora of the upper respiratory tract of dogs and cats. Pasteurella infection can be transmitted to humans by direct and indirect contact such as dog or cat bites or licks and even cat scratches [ 6 ]. Several infectious diseases in humans are attributed to Pasteurella spp. The soft tissue infection is the most important infection transmitted by Pasteurella spp. However, meningitis, bone and joint infections and respiratory infection can be transmitted by Pasteurella spp [ 13 ]. In a prospective study in United States, the author demonstrated that Pasteurella spp. was the most frequent organism isolated from dog and cat bites [ 2 ]. Pasteurella infection can be treated by second and third generation cephalosporin, macrolides, fluoroquinolones, cotrimoxazole, and penicillin [ 14 ].

Salmonella species are anaerobic and motile gram-negative bacilli that colonize in the large intestine of a variety of mammals, especially in the distal part of the colon and the mesenteric lymph nodes of the canine. Humans can also get infected through the gastrointestinal tract [fecal transmission] and develop several infectious diseases such as gastroenteritis, enteric fever, bacteremia and osteomyelitis. Gastrointestinal diseases are the most prevalent clinical presentations of salmonella in human and dogs; however, the majority of infected animals or humans is asymptomatic and may shed the pathogen through feces for a period of 6 weeks and transmit the pathogen to other animals or individuals. In developing nations, Salmonella spp. is also more prevalent than in developed countries [ 15 , 16 ]. An antibiogram should be considered for patients infected with Salmonella spp. however, it could be treated by various families of antibiotics including fluoroquinolones, beta-lactams, and macrolides [ 17 ].

Brucellosis is one of the most prevalent zoonoses, which imposes a heavy burden on the national health services. It is commonly transmitted to humans by consuming unpasteurized dairy products. Various types of brucella spp. have been recognized; that resulted in human brucellosis such as B. melitensis, B. abortus and B. suis but, B. canis has been less known as an usual pathogen in brucellosis infection in humans [ 18 , 19 ]. Although B. canis is not responsible for the brucellosis infection in humans, the reported cases were more often seen among farmer populations who had a history of exposure to body fluids of dogs, which were infected with B. canis. The incubation period may last for one to four weeks up to several months [ 19 ]. The patients may be asymptomatic or may even present serious clinical symptoms especially fever, night sweats and low back pain in the endemic region that should be differentiated from tuberculosis and other malignancies [ 20 ]. Brucellosis should be treated in order to avoid complications and sequelae of the disease. Combination therapies, which are widely employed in the treatment of brucellosis, consisted of doxycycline plus streptomycin or rifampin for 6 weeks [ 21 ].

Yersinia enterocolitica

Y. enterocolitica is a gram-negative coccobacillus zoonotic pathogen that causes yersiniosis in human and animals. Several animals are main reservoirs for Y. enterocolitica including birds, pigs, deer, and cattle. The pathogen has been isolated from dog bite wound in some studies [ 22 ]. The patients may be asymptomatic in early stage and when the pathogen invades the mucosal surface of the intestine, watery or bloody diarrhea may be present. The pathogen can also involve the peyer’s patches and represent the appendicitis symptoms [ 23 , 24 ]. Y. enterocolitica is mostly a self-limiting disease that does not need antibiotic therapy, however, patients with severe infection and immunocompromised patients should be treated with a combination of an aminoglycoside and doxycycline [ 24 ].

Campylobacter

Campylobacter spp. including campylobacter jejuni and campylobacter coli are gram-negative bacteria that usually result in campylobacter enteritis. This organism normally lives in the gastrointestinal tract of many animals. Direct contact with infected animals or their products is a leading cause of campylobacter transmission. Dogs and puppies are the major reservoirs for campylobacter. For example, in a study it was demonstrated that about 47% of the fecal specimens of dogs’ campylobacter was isolated [ 25 , 26 ]. The incubation period in campylobacter enteritis varies from one to seven days. Most of the patients present fever, vomiting, diarrhea, and abdominal pain. Also, bloody diarrhea may be present in more than 50 percent of the infected patients. Convulsion and seizure may be observed in some patients [ 27 ]. This infection is usually self-limited and does not need antimicrobial therapy. Focus on correction of electrolyte imbalance and hydration should be considered. Antibiotic therapy with fluoroquinolones, macrolides, or aminoglycosides is indicated in patients with severe disease [ 28 ].

Capnocytophaga

Capnocytophaga canimorsus is a gram-negative bacterium, which is found in the normal flora of the oropharyngeal tract of dogs and cats. The pathogen is mostly transmitted to human by dogs bite and causes an overwhelming sepsis, particularly in elderly, immunocompromised or asplenic patients [ 25 ]. The pathogen can also lead to other fatal infections including meningitis, osteomyelitis, arthritis, lung abscess or empyema and endocarditis. In addition, thrombotic thrombocytopenic purpura and hemolytic uremic syndrome can be associated with capnocytophaga septicemia especially in immunocompromised patients [ 25 , 29 ]. The literature data have demonstrated that the mortality rate due to capnocytophaga septicemia is estimated to be of one third of the infected patients. Accordingly, early empirical therapy with third generation cephalosporins in patients who received a dog bite should be considered [ 30 ].

Bordetella bronchiseptica

Bordetella bronchiseptica is a gram-negative rod bacterium belonging to the genus Bordetella. The pathogen normally lives in the upper respiratory tract of the mammals such as dogs and cats and is transmitted to humans by aerosol. B. bronchiseptica can lead to acute tracheobronchitis in dogs, which presents with harsh and kennel cough [ 31 , 32 ]. Human infection with B. bronchiseptica is very rare; however, the pathogen can also cause pneumonia and upper respiratory tract infection in dog owners [ 33 ]. Evidences demonstrated that this organism is resistant to macrolides and cephalosporins; however, in several studies, the organism was sensitive to fluoroquinolones and Trimethoprim/ sulfamethoxazole [ 34 ].

Coxiella burnetii

C. burnetii is an obligate intracellular gram-negative bacterium that causes Q fever in humans. The pathogen normally infects individuals via aerosol and direct contact with the body fluids of the infected animals. Although dogs are not the main reservoirs for C. burnetii, however, in a study it was demonstrated that C. burnetii was isolated from approximately 10 percent of farm dogs [ 35 ]. In addition, in another study by Buhariwalla and colleagues, it was reported that C. burnetii could be transmitted to human from an infected parturient dog. In addition, the patients developed the symptoms of Q fever including fever, chills, nausea, vomiting and productive cough. Opacity is a common finding in chest radiography, and, in physical examination, crackles may be heard during auscultation. The incubation period in this study was estimated to be between 8 and 12 days after the exposure to the infected animal. The patients with C. burnetii can be treated with fluoroquinolones or doxycycline successfully [ 36 ].

L. interrogans is an aerobic spirochete, which is the major cause of Leptospirosis in human. Leptospirosis is worldwide zoonoses that are mostly transmitted to human by environmental sources including contaminated soil, water, urine, or tissue of the infected animals. Rodents are the major reservoirs for Leptospirosis; however, domestic animals including dogs can play an important role in leptospirosis transmission in endemic regions [ 37 ]. Mucosal surfaces of the human body including eye, vagina, nose, mouth, or erosive lesions, which have a direct contact with the contaminated urine, are the main ways of Leptospirosis transmission. The incubation period for this infection is averagely of about 10 days (ranging from 2 to 26 days) [ 38 , 39 ]. Leptospirosis may present with a variety of symptoms from no symptom to fever, nonproductive cough, headache, musculoskeletal pain, diarrhea, nausea, vomiting, alveolar hemorrhage, and even meningitis [ 39 ]. Several antibiotics such as doxycycline, ceftriaxone, cefotaxime, penicillin, amoxicillin, and ampicilin have been successfully employed for the treatment of Leptospirosis [ 40 ].

Staphylococcus intermedius

S. intermedius is a gram-positive bacterium with a coagulase activity that normally lives in the anterior part of the nasal cavity of several animals such as dogs, pigeons, and horses. Some evidences demonstrated that this pathogen could also be isolated from the gingival of healthy dogs [ 41 ]. S. intermedius is not a common zoonotic pathogen in humans; however, several studies demonstrated that this bacterium is a potential pathogen associated with dog bite wounds and cellulitis can develop in inflicted humans [ 42 , 43 ]. This pathogen should be discriminated from staphylococcus aureus. Penicillin and amoxicillin-clavulanate are effective in the treatment of this infection [ 44 ].

Methicillin resistance staphylococcus aureus

Methicillin resistance staphylococcus aureus (MRSA) is a major cause of fatal infection in humans. Several investigations have reported that this pathogen has been isolated from some animals such as pigs, horses, cattle, cats and dogs. Of them, some believed that companion animals were the main reservoirs for the transmission of MRSA, being able to transmit the bacterium by direct contact with their owners. However, it seems that animal to human infection of MRSA is more seen in immunocompromised patients. Nevertheless, some evidences showed that this bacterium could be transmitted to healthy humans who own an infected animal [ 45 , 46 ]. Traditional anti staphylococcal antibiotics are not more effective in the treatment of infections caused by MRSA. Accordingly, newer drugs including vancomycin, linezolid and daptomycin are widely used in the treatment of MRSA infections [ 47 ].

Zoonoses are diseases that implicate both humans and animals and can be transmitted either by domestic pets or by wildlife animals. Many animals and their products can be reservoirs of zoonoses pathogens. Among them, dogs are responsible for the transmission of several zoonotic diseases to their owners. Thus, dog owners should be informed regarding the zoonotic diseases and their ways of transmission to reduce these infections in human population. Several prophylactic and therapeutic strategies have been introduced in order to decrease the zoonotic diseases. Dog owners are recommended to wash their hands after any direct contact with their dogs, their products, urine, or feces. Most of the viral and bacterial infections are transmitted from dogs to humans by dog bite; however, other infections caused by protozoa have a fecal oral transmission. Thus, food hygiene such as washing vegetables well and cooking meats adequately should be carefully done in order to eliminate the rate of zoonotic infections.

In addition, dogs should also be treated for diarrheal infections. Moreover, dog owners should feed their dogs with cooked meat to prevent campylobacter and salmonella infections. Raw meat and eggs should not be fed to dogs due to higher rate of infection susceptibility. Rabies vaccination should be considered for domestic dogs and the dog owners should also be aware of benefits of rabies vaccination before and after dogs bites. Many authors reported that increasing the knowledge of dog owners regarding dog associated zoonotic infections and prevention strategies can dramatically reduce the zoonotic infections in dog owners and their families.

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