Treating infections from Odaw, Okrudu rivers

Bacteria are found everywhere, while some are harmless others are harmful.

When they cause infections, it is usually not a great worry because we can treat them with antibiotics. Over the years, however, antibiotics do not kill bacteria as they used to, as a result of their misuse and overuse.

They have developed defensive mechanisms to make them resistant to antibiotics. Extended-spectrum beta-lactamases (ESBLs), for instance, are enzymes produced by certain types of bacteria, which can breakdown the active ingredients in many common antibiotics, making them ineffective and resistant.

When E. coli producing enzyme (ESBL-Ec) ends up in man, they cause difficult-to-treat infections as they are resistant to almost all antibiotics available in Ghana. I provide evidence of sources of such resistance to bacteria from the environment in this article.

This study forms part of surveillance carried out following a WHO protocol developed to study such phenomenon in three major components (humans, animals and the environments dubbed the One Health Approach). 

A team of scientists from the Council for Scientific and Industrial Research – Water Research Institute (CSIR-WRI) carried out the environmental aspect of this study. 

What we did

A total of 100 water samples were fetched from four main points of the well-known Odaw River in Accra and the Okrudu River in Kasoa over a 12-month period and analysed at the microbiology laboratory of CSIR-WRI.

Water sampling process from the Odaw river

From each city, water samples were collected from a source representing pre-city impact (upstream/Figs.1a & 2b) and a downstream point (Figs.1b) further away from the upstream point of the rivers.

In addition, two other samples, human and animal wastewater that discharges into these rivers were taken. Concentrations of ESBL-Ec were determined per 100ml (equivalent to half a glass of water) of river water. 

What was found

• In every 100mls counts ranged from 1,000 to 100,000,000 for E. coli and 3000 to 240,000 for ESBL-Ec. 
• As rivers flowed through these cities these counts increased by 100 and in downstream river waters, ESBL-Ec were 10 times greater in Accra compared to Kasoa. 
• Levels of E. coli and ESBL-Ec. detected were between 10 and 100 times above WHO guideline thresholds for irrigation of crops with wastewater.
• Indeed our study shows the feasibility of the WHO Tricycle Protocol in surveying antibiotic-resistant bacteria in water even in low-resource settings. 

What it implies, what must be done

• This study suggests that river water may be contributing to the spread of antibiotic resistance among humans and animals through contaminated food and direct contact. 
• Carriage of ESBL-Ec among the human population could result in difficult-to-treat infections such as urinary tract and bloodstream infections. 
• High faecal contamination of rivers is likely a result of poor disposal of untreated wastewater into the environment.

Undeniably, this is a wake-up call to keep our rivers and waterways clean and it requires a concerted effort from all relevant stakeholders and every citizen of Ghana. There has to be strict enforcement of by-laws on waste water disposal by the Ministry of Local Government, Environmental Protection Agency (EPA), the Ministry of Sanitation and Water Resources etc.

Upstream  Okurudu River,  Kasoa

Dredge Masters, for instance, removed over two million cubic meters of waste from the Odaw River including lifeless bodies. It is said that the health of humans connects to the health of the environment and clean water is the world’s first and foremost medicine.

Immediate action is, therefore, required to educate people living around the rivers on the safe use of these rivers and proper waste disposal practices.
                                                                                                                                        
The writer is a Senior Research Scientist, 
Water Research Institute, 
Council for Scientific and Industrial Research (CSIR)