Environmental Health Research

As the impact of climate change became increasingly perceptible, the intersection of environmental research and health research cannot be understated. Over the years, research at FMR evolved to have a multidisciplinary flavour with bridges formed between laboratory findings and their translation to public health measures. This naturally prompted research in environmental health at FMR in early 2000s and was added as a research theme to the portfolio. Foundation’s research initially focussed on the investigation of water quality in drought prone areas and its impact on the environment and health. Earlier studies based in rural Maharashtra were extended to understand how multiple forms of drug resistance and propagated through water bodies and affect human health. All these studies were collaborative studies of FMR and the sister organization Foundation Research for Community Health (FRCH) in Pune. Laboratory based studies were supplemented with detailed community perspectives that indicated the need for awareness and identify resilience factors within rural communities in handling water shortages.

Given the large population and with overuse/misuse of antibiotics, India needs a better and broader system such as wastewater-based surveillance to effectively monitor AMR and alert the governing bodies and local municipalities towards a timely intervention. With limited awareness on AMR in the general population in India, there is also a need to create awareness on AMR among the local communities involved. Hence, furthering the research to align with contemporary issues, the Foundation now is in the process of initiating studies involving wastewater-based surveillance of AMR for drugs selected based on predominance of drug resistance and for newer drugs using Artificial Intelligence.

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Projects awarded funding by International Development Research Centre (IDRC), Canada

Some key highlights of our research in this area are

  • Mapping contaminated water bodies in the environment and rural dwellings indicated a potent interplay of seasons with water handling practices.Feedback on the observations along with health education messages was provided to the local communities. It was concluded that access to drinking water and its quality were divergent issues.
  • The presence of multiple drug resistant organisms in the river with the potential for public health threat was documented along with a demonstration of horizontal gene transfer for the propagation of AMR in environmental sources (water)
  • The alarming situation of river Mula-Mutha was highlighted wherein increasing numbers of antibiotic resistant bacteria in the river were isolated. This represented a cumulative effect of an exponentially rising population of Pune city, the rise of anthropogenic pollution, overburdened waste water treatment plants, poor sanitation and irrational use of antibiotics.
  • Recommendations demonstrated the need to include strong regulation of sewage disposal in rivers.

Projects

  • Principal Investigator

    Dr. Kayzad Nilgiriwala

  • Collaborators

    Artificial Intelligence for Pandemic and Epidemic Preparedness (AI4PEP) program, York University, Canada

  • Project Team

    Ms. Tejal Mestry, Ms. Pratibha Kadam, Ms. Smriti Vaswani, Dr. Uma Mahajan, Mr. Nilesh Shahasane
    Mentor – Dr. Nerges Mistry; Sr. Consultants - Dr. Ashok Tamhankar, Dr. Nilima Kshirsagar

  • Funded by

    International Development Research Centre (IDRC), Canada

  • Duration

    August 2023 – July 2027

  • Budget

    INR 218 lakhs

  • Status

    Funding Withdrawal - The project has been withdrawn due to delay in clearance from Department of Economics Affairs, Government of India.

About the project

Antimicrobial resistance (AMR) is a global issue. Comprehensive and real-time tracking of AMR becomes extremely difficult in lower and middle-income countries like India with large population. Moreover, AMR surveillance is presently conducted in India only through clinical data from tertiary care hospitals which is limited and restricted to certain hospitals. In our study we propose to conduct AMR surveillance (for resistance to 5 crucial drugs – carbapenem, methicillin, azithromycin, bedaquiline, and fluoroquinolones) using wastewater from vulnerable settings (slums) in the Metropolitan city of Mumbai. This will provide a real-time scenario of the level of AMR prevailing in vulnerable settings. An AI based algorithm will be developed for preparedness of an AMR epidemic in future from the perspective of its early detection, early warning system and early response to alert and prepare the public health programme in Mumbai. The knowledge obtained during this study will be shared with stakeholders at the policy / regulatory level (local and national), to the local clinicians and pharma groups, to print and mass media, and to community settings (schools and leadership groups) for reduction of AMR in these localities.

PUBLICATION

  • Nilgiriwala, K., Mahajan, U., Ahmad, R. A, de Castro, R., Lazo, L., Kong, JD, Lee. A. V., Veerakumarasivan, A., Mohd Sharef,N., & Demidenko, S. (2024). Navigating the governance of artificial intelligence (AI) in Asian Nations: A focus on India, Indonesia, Malaysia and the Philippines (February 22, 2024).
    SSRN preprint: https://ssrn.com/abstract=4735279; http://dx.doi.org/10.2139/ssrn.4735279
  • Principal Investigator

    Dr. Tannaz Birdi

  • Collaborators

    Dr. Ragini Macaden, Dr. Mary Dias, St. John's Research Institute, Bengaluru

  • Project Team

    Ms. Rutuja R. Dhawde, Dr. Sivanandan R. Namachivayam

  • Funded by

    Norwegian Research Council

  • Duration

    September – December 2017

  • Budget

    INR 3.3 lakhs

  • Status

    Completed

About the project

In this study presence of virulence genes in multidrug resistant Escherichia coli isolated from the Mula-Mutha river, Pune was undertaken. The objective was to understand whether the isolates were of diarrhoeagenic (Enteroaggregative) or environmental origin. This was essential since the river flows through urban and rural parts of Pune and its water is used not only for industrial and agricultural purposes but also for domestic usage. One hundred and two multidrug E. coli isolates were selected from a previous study, wherein the presence of genes coding for antibiotic resistance as well as identified integrons associated with multidrug resistance were detected from the river Mula-Mutha (link to Projects 2). Isolates were subjected to multiplex PCR to detect the presence of virulence genes, set1A, set1B, senastA, aggA, aafA, pet, stx1 and stx. Sequencing was performed to confirm the amplified PCR product. This study was an extension of Project 2.

KEY FINDINGS/ACHIEVEMENTS

  • Seven of the 102 E. coli isolates subjected to molecular studies showed gene set1A alone identifying them as Enteroaggregative E. coli.
  • Majority of drug resistant E. coli were environmental in origin, and thus highlight the need for efficient public health measures to ensure that untreated sewage and industrial waste do not enter the Mula-Mutha river.

PUBLICATION

  • Namachivayama, S.R., Dhawde, R.R., Macaden, R.S., Dias, M. & Birdi, T.J. (2021). Molecular detection of virulence markers to identify diarrhoeagenic Escherichia coli isolated from Mula-Mutha river, Pune District, India. J Environ Sci Health A Tox Hazard Subst Environ Eng, 56:818-823.
  • Principal Investigator

    Dr. Tannaz Birdi

  • Collaborator

    Dr. Isabel Seifert, Norwegian Institute for Water Research

  • Project Team

    Ms Rutuja Dawde, Mr. Appasaheb Gadge (FRCH)

  • Funded by

    Norwegian Research Council

  • Duration

    May 2016 – December 2018

  • Budget

    INR 51.88 lakhs

  • Status

    Completed

ABOUT THE PROJECT

Increasing numbers of antibiotic resistant bacteria in the river represent a cumulative effect of an exponentially rising population of Pune city, rise of anthropogenic pollution, overburdening of waste water treatment plants (WWTPs), poor sanitation and irrational use of antibiotics.

A seasonal water quality assessment was undertaken for the Mula-Mutha river and for the major drinking water sources (MDWS) from villages along its banks. Additionally, the study investigated the spread of antibiotic resistance in the river Mula-Mutha. Towards this, water samples were collected from different stretches of the river. The sampling covered 4 rural points upstream of Pune city, 2 points in urban areas and 2 rural points downstream of the city. In the case of MDWS, water samples were collected from 6 villages, of which 4 were situated upstream of Pune city and 2 were situated downstream. The collected water samples were tested for the presence of Thermotolerant Faecal Coliforms (TFC) and antibiotic resistant (AR) TFC.

KEY FINDINGS/ACHIEVEMENTS

  • A heavy load of AR TFC was detected in urban stretches of the river and the villages situated immediately downstream of the city.
  • AR E coli including ceftazidime and ciprofloxacin dual drug-resistant E. coli were isolated from river Mula-Mutha.
  • Further, the AR E. coli were tested for the presence of relevant antibiotic resistant genes (ARGs) and integrons. Twenty-eight percent were resistant to > 6 antibiotics. Integrons were present in ~50%. The high levels of multi drug resistant E. coli and the presence of integrons which would facilitate horizontal gene transfer could result in an increasing pool of antibiotic resistant bacteria with implications for human health.

PUBLICATIONS

  • Dhawde,R., Surve, N., Macaden, R., Wennberg, A.C.,Seifert-Dahnn, I., Ghadge, A. & Birdi, T.(2018). Physicochemical and bacteriological analysis of water quality in drought prone areas of Pune and Satara districts of Maharashtra, India. Environments, 5: 1-20.
  • Dhawde, R., Macaden, R., Saranath, D., Nilgiriwala, N.,Ghadge, A. & Birdi, T.(2018). Antibiotic resistance characterization of environmental E. coli isolated from river Mula-Mutha, Pune district, India. Int J Environ Res Public Health, 15: 1-20.
  • Dhawde, R., Macaden, R., Ghadge, A. & Birdi, T. (2018). Seasonal prevalence of antibiotic-resistant bacteria in the river Mula-Mutha, India. Environ Monit Assess, 190: 533-540.

CONFERENCE PRESENTATION

  • Dhawde, R. Poster presentation. Conference on “Impact of Environmental Changes on Infectious Diseases 2017”, organized by Elsevier, Trieste, Italy, 17th - 19th May 2017.
  • Dhawde, R. International Conference on “Sustainable Solutions Implemented to Achieve Safe Drinking Water and Beyond”, organized by Department of Microbiology and Bhavan’s Research Center, Mumbai, 11th and 12th December 2017.

OUTCOMES

PhD degree award
Under the guidance of Dr. Tannaz Birdi, Ms. Rutuja Dhawde was awarded a doctoral degree in Applied Biology for this research work in 2018. A copy of the thesis titled “A Bacteriological analysis of water sources from Pune district with special reference to antibiotic resistant bacteria and their potential for transferring antibiotic resistance by horizontal gene transfer” is available in the FMR library