Abstract：
Estimation of community-wide consumption of illicit drugs through wastewater analysis is a new concept in Africa although widely applied in developed nations as wastewater-based epidemiology (WBE). It is an important tool that can be used in understanding supply and demand patterns of illicit drug use on a local, national, and international scale. Information on illicit drug use is currently limited in Africa, because of a lack of monitoring structures by governments and financial constraints. This study hopes to bridge that gap by contributing to Africa\'s baseline information on illicit drug use. This study provides the first application of wastewater analysis to quantitatively evaluate daily illicit drug use in the eThekwini Metropolitan Municipality of KwaZulu-Natal Province of South Africa by quantifying the major urinary excreted metabolites, called drug target residues (DTRs), in raw wastewater from four major wastewater treatment plants (WWTPs) sampled for a week. The results showed that cocaine was the dominant illicit drug consumed in the catchment followed by amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine and 3,4-methylenedioxyamphetamine, with a per capita use of 360-3000 mg day-1 1000 inh-1, 47-800 mg day-1 1000 inh-1, 19-120 mg day -1 1000 inh-1, not detected (ND) to 4.9 mg day-1 1000 inh-1, and ND to 410 g day-1 1000 inh-1 respectively. The weekly usage patterns between the four WWTPs differed probably due to the lifestyle of the populace serving the different WWTPs. These results provide useful data on illicit drug use in eThekwini that can be utilised by public health agencies to implement suitable response strategies.
摘要：
通过废水分析估算社区范围内的非法药物消费量在非洲是一个新概念，尽管在发达国家作为废水流行病学（WBE）得到了广泛的应用。这是一个重要的工具，可用于了解当地非法药物使用的供求模式，国家,国际规模。关于非法药物使用的信息目前在非洲有限，由于政府缺乏监测结构和财政限制。这项研究希望通过为非洲关于非法药物使用的基线信息做出贡献来弥合这一差距。这项研究通过量化主要的尿液排泄代谢物，提供了废水分析的首次应用，以定量评估南非夸祖鲁-纳塔尔省eThekwini大都会市的日常非法药物使用，称为药物靶残留(DTRs)，在四个主要污水处理厂(WWTP)的原废水中取样一周。结果显示，可卡因是集水区消费的主要非法药物，其次是安非他明，甲基苯丙胺,3,4-亚甲二氧基甲基苯丙胺和3,4-亚甲二氧基苯丙胺，人均使用量为360-3000mgday-11000inh-1，47-800mgday-11000inh-1，19-120mgday-11000inh-1，ND至4.9mgday-11000inh-1，ND至410gday-11000inh-1。四个WWTP之间的每周使用方式有所不同，这可能是由于服务于不同WWTP的民众的生活方式所致。这些结果提供了有关eThekwini中非法药物使用的有用数据，公共卫生机构可以利用这些数据来实施适当的应对策略。
