Mass loading, distribution, and removal of antibiotics and antiretroviral drugs in selected wastewater treatment plants in Kenya.

The discharge of active pharmaceutical ingredients (APIs) into the aquatic environment from wastewater effluents is a concern in many countries. Although many studies have been conducted to evaluate the APIs removal efficiencies and emissions to the environment in wastewater treatment plants (WWTPs), most of these studies considered the aqueous and sludge phases, disregarding the suspended particulate matter (SPM) phase. To try to understand the role of the SPM, the occurrence of five most common antibiotics and three antiretroviral drugs (ARVDs) commonly used in Kenya were investigated in this study. APIs partitioning and mass loading in influents and effluents of three different WWTPs: trickling filters, stabilization ponds, and decentralized fecal sludge system, were evaluated. API concentration levels ranging from ˂LOQ (limit of quantification) to 92 μgL-1 and ˂LOQ to 82.2 mgkg-1 were observed in aqueous samples and solid samples respectively, with SPM accounting for most of the higher concentrations. The use of the aqueous phase alone for determination of removal efficiencies showed underestimations of API removal as compared to when solid phases are also considered. Negative removal efficiencies were observed, depending on the compound and the type of WWTP. The negative removals were associated with deconjugation of metabolites, aggregated accumulation of APIs in the WWTPs, as well as unaccounted hydraulic retention time during sampling. Compound characteristics, environmental factors, and WWTPs operation influenced WWTPs removal efficiencies. Wastewater stabilization ponds had the poorest removals efficiencies with an average of -322%. High total mass loads into the WWTPs influent and effluent of 22,729 and 22,385 mg day-1 1000 PE-1 were observed respectively. The results aims at aiding scientists and engineers in planning and designing of WWTPs. Findings also aim at aiding policy-making on pharmaceutical drug use and recommend proper wastewater management practices to manage the high mass loading observed in the WWTPs.