Antiretroviral Drugs in Water: An African Challenge with Kenya and South Africa as Hotspots and Plausible Remediation Strategies

The occurrence of antiretroviral drugs in water bodies has been extensively documented with more studies focussing on contamination in the African continent. The environmental presence of antiretroviral drugs is a major concern due to their potential toxicity to the aquatic life and drug resistance in humans. Hence, recent studies have focussed on investigating the remediation strategies. Kenya and South Africa are hotspots due to the frequent detection of these contaminants in their water systems. Lamivudine and nevirapine have been observed as antiretroviral drugs detected at the highest concentrations of 167 and 1.640 ng/mL in Kenyan and South African surface waters, respectively. This highlights a need for development of remediation strategies for elimination of antiretroviral drugs in water bodies. Thus far, limited work focussing on removal of antiretroviral drugs in water has been conducted with interests on the applications of synthetic adsorbents and those modified from natural materials. At the same time, degradation methods and application of aquatic plants for uptake of antiretroviral drugs have been investigated. However, in the African context, these strategies are not fully explored which could relate to them being expensive, hence the use of natural extracts being reported. Therefore, the main scope of the present review was to highlight the prevalence of pollutant antiretroviral drugs in African water systems. It also provides the critical evaluation of remediation processes reported in literature which are based on degradation, adsorption, and phytoremediation studies. Furthermore, the direction and considerations for future research are provided.