Pharmaceuticals in freshwater aquatic environments: A comparison of the African and European challenge

Sci Total Environ. 2019 Mar 1:654:324-337. doi: 10.1016/j.scitotenv.2018.11.072. Epub 2018 Nov 9.


Hundreds of tons of pharmaceutical compounds are annually dispensed and consumed worldwide. Pharmaceuticals are an important class of emerging environmental micropollutants: their presence in water bodies is an increasing environmental concern. The aim of this review paper is to provide a comprehensive review of the occurrence of pharmaceuticals in freshwater aquatic environments in the African and European context. A literature survey has been performed, resulting in 3024 data points related to environmental occurrence. The concentration levels of 71 pharmaceuticals were assessed. The top ten most frequently detected and quantified compounds in both continents were sulfamethoxazole, carbamazepine, diclofenac, trimethoprim, ibuprofen, naproxen, paracetamol (acetaminophen), ketoprofen, venlafaxine and clarithromycin. The maximum concentrations of 17β-estradiol, estriol, ciprofloxacin, sulfamethoxazole, paracetamol, naproxen reported in African aquatic environments were ~3140, ~20,000, ~125, ~100, ~215 and ~171 times higher, respectively, than the concentrations reported in European based studies. The variation in pharmaceutical consumption, partial removal of pharmaceuticals in wastewater treatment processes, and the direct discharge of livestock animal farm wastewater were identified among the major reasons for the observed differences. Several pharmaceuticals were found in aquatic environments of both continents in concentration levels higher than their ecotoxicity endpoints. In Europe, compounds such as diclofenac, ibuprofen, triclosan, sulfadimidine, carbamazepine and fluoxetine were reported in a concentration higher than the available ecotoxicity endpoints. In Africa, much more compounds reached concentrations more than the ecotoxicity endpoints, including diclofenac, ibuprofen, paracetamol, naproxen, ciprofloxacin, triclosan, trimethoprim, sulfamethoxazole, carbamazepine and fluoxetine, estriol and 17β-estradiol. Details for each therapeutic group are presented in this review.

Keywords: Africa; Aquatic pollutants; Emerging contaminants; Europe; Pharmaceuticals.

Publication types

  • Review

MeSH terms

  • Africa
  • Carbamazepine / analysis*
  • Ecotoxicology
  • Environmental Monitoring / methods*
  • Europe
  • Fresh Water / chemistry*
  • Pharmaceutical Preparations / analysis*
  • Sulfamethoxazole / analysis*
  • Water Pollutants, Chemical / analysis*


  • Pharmaceutical Preparations
  • Water Pollutants, Chemical
  • Carbamazepine
  • Sulfamethoxazole