Estimation of alkali dosage and contact time for treating human excreta containing viruses as an emergency response: a systematic review

Front Public Health. 2023 Nov 10:11:1286595. doi: 10.3389/fpubh.2023.1286595. eCollection 2023.


Water, sanitation, and hygiene provisions are essential during emergencies to prevent infectious disease outbreaks caused by improper human excreta management in settlements for people affected by natural disasters and conflicts. Human excreta disinfection is required when long-term containment in latrines is not feasible on-site. Alkali additives, including lime, are effective disinfectants for wastewater and faecal sludge containing large amounts of solid and dissolved organic matter. The aim of this study was to determine the minimum dose and contact time of alkali additives for treating virus-containing human excreta in emergency situations. We used literature data collected by searching Google Scholar and Web of Science. The date of the last search for each study was 31th May 2023. Only peer-reviewed articles that included disinfection practices in combination with quantitative data for the physicochemical data of a matrix and viral decay were selected for data extraction. Two reviewers independently collected data from each study. We extracted datasets from 14 studies that reported quantitative information about their disinfection tests, including viral decay over time, matrix types, and physicochemical properties. Three machine learning algorithms were applied to the collected dataset to determine the time required to achieve specified levels of virus inactivation under different environmental conditions. The best model was used to estimate the contact time to achieve a 3-log10 inactivation of RNA virus in wastewater and faeces. The most important variables for predicting the contact time were pH, temperature, and virus type. The estimated contact time for 3 log inactivation of RNA virus was <2 h at pH 12, which was achieved by adding 1.8 and 3.1% slaked lime to wastewater and faeces, respectively. The contact time decreased exponentially with the pH of the sludge and wastewater. In contrast, the pH of the sludge and wastewater increased linearly with the slaked lime dosage. Lime treatment is a promising measure where long-term containment in latrine is not feasible in densely populated areas, as 1 day is sufficient to inactivate viruses. The relationship we have identified between required contact time and lime dosage is useful for practitioners in determining appropriate treatment conditions of human waste.

Keywords: alkaline treatment; disinfection; machine learning; sanitation; slaked lime; viruses.

Publication types

  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Disinfectants*
  • Humans
  • Sewage / chemistry
  • Viruses*
  • Wastewater


  • lime
  • Wastewater
  • Sewage
  • Disinfectants

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by JSPS KAKENHI (Grant No. 22K20442).