Abstract
Wastewater-based epidemiology (WBE) is an approach that can be used to estimate COVID-19 prevalence in the population by detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in wastewater. As the WBE approach uses pooled samples from the study population, it is an inexpensive and non-invasive mass surveillance method compared to individual testing. Thus, it offers a good complement in low- and middle-income countries (LMICs) facing high costs of testing or social stigmatization, and it has a huge potential to monitor SARS-CoV-2 and its variants to curb the global COVID-19 pandemic. The aim of this review is to systematize the current evidence about the application of the WBE approach in mass surveillance of COVID-19 infection in LMICs, as well as its future potential. Among other parameters, population size contributing the fecal input to wastewater is an important parameter for COVID-19 prevalence estimation. It is easier to back-calculate COVID-19 prevalence in the community with centralized wastewater systems, because there can be more accurate estimates about the size of contributing population in the catchment. However, centralized wastewater management systems are often of low quality (or even non-existent) in LMICs, which raises a major concern about the ability to implement the WBE approach. However, it is possible to mobilize the WBE approach, if large areas are divided into sub-areas, corresponding to the existing wastewater management systems. In addition, a strong coordination between stakeholders is required for estimating population size respective to wastewater management systems. Nevertheless, further international efforts should be leveraged to strengthen the sanitation infrastructures in LMICs, using the lessons gathered from the current COVID-19 pandemic to be prepared for future pandemics.
Highlights
This paper focuses on wastewater surveillance in diverse wastewater management systems existing in low- and middle-income countries (LMICs) coupled with the possibility of translating the obtained SARS-CoV-2 concentration data into the prevalence estimation/trend identification/status of infection in the general population
We provide a series of policy and practice recommendations to execute the Wastewater-based epidemiology (WBE) approach that can contribute positively in the ongoing efforts in LMICs to control the COVID-19 pandemic
Despite the possible challenges, the application of the WBE approach for the mass surveillance of COVID-19 could be possible in LMICs
Summary
A handful of studies that have translated the wastewater concentration of SARS-CoV-2 into the prevalence of COVID-19 in population [16,22,23,24,25] that can be applicable for public health decision making. We discuss the benefits the WBE approach has and the challenges to mobilize it effectively in the context of LMICs. This paper focuses on wastewater surveillance in diverse wastewater management systems existing in LMICs coupled with the possibility of translating the obtained SARS-CoV-2 concentration data into the prevalence estimation/trend identification/status of infection in the general population. We provide a series of policy and practice recommendations to execute the WBE approach that can contribute positively in the ongoing efforts in LMICs to control the COVID-19 pandemic
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
