Utilizing river and wastewater as a SARS-CoV-2 surveillance tool in settings with limited formal sewage systems - Repository

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: https://doi.org/10.1038/s41467-023-43047-y

Abstract

The COVID-19 pandemic has profoundly impacted health systems globally and robust surveillance has been critical for pandemic control, however not all countries can currently sustain community pathogen surveillance programs. Wastewater surveillance has proven valuable in high-income settings, but less is known about the utility of water surveillance of pathogens in low-income countries. Here we show how wastewater surveillance of SAR-CoV-2 can be used to identify temporal changes and help determine circulating variants quickly. In Malawi, a country with limited community-based COVID-19 testing capacity, we explore the utility of rivers and wastewater for SARS-CoV-2 surveillance. From May 2020–May 2022, we collect water from up to 112 river or defunct wastewater treatment plant sites, detecting SARS-CoV-2 in 8.3% of samples. Peak SARS-CoV-2 detection in water samples predate peaks in clinical cases. Sequencing of water samples identified the Beta, Delta, and Omicron variants, with Delta and Omicron detected well in advance of detection in patients. Our work highlights how wastewater can be used to detect emerging waves, identify variants of concern, and provide an early warning system in settings with no formal sewage systems.

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Copyright © The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Cite as

Barnes, K., Levy, J., Gauld, J., Rigby, J., Kanjerwa, O., Uzzell, C., Chilupsya, C., Anscombe, C., Tomkins-Tinch, C., Mbeti, O., Cairns, E., Thole, H., McSweeney, S., Chibwana, M., Ashton, P., Jere, K., Meschke, J., Diggle, P., Cornick, J., Chilima, B., Jambo, K., Andersen, K., Kawalazira, G., Paterson, S., Nyirenda, T. & Feasey, N. 2023, 'Utilizing river and wastewater as a SARS-CoV-2 surveillance tool in settings with limited formal sewage systems', Nature Communications, 14, article no: 7883. https://doi.org/10.1038/s41467-023-43047-y

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DOI: https://doi.org/10.1038/s41467-023-43047-y

Repository URI: http://hdl.handle.net/10023/28913