Utilizing river and wastewater as a SARS-CoV-2 surveillance tool in settings with limited formal sewage systems
Nature Communications·
- DOI
- 10.1038/s41467-023-43047-y
- PMID
- 38036496
- PMCID
- PMC10689440
- OpenAlex
- W4389193853
- Study type
- Journal article
- Publisher
- Springer Science and Business Media LLC
- Article type
- journal-article
- Integrity
- current
Publication version
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Open linked preprint →Why this research matters now
Water-based surveillance can provide early warning of emerging COVID-19 waves and identify variants of concern in settings lacking formal sewage infrastructure and robust community testing programs.
Structured evidence summary
Research question
The study examines whether river and wastewater sampling can serve as a SARS-CoV-2 surveillance tool in Malawi, a low-income country with limited formal sewage infrastructure and community testing capacity.
Study design
Water samples were collected from up to 112 river or defunct wastewater treatment plant sites in Malawi between May 2020 and May 2022. SARS-CoV-2 was detected using unspecified methods, and sequencing was performed on positive samples to identify circulating variants.
Population and setting
The study was conducted in Malawi, a low-income country with limited community-based COVID-19 testing capacity and no formal sewage systems.
Main findings
SARS-CoV-2 was detected in 8.3% of water samples. Peak detection in water samples occurred before peaks in clinical cases. Sequencing identified Beta, Delta, and Omicron variants, with Delta and Omicron detected in water prior to their detection in patient samples.
Public-health relevance
Water-based surveillance can provide early warning of emerging COVID-19 waves and identify variants of concern in settings lacking formal sewage infrastructure and robust community testing programs.
Important limitations
This summary relies on the supplied single-article abstract and bibliographic metadata. Full interpretation of sampling methods, detection sensitivity, temporal resolution, and generalizability requires review of the complete published paper.
GIDS interpretation
The article demonstrates how environmental water sampling can detect SARS-CoV-2 RNA and variants in resource-limited settings. It informs methods for pathogen surveillance where clinical testing infrastructure is sparse, but does not itself constitute surveillance signal data.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 10 auditable classifier relationships to diseases, places, topics, and study design.