Search Results (109)

Wastewater-based epidemiology (WBE) is increasingly used to monitor public health trends and chemical consumption by analyzing biomarkers in untreated wastewater. As a complementary approach to traditional epidemiological surveillance, WBE provides insights into infectious disease spread, drug use, and pharmaceutical consumption. However, accurate population normalization remains a major challenge, because census-based population estimates often do not correspond to hydrologically defined wastewater catchments. This study evaluates whether routinely monitored wastewater quality parameters can serve as cost-effective population-normalization proxies in WBE. Using data from Latvia’s national COVID-19 wastewater surveillance program, the performance of conventional wastewater parameters (BOD₅, COD, suspended solids, total phosphorus, and total nitrogen) was compared with endogenous and exogenous biomarkers, including 5-HIAA, caffeine, cotinine, ethyl sulfate, gabapentin, ibuprofen, and diclofenac. Population estimates based on census and operator data were assessed under varying weather conditions. The results indicate that routine wastewater parameters, particularly total nitrogen, may serve as suitable indicators for population normalization in WBE, with performance comparable to or exceeding that of commonly used biomarkers. These findings support the use of routinely monitored parameters as scalable and accessible tools for improving WBE reliability and strengthening public health surveillance and early warning systems. Full article

Wastewater-based epidemiology (WBE) has matured into a population-level surveillance complement with operational precedent in poliovirus environmental surveillance, institutionalised systems for SARS-CoV-2, and expanding evidence across respiratory pathogens, substance-use markers, and antimicrobial-resistance targets at uneven maturity. The unresolved problem is specific: sub-sewershed spatio-temporal inference under sewer-network and observational aggregation. Intra-catchment heterogeneity, hydraulic dynamics, and equity-relevant population differences can all be obscured by aggregate-scale modelling. Current artificial intelligence/machine learning (AI/ML) methods in WBE can be organised into four threads: temporal forecasting, spatial–statistical localisation, sewer-network and hydraulic transport, and cross-site transfer. These methods solve useful parts of the surveillance problem at the scales they target, but they do not yet supply transferable latent sub-sewershed representations under downstream aggregation. This review proposes a candidate multimodal foundation-model framework that treats place and time as jointly learnable entities, integrates a graph backbone over the sewer-network topology, incorporates physics-informed constraints, and embeds equity-conscious downstream validation as a design requirement. The framework is intended to make sub-sewershed hypotheses explicit, testable, uncertainty-bounded, and accountable to environmental-justice-relevant external validation. Whether those hypotheses survive empirical testing remains an open question. Full article

In Africa, the disease burden of diarrheal and respiratory diseases is amplified by limited surveillance capacity, diagnostic limitations, and socioeconomic inequalities. In rapidly urbanizing settings such as Kigali (Rwanda), integrating wastewater-based epidemiology (WBE) into existing surveillance systems offers a promising strategy for generating real-time epidemiological intelligence, identifying community-level hotspots, and addressing gaps in traditional reporting systems. Gastrointestinal and respiratory infections remain major causes of morbidity and mortality globally, particularly in low- and middle-income countries (LMICs), where traditional clinical surveillance systems frequently underreport the true disease burden. This systematic review synthesizes current evidence on the detection of gastrointestinal and respiratory pathogens in wastewater and evaluates the utility of WBE for early warning and public health action. A narrative review approach was used to identify peer-reviewed literature, global health reports, and surveillance studies focusing on the wastewater detection of gastrointestinal and respiratory pathogens. Databases including PubMed, Scopus, and Google Scholar were searched for studies published between 2000 and 2026. The search yielded 1247 records, of which 312 duplicates were removed. After title/abstract screening, 228 full-text articles were retrieved and assessed for eligibility. After a detailed evaluation, 108 studies were excluded for the following reasons: absence of pathogen-specific wastewater data (n = 46), a focus on environmental monitoring without public health relevance (n = 25), insufficient methodological description (n = 21), or other eligibility limitations such as a lack of primary data (n = 16). WBE provides a non-invasive, cost-effective approach for monitoring symptomatic and asymptomatic infections. Challenges involve variability in sampling, environmental factors affecting viral decay, and differences in laboratory workflows. WBE is a powerful complement to traditional infectious disease surveillance, offering early warning capabilities, population-level coverage, and real-time insights into pathogen circulation. Integrating WBE into surveillance programs, especially in LMICs such as Rwanda, can significantly strengthen epidemic preparedness, guide resource allocation, and improve outbreak response. Sustained investment in laboratory capacity, standardized protocols, and multisector collaboration is essential to fully leverage WBE for public health protection. Full article

Background: Wastewater-based epidemiology (WBE) is a valuable population-level surveillance tool for monitoring SARS-CoV-2 circulation. However, evidence on optimal viral concentration approaches in confined institutional settings such as prisons remains limited. This study aimed to compare the performance of Direct Capture (DC) and Electronegative Membrane Filtration (EMF) for SARS-CoV-2 RNA detection in wastewater from a prison facility in Selangor, Malaysia. Methods: Composite wastewater samples collected over 18 weeks (April–August 2023; n = 50) were analysed by RT-dPCR targeting the N1 and N2 gene regions, with concentrations normalized to pepper mild mottle virus (PMMoV). DC consistently outperformed EMF across both gene targets. Median concentrations obtained using DC were 11.09 × 10³ copies L⁻¹ (N1) and 3.43 × 10³ copies L⁻¹ (N2), compared with 0.70 × 10³ copies L⁻¹ (N1) and 0.48 × 10³ copies L⁻¹ (N2) using EMF. Detection frequencies were higher with DC (N1: 94%, N2: 84%) than with EMF (N1: 88%, N2: 76%). Paired statistical analysis confirmed significant differences between methods (N1: p = 2.3 × 10⁻⁷; N2: p = 9.4 × 10⁻⁵), and Bland–Altman analysis demonstrated systematic underestimation by EMF (mean bias −1.15 log₁₀ for N1; −0.87 log₁₀ for N2), indicating that the methods are not analytically interchangeable. Conclusions: Normalization reduced absolute SARS-CoV-2 RNA concentrations while preserving temporal trends, supporting its use to improve comparability across sampling periods. Overall, these findings demonstrate that DC combined with N1 detection provides a more sensitive and reliable approach for SARS-CoV-2 WBE in confined settings, underscoring the importance of methodological optimization to strengthen early-warning capacity in high-risk environments. Full article

(1) Background: Metabolic disorders, including hypertension, hyperlipidemia, and hyperglycemia (HHH), rank at the top of the disease burden in China. However, population-level assessment of pharmacological treatment remains limited by the lack of scalable metrics for monitoring medication use and outcomes. (2) Methods: We pioneered the use of standardized combined “HHH” medication usage—encompassing antihypertensive, antidiabetic, and lipid-lowering agents—as an integrated proxy for evaluating interventions for cardiovascular diseases and diabetes. Leveraging wastewater-based epidemiology (WBE), we quantified HHH medication loads (mg/d/1000 persons) across 30 prefectures covering all regions in China, and mapped the associated geographical disparities using independent t-tests. Associations with environmental, socioeconomic, demographic, social service, and health-related behavioral and lifestyle factors were further examined via correlation analysis. (3) Results: Our findings confirmed a pronounced north–south gradient in HHH medication uses (the mean standardized loads in the north were approximately twice as high as those in the south, p < 0.05). Furthermore, aging, sex ratio, nicotine consumption, obesity rate, the comprehensive Air Quality Index (AQI), precipitation and the Urban Wellness and Healthcare Index were identified as the top seven influencing factors (|r| values ranging from 0.37 to 0.71, all p < 0.05). (4) Conclusions: As a comprehensive national-scale analysis of multi-drug use for HHH via WBE, this study provides valuable insights into national multi-disease pharmacological treatment, offering evidence-based support for refining clinical prescribing guidelines and rationalizing the allocation of healthcare resources. Full article

Dengue fever, with a high proportion of asymptomatic infections, poses a major global public health challenge that traditional surveillance systems frequently underestimate. Wastewater-based epidemiology (WBE) has emerged as a promising approach to monitoring infectious diseases beyond enteric viruses. Dengue virus is shed in urine, feces, and saliva, providing a biological basis for wastewater detection alongside clinical surveillance. This systematic review and meta-analysis synthesize current evidence on dengue virus (DENV) detection in wastewater and evaluate methodological factors influencing detection success in WBE. A systematic literature search using selected databases and predetermined keywords, followed by eligibility screening, resulted in ten studies being included, covering community surveillance and experimental trials. DENV ribonucleic acids (RNA) were most consistently detected and enriched in wastewater solids, indicating this matrix as the most reliable for surveillance. Among concentration methods, ultrafiltration achieved the highest viral recovery efficiency, while reverse transcription digital polymerase chain reaction (RT-dPCR) demonstrated superior sensitivity and precision compared to those of reverse transcription quantitative polymerase chain reaction (RT-qPCR), particularly at low viral concentrations. Storage at −80 °C was critical for preserving RNA integrity. The meta-analysis yielded a pooled DENV positivity rate of 24% (95% CI: 20–28%) after exclusion of outliers. Overall, solid-phase analysis combined with RT-dPCR represents the most sensitive methodological approach across the included studies. Harmonized protocols are needed to support future translation of dengue WBE into community surveillance as current evidence mainly demonstrates methodological feasibility and provides a technical foundation for future public health integration. Therefore, further longitudinal and multi-site validation is required to establish its broader applicability for dengue surveillance. Full article

Wastewater is a complex and dynamic issue, particularly at the human–animal–environment interface, bearing biological and chemical hazards that may serve as a resource for transmission pathways for pathogens, antimicrobial resistance (AMR) determinants, heavy metals, pharmaceutical residues, per- and polyfluoroalkyl substances (PFAS), and microplastics. Rising global health issues necessitate effective wastewater treatment and advanced research to support risk-informed circular management within a one health framework, incorporating wastewater-based epidemiology (WBE), multi-omics approaches, nanobiotechnology, and green technologies. Inadequate wastewater treatment and uncontrolled discharge result in the generation of more than 380 billion cubic meters of wastewater annually worldwide, contributing to ecological degradation, the spread of AMR, and long-term toxicological risks. Despite significant advances in wastewater treatment, several challenges remain, including complex contaminant mixtures, limited detection and monitoring technologies, variable treatment efficiency, and weak regulatory and governance frameworks. This review highlights key wastewater treatment issues and presents recent advances in WBE and multi-omics approaches, such as metagenomics, resistome profiling, virome analysis, and chemical fingerprinting for contaminant monitoring and public health risk assessment. This review also examines circular reuse strategies focused on water reclamation, nutrient recovery, bioenergy production, and resource recovery, with particular emphasis on nature-based systems, hybrid biological–physicochemical treatment platforms, and green nanobiotechnology as promising approaches to improve treatment performance while minimizing environmental impacts. In conclusion, this review highlights the importance of integrated and sustainable wastewater management approaches within the One Health framework to address emerging challenges and promote environmental resilience, public health protection, and circular resource recovery. Full article

Wastewater-based epidemiology (WBE) has emerged as a powerful approach for population-level monitoring of chemical exposure, health status, and disease transmission by analysing wastewater. Although chromatographic and molecular techniques remain the gold standard in WBE, their high cost, infrastructural demands, and limited suitability for decentralized and real-time monitoring motivate the development of complementary sensing technologies. In this context, optical (bio)sensors, particularly fluorescence-based platforms, have attracted increasing attention due to their high sensitivity, rapid response, and potential for on-site monitoring. This review discusses recent advances in fluorescent optical (bio)sensors for WBE, with a particular focus on carbon dots (CDs), including waste- and biomass-derived CDs produced via green synthesis as well as CDs obtained from commercial chemicals. The applicability of CD-based sensors to wastewater-relevant analytes is evaluated, highlighting current achievements, as well as existing limitations and challenges related to real-sample validation and the translation of these platforms into robust, field-deployable systems for their implementation in sustainable wastewater monitoring and public health surveillance. Full article

Wastewater-based epidemiology (WBE) is an approach that uses information obtained from the analysis of various metabolites or residues in wastewater with the aim of assessing the consumption of or exposure to chemicals or pathogens in a population connected to a sewage system. The aim of this work was to develop methods for the isolation and analysis of seven beta-blockers (acebutolol, atenolol, betaxolol, metoprolol, nadolol, pindolol and propranolol) in wastewater samples collected from the influent of the wastewater treatment plant in Cluj-Napoca, Romania, in order to estimate their consumption among the population in two time periods (February and October 2024) using WBE. The selected beta-blockers were extracted by solid phase extraction using a Strata C18-U cartridge and analyzed by liquid chromatography coupled with tandem mass spectrometry. The consumption was estimated using the daily mass load of pharmaceutical products reported per 1000 inhabitants (mg/day/1000inh) and varied in the following ranges: atenolol 0.03–3.74, nadolol 0.03–0.1, propranolol 0.04–0.72, betaxolol 0.07–0.38, and metoprolol 54.85–276.45. From the obtained results, it can be observed that metoprolol is the most used beta-blocker in the investigated population, followed by atenolol, propranolol and betaxolol. Other beta-blockers are consumed in small quantities or occasionally. Full article

Despite the importance of wastewater environmental monitoring in disease prevention and response strategies, its use remains poorly documented in Senegal. In addition, there is more onsite sanitation than sewer networks in Dakar, and open drains channel for rainwater are also used as clandestine wastewater discharge into the sea. This study aimed to assess the presence of specific pathogens in wastewater, faecal sludge, and bathing water (the sea). Samples were taken at treatment plants, an open drain, and in the receiving environment (the sea) from June to December 2023. Total nucleic acid was subjected to multiplex qualitative qPCR using SeeGene Allplex™ kits targeting 34 gastrointestinal pathogens. Descriptive statistics, multiple correspondence analysis (MCA) and logistic regression were performed. Considering all matrices, across 51 analysed samples, the results revealed strong bacterial (96.08%, n = 49), parasitic (84.31%, n = 43), and viral (68.63%, n = 35) presence. These results showed high levels of Aeromonas spp. (96.08%), Blastocystis hominis (80.39%), Enterocytozoon (58.82%), and Norovirus GII (74.51%) among bacteria, protozoa, helminths, and viruses, respectively. Moreover, faecal sludge and pumping station samples show more identified pathogen than wastewater treatment plant and seawater samples. The MCA revealed that the dry season is spatially associated with a greater number of pathogens than the rainy season, but the latter showed a greater species diversity. Logistic regression showed that certain physicochemical parameters, including BOD5, turbidity, pH, and suspended solids, influence pathogen detection. However, qualitative detection and sampling period may constitute limitations. These results reveal that wastewater and bathing water can serve as sources of information on the circulation of pathogens of interest with epidemic potential. Therefore, this valuable epidemiological tool could serve as an adjunct to clinical surveillance in order to prevent future epidemics. Full article

Wastewater-based epidemiology (WBE) allows for early surveillance of viral pathogens, including SARS-CoV-2. Simplified low-cost approaches are needed to deploy WBE surveillance in resource-limited small-island settings, where high sensitivity must be maintained. In this study, we optimized key upstream steps in an electronegative membrane virus adsorption–elution (VIRADEL) workflow, including sample acidification, composite sampling duration, and RT-qPCR inhibition mitigation. Wastewater influent was sampled at a pump station in Grenada using 12 h and 24 h time-weighted composite samples, concentrated using electronegative membrane VIRADEL with and without sample acidification (pH 3.5), and used Phi 6 (enveloped virus) and MS2 (non-enveloped virus) bacteriophages as process controls and PMMoV as a fecal-derived normalization target. Targets for SARS-CoV-2 N1 and a non-enveloped virus surrogate were measured by RT-qPCR. Quantitative wastewater data were compared to reported clinical cases in the community. Sample acidification significantly increased recovery of the enveloped process control, Phi 6 (p < 0.01) indicating improved efficiency in capturing enveloped viral targets during filtration. Twelve-hour composite samples had a false-negative percentage of 88%, while 24 h samples had only 6% false negatives and were able to mirror clinical case trends. Wastewater viral signals were detected 3–5 days prior to an increase in clinical cases. Hydraulic travel time within the contributing sewer network was not directly measured; therefore, the reported 3–5 day lead time reflects the combined effect of shedding dynamics, sampling integration, and sewer transport. This optimized workflow was deployed for nine months showing sustained analytical performance and operational feasibility. Full article

Wastewater-Based Epidemiology (WBE) has emerged as a critical tool for monitoring SARS-CoV-2 circulation at the community level. This study assessed spatiotemporal viral dynamics in Las Heras, Mendoza, Argentina, by comparing wastewater samples from six sewer maintenance holes and three wastewater treatment plants (WWTPs) between January and June 2021, and by conducting long-term surveillance at Campo Espejo WWTP during epidemic (2020–2021) and endemic (2024–2025) phases of COVID-19. Viral particles from sewer manholes and WWTPs samples were concentrated by polyethylene glycol precipitation or aluminum polychloride adsorption–precipitation methods, and then SARS-CoV-2 RNA was quantified by reverse transcription quantitative polymerase chain reaction targeting N1 and N2 nucleocapsid viral markers. Results showed consistent detection of viral RNA across all sites, with peaks in wastewater preceding diagnosed COVID-19 cases increases, confirming WBE as an early-warning system. Localized sewer sampling identified urban hotspots, while WWTPs monitoring captured broader epidemiological trends. Recently, COVID-19 surveillance showed lower and intermittent viral loads, decoupled from diagnosed cases, compared to epidemic phase, indicating a transition to endemic circulation. Overall, combining upstream and downstream WBE enhanced spatial and temporal resolution, demonstrating its utility for public health monitoring during both epidemic and endemic phases. Full article

Several researchers have documented the occurrence of the unfamiliar severe acute respiratory syndrome coronavirus 2 ribonucleic acid (also known as SARS-CoV-2 RNA) in various raw wastewater (WW) samples analyzed globally. The efficiency of strategic WW-based epidemiology (WBE) approach as a timely cautioning tool for human coronavirus disease-2019 (COVID) and other similar outbreaks is highly promising. This strategy offers a cost-effective, population-wide surveillance tool that can detect rising case trends, from days to weeks before clinical reports, thus enabling proactive public health interventions. This study aimed to detect the occurrence of the viral genome in WW over four seasons, which contributes to the database for multi-plant surveillance research in South Africa. About 480 WW influent samples were amassed from ten sampling points situated in nine wastewater treatment facilities (WWTFs) in Amathole District Municipality (ADM) located in the Province of Eastern Cape (EC), South Africa (SA). The study was carried out for a period of one year. Quantitative real-time polymerase chain reaction (i.e., RT-PCR) was operated to identify the viral genomes in the respective total RNA samples. Of the 480 extracted RNA samples, 210 (44%) were positive with viral genome copies (gc) that ranged from 700 to 40,000 GC/mL. Our results were contrasted with existing COVID-19-positive cases throughout the COVID omicron wave in the ECP. Variations in gc were observed across different seasons, with the highest GC observed in winter. In contrast, there were significant inconsistencies in the existing data of COVID-19 clinical cases, thus indicating no connection between both data. However, with more similar studies, advanced innovative WBE strategies could possibly act as prompt warning tools to signal public health officials about potential future outbreaks. Full article

Following the COVID-19 pandemic, researchers have increasingly focused on monitoring the spread of the virus and improving methods to detect changes in the SARS-CoV-2 genome. Although clinical surveillance provides direct and reliable results, it has limited applicability. Wastewater-based epidemiology (WBE) has therefore emerged as a valuable, non-invasive complementary tool for disease surveillance. It provides a comprehensive picture of virus circulation in a population, including asymptomatic individuals and those who do not seek healthcare. In addition, it facilitates early detection of outbreaks and the collection of epidemiologic data at the community level. However, WBE also presents technical challenges, including variations in sampling and testing protocols, the presence of inhibitors that affect viral RNA extraction, and the need for standardised procedures between studies. These challenges should be addressed for possible future infectious disease outbreaks. One of the challenges facing researchers was to develop efficient methods that could overcome the extraction and detection problems related to inhibitors present in wastewater. To this aim, this systematic review highlights the potential use of WBE, the variety of techniques, and the most effective methods for the detection and quantification of SARS-CoV-2 in wastewater samples. A reproducible electronic search of the literature was conducted in the Web of Science (WoS) and PubMed databases for articles published between 2020 and 2024. Our search revealed that the majority of observed WBE applications emphasised a correlation between SARS-CoV-2 RNA concentration trends in wastewater and epidemiological data. Another relevant issue that the articles often discussed and compared was the techniques used in different steps of sample processing, such as sample collection, concentration and detection, hence the lack of standardised procedures. This paper provides a framework regarding previous research on WBE to gain a better understanding that will lead to functional solutions. Full article

Polyethylene Glycol (PEG) precipitation and Nanotrap^® Microbiome Particles (NMP) are widely used methods for concentrating viruses in wastewater due to their simplicity, cost-effectiveness, efficiency, and rapid turnaround time. This study compared the performance of these methods in detecting noroviruses (GI and GII) and SARS-CoV-2 collected from two wastewater treatment facilities using quantitative PCR. Norovirus was detected in all samples (23/23) using both protocols, but PEG yielded higher mean concentrations for GI and GII than NMP, indicating improved quantitative recovery for non-enveloped viruses. For SARS-CoV-2, NMP showed significantly higher positive ratios for the N2 gene (Fisher’s Exact Test, p < 0.01), but no significant difference was observed for the N1 gene (p > 0.05), indicating comparable performance between the methods for this target. These findings highlight PEG’s effectiveness for non-enveloped viruses and NMP’s suitability for enveloped viruses, emphasizing the importance of selecting virus concentration methods based on viral structure. This study provides a framework for optimizing wastewater-based epidemiology (WBE) protocols and enhancing public health surveillance for diverse viral targets. Future research should focus on refining these methodologies and exploring their applicability to other viral pathogens to enhance public health surveillance frameworks. Full article