The feasibility of SARS-CoV-2 surveillance using wastewater and environmental sampling in Indonesia

PLoS One. 2022 Oct 14;17(10):e0274793. doi: 10.1371/journal.pone.0274793. eCollection 2022.

Abstract

Background: Wastewater-based epidemiology (WBE) surveillance as an early warning system (EWS) for monitoring community transmission of SARS-CoV-2 in low- and middle-income country (LMIC) settings, where diagnostic testing capacity is limited, needs further exploration. We explored the feasibility to conduct a WBE surveillance in Indonesia, one of the global epicenters of the COVID-19 pandemic in the middle of 2021, with the fourth largest population in the world where sewer and non-sewered sewage systems are implemented. The feasibility and resource capacity to collect samples on a weekly or fortnightly basis with grab and/or passive sampling methods, as well as to conduct qualitative and quantitative identification of SARS-CoV-2 ribonucleic acid (RNA) using real-time RT-PCR (RT-qPCR) testing of environmental samples were explored.

Materials and methods: We initiated a routine surveillance of wastewater and environmental sampling at three predetermined districts in Special Region of Yogyakarta Province. Water samples were collected from central and community wastewater treatment plants (WWTPs), including manholes flowing to the central WWTP, and additional soil samples were collected for the near source tracking (NST) locations (i.e., public spaces where people congregate).

Results: We began collecting samples in the Delta wave of the COVID-19 pandemic in Indonesia in July 2021. From a 10-week period, 54% (296/544) of wastewater and environmental samples were positive for SARS-CoV-2 RNA. The sample positivity rate decreased in proportion with the reported incidence of COVID-19 clinical cases in the community. The highest positivity rate of 77% in week 1, was obtained for samples collected in July 2021 and decreased to 25% in week 10 by the end of September 2021.

Conclusion: A WBE surveillance system for SARS-CoV-2 in Indonesia is feasible to monitor the community burden of infections. Future studies testing the potential of WBE and EWS for signaling early outbreaks of SARS-CoV-2 transmissions in this setting are required.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19* / diagnosis
  • COVID-19* / epidemiology
  • Feasibility Studies
  • Humans
  • Indonesia / epidemiology
  • Pandemics
  • RNA, Viral / analysis
  • RNA, Viral / genetics
  • SARS-CoV-2* / genetics
  • Sewage
  • Soil
  • Wastewater / analysis
  • Water / analysis

Substances

  • RNA, Viral
  • Sewage
  • Soil
  • Waste Water
  • Water

Associated data

  • figshare/10.6084/m9.figshare.19824445

Grants and funding

This Project was funded by the Global Innovation Fund and PATH (PATH.org). The Global Investment Fund had no involvement in study design, data collection or analysis and PATH participated in study design and reviewing the draft manuscript, but had no role in data collection or analysis, writing of the manuscript or the decision to submit it for publication.