Application of wastewater-based epidemiology for monitoring COVID-19 in hospital and housing wastewaters

Sarmila Tandukar; Ocean Thakali; Rakshya Baral; Ananda Tiwari; Eiji Haramoto; Reshma Tuladhar; Dev Raj Joshi; Samendra P Sherchan

doi:10.1016/j.scitotenv.2024.171877

Application of wastewater-based epidemiology for monitoring COVID-19 in hospital and housing wastewaters

Sci Total Environ. 2024 Mar 24:171877. doi: 10.1016/j.scitotenv.2024.171877. Online ahead of print.

Authors

Sarmila Tandukar¹, Ocean Thakali¹, Rakshya Baral², Ananda Tiwari³, Eiji Haramoto⁴, Reshma Tuladhar⁵, Dev Raj Joshi⁵, Samendra P Sherchan⁶

Affiliations

¹ Organization for Public Health and Environmental Management, Lalitpur, Nepal.
² Center of Research Excellence in Wastewater based Epidemiology, Morgan State University, Baltimore, MD 21251, United States of America.
³ Expert Microbiology Research Unit, Finnish Institute for Health and Welfare, Kuopio 70701, Finland.
⁴ Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan.
⁵ Department of Microbiology, Tribhuvan University, Kathmandu, Nepal.
⁶ Organization for Public Health and Environmental Management, Lalitpur, Nepal; Center of Research Excellence in Wastewater based Epidemiology, Morgan State University, Baltimore, MD 21251, United States of America; Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan; Department of Microbiology, Tribhuvan University, Kathmandu, Nepal; Department of Environmental Health Sciences, Tulane University, New Orleans, LA 70112, United States of America. Electronic address: sshercha@tulane.edu.

PMID: 38531458
DOI: 10.1016/j.scitotenv.2024.171877

Abstract

An alternative and complementary diagnostic method of surveillance is provided by wastewater-based surveillance (WBS), particularly in low-income nations like Nepal with scant wastewater treatment facilities and clinical testing infrastructure. In this study, a total of 146 water samples collected from two hospitals (n = 63) and three housing wastewaters (n = 83) from the Kathmandu Valley over the period of March 2021-Febraury 2022 were investigated for Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using quantitative reverse transcription TaqMan PCR assays targeting the N and E genes. Of the total, 67 % (98/146) samples were positive for SARS-CoV-2 RNA either by using N or E gene assay, with concentrations ranging from 3.6 to 9.1 log₁₀ copies/L. There was a significant difference found between positive ratio (Chi-square test, p < 0.05) and concentration (t-test, p = 0.009) of SARS-CoV-2 RNA detected from hospital wastewater and housing waters. Wastewater data are correlated with COVID-19 active cases, indicating significance in specific areas like the Hospital (APFH) (p < 0.05). According to the application of a bivariate linear regression model (p < 0.05), the concentrations of N-genes may be used to predict the COVID-19 cases in the APFH. Remarkably, SARS-CoV-2 RNA was detected prior to, during, and following clinical case surges, implying that wastewater surveillance could serve as an early warning system for public health decisions. The significance of WBS in tracking and managing pandemics is emphasized by this study, especially in resource-constrained settings.

Keywords: Hospital wastewater; Housing wastewater; Nepal; SARS-CoV-2; Wastewater; Wastewater-based surveillance.