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

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.

Significance of wastewater surveillance in detecting the prevalence of SARS-CoV-2 variants and other respiratory viruses in the community – A multi-site evaluation

“…WBE for SARS-CoV-2 analysis is a recent global endeavor to mitigate low testing frequencies and reporting information to gather more comprehensive data on the current status of COVID-19 in a community. [ 20 , [27] , [28] , [29] , [30] ] Moreover, WBE has been effective in detecting key variants responsible for the evolution of SARS-CoV-2 infectivity and pathogenicity. [ 13 , 15 , 20 , 31 ] In this study, we analyzed multiple WRFs and local collection sites in the Reno-Sparks metropolitan area using RT-qPCR to quantify the presence of SARS-CoV-2 and its variants.…”

Real-time sewage surveillance for SARS-CoV-2 in Dhaka, Bangladesh versus clinical COVID-19 surveillance: a longitudinal environmental surveillance study (December, 2019–December, 2021)

“…Although SARS-CoV-2 has been detected in sewage from populations residing in LMICs, most of these studies collected sewage from formal sewage networks and wastewater treatment plants with a well defined catchment area and population. 24 , 25 , 26 , 27 Before this study, very few had collected sewage from informal sewage lines where the catchment area and populations are not defined, and these had not assessed temporal trends of sewage viral load with clinical case incidence, stratifying by the income level of the population. 28 Informal sewage networks are common in cities across many low-income and middle-income countries, and are regularly sampled for poliovirus as part of the Global Polio Eradication Initiative's surveillance strategy, where catchments are hard to define.…”

Significance of Wastewater Surveillance in Detecting the Prevalence of SARS-CoV-2 Variants and Other Respiratory Viruses in the Community – A Multi-Site Evaluation

“…WBE for SARS-CoV-2 analysis is a recent global endeavor to mitigate low testing frequencies and reporting information to gather more comprehensive data on the current status of COVID-19 in a community. 20,[27][28][29][30] Moreover, WBE has been effective in detecting key variants responsible for the evolution of SARS-CoV-2 infectivity and pathogenicity. 13,15,20,31 In this study, we analyzed multiple WRFs and local collection sites in the Reno-Sparks metropolitan area using RT-qPCR to quantify the presence of SARS-CoV-2 and its variants.…”