Wastewater surveillance for early pathogen detection in Asia

Area of Science:

• Public Health and Epidemiology
• Environmental Science and Engineering
• Infectious Disease Surveillance

Background:

• Wastewater surveillance (WS) is a vital population-based tool for early pathogen detection and public health action.
• Global guidance exists for WS in Asia, but regional priorities and needs are not well understood.

Purpose of the Study:

• To conduct a cross-sectional assessment of wastewater surveillance efforts in Asia.
• To understand the current landscape, priorities, and needs of WS in the Asian region.

Main Methods:

• An institutional survey was administered to 45 institutions across 19 Asian countries.
• The survey collected data on 89 separate wastewater surveillance projects.
• Analysis focused on project scope, funding, sampling, and targeted pathogens.

Main Results:

• Eighty-nine WS projects were identified across 45 institutions in 19 Asian countries.
• Projects were primarily research-oriented, with 20% integrated into national surveillance.
• Commonly monitored pathogens included SARS-CoV-2, AMR bacteria, enterovirus, influenza, and poliovirus.

Conclusions:

• Substantial progress in WS adoption in Asia is evident, despite challenges like funding and government support.
• Future sustainability and scalability depend on documenting public health use cases and enhancing national planning.
• Developing tailored protocols, regional guidance, and multi-pathogen approaches, including genomics, can advance cost-efficient WS for public health.