Abstract
Equitable SARS-CoV-2 surveillance in low-resource communities lacking centralized sewers is critical as wastewater-based epidemiology (WBE) progresses. However, large-scale studies on SARS-CoV-2 detection in wastewater from low-and middle-income countries is limited because of economic and technical reasons. In this study, wastewater samples were collected twice a month from 186 urban and rural subdistricts in nine provinces of Thailand mostly having decentralized and non-sewered sanitation infrastructure and analyzed for SARS-CoV-2 RNA variants using allele-specific RT-qPCR. Wastewater SARS-CoV-2 RNA concentration was used to estimate the real-time incidence and time-varying effective reproduction number (Re). Results showed an increase in SARS-CoV-2 RNA concentrations in wastewater from urban and rural areas 14–20 days earlier than infected individuals were officially reported. It also showed that community/food markets were “hot spots” for infected people. This approach offers an opportunity for early detection of transmission surges, allowing preparedness and potentially mitigating significant outbreaks at both spatial and temporal scales.
| Original language | English |
|---|---|
| Article number | 107019 |
| Pages (from-to) | 1-21 |
| Number of pages | 21 |
| Journal | iScience |
| Volume | 26 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - 21 Jul 2023 |
Bibliographical note
Funding Information:Funding Sources: D.L.W. was supported by Balvi Filantropic Fund and Chulalongkorn University (Second Century Fund- C2F Postdoctoral Fellowship), University of Western Australia (Overseas Research Experience Fellowship) and Yamagata Prefectural Central Hospital , Yamagata, Japan (Clinical Residency Fellowship). C.M. was supported by the Centre of Excellence in Mathematics , Ministry of Higher Education, Science, Research and Innovation, Thailand , Center of Excellence on Medical Biotechnology (CEMB), and Thailand Center of Excellence in Physics (ThEP). A.K. is a Rothwell Family Fellow. The funder(s) had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.
Funding Information:
We thank all the volunteers who kindly supported with sample collection. Also, thanks to Dr. Ong-orn Prasarnphanich at the United States Centers for Disease Control and Prevention (CDC) Thailand for technical support and the previous Chargé d'Affaires of the United States of America to Thailand (US Embassy & Consulate in Thailand), Mr. Michael Heath, for facilitating collaboration with the CDC and Armed Forces Research Institute of Medical Sciences (AFRIMS). We also thank the LGBTQIA+ community in Thailand for generous support with sample collection, TEDxChiangMai team and Martin venzky-Stalling for facilitating platform for collaboration, and marginalized, vulnerable indigenous communities in northern Thailand for support with sample collection. Special thanks to Nuttawut Kietchaiyakorn for helping with the illustrations. Ethics approval was not required for this type of environmental wastewater surveillance study. Funding Sources: D.L.W. was supported by Balvi Filantropic Fund and Chulalongkorn University (Second Century Fund- C2F Postdoctoral Fellowship), University of Western Australia (Overseas Research Experience Fellowship) and Yamagata Prefectural Central Hospital, Yamagata, Japan (Clinical Residency Fellowship). C.M. was supported by the Centre of Excellence in Mathematics, Ministry of Higher Education, Science, Research and Innovation, Thailand, Center of Excellence on Medical Biotechnology (CEMB), and Thailand Center of Excellence in Physics (ThEP). A.K. is a Rothwell Family Fellow. The funder(s) had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. D.L.W. conception, funding acquisition, investigation, data curation, formal analysis, supervision, writing the original draft of the manuscript. M.A. conception, investigation, data curation, formal analysis, supervision, writing the original draft of the manuscript. P.H. conception, funding acquisition, investigation, data curation, formal analysis, supervision, writing the original draft of the manuscript. C.H. conception, funding acquisition, investigation, data curation, formal analysis, supervision, writing the original draft of the manuscript. C.M. data curation, formal analysis, supervision, writing the original draft of the manuscript. S.C. data curation, formal analysis, supervision, writing the original draft of the manuscript. S.A. data curation, formal analysis, supervision, writing the original draft of the manuscript. P.P. supervision, critical review and editing of the manuscript. S.A. supervision, critical review and editing of the manuscript. A.H.R.S.M. supervision, critical review and editing of the manuscript. E.D.L. supervision, critical review and editing of the manuscript. A.T.H. supervision, critical review and editing of the manuscript. P.V. data curation, formal analysis. T.S. data curation, formal analysis. S.L-I. supervision, critical review and editing of the manuscript. R.J.S. supervision, critical review and editing of the manuscript. P.O. supervision, critical review and editing of the manuscript. N.K.D.R. supervision, critical review and editing of the manuscript. P.K. supervision, critical review and editing of the manuscript. D.S. supervision, critical review and editing of the manuscript. T.F. supervision, critical review and editing of the manuscript. K.S. supervision, critical review and editing of the manuscript. A.L. supervision, critical review and editing of the manuscript. T.K. supervision, critical review and editing of the manuscript. N.H. supervision, critical review and editing of the manuscript. P.G.H. supervision, critical review and editing of the manuscript. A.K. supervision, critical review and editing of the manuscript. A.S. supervision, critical review and editing of the manuscript. T.C. critical review and editing of the manuscript. S.T. supervision, critical review and editing of the manuscript. A.DM. supervision, critical review and editing of the manuscript. H.I. supervision, critical review and editing of the manuscript. No author declares any potential conflict of interest or competing financial or non-financial interest in relation to the manuscript. We support inclusive, diverse, and equitable conduct of research. One or more of the authors of this paper self-identifies as an underrepresented ethnic minority in their field of research or within their geographical location. One or more of the authors of this paper self-identifies as a gender minority in their field of research. One or more of the authors of this paper self-identifies as a member of the LGBTQIA+ community. One or more of the authors of this paper self-identifies as living with a disability. While citing references scientifically relevant for this work, we also actively worked to promote gender balance in our reference list.
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