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. 2022 Jul 12;19(14):8515.
doi: 10.3390/ijerph19148515.

Community Wastewater-Based Surveillance Can Be a Cost-Effective Approach to Track COVID-19 Outbreak in Low-Resource Settings: Feasibility Assessment for Ethiopia Context

Solomon Ali  1 , Esayas Kebede Gudina  2 , Addisu Gize  1 , Abde Aliy  3 , Birhanemeskel Tegene Adankie  1 , Wondwossen Tsegaye  1 , Gadissa Bedada Hundie  1 , Mahteme Bekele Muleta  4 , Tesfaye Rufael Chibssa  3 , Rediet Belaineh  3 , Demessa Negessu  3 , Dereje Shegu  3 , Guenter Froeschl  5   6 , Andreas Wieser  5   6   7
Affiliations

Community Wastewater-Based Surveillance Can Be a Cost-Effective Approach to Track COVID-19 Outbreak in Low-Resource Settings: Feasibility Assessment for Ethiopia Context

Solomon Ali et al. Int J Environ Res Public Health. .

Abstract

Wastewater surveillance systems have become an important component of COVID-19 outbreak monitoring in high-income settings. However, its use in most low-income settings has not been well-studied. This study assessed the feasibility and utility of wastewater surveillance system to monitor SARS-CoV-2 RNA in Addis Ababa, Ethiopia. The study was conducted at nine Membrane Bio-reactor (MBR) wastewater processing plants. The samples were collected in two separate time series. Wastewater samples and known leftover RT-PCR tested nasopharyngeal swabs were processed using two extraction protocols with different sample conditions. SARS-CoV-2 wastewater RT-PCR testing was conducted using RIDA GENE SARS-CoV-2 RUO protocol for wastewater SARS-CoV-2 RNA testing. Wastewater SARS-CoV-2 RNA RT-PCR protocol adaptation, optimization, and detection were conducted in an Addis Ababa, Ethiopia context. Samples collected during the first time series, when the national COVID-19 case load was low, were all negative. Conversely, samples collected during the second time series were all positive, coinciding with the highest daily reported new cases of COVID-19 in Ethiopia. The wastewater-based SARS-CoV-2 surveillance approach is feasible for Addis Ababa. The COVID-19 wastewater based epidemiological approach can potentially fill the evidence gap in distribution and dynamics of COVID-19 in Ethiopia and other low-income settings.

Keywords: COVID-19; MBR; RT-PCR; SARS-CoV-2; SPHMMC; wastewater; wastewater-based epidemiology.

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Conflict of interest statement

All authors declared that there is no conflict of interest concerning this manuscript.

Figures

Figure 1
Figure 1
Map of decentralized MBR units in Addis Ababa, where group 1 represents MBR units included in this study and group 2 represents MBR units not included in the current study. Woredas are geographical units in Addis Ababa. Source: this map is created by Chaile Mulu (Geospatial Epidemiologist at National Data Management Center, Ethiopian Public Health Institute).
Figure 2
Figure 2
Daily new COVID-19 cases and RT-PCR test positive rate of Ethiopia as reported by the Ministry of Health during our study periods of 19 October to 13 December 2020 and 19 December 2021 to 15 January 2022 (data source: Ministry of Health-Ethiopia daily COVID-19 testing period).
See this image and copyright information in PMC

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