Wastewater-based epidemiology for preventing outbreaks and epidemics in Latin America – Lessons from the past and a look to the future

• Published in: The Science of the total environment Vol. 865; p. 161210
• Main Authors: Prado, Tatiana, Rey-Benito, Gloria, Miagostovich, Marize Pereira, Sato, Maria Inês Zanoli, Rajal, Veronica Beatriz, Filho, Cesar Rossas Mota, Pereira, Alyne Duarte, Barbosa, Mikaela Renata Funada, Mannarino, Camille Ferreira, da Silva, Agnes Soares
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 20-03-2023
• Subjects: COVID-19 - epidemiology; Disease Outbreaks - prevention & control; Environmental surveillance; Humans; Latin America; Latin America - epidemiology; Pandemics - prevention & control; Pathogens; Public health; SARS-CoV-2; Wastewater-Based Epidemiological Monitoring; Wastewater-based epidemiology; Latin America; Pathogens; Environmental surveillance; Public health; Wastewater-based epidemiology; Latin America
• ISSN: 0048-9697; 1879-1026
• DOI: 10.1016/j.scitotenv.2022.161210

Wastewater-based epidemiology (WBE) is an approach with the potential to complement clinical surveillance systems. Using WBE, it is possible to carry out an early warning of a possible outbreak, monitor spatial and temporal trends of infectious diseases, produce real-time results and generate representative epidemiological information in a territory, especially in areas of social vulnerability. Despite the historical uses of this approach, particularly in the Global Polio Eradication Initiative, and for other pathogens, it was during the COVID-19 pandemic that occurred an exponential increase in environmental surveillance programs for SARS-CoV-2 in wastewater, with many experiences and developments in the field of public health using data for decision making and prioritizing actions to control the pandemic. In Latin America, WBE was applied in heterogeneous contexts and with emphasis on populations that present many socio-environmental inequalities, a condition shared by all Latin American countries. This manuscript addresses the concepts and applications of WBE in public health actions, as well as different experiences in Latin American countries, and discusses a model to implement this surveillance system at the local or national level. We emphasize the need to implement this sentinel surveillance system in countries that want to detect the early entry and spread of new pathogens and monitor outbreaks or epidemics of infectious agents in their territories as a complement of public health surveillance systems.
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•Main concepts of WBE in public health are addressed.•Critical review of WBE in Latin America described.•Approach to use WBE in socially vulnerable areas proposed.•WBE framework for Latin America suggested.