Authors
Jean Claude Mugisha, Tolessa Muleta Daba, Raphael Ndahimana, Jean Pierre Musabyimana, Misbah Gashegu, Christopher A Green, Claude Mambo Muvunyi, Leon Mutesa
Published in
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. Pages 109097. Sep 08, 2026. Epub Sep 08, 2026.
Abstract
Wastewater-based epidemiology (WBE) has emerged as a critical tool for public health surveillance, yet its application across diverse pathogens and geographical settings remains inconsistent. This systematic review synthesizes global evidence on wastewater surveillance to identify associated risk factors.
Following PRISMA 2020 guidelines (PROSPERO: CRD420261297382), a systematic search was conducted across PubMed, Scopus, Google Scholar, and Web of Science for studies published between 2000 and 2025.
Thirty-nine peer-reviewed studies were included. The evidence base is geographically skewed toward the European Region (48.7%) and the Americas (23.1%), with significant underrepresentation in LMICs. Viruses were the primary biological target (89.7%), followed by bacteria (7.7%) and parasites (2.6%). A proportion meta-analysis of 31 eligible studies demonstrated a pooled wastewater pathogen detection prevalence of 62% (95% CI: 47.5-74.6%), with the European Region yielding the highest regional estimate (73%) and the African Region the lowest (8.3%). Conventional PCR and sequencing methods showed higher pooled detection rates (92.4% and 90.1%, respectively) than RT-qPCR (47.9%).
WBE provides a robust early-warning system indicating a need for broader pathogen diversity, incorporating bacterial and parasitic surveillance and expansion into rural and resource-limited regions.
PMID:
42710802
Bibliographic data and abstract were imported from PubMed on 09 Sep 2026.
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