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Li Q, Lee BE, Gao T, Qiu Y, Ellehoj E, Yu J, Diggle M, Tipples G, Maal-Bared R, Hinshaw D, Sikora C, Ashbolt NJ, Talbot J, Hrudey SE, Pang X. Number of COVID-19 cases required in a population to detect SARS-CoV-2 RNA in wastewater in the province of Alberta, Canada: Sensitivity assessment. J Environ Sci (China) 2023; 125:843-850. [PMID: 36375966 PMCID: PMC9068596 DOI: 10.1016/j.jes.2022.04.047] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/24/2022] [Accepted: 04/27/2022] [Indexed: 05/03/2023]
Abstract
With a unique and large size of testing results of 1,842 samples collected from 12 wastewater treatment plants (WWTP) for 14 months through from low to high prevalence of COVID-19, the sensitivity of RT-qPCR detection of SARS-CoV-2 RNA in wastewater that correspond to the communities was computed by using Probit analysis. This study determined the number of new COVID-19 cases per 100,000 population required to detect SARS-CoV-2 RNA in wastewater at defined probabilities and provided an evidence-based framework of wastewater-based epidemiology surveillance (WBE). Input data were positive and negative test results of SARS-CoV-2 RNA in wastewater samples and the corresponding new COVID-19 case rates per 100,000 population served by each WWTP. The analyses determined that RT-qPCR-based SARS-CoV-2 RNA detection threshold at 50%, 80% and 99% probability required a median of 8 (range: 4-19), 18 (9-43), and 38 (17-97) of new COVID-19 cases /100,000, respectively. Namely, the positive detection rate at 50%, 80% and 99% probability were 0.01%, 0.02%, and 0.04% averagely for new cases in the population. This study improves understanding of the performance of WBE SARS-CoV-2 RNA detection using the large datasets and prolonged study period. Estimated COVID-19 burden at a community level that would result in a positive detection of SARS-CoV-2 in wastewater is critical to support WBE application as a supplementary warning/monitoring system for COVID-19 prevention and control.
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Affiliation(s)
- Qiaozhi Li
- School of Public Health, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Bonita E Lee
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Tiejun Gao
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Yuanyuan Qiu
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Erik Ellehoj
- University of Alberta Central Receiving, Edmonton, Alberta, T6G 2R3, Canada
| | - Jiaao Yu
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Mathew Diggle
- Provincial Laboratory for Public Health, Edmonton, Alberta, Canada
| | - Graham Tipples
- Provincial Laboratory for Public Health, Edmonton, Alberta, Canada
| | | | - Deena Hinshaw
- Department of Medicine, University of Alberta, Edmonton, AB T6G 2G3, Canada
| | - Christopher Sikora
- Department of Medicine, University of Alberta, Edmonton, AB T6G 2G3, Canada
| | - Nicholas J Ashbolt
- Faculty of Science and Engineering, Southern Cross University, East Lismore NSW 2480, Australia
| | - James Talbot
- Department of Medicine, University of Alberta, Edmonton, AB T6G 2G3, Canada
| | - Steve E Hrudey
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Xiaoli Pang
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2B7, Canada; Provincial Laboratory for Public Health, Edmonton, Alberta, Canada.
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