Article type
Abstract
Background
Cholera outbreaks are increasingly prevalent in Southern Africa and countries worldwide that have not seen incidences of cholera in years. Following the successful implementation of wastewater surveillance during the COVID-19 pandemic, there has been a notable surge in interest regarding the potential of wastewater surveillance to detect and predict pathogen and disease outbreaks. Despite significant investment in systems like wastewater surveillance, there is a lack of clarity regarding the most effective interventions. Without clear guidance on monitoring and preparedness for cholera outbreaks, there is a risk of inefficient resource allocation. We undertook a study to systematically synthesize available evidence to inform international policy on the best methods for cholera surveillance. However, we encountered challenges in synthesizing the available data, which poses obstacles to effectively informing public health actions.
Objective
We share lessons learned from synthesizing studies on water and wastewater-based environmental surveillance of toxigenic Vibrio cholerae. Further, through our lessons, we aim to enhance approaches for production and use of evidence for mitigating cholera and other infectious disease outbreaks.
Findings
Our multidisciplinary team conducted a scoping review. We searched between May and June 2023 on PubMed and Scopus using a comprehensive search strategy. We identified 597 records from PubMed and Scopus. A total of 105 studies were included. Studies were conducted in 42 countries. Thirteen studies were retrospective, and 43 linked to clinical outcome data. Key challenges included 1) reporting on study designs was unclear/ poor 2) reporting with clinical data limited and 3) linkages with existing public health programmes to inform responses was rare.
Conclusion
Evidence-informed approaches for anticipating and planning for outbreaks is vital. Our experience underscores the value of interdisciplinary collaboration between natural and public health scientists. Lessons emphasize the role of good quality environmental health evidence linked with health outcomes in mitigating cholera outbreaks. Current reporting on evidence in this field needs urgent attention to minimize wasteful investment in surveillance systems of unknown benefit.
Relevance and importance to patients
No direct impact on patients. Better surveillance may enhance public health actions for cholera outbreaks.
Cholera outbreaks are increasingly prevalent in Southern Africa and countries worldwide that have not seen incidences of cholera in years. Following the successful implementation of wastewater surveillance during the COVID-19 pandemic, there has been a notable surge in interest regarding the potential of wastewater surveillance to detect and predict pathogen and disease outbreaks. Despite significant investment in systems like wastewater surveillance, there is a lack of clarity regarding the most effective interventions. Without clear guidance on monitoring and preparedness for cholera outbreaks, there is a risk of inefficient resource allocation. We undertook a study to systematically synthesize available evidence to inform international policy on the best methods for cholera surveillance. However, we encountered challenges in synthesizing the available data, which poses obstacles to effectively informing public health actions.
Objective
We share lessons learned from synthesizing studies on water and wastewater-based environmental surveillance of toxigenic Vibrio cholerae. Further, through our lessons, we aim to enhance approaches for production and use of evidence for mitigating cholera and other infectious disease outbreaks.
Findings
Our multidisciplinary team conducted a scoping review. We searched between May and June 2023 on PubMed and Scopus using a comprehensive search strategy. We identified 597 records from PubMed and Scopus. A total of 105 studies were included. Studies were conducted in 42 countries. Thirteen studies were retrospective, and 43 linked to clinical outcome data. Key challenges included 1) reporting on study designs was unclear/ poor 2) reporting with clinical data limited and 3) linkages with existing public health programmes to inform responses was rare.
Conclusion
Evidence-informed approaches for anticipating and planning for outbreaks is vital. Our experience underscores the value of interdisciplinary collaboration between natural and public health scientists. Lessons emphasize the role of good quality environmental health evidence linked with health outcomes in mitigating cholera outbreaks. Current reporting on evidence in this field needs urgent attention to minimize wasteful investment in surveillance systems of unknown benefit.
Relevance and importance to patients
No direct impact on patients. Better surveillance may enhance public health actions for cholera outbreaks.