Integration of poliovirus and enteropathogen sewage surveillance in Dhaka Bangladesh: a longitudinal surveillance study June 2019 – June 2020
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Environmental surveillance (ES) for poliovirus is a surveillance method used by the Global Polio Eradication Initiative (GPEI). ES will continue following certification of poliovirus eradication, potentially through its integration into other infectious disease surveillance programs.
We evaluated TaqMan array cards (TAC) to detect poliovirus in sewage, whilst simultaneously testing for 11 other enteric pathogens and 34 markers of antimicrobial resistance (AMR) across 12 sites in Dhaka, Bangladesh. Sites were selected following mapping of the informal sewage network and a demographic survey of the population. Samples were collected before and after a bivalent oral polio vaccine (bOPV) campaign. 372 samples were collected over 379 days. A water-quality probe measured physicochemical properties of the sewage. A Multivariable mixed-effects Gamma Hurdle regression model was used to measure the association between enterovirus detection and concentration with site properties.
The highest concentration of Sabin-1 and -3 poliovirus was detected two weeks after the bOPV campaign (mean (SD) Sabin- 1 and -3 viral copies per L of sewage: 0·83 (2·13) and 0·84 (1·96)) , (vs baseline 0·05 (0·21) and 0·11 (0·50) respectively) [p=0·004: SL1, p=0·005: SL3] . Detection of enteroviruses was more likely with increasing levels of Total Dissolved Solids (mg/L) (aOR per absolute increase of 100 units 1·39 95%CI: 1·17 – 1·61). The median ES viral load of rotavirus was 0·567 (IQR 0·202-0·839), and this pathogen had the strongest correlation with respective concurrent clinical case incidence (cor = 0·828, p = 0·0017). Thirty-one AMR genes of clinical significance were detected.
When GPEI dissolves, poliovirus surveillance needs to be integrated into other surveillance programs. TAC may provide a method to screen suitable pathogens to survey in sewage alongside poliovirus. Further validation is now required across different geographies and poliovirus prevalence, and interpretation of data requires an understanding of site sensitivity.
Funding: Gates Foundation (INV-007652)
We evaluated TaqMan array cards (TAC) to detect poliovirus in sewage, whilst simultaneously testing for 11 other enteric pathogens and 34 markers of antimicrobial resistance (AMR) across 12 sites in Dhaka, Bangladesh. Sites were selected following mapping of the informal sewage network and a demographic survey of the population. Samples were collected before and after a bivalent oral polio vaccine (bOPV) campaign. 372 samples were collected over 379 days. A water-quality probe measured physicochemical properties of the sewage. A Multivariable mixed-effects Gamma Hurdle regression model was used to measure the association between enterovirus detection and concentration with site properties.
The highest concentration of Sabin-1 and -3 poliovirus was detected two weeks after the bOPV campaign (mean (SD) Sabin- 1 and -3 viral copies per L of sewage: 0·83 (2·13) and 0·84 (1·96)) , (vs baseline 0·05 (0·21) and 0·11 (0·50) respectively) [p=0·004: SL1, p=0·005: SL3] . Detection of enteroviruses was more likely with increasing levels of Total Dissolved Solids (mg/L) (aOR per absolute increase of 100 units 1·39 95%CI: 1·17 – 1·61). The median ES viral load of rotavirus was 0·567 (IQR 0·202-0·839), and this pathogen had the strongest correlation with respective concurrent clinical case incidence (cor = 0·828, p = 0·0017). Thirty-one AMR genes of clinical significance were detected.
When GPEI dissolves, poliovirus surveillance needs to be integrated into other surveillance programs. TAC may provide a method to screen suitable pathogens to survey in sewage alongside poliovirus. Further validation is now required across different geographies and poliovirus prevalence, and interpretation of data requires an understanding of site sensitivity.
Funding: Gates Foundation (INV-007652)
Date Issued
2026-05-01
Date Acceptance
2025-12-19
Citation
The Lancet Microbe, 2026, 7 (5)
ISSN
2666-5247
Publisher
Elsevier
Journal / Book Title
The Lancet Microbe
Volume
7
Issue
5
Copyright Statement
© 2025 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
License URL
Publication Status
Published
Article Number
101343
Date Publish Online
2026-05-08