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Meta-analysis of the SARS-CoV-2 positivity rate in municipal wastewater

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Abstract

The aim of this study is to conduct a systematic analysis of the SARS-CoV-2 levels in urban sewage and evaluate the associated positivity rates, thereby developing comprehensive insights into the epidemic situation and providing valuable inputs for the development of effective disease prevention and control strategies. The PubMed, Scopus, Embase, China National Knowledge Infrastructure, Wanfang Database, and VIP databases were systematically searched based on the predefined retrieval strategy. The literature published up to February 2023 was meticulously screened according to the predetermined inclusion and exclusion criteria, and the relevant data were extracted for subsequent integration. The quality assessment of the included studies adhered to the rigorous Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement guidelines. The meta-analysis was conducted using Stata 17.0 software. The meta-analysis included a total of 34 studies, encompassing 8429 municipal wastewater samples. A random effects model was employed for the analysis, revealing an overall SARS-CoV-2 positivity rate of 53.7% in the municipal wastewater samples. The subgroup analyses demonstrated significant regional variations in the SARS-CoV-2 positivity rate in municipal wastewater, with Africa exhibiting the highest rate at 62.5% (95% confidence interval [CI] 47.4 ~ 76.0%) and Oceania displaying the lowest at 33.3% (95% CI 22.0 ~ 46.3%). However, the subgroup analyses based on the sampling site, strain prevalence period, and laboratory testing method did not yield any statistically significant differences. The SARS-CoV-2 positivity rate in wastewater is relatively high globally, although it exhibits regional disparities. Regions with larger populations and lower economic levels demonstrate higher viral detection rates in sewage. Different types of wastewater sampling sites can be employed to monitor distinct aspects of the COVID-19 pandemic. Continuous surveillance of SARS-CoV-2 in wastewater plays a pivotal role in complementing clinical data, helping to track outbreak progression across diverse regions.

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Funding

This work was supported by the Young Innovative Talents of Zhejiang Health Science and Technology Program (grant number 2022RC063); the Key Project of Hangzhou Health Science and Technology Plan (grant number ZD20210026); the Hangzhou Medical and Health Technology Major Project (grant number Z20210006); and the Zhejiang Medical and Health Technology Plan Project (grant number 2022KY1039).

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  1. Hangzhou Center for Disease Control and Prevention, Hangzhou, 310021, Zhejiang, China

    Keyi Cheng, Ye Lv, Chaokang Li, Shi Cheng, Shanshan Xu, Xin Gao & Hong Xu

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  1. Keyi Cheng
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  2. Ye Lv
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Contributions

All the authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by CK, XH, and LY. The first draft of the manuscript was written by CHENG Keyi, and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.

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Correspondence to Hong Xu.

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Cheng, K., Lv, Y., Li, C. et al. Meta-analysis of the SARS-CoV-2 positivity rate in municipal wastewater. Environ Geochem Health 46, 119 (2024). https://doi.org/10.1007/s10653-024-01895-7

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