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Official websites use. Share sensitive information only on official, secure websites. The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner s are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Although wastewater-based epidemiology WBE successfully functioned as a tool for monitoring the coronavirus disease COVID pandemic globally, relatively little is known about its utility in low-income countries.
A total of influent and 33 effluent wastewater samples were collected from three Wastewater Treatment Plants WWTPs using a h composite Moore swab sampling method from February to November Wastewater viral concentrations were normalized using flow rate and number of people served. In contrast, two out of 11 effluents from Waste Stabilization Pond were found positive. The estimated number of infected people in the Kality Treatment catchment area was times the number of COVID cases reported during the study period in Addis Ababa.
Additionally, this study provides further evidence of the importance of wastewater-based surveillance in general to monitor infectious diseases in low-income settings. Economic stability and human health are considerably affected by infectious diseases as they cause one-fourth of the mortalities around the world 1. Since then, SARS-CoV-2 has been responsible for more than million confirmed cases and around 7 million deaths worldwide as of December 4.
In this regard, Africa reported only around 1. On February 25, Nigeria became the second country to report a first case, and on February 27, Algeria became the third country to do so 6. The first cases in other African countries, including Ethiopia, were only detected in March 7. As a result, the pandemic spread quickly to Africa 8.
Ethiopia reported around 5 and 4. Surveillance focused on clinical and laboratory testing which has drawbacks such as excessive costs, failure to detect asymptomatic patients, and underestimating of infection prevalence Recent study findings in Ethiopia indicated that high asymptomatic cases are associated with persistently activated immune system 17 , This will affect the clinical COVID case detection and reporting as testing of samples was prompted mainly by symptoms Hence, the community may not be prepared in terms of infection prevention and control, and management of COVID infection Fecal shedding can persist for several weeks, typically longer than positivity in oropharyngeal swabs 21 , Anyhow, virus shedding in the feces of symptomatic and asymptomatic infected individuals enables the detection of viral RNA in influent sewage or wastewater 26 , Wastewater-based epidemiology WBE for COVID surveillance can be used as an alternative for early warning of COVID outbreaks or as a control mechanism for potential virus transmission independent of individual healthcare-seeking behaviors.