ArticlePLOS global public health2026
Environmental pathogen surveillance in cities without universal piped wastewater infrastructure.
Article in PLOS global public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Enteric pathogens in soil adjacent to public waste bins in Maputo, Mozambique offers potential for environmental surveillance.PLOS global public health · 2026Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although wastewater surveillance for assessing community health and well-being is now mainstream, most cities in low- and middle-income countries lack conventional wastewater services. In these settings, environmental surveillance beyond conventional wastewater offers the potential to inform public health responses, design interventions intended to reduce exposures, and to evaluate infection control programs. To explore these potential use cases, we measured pathogens, source-tracking markers, and fecal indicator bacteria in wastewater treatment plant (WWTP) influent and effluent, wastewater surface discharges, impacted river water, impacted soils, open drains, stormwater, and fecal sludges from onsite sanitation in Maputo, Mozambique. We detected a wide range of pathogens by multi-parallel RT-qPCR across all matrices, revealing a nuanced picture of pathogen flows in the city and suggesting the potential for exposures beyond those typically included in studies of sanitation and health. We developed a regression model with multiple pathogens as the dependent variable and observed lower pathogen concentrations in direct wastewater discharges (mean difference -1.4 log10 per liter, 95% CI: -1.7, -1.1), WWTP effluent (-0.97 log10, 95% CI: -1.5, -0.47), water from open drains (-2.0 log10, 95% CI: -2.5, -1.6), impacted river water (-3.0 log10, 95% CI: -3.7, -2.4), and stormwater (-4.7 log10, 95% CI: -7.0, -3.3) compared to WWTP influent. We further observed that a one standard deviation increase in 7-day cumulative precipitation was associated with an increase in the pathogen concentration in all matrices (0.11 log10, [0.04, 0.19]). Despite lower concentrations of pathogens in matrices compared to WWTP influent, frequent detection of pathogens indicates clear potential to use environmental pathogen surveillance to inform public health responses in cities lacking universal conventional wastewater, with a wide range of promising applications.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.