Holm Rochelle H, Pocock Gina, Severson Marie A, Huber Victor C, Smith Ted, McFadden Lisa M
Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, 302 E. Muhammad Ali Blvd., Louisville, KY 40202, United States.
Waterlab, 23B De Havilland Crescent, 0020 Persequor Technopark, South Africa.
Geoforum. 2023 Aug;144:103816. doi: 10.1016/j.geoforum.2023.103816. Epub 2023 Jun 26.
The SARS-CoV-2 pandemic highlighted the need for novel tools to promote health equity. There has been a historical legacy around the location and allocation of public facilities (such as health care) focused on efficiency, which is not attainable in rural, low-density, United States areas. Differences in the spread of the disease and outcomes of infections have been observed between urban and rural populations throughout the COVID-19 pandemic. The purpose of this article was to review rural health disparities related to the SARS-CoV-2 pandemic while using evidence to support wastewater surveillance as a potentially innovative tool to address these disparities more widely. The successful implementation of wastewater surveillance in resource-limited settings in South Africa demonstrates the ability to monitor disease in underserved areas. A better surveillance model of disease detection among rural residents will overcome issues around the interactions of a disease and social determinants of health. Wastewater surveillance can be used to promote health equity, particularly in rural and resource-limited areas, and has the potential to identify future global outbreaks of endemic and pandemic viruses.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行凸显了对促进健康公平的新型工具的需求。围绕公共设施（如医疗保健）的选址和分配存在着一种历史遗留问题，其侧重于效率，而这在美国农村低密度地区是无法实现的。在整个新冠疫情期间，城市和农村人口之间在疾病传播和感染结果方面存在差异。本文的目的是回顾与SARS-CoV-2大流行相关的农村健康差异，同时利用证据支持将废水监测作为一种潜在的创新工具，以更广泛地解决这些差异。在南非资源有限的环境中成功实施废水监测，证明了在服务不足地区监测疾病的能力。建立一个更好的农村居民疾病检测监测模型，将克服围绕疾病与健康社会决定因素相互作用的问题。废水监测可用于促进健康公平，特别是在农村和资源有限的地区，并且有可能识别未来全球地方性和大流行性病毒的爆发。
