To inform the development of global wastewater monitoring systems, we surveyed programs in 43 countries. We summarize approaches used for implementation and present considerations for frameworks to inform adaptive sampling, flexible testing, enhanced data reporting, and ethical monitoring.
The successful use of wastewater-based data during the COVID-19 pandemic has led to the creation of the National Wastewater Surveillance System in the USA for pathogen monitoring. Now a complementary system is needed for help tackling the opioid epidemic.
Little information has been reported in the literature on the costs of wastewater monitoring, particularly in LMICs. We surveyed 12 wastewater monitoring programs in low- and middle-income countries to collect information on program costs and how those costs vary by implementation features.
This project explores the utility of wastewater-based epidemiology as a public health tool for characterizing opioid use in the US. We conducted pilot studies focused on monitoring pharmaceutical opioids and other drugs in and around Knox County and Memphis, Tennessee; and Madison, Wisconsin.
Wastewater monitoring has been used to identify SARS-CoV-2 outbreaks and track new variants. This sentinel system should be expanded to monitor other pathogens and boost public health preparedness.
This paper presents an algorithm that reliably distinguishes signal from noise in wastewater data to flag community-level COVID-19 surges. Our approach gives public health officials a timely, data-driven way to assess when increased public health action may be needed.
Findings from a survey of 12 state and 194 local public health agency leaders on factors influencing pandemic management, the landscape of wastewater surveillance, barriers and supports to implementation, the value of wastewater data, and future interest in monitoring wastewater for public health.
The authors sought to determine whether self-reported intent to comply with public health recommendations correlates with future coronavirus disease 2019 (COVID-19) disease burden.
The authors developed an automated qualitative assistant (AQUA) using machine-learning methods to rapidly and accurately code large text datasets. The tool replaces Latent Semantic Indexing with a more transparent graph-theoretic topic extraction and clustering method.
Mathematica can help states interested in legalizing adult-use (recreational) marijuana (1) predict the economic, public health, and public safety impacts of cannabis legalization and (2) assess how different licensing schemes can promote diversity and equity among licensed cannabis businesses.
This study examines moderators and predictors of improvement in body dysmorphic disorder, a common and severe disorder, after treatment with cognitive behavioral therapy versus enhanced supportive therapy.
We discuss ways to transform wastewater surveillance from an academic exercise into a tool for epidemic response, generalizing lessons learned by a global network of wastewater researchers around COVID-19 and opioids.
Results from a wastewater pilot study in a rural Western North Carolina town that is home to a major regional university.
With the COVID-19 pandemic, test kit shortages have created large blind spots with respect to disease transmission. Wastewater testing provides a new way to rapidly measure the viral exposure of thousands of people in a community.
Although cognitive-behavioral therapy (CBT) is highly efficacious for body dysmorphic disorder (BDD), not all patients benefit, and mechanisms underlying response remain unknown.
By testing samples of municipal wastewater, officials can quickly assess the presence and spread of COVID-19 infections in their community.
When combined with data on prescriptions filled at local pharmacies, EMS drug overdose calls, and drug seizures by law enforcement, wastewater testing can yield insights into the extent of black-market activity, policing impact on community drug use, and where and when drug overdoses might occur.
This brief discusses several factors and unknowns that states should consider when deciding whether to legalize marijuana. Drawing from our research for the Massachusetts Marijuana Baseline Health Study, we summarize potential impacts on tax revenue, public health, public safety, and regulation.
The Anxiety Symptoms Questionnaire (ASQ) is a brief self-report questionnaire which measures frequency and intensity of symptoms and was developed to improve assessment of anxiety symptoms in a clinical setting.
This article describes results from a large, multi-site randomized clinical trial comparing cognitive behavioral therapy with supportive psychotherapy for adults with body dysmorphic disorder – an often severe psychiatric condition associated with high rates of hospitalization and suicidality.
This issue brief describes the HRQOL of individuals included in the Health Care Survey of Department of Defense Beneficiaries (HCSDB)—specifically, the survey administered in the third quarter (Q3) of 2018.
Potential of wastewater analysis for informing public health and safety policies and approaches.
The objective of this study was to investigate predictors of long-term recovery from eating disorders 22 years after entry into a longitudinal study.
This report synthesizes research and recommendations from Mathematica’s symposium on “The Potential of Wastewater Testing for Public Health and Safety."
The authors share mentoring strategies that have emerged at their organization, Mathematica, to overcome these obstacles.
Continuation-phase escitalopram delayed time to relapse, and fewer escitalopram-treated subjects relapsed than did placebo-treated subjects.
An overview of the potential of municipal wastewater testing to provide comprehensive estimates of opioid use across the country. The methodology allows for analysis of geographic and temporal trends in drug use, rapid feedback for program evaluations, and identification of new drugs of abuse.