Abstract：
Wastewater analysis can serve as a source of public health information. In recent years, wastewater-based epidemiology (WBE) has emerged and proven useful for the detection of infectious diseases. However, insights from the wastewater treatment plant do not allow for the small-scale differentiation within the sewer system that is needed to analyze the target population under study in more detail. Small-scale WBE offers several advantages, but there has been no systematic overview of its application. The aim of this scoping review is to provide a comprehensive overview of the current state of knowledge on small-scale WBE for infectious diseases, including methodological considerations for its application. A systematic database search was conducted, considering only peer-reviewed articles. Data analyses included quantitative summary and qualitative narrative synthesis. Of 2130 articles, we included 278, most of which were published since 2020. The studies analyzed wastewater at the building level (n = 203), especially healthcare (n = 110) and educational facilities (n = 80), and at the neighborhood scale (n = 86). The main analytical parameters were viruses (n = 178), notably SARS-CoV-2 (n = 161), and antibiotic resistance (ABR) biomarkers (n = 99), often analyzed by polymerase chain reaction (PCR), with DNA sequencing techniques being less common. In terms of sampling techniques, active sampling dominated. The frequent lack of detailed information on the specification of selection criteria and the characterization of the small-scale sampling sites was identified as a concern. In conclusion, based on the large number of studies, we identified several methodological considerations and overarching strategic aspects for small-scale WBE. An enabling environment for small-scale WBE requires inter- and transdisciplinary knowledge sharing across countries. Promoting the adoption of small-scale WBE will benefit from a common international conceptualization of the approach, including standardized and internationally accepted terminology. In particular, the development of good WBE practices for different aspects of small-scale WBE is warranted. This includes the establishment of guidelines for a comprehensive characterization of the local sewer system and its sub-sewersheds, and transparent reporting to ensure comparability of small-scale WBE results.
摘要：
废水分析可以作为公共卫生信息的来源。近年来,基于废水的流行病学（WBE）已经出现，并被证明可用于检测传染病。然而,污水处理厂的见解不允许下水道系统内的小规模分化，这需要更详细地分析研究中的目标人群。小规模WBE提供了几个优点，但是对其应用还没有系统的概述。本次范围审查的目的是全面概述小规模WBE传染病的知识现状，包括其应用的方法学考虑。进行了系统的数据库检索,只考虑同行评审的文章。数据分析包括定量总结和定性叙事综合。在2130篇文章中，我们包括278个，其中大部分是自2020年以来发布的。研究分析了建筑物水平的废水（n=203），特别是医疗保健(n=110)和教育设施(n=80)，在邻域尺度(n=86)。主要分析参数为病毒(n=178),特别是SARS-CoV-2（n=161），和抗生素耐药性（ABR）生物标志物（n=99），通常通过聚合酶链反应（PCR）进行分析，DNA测序技术不太常见。在采样技术方面，主动抽样占主导地位。人们认为，经常缺乏关于选择标准规格和小规模采样点特征的详细信息，这是一个令人关切的问题。总之,根据大量的研究，我们确定了小规模WBE的几个方法学考虑因素和总体战略方面。小规模WBE的有利环境需要各国之间的跨学科和跨学科知识共享。促进采用小规模WBE将受益于该方法的共同国际概念化，包括标准化和国际公认的术语。特别是,有必要为小规模WBE的不同方面发展良好的WBE做法。这包括制订指引,以全面描述本地下水道系统及其子下水道的特征,和透明的报告，以确保小规模WBE结果的可比性。
