Wastewater Monitoring in Indigenous Communities

Wastewater monitoring is emerging as a vital tool for public health, offering a rapid, cost-effective way of tracking infectious diseases. By analyzing wastewater data, Indigenous communities can proactively address public health concerns before they escalate.

Indigenous Communities Face a Higher Burden of Infectious Diseases

Indigenous Americans have long faced significant health disparities, which have been starkly highlighted during the COVID-19 pandemic. According to the CDC, the COVID-19 mortality rate for Indigenous Americans was almost twice that of white Americans, showcasing the disproportionate burden of infectious diseases in Indigenous communities.

One of the primary reasons for this vulnerability is the high prevalence of chronic diseases among Indigenous populations. For instance, 23.5% of the Indigenous population has diabetes, compared to 8% of white, non-Hispanic people. Similarly, Indigenous Americans are 50% more likely to be diagnosed with coronary heart disease. These chronic conditions increase the risk of severe outcomes from infectious diseases, making Indigenous populations particularly susceptible to complications and higher mortality rates.

Additionally, access to healthcare in many Indigenous communities is difficult, with many areas facing underfunded health systems and healthcare worker shortages. This lack of resources limits the ability to provide timely and effective medical care, exacerbating health disparities [4].

Furthermore, decades of systemic racism have led to persistent health disparities, resulting in a life expectancy for Indigenous Americans that is 5.5 years lower than the combined U.S. population. The cumulative effect of these factors means that Indigenous communities are often at a greater disadvantage when it comes to managing and preventing infectious diseases [6].

The Process of Wastewater Monitoring

Wastewater monitoring involves collecting samples from sewage systems and testing them for pathogens like viruses and bacteria. This method can detect the presence of infectious agents in a community before they are identified through clinical testing.

1. Sample Collection

The first step in wastewater monitoring is collecting samples from sewage systems. If an individual has an active infection, they may shed pathogens through their bodily fluids, which eventually end up in sewage systems when they use the toilet.

2. Laboratory Analysis

Once collected, samples are processed for analysis. Pathogens in wastewater are often present in low concentrations, so the samples need to be concentrated to detect them effectively. Then, nucleic acids (DNA or RNA) are extracted from the concentrated samples to detect and quantify the presence of specific pathogens.

3. Data Interpretation

After laboratory analysis, the data is interpreted to provide actionable insights. This involves interpreting the pathogen load in the wastewater to indicate the level of infection in the community and observe trends over time. Comparing data across different locations or time periods can identify hotspots of infection and inform targeted public health interventions.

*Source:* *https://www.nature.com/articles/s41591-022-01940-x*

Benefits of Wastewater Monitoring in Indigenous Communities

Wastewater monitoring is a highly effective method to provide historically underserved communities with crucial health information. With access to this data, tribal leaders, health systems, and community members can more effectively advocate for the resources necessary to address current and future health challenges.

One of the primary advantages is the early detection of health threats, allowing for a proactive response to infectious disease spikes. By detecting pathogens in wastewater before symptomatic cases appear, Indigenous communities can respond to emerging health threats, potentially preventing outbreaks and reducing the spread of infectious diseases.

Testing wastewater is also more cost-effective than conducting individual clinical tests, as a single sample can provide insights into the health of hundreds or thousands of people. This approach significantly reduces the financial burden on health systems, making it a practical solution for communities with limited resources or access to healthcare [6].

Furthermore, wastewater monitoring promotes health equity by eliminating access and affordability barriers associated with diagnostic testing methods. It also provides insights that are independent of individual behaviors, such as a reluctance to seek medical care or a fear of stigma. By offering comprehensive data on community health, wastewater monitoring helps target interventions more effectively, ensuring that resources are directed to where they are most needed [7].

Considerations for Collaborating with Indigenous Communities

Although wastewater surveillance has shown great promise as a method of monitoring disease trends, collaboration with Indigenous communities cannot occur without accounting for data security and sovereignty.

American Indigenous communities have long faced harm resulting from research misconduct, contributing to a deep-rooted mistrust of biomedical research. Government agencies and researchers have perpetuated this mistrust through various forms of harm, including a lack of informed consent, misinterpretation of data and culture, breaches of privacy, mishandling of biological samples, and medical malpractice. Historically, researchers have collected data from American Indigenous communities without meaningful engagement, leading to the publication of negative findings that stigmatized and harmed these communities' social, economic, and cultural systems [8].

Establishing trust and communication is crucial to integrating wastewater monitoring within Indigenous communities. Data should go directly to the communities themselves, ensuring information is not shared without explicit consent. Effective collaboration also entails understanding community priorities in infrastructure and data management, recognizing that each community has different needs and capacities for wastewater surveillance.

Culturally sensitive communication involves engaging tribal leadership and community members in all decision-making processes. Maintaining trust requires understanding the community's history and current needs, respecting boundaries to ensure that data sharing and surveillance efforts are conducted in a manner aligned with community values and preferences. Furthermore, ongoing communication fosters transparency and ensures that wastewater monitoring initiatives contribute positively to community well-being while respecting Indigenous sovereignty and rights.

About Kraken Sense

Kraken Sense develops all-in-one pathogen detection solutions to accelerate time to results by replacing lab testing with a single field-deployable device. Our proprietary device, the KRAKEN, has the ability to detect bacteria and viruses down to 1 copy. It has already been applied for epidemiology detection in wastewater and microbial contamination testing in food processing, among many other applications. Our team of highly-skilled Microbiologists and Engineers tailor the system to fit individual project needs. To stay updated with our latest articles and product launches, follow us on LinkedIn, Twitter, and Instagram, or sign up for our email newsletter. Discover the potential of continuous, autonomous pathogen testing by speaking to our team.