Surveillance of SARS-CoV-2, rotavirus, norovirus genogroup II, and human adenovirus in wastewater as an epidemiological tool to anticipate outbreaks of COVID-19 and acute gastroenteritis in a city without a wastewater treatment plant in the Peruvian Highlands.

The coronavirus disease 2019 (COVID-19) pandemic has demonstrated that Wastewater Based Epidemiology is a fast and economical alternative for monitoring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the community level in high-income countries. In the present study, wastewater from a city in the Peruvian Highlands, which lacks a wastewater treatment plant, was monitored for one year to assess the relationship between the concentration of SARS-CoV-2 and the reported cases of COVID-19 in the community. Additionally, we compared the relationship between rotavirus (RV), norovirus genogroup II (NoV GGII), and human adenovirus (HAdV) with the number of reported cases of acute gastroenteritis. Before commencing the analysis of the samples, the viral recovery efficacy of three processing methods was determined in spiked wastewater with SARS-CoV-2. This evaluation demonstrated the highest recovery rate with direct analysis (72.2 %), as compared to ultrafiltration (50.8 %) and skimmed milk flocculation (5.6 %). Wastewater monitoring revealed that 72 % (36/50) of the samples tested positive for SARS-CoV-2, with direct analysis yielding the highest detection frequency and quantification of SARS-CoV-2. Furthermore, a strong correlation was observed between the concentration of SARS-CoV-2 in wastewater and the reported cases of COVID-19, mainly when we shift the concentration of SARS-CoV-2 by two weeks, which allows us to anticipate the onset of the fourth and fifth waves of the pandemic in Peru up to two weeks in advance. All samples processed using the skimmed milk flocculation method tested positive and showed high concentrations of RV, NoV GGII, and HAdV. In fact, the highest RV concentrations were detected up to four weeks before outbreaks of acute gastroenteritis reported in children under four years of age. In conclusion, the results of this study suggest that periodic wastewater monitoring is an excellent epidemiological tool for surveillance and can anticipate outbreaks of infectious diseases, such as COVID-19, in low- and middle-income countries.

Análisis de la situación de salud del Departamento de Junin año 2001 / Situation analysis of the health department of Junin 2001

El presente documento está estructurado en tres capítulos. En el capítulo 1 se trata la formación sociodemográfica del Departamento de Junín, indicando las características más importantes que son factores de riesgo para la presencia de daños y brotes; en el capítulo 2, se realiza el análisis de los condicionantes y determinantes de la situación de salud, se describe el análsisi del proceso salud - enfermedad, analizando la estructura de la morbilidad, la mortalidad y los grupos vulnerables; y en el capítulo 3, se presenta la respuesta social a los problemas de salud en función a la demanda de los servicios

Análisis de la situación de salud del Departamento de Junin año 2001 / Situation analysis of the health department of Junin 2001

El presente documento está estructurado en tres capítulos. En el capítulo 1 se trata la formación sociodemográfica del Departamento de Junín, indicando las características más importantes que son factores de riesgo para la presencia de daños y brotes; en el capítulo 2, se realiza el análisis de los condicionantes y determinantes de la situación de salud, se describe el análsisi del proceso salud - enfermedad, analizando la estructura de la morbilidad, la mortalidad y los grupos vulnerables; y en el capítulo 3, se presenta la respuesta social a los problemas de salud en función a la demanda de los servicios(AU)