Rising Tide of Antibiotic Resistance in Sub-Saharan Africa: A Meta-Analysis of Vibrio cholerae Susceptibility(2014-2024)

Results: Following these preliminary tests with spiked samples, Nanotrap Microbiome "A" Particles and polyethylene-glycol (PEG) precipitation coupled with the MagMAX Wastewater Ultra Nucleic Acid Isolation Kit were taken forward for 6-month field trials performed at Kwame Nkrumah University of Science and Technology (Kumasi, Ghana) and Christian Medical College Vellore (India).In London, these methods showed consistent high recovery across pathogens in spiked wastewater with average recovery rates for nOPV2 and typhi of 3.08% and 45.87% (Ceres) and 3.29% and 100% (PEG).The Wastewater Kit performed well in extracting RNA/DNA across the organisms, recovering 72.27% (cholera surrogate), 100% (typhi), and 88.2% (nOPV2) of the spike compared to the optimal extraction kit for each organism.Discussion: Over the field trial, 40 samples will be collected per month in each country, using both grab and Moore swabs.Methods are being further refined in the field, with initial results indicating detection of strain markers for V. cholera, and S. Typhi.Further analysis will allow comparison of the sensitivity of grab and Moore swab for detecting both viruses and bacteria.Expected Outcome: This study aims to provide proof of principle data for cost effective surveillance of multiple pathogens in LMICs with the development of streamlined, integrated protocols.Ideally these protocols can then be adopted by public health bodies or other surveillance programs to provide added value to existing surveillance.Conclusion: Both Nanotrap Microbiome "A" Particles and PEG precipitation used in conjunction with the MagMAX Wastewater Kit showed promise for multi-pathogen detection in wastewater.Continued refinement of these methods throughout ongoing field trials holds the potential to offer significant utility in infectious disease surveillance.