Global prevalence, genetic diversity, and environmental fate of gastroenteric viruses in wastewater treatment system: A systematic review and meta-analysis.

Enteropathogenic viruses are a major cause of childhood diarrheal illness and deaths, particularly posing a disproportionate burden on developing countries. This study systematically analysed multi-pathogen surveillance studies for gastroenteric viruses in raw and treated effluent to investigate their prevalence pattern, treatment reduction, relative viability, and viral diversity using meta-analysis and sensitivity analysis. Based on PCR findings, human norovirus with pooled prevalence of 87% (95% CI; 71-94) and aichivirus with 87% (95% CI; 59-97) predominated in raw wastewater worldwide, followed by enterovirus 86% (95% CI; 66-95), adenovirus 81% (95% CI; 63-91), sapovirus 71 (95% CI; 35-92), astrovirus 64% (95% CI; 32-87), rotavirus 62% (95% CI; 46-76), and hepatitis A virus (HAV) 37% (95% CI; 19-60). In treated effluent, human adenovirus with estimated pooled prevalence of 51% (95% CI; 11-90), was most prevalent, followed by norovirus 50% (95% CI; 18-81), enterovirus 34% (95% CI; 14-63), rotavirus 29% (95% CI; 16-46), HAV 21% (95% CI; 10-37), aichivirus 17% (95% CI; 1-81), and sapovirus 2% (95% CI; 0-9). Viable rotavirus was higher in effluent samples (29.4% vs 16.4%), followed by adenovirus (68.9% vs 11.1%), while enterovirus (60.5% vs 2.1%) had the least detected infectious viral particles post treatment. Human norovirus GII (56.5%; 2402/4179) predominated over the GI norovirus (42.5%, 1777/4179), with GII.4 and GI.2 being the most prevalent species within GII and GI, respectively. Rotavirus genotype G3 (24%) and G2 (22%) dominated the VP7 strains, while genotype P[8] (63%) and P[4] (30%) predominated other circulating VP4 strains. This study confirms high circulation of human norovirus, adenovirus, enterovirus, and aichivirus in wastewater treatment systems. Their persistence during treatment emphasizes the importance of considering these viruses as crucial biological targets in water quality monitoring, improving wastewater treatment strategies, and leveraging wastewater surveillance for public health protection.