Multi-Pathogen Wastewater Surveillance Enables Real-Time Public Health Interventions During a Major African Football Tournament
Application: Wastewater-Based Surveillance | Infectious Disease | Public Health Preparedness
Technology: Nanotrap® Microbiome Particles
Publication: Nsawotebba A, et al. Multi-Pathogen Wastewater Surveillance enables Real-Time Targeted Public Health Interventions During the 2025 African Nations Championship Football Tournament. medRxiv, June 2026.
Overview
A study conducted during the 2025 African Nations Championship (CHAN) football tournament in Uganda demonstrated how wastewater-based surveillance can provide actionable public health intelligence during large-scale gatherings.
Researchers from Uganda's Ministry of Health and collaborating public health organizations implemented a multi-pathogen surveillance program at Mandela National Stadium in Kampala. Using Ceres Nanosciences' Nanotrap® Microbiome Particles to concentrate pathogens from wastewater, the team monitored a broad panel of infectious disease targets, including enteric and respiratory pathogens and mpox virus.
The surveillance program successfully detected nine distinct pathogens and supported real-time public health interventions, demonstrating the feasibility of integrating wastewater monitoring into outbreak preparedness and response strategies in resource-limited settings.
Study Highlights
304 wastewater samples analyzed: Samples were collected from 38 stadium wastewater collection points across eight match days in August 2025.
85.2% pathogen positivity: 259 of 304 samples tested positive for at least one pathogen, demonstrating the diversity of infectious disease signals captured through wastewater surveillance.
Nine pathogens detected: The study identified enteric, respiratory, and emerging infectious disease targets, including Shigella spp., Rotavirus A, Enterovirus, mpox virus, SARS-CoV-2, and Influenza B.
Mpox detection: Mpox viral DNA was detected in 28.6% of samples, demonstrating the ability of wastewater monitoring to identify an emerging public health threat during a mass gathering.
Frequent multi-pathogen detection: 69.1% of positive samples contained signals from two or more pathogens, highlighting the value of broad surveillance panels.
Real-time public health response: Surveillance findings informed enhanced sanitation, hygiene promotion, targeted risk communication, clinical surveillance, and environmental health assessments during the tournament.
Nanotrap Technology in Action
Nanotrap® Microbiome Particles served as the pathogen concentration technology within the surveillance workflow.
Wastewater was collected using Moore swabs deployed at 38 manholes throughout the stadium. Following sample recovery, 35 mL aliquots were processed using Nanotrap Enhancement Reagent 2 and Nanotrap Microbiome Particles.
After a brief incubation, magnetic separation was used to concentrate captured material into a smaller volume for downstream nucleic acid extraction and qPCR analysis.
This workflow enabled the research team to process wastewater samples for detection of multiple pathogen targets using established molecular diagnostic methods.
The study illustrates the practical integration of Nanotrap technology into a field-deployed, multi-pathogen wastewater surveillance program, supporting laboratory testing during a major public health event.
Key Findings
The most frequently detected pathogens were:
Pathogen | Positive Samples |
Shigella spp. | 53.6% |
Rotavirus A | 35.9% |
Enterovirus | 32.2% |
Mpox virus | 28.6% |
Rotavirus C | 21.4% |
Enteric Adenovirus | 18.4% |
SARS-CoV-2 | 11.8% |
Influenza B | 8.2% |
Salmonella spp. | 4.9% |
Enteric pathogens accounted for many of the detections, while the identification of mpox and respiratory viruses demonstrated the breadth of pathogens that could be monitored through the same surveillance framework.
Importantly, the findings were translated into public health actions during the event, including increased sanitation measures, targeted hygiene messaging, enhanced symptom screening, and environmental health inspections.
Significance
This study provides a real-world example of wastewater-based surveillance supporting public health decision-making during a major international sporting event in a resource-limited setting.
By combining Nanotrap-based pathogen concentration with molecular detection methods, researchers successfully implemented a multi-pathogen monitoring program that generated actionable surveillance data.
The findings highlight the potential for wastewater surveillance to complement traditional clinical surveillance, strengthen preparedness for emerging infectious disease threats, and support targeted public health interventions.
The study also demonstrates how Nanotrap technology can be incorporated into surveillance workflows deployed in low- and middle-income countries, supporting efforts to expand access to environmental pathogen monitoring.
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