Mycobacterium tuberculosis complex in wastewater: An emerging One Health concern at the human-animal-environment interface

Abstract

Members of the Mycobacterium tuberculosis complex (MTBC), which comprises both human and animal-adapted species, continue to be a major global health concern. There is growing evidence that MTBC can be found in wastewater systems outside of clinical settings, indicating ongoing shedding from infected people, animals, and sources connected to healthcare. The role of wastewater as a possible reservoir and indicator of TB dynamics at the community level is called into doubt by its environmental presence. A pertinent viewpoint for comprehending MTBC circulation across human, animal, and environmental interfaces is offered by the One Health framework. Wastewater is a useful matrix for evaluating disease transmission outside of conventional surveillance systems because it serves as a confluence point for biological elements from many origins. However, concerns regarding viability, persistence, and its link to real transmission risk hamper the interpretation of MTBC detection in wastewater. The current understanding of MTBC occurrence in wastewater, including sources of contamination, environmental survival, detection techniques, and epidemiological significance, is compiled in this review. Improved detection has been made possible by molecular techniques, especially PCR-based technologies, however there are still issues with identifying viable organisms and measuring infection load. MTBC in wastewater is a new environmental issue that could have an impact on ecosystem integrity and public health monitoring. A One Health approach that incorporates wastewater monitoring may improve early detection skills and offer further insights into the dynamics of tuberculosis in human, animal, and environmental systems.