SORMAS goes One Health: Water-based Outbreak Prediction in Peri-Urban Africa

Surface water can accumulate microbes that circulate at the human-domestic livestock-wildlife interface often before disease outbreaks are reported. Our study aims to generate baseline data and novel insights into the depth of microbial diversity and candidate pathogens for epidemics in peri-urban Africa. In addition, it conceptualises the incorporation of environmental signals into the Surveillance Outbreak Response Management and Analysis System (SORMAS). Ten water sources in the Kumasi area, Ghana, where sampled for seven weeks (1 sample (2L surface water)/site per week). Samples were filtered using a multistep procedure to enrich bacteria and viruses, which are subsequently analysed by cultural, metagenomic and metataxonomic approaches to investigate the microbial diversity and identify candidate pathogens. In addition, pheno- and genotypical analysis, including resistance profiling for enterobacterales is conducted. We present our protocols used to sample the different water sources in Kumasi and provide details about the laboratory downstream processing of water samples including first results on the microbial diversity and antibiotic resistance screening. In addition, we outline the development process of a concept for a digital environmental surveillance component for SORMAS. Our findings have the potential to support the development of strategies for the early detection and management of emerging diseases at the human-wildlife-livestock interface.