Wastewater Surveillance in Côte d’Ivoire: An Essential Tool for Public Health in a Resource-Limited Context

Abstract

Wastewater surveillance represents an innovative and cost-effective approach to strengthening epidemiological surveillance systems in Côte d’Ivoire. In the face of persistent infectious diseases (COVID-19, cholera, dengue, MPox) and the limitations of conventional surveillance systems, particularly for asymptomatic infections, this method offers a promising alternative for the early detection of pathogens. This article assesses the feasibility of deploying wastewater surveillance in the Ivorian context, providing a critical analysis of adapted sampling strategies and proposing a sustainable operational framework. Through a narrative synthesis of international scientific data and local institutional reports, the available evidence is analyzed, with a particular focus on recent Ivorian case studies. Passive sampling emerges as a viable alternative to costly active methods, with a proof of concept established locally. Major identified challenges include infrastructure deficits, lack of protocol standardization, and limitations in multisectoral coordination. An operational framework progressively integrating passive sampling, local capacity building, and adapted governance is proposed to establish wastewater surveillance as a sustainable tool for the Ivorian health system.