TWESP: Typhoid Wastewater Environmental Surveillance Project

Project status: Active

Research areas > Infection, Immunity and Global Health > Enteric Diseases

Wastewater surveillance for Salmonella Typhi and Salmonella Paratyphi A in Indonesia

Typhoid fever remains an important cause of illness for children and adolescents in many parts of Asia, including Indonesia.

However, understanding how widely the disease is circulating can be difficult because clinical surveillance is limited and laboratory confirmation is rarely performed.

Our project is using wastewater surveillance to generate evidence on typhoid circulation to inform vaccine policy in Indonesia.

Typhoid fever remains an important cause of illness for children and adolescents in many parts of Asia, including Indonesia.

However, understanding how widely the disease is circulating can be difficult because clinical surveillance is limited and...

Typhoid fever remains an important cause of illness for children and adolescents in many parts of Asia, including Indonesia.

However, understanding how widely the disease is circulating can be difficult because clinical surveillance is limited and laboratory confirmation is rarely performed.

Our project is using wastewater surveillance to generate evidence on typhoid circulation to inform vaccine policy in Indonesia.

About our project

The Typhoid Wastewater Environmental Surveillance Project (TWESP) uses wastewater epidemiological surveillance to detect Salmonella Typhi in community wastewater samples. Wastewater surveillance involves testing sewage and other environmental samples to identify disease-causing organisms circulating within a population.

Key publication

Oktaria V, Murni IK, Handley A, Donato CM, Nuryastuti T, Supriyati E, McCarthy DT, Watts E, Dinari R, Sari HM, Thobari JA, Laksono IS, Bines JE. Environmental surveillance for Salmonella Typhi to detect the typhoid burden in Yogyakarta, Indonesia. Int J Hyg Environ Health. 2025 May;266:114572. doi: 10.1016/j.ijheh.2025.114572. Epub 2025 Mar 30. PMID: 40163994; PMCID: PMC12042821.

Collaborations

This is a collaborative research project led by the Murdoch Children’s Research Institute (MCRI) in partnership with Universitas Gadjah Mada (UGM) in Indonesia.

Research teams from UGM and MCRI have shown that wastewater surveillance is feasible in Indonesia. The project successfully implemented sampling across various locations, including:

Wastewater treatment plants
Communal sanitation systems
Rivers
Septic tanks

Testing in Yogyakarta has detected Salmonella Typhi in environmental samples, with genomic sequencing confirming the presence of the bacteria.

Our focus for 2026–2027

TWESP continues to monitor wastewater for Salmonella Typhi and will expand its testing to include Salmonella Paratyphi A throughout 2026 and 2027.

The findings from this project will provide important evidence to inform national discussions on introducing a typhoid conjugate vaccine in Indonesia.