{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T23:04:37Z","timestamp":1771023877833,"version":"3.50.1"},"reference-count":40,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"unspecified","delay-in-days":159,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>Temporal variability and methodological differences in data normalization, among other factors, complicate effective trend analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) wastewater surveillance data and its alignment with coronavirus disease 2019 (COVID-19) clinical outcomes. As there is no consensus approach for these analyses yet, this study explored the use of piecewise linear trend analysis (joinpoint regression) to identify significant trends and trend turning points in SARS-CoV-2 RNA wastewater concentrations (normalized and non-normalized) and corresponding COVID-19 case rates in the greater Las Vegas metropolitan area (Nevada, USA) from mid-2020 to April 2023. The analysis period was stratified into three distinct phases based on temporal changes in testing protocols, vaccination availability, SARS-CoV-2 variant prevalence, and public health interventions. While other statistical methodologies may require fewer parameter specifications, joinpoint regression provided an interpretable framework for characterization and comparison of trends and trend turning points, revealing sewershed-specific variations in trend magnitude and timing that also aligned with known variant-driven waves. Week-level trend agreement corroborated previous findings demonstrating a close relationship between SARS-CoV-2 wastewater surveillance data and COVID-19 outcomes. These findings guide future applications of advanced statistical methodologies and support the continued integration of wastewater-based epidemiology as a complementary approach to traditional COVID-19 surveillance systems.<\/jats:p>","DOI":"10.1017\/s0950268825100058","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T12:23:12Z","timestamp":1749471792000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["Application of joinpoint regression to SARS-CoV-2 wastewater-based epidemiology in Las Vegas, Nevada, USA"],"prefix":"10.1017","volume":"153","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9139-1873","authenticated-orcid":false,"given":"Casey A.","family":"Barber","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lung-Chang","family":"Chien","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Labus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Crank","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katerina","family":"Papp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Gerrity","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheryl","family":"Collins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edwin C.","family":"Oh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anil T.","family":"Mangla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cassius","family":"Lockett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2311-7506","authenticated-orcid":false,"given":"L.-W. Antony","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2025,6,9]]},"reference":[{"key":"S0950268825100058_r30","unstructured":"[30] Centers for Disease Control and Prevention Wastewater Surveillance Testing Methods (https:\/\/www.cdc.gov\/nwss\/testing.html). 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Accessed 23 June 2023."},{"key":"S0950268825100058_r1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2022.158964"},{"key":"S0950268825100058_r7","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pwat.0000088"},{"key":"S0950268825100058_r40","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2022.159165"},{"key":"S0950268825100058_r6","unstructured":"[6] Centers for Disease Control and Prevention COVID Data Tracker: Wastewater Surveillance (https:\/\/covid.cdc.gov\/covid-data-tracker\/#wastewater-surveillance). Accessed 14 February 2023."},{"key":"S0950268825100058_r27","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"S0950268825100058_r18","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z"},{"key":"S0950268825100058_r39","unstructured":"[39] U.S. Census Bureau Quick Facts: Clark County, Nevada (https:\/\/www.census.gov\/quickfacts\/fact\/table\/clarkcountynevada\/PST045222). Accessed 7 June 2023."},{"key":"S0950268825100058_r36","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2021.151534"},{"key":"S0950268825100058_r19","doi-asserted-by":"publisher","DOI":"10.1590\/0037-8682-0469-2020"},{"key":"S0950268825100058_r35","unstructured":"[35] Las Vegas Convention and Visitors Authority Visitor Statistics (https:\/\/www.lvcva.com\/research\/visitor-statistics\/). Accessed 8 May 2024."},{"key":"S0950268825100058_r14","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.0550"},{"key":"S0950268825100058_r2","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2022.158967"},{"key":"S0950268825100058_r25","doi-asserted-by":"publisher","DOI":"10.1177\/001316446002000104"},{"key":"S0950268825100058_r22","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa423"},{"key":"S0950268825100058_r23","doi-asserted-by":"publisher","DOI":"10.3390\/covid2120128"},{"key":"S0950268825100058_r3","doi-asserted-by":"publisher","DOI":"10.1016\/j.watres.2022.118070"},{"key":"S0950268825100058_r20","first-page":"236","article-title":"Incidence and investigation of Covid-19 trend in Babol, northern Iran: A Joinpoint regression analysis","volume":"13","author":"Khaleghi","year":"2022","journal-title":"Caspian Journal of Internal Medicine"},{"key":"S0950268825100058_r11","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7036a2"},{"key":"S0950268825100058_r34","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2020.143493"},{"key":"S0950268825100058_r15","doi-asserted-by":"publisher","DOI":"10.1016\/j.coesh.2022.100363"},{"key":"S0950268825100058_r26","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2012.031"},{"key":"S0950268825100058_r5","unstructured":"[5] WastewaterSCAN Dashboard (data.wastewaterscan.org). 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Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike licence (http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the same Creative Commons licence is used to distribute the re-used or adapted article and the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e68"}}