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Ofori SK, Schwind JS, Sullivan KL, Chowell G, Cowling BJ, Fung ICH. Modeling the health impact of increasing vaccine coverage and nonpharmaceutical interventions against coronavirus disease 2019 in Ghana. Pathog Glob Health 2024:1-15. [PMID: 38318877 DOI: 10.1080/20477724.2024.2313787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
Seroprevalence studies assessing community exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Ghana concluded that population-level immunity remained low as of February 2021. Thus, it is important to demonstrate how increasing vaccine coverage reduces the economic and public health impacts associated with SARS-CoV-2 transmission. To that end, this study used a Susceptible-Exposed-Presymptomatic-Symptomatic-Asymptomatic-Recovered-Dead-Vaccinated compartmental model to simulate coronavirus disease 2019 (COVID-19) transmission and the role of public health interventions in Ghana. The impact of increasing vaccination rates and decline in transmission rates due to nonpharmaceutical interventions (NPIs) on cumulative infections and deaths averted was explored under different scenarios. Latin hypercube sampling-partial rank correlation coefficient (LHS-PRCC) was used to investigate the uncertainty and sensitivity of the outcomes to the parameters. Simulation results suggest that increasing the vaccination rate to achieve 50% coverage was associated with almost 60,000 deaths and 25 million infections averted. In comparison, a 50% decrease in the transmission coefficient was associated with the prevention of about 150,000 deaths and 50 million infections. The LHS-PRCC results indicated that in the context of vaccination rate, cumulative infections and deaths averted were most sensitive to vaccination rate, waning immunity rates from vaccination, and waning immunity from natural infection. This study's findings illustrate the impact of increasing vaccination coverage and/or reducing the transmission rate by NPI adherence in the prevention of COVID-19 infections and deaths in Ghana.
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Affiliation(s)
- Sylvia K Ofori
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia
| | - Jessica S Schwind
- Institute for Health Logistics & Analytics, Georgia Southern University, Statesboro, Georgia
| | - Kelly L Sullivan
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia
| | - Gerardo Chowell
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Isaac Chun-Hai Fung
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia
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2
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Bloch EM, Kyeyune D, White JL, Ddungu H, Ashokkumar S, Habtehyimer F, Baker O, Kasirye R, Patel EU, Grabowski MK, Musisi E, Moses K, Hume HA, Lubega I, Shrestha R, Motevalli M, Fernandez RE, Reynolds SJ, Redd AD, Wambongo Musana H, Dhabangi A, Ouma J, Eroju P, de Lange T, Fowler MG, Musoke P, Stramer SL, Whitby D, Zimmerman PA, McCullough J, Sachithanandham J, Pekosz A, Goodrich R, Quinn TC, Ness PM, Laeyendecker O, Tobian AAR. SARS-CoV-2 seroprevalence among blood donors in Uganda: 2019-2022. Transfusion 2023; 63:1354-1365. [PMID: 37255467 PMCID: PMC10525030 DOI: 10.1111/trf.17449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/16/2023] [Accepted: 05/16/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND The true burden of COVID-19 in low- and middle-income countries remains poorly characterized, especially in Africa. Even prior to the availability of SARS-CoV-2 vaccines, countries in Africa had lower numbers of reported COVID-19 related hospitalizations and deaths than other regions globally. METHODS Ugandan blood donors were evaluated between October 2019 and April 2022 for IgG antibodies to SARS-CoV-2 nucleocapsid (N), spike (S), and five variants of the S protein using multiplexed electrochemiluminescence immunoassays (MesoScale Diagnostics, Rockville, MD). Seropositivity for N and S was assigned using manufacturer-provided cutoffs and trends in seroprevalence were estimated by quarter. Statistically significant associations between N and S antibody seropositivity and donor characteristics in November-December 2021 were assessed by chi-square tests. RESULTS A total of 5393 blood unit samples from donors were evaluated. N and S seropositivity increased throughout the pandemic to 82.6% in January-April 2022. Among seropositive individuals, N and S antibody levels increased ≥9-fold over the study period. In November-December 2021, seropositivity to N and S antibody was higher among repeat donors (61.3%) compared with new donors (55.1%; p = .043) and among donors from Kampala (capital city of Uganda) compared with rural regions (p = .007). Seropositivity to S antibody was significantly lower among HIV-seropositive individuals (58.8% vs. 84.9%; p = .009). CONCLUSIONS Despite previously reported low numbers of COVID-19 cases and related deaths in Uganda, high SARS-CoV-2 seroprevalence and increasing antibody levels among blood donors indicated that the country experienced high levels of infection over the course of the pandemic.
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Affiliation(s)
- Evan M Bloch
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Jodie L White
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Swetha Ashokkumar
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Feben Habtehyimer
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Owen Baker
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Eshan U Patel
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - M Kate Grabowski
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ezra Musisi
- Uganda Blood Transfusion Services, Kampala, Uganda
| | - Khan Moses
- Uganda Blood Transfusion Services, Kampala, Uganda
| | - Heather A Hume
- Department of Pediatrics, University of Montreal, Montréal, Quebec, Canada
| | | | - Ruchee Shrestha
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mahnaz Motevalli
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Reinaldo E Fernandez
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Steven J Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Andrew D Redd
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Aggrey Dhabangi
- Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Joseph Ouma
- MUJHU Research Collaboration, Kampala, Uganda
| | | | - Telsa de Lange
- National Institute of Allergy and Infectious Diseases Office of Cyber Infrastructure and Computational Biology, Bethesda, Maryland, USA
| | - Mary Glenn Fowler
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Susan L Stramer
- Scientific Affairs, American Red Cross, Gaithersburg, Maryland, USA
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Peter A Zimmerman
- The Center for Global Health & Diseases, Pathology Department, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jeffrey McCullough
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
| | - Jaiprasath Sachithanandham
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Andrew Pekosz
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Raymond Goodrich
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - Thomas C Quinn
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Paul M Ness
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Aaron A R Tobian
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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3
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Ojji DB, Sancilio A, Shedul GL, Orji IA, Chopra A, Abu J, Akor B, Ripiye N, Akinlade F, Okoye D, Okpetu E, Eze H, Odoh E, Baldridge AS, Tripathi P, Abubakar H, Jamda AM, Hirschhorn LR, McDade T, Huffman MD. Nigeria healthcare worker SARS-CoV-2 serology study: Results from a prospective, longitudinal cohort. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000549. [PMID: 36962953 PMCID: PMC10022168 DOI: 10.1371/journal.pgph.0000549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 12/09/2022] [Indexed: 01/19/2023]
Abstract
Healthcare workers, both globally and in Nigeria, have an increased risk for SARS-CoV-2 infection compared with the general population due to higher risk contacts, including occupational exposures. In addition, primary healthcare workers represent an important group for estimating prior infection to SARS-CoV-2 because they work at the first point-of-contact for most patients yet have not been included in prior COVID-19 seroepidemiology research in Nigeria. We sought to evaluate baseline seroprevalence, rates of seroconversion (IgG- to IgG+) and seroreversion (IgG+ to IgG-), change in IgG concentration at 3- and 6-month follow-up, and factors associated with seropositivity. From June 2020 to December 2020, we conducted a longitudinal seroepidemiology study among frontline health care workers in Nigeria using a validated dried blood spot assay. Among 525 participants, mean (SD) age was 39.1 (9.7) years, 61.0% were female, and 45.1% were community health workers. The six-month follow-up rate was 93.5%. Seropositivity rates increased from 31% (95% CI: 27%, 35%) at baseline to 45% (95% CI: 40%, 49%) at 3-month follow-up, and 70% (95% CI: 66%, 74%) at 6-month follow-up. There was a corresponding increase in IgG levels from baseline (median = 0.18 ug/mL) to 3-month (median = 0.35 ug/mL) and 6-month follow-up (median = 0.59 ug/mL, Ptrend < .0001). A minority of participants reported symptoms from February 2020 until baseline (12.2%) or during 3-month (6.6%) or 6-month (7.5%) follow-up. only 1 participant was hospitalized. This study demonstrated high baseline, 3-month and 6-month follow-up prevalence of IgG antibodies to SARS-CoV-2 during the first two waves of the COVID-19 pandemic in Nigeria among a cohort of unvaccinated frontline healthcare workers, including primary healthcare workers despite low symptomatology. These results may have implications in state- and national-level disease pandemic modeling. Trial registration: NCT04158154.
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Affiliation(s)
- Dike B. Ojji
- Department of Internal Medicine, Faculty of Clinical Sciences, Federal Capital Territory, University of Abuja, Abuja, Nigeria
- Cardiovascular Research Unit, University of Abuja and University of Abuja Teaching Hospital, Federal Capital Territory, Abuja, Nigeria
| | - Amelia Sancilio
- Northwestern University Department of Anthropology and Institute for Policy Research, Evanston, Illinois, United States of America
| | - Gabriel L. Shedul
- Department of Internal Medicine, Faculty of Clinical Sciences, Federal Capital Territory, University of Abuja, Abuja, Nigeria
| | - Ikechukwu A. Orji
- Department of Internal Medicine, Faculty of Clinical Sciences, Federal Capital Territory, University of Abuja, Abuja, Nigeria
| | - Aashima Chopra
- Northwestern University Department of Preventive Medicine, Chicago, Illinois, United States of America
| | - Joel Abu
- Department of Internal Medicine, Faculty of Clinical Sciences, Federal Capital Territory, University of Abuja, Abuja, Nigeria
| | - Blessing Akor
- Department of Internal Medicine, Faculty of Clinical Sciences, Federal Capital Territory, University of Abuja, Abuja, Nigeria
| | - Nana Ripiye
- Department of Internal Medicine, Faculty of Clinical Sciences, Federal Capital Territory, University of Abuja, Abuja, Nigeria
| | - Funmi Akinlade
- Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Douglas Okoye
- Department of Internal Medicine, Faculty of Clinical Sciences, Federal Capital Territory, University of Abuja, Abuja, Nigeria
| | - Emmanuel Okpetu
- Department of Internal Medicine, Faculty of Clinical Sciences, Federal Capital Territory, University of Abuja, Abuja, Nigeria
| | - Helen Eze
- Department of Internal Medicine, Faculty of Clinical Sciences, Federal Capital Territory, University of Abuja, Abuja, Nigeria
| | - Emmanuel Odoh
- Abaji Department of Primary Care, Abaji, Federal Capital Territory, Abuja, Nigeria
| | - Abigail S. Baldridge
- Northwestern University Department of Preventive Medicine, Chicago, Illinois, United States of America
- Bluhm Cardiovascular Institute Clinical Trials Unit, Northwestern Medicine, Chicago, Illinois, United States of America
| | - Priya Tripathi
- Northwestern University Department of Preventive Medicine, Chicago, Illinois, United States of America
| | - Haruna Abubakar
- Cardiovascular Research Unit, University of Abuja and University of Abuja Teaching Hospital, Federal Capital Territory, Abuja, Nigeria
| | - Abubakar M. Jamda
- Department of Community Medicine, Faculty of Clinical Sciences, Federal Capital Territory, University of Abuja, Abuja, Nigeria
| | - Lisa R. Hirschhorn
- Northwestern University Department of Medical Social Sciences, Chicago, Illinois, United States of America
| | - Thomas McDade
- Northwestern University Department of Anthropology and Institute for Policy Research, Evanston, Illinois, United States of America
| | - Mark D. Huffman
- Northwestern University Department of Preventive Medicine, Chicago, Illinois, United States of America
- Northwestern University Department of Medicine, Chicago, Illinois, United States of America
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
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4
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Lapidus S, Liu F, Casanovas-Massana A, Dai Y, Huck JD, Lucas C, Klein J, Filler RB, Strine MS, Sy M, Deme AB, Badiane AS, Dieye B, Ndiaye IM, Diedhiou Y, Mbaye AM, Diagne CT, Vigan-Womas I, Mbengue A, Sadio BD, Diagne MM, Moore AJ, Mangou K, Diallo F, Sene SD, Pouye MN, Faye R, Diouf B, Nery N, Costa F, Reis MG, Muenker MC, Hodson DZ, Mbarga Y, Katz BZ, Andrews JR, Campbell M, Srivathsan A, Kamath K, Baum-Jones E, Faye O, Sall AA, Vélez JCQ, Cappello M, Wilson M, Ben-Mamoun C, Tedder R, McClure M, Cherepanov P, Somé FA, Dabiré RK, Moukoko CEE, Ouédraogo JB, Boum Y, Shon J, Ndiaye D, Wisnewski A, Parikh S, Iwasaki A, Wilen CB, Ko AI, Ring AM, Bei AK. Plasmodium infection is associated with cross-reactive antibodies to carbohydrate epitopes on the SARS-CoV-2 Spike protein. Sci Rep 2022; 12:22175. [PMID: 36550362 PMCID: PMC9778468 DOI: 10.1038/s41598-022-26709-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Sero-surveillance can monitor and project disease burden and risk. However, SARS-CoV-2 antibody test results can produce false positive results, limiting their efficacy as a sero-surveillance tool. False positive SARS-CoV-2 antibody results are associated with malaria exposure, and understanding this association is essential to interpret sero-surveillance results from malaria-endemic countries. Here, pre-pandemic samples from eight malaria endemic and non-endemic countries and four continents were tested by ELISA to measure SARS-CoV-2 Spike S1 subunit reactivity. Individuals with acute malaria infection generated substantial SARS-CoV-2 reactivity. Cross-reactivity was not associated with reactivity to other human coronaviruses or other SARS-CoV-2 proteins, as measured by peptide and protein arrays. ELISAs with deglycosylated and desialated Spike S1 subunits revealed that cross-reactive antibodies target sialic acid on N-linked glycans of the Spike protein. The functional activity of cross-reactive antibodies measured by neutralization assays showed that cross-reactive antibodies did not neutralize SARS-CoV-2 in vitro. Since routine use of glycosylated or sialated assays could result in false positive SARS-CoV-2 antibody results in malaria endemic regions, which could overestimate exposure and population-level immunity, we explored methods to increase specificity by reducing cross-reactivity. Overestimating population-level exposure to SARS-CoV-2 could lead to underestimates of risk of continued COVID-19 transmission in sub-Saharan Africa.
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Affiliation(s)
- Sarah Lapidus
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Feimei Liu
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Arnau Casanovas-Massana
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Yile Dai
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - John D Huck
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Carolina Lucas
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Jon Klein
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Renata B Filler
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Madison S Strine
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Mouhamad Sy
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Awa B Deme
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Aida S Badiane
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Baba Dieye
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Ibrahima Mbaye Ndiaye
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Younous Diedhiou
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Amadou Moctar Mbaye
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Cheikh Tidiane Diagne
- DiaTROPIX Rapid Diagnostic Tests Facility, Institut Pasteur de Dakar, Dakar, Senegal
| | - Inés Vigan-Womas
- Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Alassane Mbengue
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Bacary D Sadio
- Pôle Virologie, Institut Pasteur de Dakar, Dakar, Senegal
| | | | - Adam J Moore
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Khadidiatou Mangou
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Fatoumata Diallo
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Seynabou D Sene
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Mariama N Pouye
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Rokhaya Faye
- Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Babacar Diouf
- Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Nivison Nery
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brazil
- Department of Internal Medicine, Yale Occupational and Environmental Medicine Program, Yale School of Medicine, New Haven, CT, USA
| | - Federico Costa
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil
| | - Mitermayer G Reis
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil
- Faculty of Medicine, Federal University of Bahia, Salvador, Brazil
| | - M Catherine Muenker
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Daniel Z Hodson
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | | | - Ben Z Katz
- Division of Infectious Diseases, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, USA
| | - Jason R Andrews
- Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Melissa Campbell
- Yale Center for Clinical Investigation, Yale School of Medicine, New Haven, CT, USA
| | - Ariktha Srivathsan
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | | | | | - Ousmane Faye
- Pôle Virologie, Institut Pasteur de Dakar, Dakar, Senegal
| | | | - Juan Carlos Quintero Vélez
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Grupo de Investigación Ciencias Veterinarias Centauro, University of Antioquia, Medellín, Colombia
- Grupo de Investigación Microbiología Básica y Aplicada, University of Antioquia, Medellín, Colombia
| | - Michael Cappello
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | - Michael Wilson
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Choukri Ben-Mamoun
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Richard Tedder
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
- South London Specialist Virology Centre, Kings College Hospital NHS Foundation Trust, London, UK
| | - Myra McClure
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Peter Cherepanov
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, NW1 1AT, UK
- Crick COVID19 Consortium, Francis Crick Institute, London, NW1 1AT, UK
| | - Fabrice A Somé
- Institut de Recherche en Sciences de La Santé (IRSS)/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Roch K Dabiré
- Institut de Recherche en Sciences de La Santé (IRSS)/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Carole Else Eboumbou Moukoko
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, 2701, BP, Cameroon
- Malaria Research Unit, Center Pasteur Cameroon, Yaoundé, Cameroon
| | - Jean Bosco Ouédraogo
- Institut de Recherche en Sciences de La Santé (IRSS)/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Yap Boum
- Médecins Sans Frontières, University of Yaoundé and Epicentre, Yaoundé, Cameroon
| | | | - Daouda Ndiaye
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Adam Wisnewski
- Department of Internal Medicine, Yale Occupational and Environmental Medicine Program, Yale School of Medicine, New Haven, CT, USA
| | - Sunil Parikh
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Akiko Iwasaki
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
- Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - Craig B Wilen
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Albert I Ko
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil
| | - Aaron M Ring
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Amy K Bei
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA.
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal.
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal.
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5
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Baroncelli S, Galluzzo CM, Orlando S, Mphwere R, Kavalo T, Luhanga R, Amici R, Floridia M, Andreotti M, Scarcella P, Marazzi MC, Giuliano M. Dynamics of SARS-CoV-2 exposure in Malawian infants between February 2020 and May 2021. JOURNAL OF CLINICAL VIROLOGY PLUS 2022; 2:100110. [PMID: 36128323 PMCID: PMC9477783 DOI: 10.1016/j.jcvp.2022.100110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 11/21/2022] Open
Abstract
Background Very limited information is available on SARS-CoV-2 seroprevalence in infants in sub-Saharan countries. Objective In this study, we aimed to determine the rate and the temporal evolution of SARS CoV-2 seropositivity in breastfed Malawian infants. Study design Blood samples (n = 250) from 158 infants, born to HIV-negative women and women living with HIV, collected from February 2020 to May 2021, were first tested using an Anti-IgG/A/M SARS CoV 2 ELISA assay against trimeric spike protein, and then, if positive, confirmed using a second ELISA assay detecting IgG against Receptor Binding Domain. Results The confirmed prevalence of anti-SARS CoV-2 antibodies was 31.0% (95% CI: 23.7%-38.3%) with no significant difference between HIV-exposed and HIV-unexposed infants (29.3% and 37.1% respectively, P = 0.410). The presence of anti-SARS-CoV-2 IgG was not associated with maternal socioeconomic or demographic indices. Conclusions Our data underline the wide spread of the SARS-CoV-2 infection in the pediatric population in sub-Saharan Africa. Design of more specific serological tests for African samples and improvements in serosurveillance programs are needed for more rigorous monitoring of the dynamics of SARS-CoV-2 infection in Africa.
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Affiliation(s)
- Silvia Baroncelli
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Clementina Maria Galluzzo
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Stefano Orlando
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Robert Mphwere
- DREAM Program, Community of S. Egidio, P.O. Box 30355, Blantyre, Malawi
| | - Thom Kavalo
- DREAM Program, Community of S. Egidio, P.O. Box 30355, Blantyre, Malawi
| | - Richard Luhanga
- DREAM Program, Community of S. Egidio, P.O. Box 30355, Blantyre, Malawi
| | - Roberta Amici
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Marco Floridia
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Mauro Andreotti
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Paola Scarcella
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | | | - Marina Giuliano
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
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Price R, Cho J, Nelson S. SARS-CoV-2 Seroprevalence at an Urban Hospital in Haiti. Cureus 2022; 14:e27690. [PMID: 36072217 PMCID: PMC9440879 DOI: 10.7759/cureus.27690] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2022] [Indexed: 11/24/2022] Open
Abstract
Background: Much to the surprise of the global community, Haiti has had far fewer COVID-19 cases and deaths than initially expected. In this study, we sought to estimate the seroprevalence of COVID-19 in a convenience cohort based in Port-au-Prince, Haiti, to elucidate potential reasons for the apparently low burden of COVID-19 in Haiti. Methods: We performed a cross-sectional analysis of SARS-CoV-2 antibody prevalence in patients aged one to 89 years old who were seen at the Haiti Adventist Hospital (HAH) laboratory between December 17, 2020, and July 3, 2021, with an order requiring a blood draw. We excluded patients outside of the age range and those who did not verbally consent to the study. We tested residual patient serum samples using the Biosys PlusTM COVID-19 IgM/IgG Rapid Test. Findings: Of 9,740 patients seen by the HAH laboratory from December 2020 to July 2021, 538 consented to have antibody testing and answer survey questions. 529 were included in the final analysis. We excluded nine participants who were aged greater than 89 (n=3), aged less than one (n=2), or had results that were not properly recorded (n=4). Three of the tested patients were repeat testers, with one who had been tested three times. These repeat results were included for a final seroprevalence analysis of 533 samples. In the final participant pool, 142 (26.6%) of 533 samples tested positive for either IgM, IgG, or both antibodies to the SARS-CoV-2 virus. Adjustment for test sensitivity resulted in an estimated seroprevalence of 28.7% (95% CI 24.9-32.9). We observed significant differences in seroprevalences among age groups, with seroprevalence increasing with age. Interpretation: The SARS-CoV-2 antibody seroprevalence in Haiti appears to be greater than the publicly reported statistics by several orders of magnitude. Furthermore, a reduced fatality rate relative to high-income countries points to uncertain factors that may confer immunologic resistance in the Haitian population.
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Ratovoson R, Raberahona M, Razafimahatratra R, Randriamanantsoa L, Andriamasy EH, Herindrainy P, Razanajatovo N, Andriamandimby SF, Rakotonaivo A, Randrianarisaona F, Dussart P, Heraud JM, de Randria MJDD, Schoenhals M, Randremanana RV. SARS-CoV-2 infection rate in Antananarivo frontline health care workers, Madagascar. Influenza Other Respir Viruses 2022; 16:994-1003. [PMID: 35754109 PMCID: PMC9350202 DOI: 10.1111/irv.13022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Health care workers (HCWs) represent a vulnerable population during epidemic periods. Our cohort study aimed to estimate the risk of infection and associated factors among HCWs during the first wave of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Madagascar. METHODS A prospective cohort study was carried out in three hospitals that oversaw the first cases of COVID-19. Monthly ELISA-based serological tests were conducted, and nasopharyngeal swabs were collected in the case of symptoms linked to COVID-19 for RT-PCR analysis. Survival analyses were used to determine factors associated with SARS-CoV-2 infection. RESULTS The study lasted 7 months from May 2020. We included 122 HCWs, 61.5% of whom were women. The median age was 31.9 years (IQR: 26.4-42.3). In total, 42 (34.4%) had SARS-CoV-2 infections, of which 20 were asymptomatic (47.6%). The incidence of SARS-CoV-2 infection was 9.3% (95% CI [6.5-13.2]) person-months. Sixty-five HCWs presented symptoms, of which 19 were positive by RT-PCR. When adjusted for exposure to deceased cases, infection was more frequent in HCWs younger than 30 years of age (RR = 4.9, 95% CI [1.4-17.2]). CONCLUSION Our results indicate a high incidence of infection with SARS-CoV-2 among HCWs, with a high proportion of asymptomatic cases. Young HCWs are more likely to be at risk than others. Greater awareness among young people is necessary to reduce the threat of infection among HCWs.
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Affiliation(s)
- Rila Ratovoson
- Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Mihaja Raberahona
- Centre Hospitalier Universitaire Joseph Raseta Befelatanana, Antananarivo, Madagascar
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8
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Hajissa K, Islam MA, Hassan SA, Zaidah AR, Ismail N, Mohamed Z. Seroprevalence of SARS-CoV-2 Antibodies in Africa: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127257. [PMID: 35742506 PMCID: PMC9223681 DOI: 10.3390/ijerph19127257] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 02/06/2023]
Abstract
A reliable estimate of SARS-CoV-2-specific antibodies is increasingly important to track the spread of infection and define the true burden of the ongoing COVID-19 pandemic. A systematic review and a meta-analysis were conducted with the objective of estimating the seroprevalence of SARS-CoV-2 infection in Africa. A systematic search of the PubMed, Scopus, Web of Science and Google Scholar electronic databases was conducted. Thirty-five eligible studies were included. Using meta-analysis of proportions, the overall seroprevalence of anti-SARS-CoV-2 antibodies was calculated as 16% (95% CI 13.1-18.9%). Based on antibody isotypes, 14.6% (95% CI 12.2-17.1%) and 11.5% (95% CI 8.7-14.2%) were seropositive for SARS-CoV-2 IgG and IgM, respectively, while 6.6% (95% CI 4.9-8.3%) were tested positive for both IgM and IgG. Healthcare workers (16.3%) had higher seroprevalence than the general population (11.7%), blood donors (7.5%) and pregnant women (5.7%). The finding of this systematic review and meta-analysis (SRMA) may not accurately reflect the true seroprevalence status of SARS-CoV-2 infection in Africa, hence, further seroprevalence studies across Africa are required to assess and monitor the growing COVID-19 burden.
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Affiliation(s)
- Khalid Hajissa
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Department of Zoology, Faculty of Science and Technology, Omdurman Islamic University, P.O. Box 382, Omdurman 14415, Sudan
| | - Md Asiful Islam
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK
- Correspondence: or (M.A.I.); (Z.M.)
| | - Siti Asma Hassan
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Abdul Rahman Zaidah
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Nabilah Ismail
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Zeehaida Mohamed
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Correspondence: or (M.A.I.); (Z.M.)
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9
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Gelanew T, Seyoum B, Mulu A, Mihret A, Abebe M, Wassie L, Gelaw B, Sorsa A, Merid Y, Muchie Y, Teklemariam Z, Tesfaye B, Osman M, Jebessa G, Atinafu A, Hailu T, Habte A, Kenea D, Gadisa A, Admasu D, Tesfaye E, Bates TA, Bulcha JT, Tschopp R, Tsehay D, Mullholand K, Howe R, Genetu A, Tafesse FG, Abdissa A. High seroprevalence of anti-SARS-CoV-2 antibodies among Ethiopian healthcare workers. BMC Infect Dis 2022; 22:261. [PMID: 35296265 PMCID: PMC8926102 DOI: 10.1186/s12879-022-07247-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 03/07/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND COVID-19 pandemic has a devastating impact on the economies and health care system of sub-Saharan Africa. Healthcare workers (HWs), the main actors of the health system, are at higher risk because of their occupation. Serology-based estimates of SARS-CoV-2 infection among HWs represent a measure of HWs' exposure to the virus and could be used as a guide to the prevalence of SARS-CoV-2 in the community and valuable in combating COVID-19. This information is currently lacking in Ethiopia and other African countries. This study aimed to develop an in-house antibody testing assay, assess the prevalence of SARS-CoV-2 antibodies among Ethiopian high-risk frontline HWs. METHODS We developed and validated an in-house Enzyme-Linked Immunosorbent Assay (ELISA) for specific detection of anti-SARS-CoV-2 receptor binding domain immunoglobin G (IgG) antibodies. We then used this assay to assess the seroprevalence among HWs in five public hospitals located in different geographic regions of Ethiopia. From consenting HWs, blood samples were collected between December 2020 and February 2021, the period between the two peaks of COVID-19 in Ethiopia. Socio-demographic and clinical data were collected using questionnaire-based interviews. Descriptive statistics and bivariate and multivariate logistic regression were used to determine the overall and post-stratified seroprevalence and the association between seropositivity and potential risk factors. RESULTS Our successfully developed in-house assay sensitivity was 100% in serum samples collected 2- weeks after the first onset of symptoms whereas its specificity in pre-COVID-19 pandemic sera was 97.7%. Using this assay, we analyzed a total of 1997 sera collected from HWs. Of 1997 HWs who provided a blood sample, and demographic and clinical data, 51.7% were females, 74.0% had no symptoms compatible with COVID-19, and 29.0% had a history of contact with suspected or confirmed patients with SARS-CoV-2 infection. The overall seroprevalence was 39.6%. The lowest (24.5%) and the highest (48.0%) seroprevalence rates were found in Hiwot Fana Specialized Hospital in Harar and ALERT Hospital in Addis Ababa, respectively. Of the 821 seropositive HWs, 224(27.3%) of them had a history of symptoms consistent with COVID-19 while 436 (> 53%) of them had no contact with COVID-19 cases as well as no history of COVID-19 like symptoms. A history of close contact with suspected/confirmed COVID-19 cases is associated with seropositivity (Adjusted Odds Ratio (AOR) = 1.4, 95% CI 1.1-1.8; p = 0.015). CONCLUSION High SARS-CoV-2 seroprevalence levels were observed in the five Ethiopian hospitals. These findings highlight the significant burden of asymptomatic infection in Ethiopia and may reflect the scale of transmission in the general population.
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Affiliation(s)
| | - Berhanu Seyoum
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | | | - Adane Mihret
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Markos Abebe
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Liya Wassie
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Baye Gelaw
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebe Sorsa
- Arsi University, Asella College of Health Sciences, Asella, Ethiopia
| | - Yared Merid
- College of Medicine and Health Sciences, Department of Medical Microbiology, Hawassa University, Hawassa, Ethiopia
| | - Yilkal Muchie
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Zelalem Teklemariam
- Department of Medical Laboratory Sciences College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | | | - Mahlet Osman
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Gutema Jebessa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Abay Atinafu
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Tsegaye Hailu
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Antenehe Habte
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Dagaga Kenea
- Arsi University, Asella College of Health Sciences, Asella, Ethiopia
| | - Anteneh Gadisa
- College of Medicine and Health Sciences, Department of Medical Microbiology, Hawassa University, Hawassa, Ethiopia
| | - Desalegn Admasu
- Department of Medical Laboratory Sciences College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Emnet Tesfaye
- College of Medicine and Health Sciences, Department of Medical Microbiology, Hawassa University, Hawassa, Ethiopia
| | - Timothy A Bates
- Department of Molecular Microbiology and Immunology, Oregon Health & Sciences University, Portland, OR, USA
| | - Jote Tafese Bulcha
- Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, MA, USA
| | - Rea Tschopp
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | - Kim Mullholand
- London School of Hygiene and Tropical Medicine, London, UK
| | - Rawleigh Howe
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Abebe Genetu
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Fikadu G Tafesse
- Department of Molecular Microbiology and Immunology, Oregon Health & Sciences University, Portland, OR, USA.
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Etyang AO, Lucinde R, Karanja H, Kalu C, Mugo D, Nyagwange J, Gitonga J, Tuju J, Wanjiku P, Karani A, Mutua S, Maroko H, Nzomo E, Maitha E, Kamuri E, Kaugiria T, Weru J, Ochola LB, Kilimo N, Charo S, Emukule N, Moracha W, Mukabi D, Okuku R, Ogutu M, Angujo B, Otiende M, Bottomley C, Otieno E, Ndwiga L, Nyaguara A, Voller S, Agoti CN, Nokes DJ, Ochola-Oyier LI, Aman R, Amoth P, Mwangangi M, Kasera K, Ng’ang’a W, Adetifa IMO, Wangeci Kagucia E, Gallagher K, Uyoga S, Tsofa B, Barasa E, Bejon P, Scott JAG, Agweyu A, Warimwe GM. Seroprevalence of Antibodies to Severe Acute Respiratory Syndrome Coronavirus 2 Among Healthcare Workers in Kenya. Clin Infect Dis 2022; 74:288-293. [PMID: 33893491 PMCID: PMC8135298 DOI: 10.1093/cid/ciab346] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Few studies have assessed the seroprevalence of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among healthcare workers (HCWs) in Africa. We report findings from a survey among HCWs in 3 counties in Kenya. METHODS We recruited 684 HCWs from Kilifi (rural), Busia (rural), and Nairobi (urban) counties. The serosurvey was conducted between 30 July and 4 December 2020. We tested for immunoglobulin G antibodies to SARS-CoV-2 spike protein, using enzyme-linked immunosorbent assay. Assay sensitivity and specificity were 92.7 (95% CI, 87.9-96.1) and 99.0% (95% CI, 98.1-99.5), respectively. We adjusted prevalence estimates, using bayesian modeling to account for assay performance. RESULTS The crude overall seroprevalence was 19.7% (135 of 684). After adjustment for assay performance, seroprevalence was 20.8% (95% credible interval, 17.5%-24.4%). Seroprevalence varied significantly (P < .001) by site: 43.8% (95% credible interval, 35.8%-52.2%) in Nairobi, 12.6% (8.8%-17.1%) in Busia and 11.5% (7.2%-17.6%) in Kilifi. In a multivariable model controlling for age, sex, and site, professional cadre was not associated with differences in seroprevalence. CONCLUSION These initial data demonstrate a high seroprevalence of antibodies to SARS-CoV-2 among HCWs in Kenya. There was significant variation in seroprevalence by region, but not by cadre.
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Affiliation(s)
| | - Ruth Lucinde
- KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | - Henry Karanja
- KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Daisy Mugo
- KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - John Gitonga
- KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | - James Tuju
- KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Angela Karani
- KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Hosea Maroko
- KEMRI Center for Infectious and Parasitic Diseases Control Research, Alupe, Kenya
| | | | | | | | | | | | | | | | | | | | | | - David Mukabi
- Department of Health, Busia County, Busia, Kenya
| | | | | | | | - Mark Otiende
- KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | - Christian Bottomley
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Edward Otieno
- KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Amek Nyaguara
- KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | - Shirine Voller
- KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | | | - Rashid Aman
- Ministry of Health, Government of Kenya, Nairobi, Kenya
| | - Patrick Amoth
- Ministry of Health, Government of Kenya, Nairobi, Kenya
| | | | | | - Wangari Ng’ang’a
- Presidential Policy and Strategy Unit, The Presidency, Government of Kenya, Nairobi, Kenya
| | - Ifedayo M O Adetifa
- KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Katherine Gallagher
- KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sophie Uyoga
- KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Edwine Barasa
- KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | - Philip Bejon
- KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | - J Anthony G Scott
- KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - George M Warimwe
- KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
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Abatan B, Agboghoroma O, Akemoke F, Antonio M, Awokola B, Bittaye M, Bojang A, Bojang K, Brotherton H, Cerami C, Clarke E, D'Alessandro U, de Silva T, Drammeh M, Forrest K, Hofmann N, Jagne S, Jah H, Jarju S, Jaye A, Jobe M, Kampmann B, Manjang B, Martinez-Alvarez M, Mohammed N, Nadjm B, Ndiath MO, Nkereuwem E, Nwakanma D, Oko F, Okoh E, Okomo U, Olatunji Y, Oriero E, Prentice AM, Roberts C, Roca A, Sabally B, Sambou S, Samateh A, Secka O, Sesay AK, Singhateh Y, Susso B, Usuf E, Vilane A, Wariri O. Intense and Mild First Epidemic Wave of Coronavirus Disease, The Gambia. Emerg Infect Dis 2021; 27:2064-2072. [PMID: 34286683 PMCID: PMC8314844 DOI: 10.3201/eid2708.204954] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is evolving differently in Africa than in other regions. Africa has lower SARS-CoV-2 transmission rates and milder clinical manifestations. Detailed SARS-CoV-2 epidemiologic data are needed in Africa. We used publicly available data to calculate SARS-CoV-2 infections per 1,000 persons in The Gambia. We evaluated transmission rates among 1,366 employees of the Medical Research Council Unit The Gambia (MRCG), where systematic surveillance of symptomatic cases and contact tracing were implemented. By September 30, 2020, The Gambia had identified 3,579 SARS-CoV-2 cases, including 115 deaths; 67% of cases were identified in August. Among infections, MRCG staff accounted for 191 cases; all were asymptomatic or mild. The cumulative incidence rate among nonclinical MRCG staff was 124 infections/1,000 persons, which is >80-fold higher than estimates of diagnosed cases among the population. Systematic surveillance and seroepidemiologic surveys are needed to clarify the extent of SARS-CoV-2 transmission in Africa.
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Barrie MB, Lakoh S, Kelly JD, Kanu JS, Squire J, Koroma Z, Bah S, Sankoh O, Brima A, Ansumana R, Goldberg SA, Chitre S, Osuagwu C, Maeda J, Barekye B, Numbere TW, Abdulaziz M, Mounts A, Blanton C, Singh T, Samai M, Vandi MA, Richardson ET. SARS-CoV-2 antibody prevalence in Sierra Leone, March 2021: a cross-sectional, nationally representative, age-stratified serosurvey. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.06.27.21259271. [PMID: 34230939 PMCID: PMC8259916 DOI: 10.1101/2021.06.27.21259271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background As of 26 March 2021, the Africa CDC had reported 4,159,055 cases of COVID-19 and 111,357 deaths among the 55 African Union Member States; however, no country has published a nationally representative serosurvey as of May 2021. Such data are vital for understanding the pandemic's progression on the continent, evaluating containment measures, and policy planning. Methods We conducted a cross-sectional, nationally representative, age-stratified serosurvey in Sierra Leone in March 2021 by randomly selecting 120 Enumeration Areas throughout the country and 10 randomly selected households in each of these. One to two persons per selected household were interviewed to collect information on socio-demographics, symptoms suggestive of COVID-19, exposure history to laboratory-confirmed COVID-19 cases, and history of COVID-19 illness. Capillary blood was collected by fingerstick, and blood samples were tested using the Hangzhou Biotest Biotech RightSign COVID-19 IgG/IgM Rapid Test Cassette. Total seroprevalence was was estimated after applying sampling weights. Findings The overall weighted seroprevalence was 2.6% (95% CI 1.9-3.4). This is 43 times higher than the reported number of cases. Rural seropositivity was 1.8% (95% CI 1.0-2.5), and urban seropositivity was 4.2% (95% CI 2.6-5.7). Interpretation Although overall seroprevalence was low compared to countries in Europe and the Americas (suggesting relatively successful containment in Sierra Leone), our findings indicate enormous underreporting of active cases. This has ramifications for the country's third wave (which started in June 2021), where the average number of daily reported cases was 87 by the end of the month: this could potentially be on the order of 3,700 actual infections, calling for stronger containment measures in a country with only 0.2% of people fully vaccinated. It may also reflect significant underreporting of incidence and mortality across the continent.
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Affiliation(s)
- Mohamed Bailor Barrie
- Institute for Global Health Sciences, University of California, San Francisco, USA
- Partners In Health, Sierra Leone
| | - Sulaiman Lakoh
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | | | - Joseph Sam Kanu
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - James Squire
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Zikan Koroma
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | | | - Osman Sankoh
- Statistics Sierra Leone
- Njala University, Sierra Leone
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Heidelberg Institute of Global Heath, University of Heidelberg Medical School, Germany
| | | | | | - Sarah A. Goldberg
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Smit Chitre
- Department of Global Health & Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Chidinma Osuagwu
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Justin Maeda
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Bernard Barekye
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | | | - Mohammed Abdulaziz
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Anthony Mounts
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Curtis Blanton
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tushar Singh
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mohamed Samai
- College of Medicine and Allied Health Sciences, Freetown, Sierra Leone
| | - Mohamed A. Vandi
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Eugene T. Richardson
- Department of Global Health & Social Medicine, Harvard Medical School, Boston, MA, USA
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
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13
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Morton B, Barnes KG, Anscombe C, Jere K, Matambo P, Mandolo J, Kamng'ona R, Brown C, Nyirenda J, Phiri T, Banda NP, Van Der Veer C, Mndolo KS, Mponda K, Rylance J, Phiri C, Mallewa J, Nyirenda M, Katha G, Kambiya P, Jafali J, Mwandumba HC, Gordon SB, Cornick J, Jambo KC. Distinct clinical and immunological profiles of patients with evidence of SARS-CoV-2 infection in sub-Saharan Africa. Nat Commun 2021; 12:3554. [PMID: 34117221 PMCID: PMC8196064 DOI: 10.1038/s41467-021-23267-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/21/2021] [Indexed: 01/08/2023] Open
Abstract
Although the COVID-19 pandemic has left no country untouched there has been limited research to understand clinical and immunological responses in African populations. Here we characterise patients hospitalised with suspected (PCR-negative/IgG-positive) or confirmed (PCR-positive) COVID-19, and healthy community controls (PCR-negative/IgG-negative). PCR-positive COVID-19 participants were more likely to receive dexamethasone and a beta-lactam antibiotic, and survive to hospital discharge than PCR-negative/IgG-positive and PCR-negative/IgG-negative participants. PCR-negative/IgG-positive participants exhibited a nasal and systemic cytokine signature analogous to PCR-positive COVID-19 participants, predominated by chemokines and neutrophils and distinct from PCR-negative/IgG-negative participants. PCR-negative/IgG-positive participants had increased propensity for Staphylococcus aureus and Streptococcus pneumoniae colonisation. PCR-negative/IgG-positive individuals with high COVID-19 clinical suspicion had inflammatory profiles analogous to PCR-confirmed disease and potentially represent a target population for COVID-19 treatment strategies.
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Affiliation(s)
- Ben Morton
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi.
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
| | - Kayla G Barnes
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- Harvard School of Public Health, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- University of Glasgow MRC Centre for Virus Research, Glasgow, UK
| | - Catherine Anscombe
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Khuzwayo Jere
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
- University of Malawi-College of Medicine, Blantyre, Malawi
| | - Prisca Matambo
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Jonathan Mandolo
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Raphael Kamng'ona
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Comfort Brown
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - James Nyirenda
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Tamara Phiri
- Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | - Charlotte Van Der Veer
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Kwazizira S Mndolo
- Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Kelvin Mponda
- Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Jamie Rylance
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Chimota Phiri
- Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Jane Mallewa
- University of Malawi-College of Medicine, Blantyre, Malawi
| | - Mulinda Nyirenda
- University of Malawi-College of Medicine, Blantyre, Malawi
- Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Grace Katha
- Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Paul Kambiya
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - James Jafali
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Henry C Mwandumba
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- University of Malawi-College of Medicine, Blantyre, Malawi
| | - Stephen B Gordon
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Jennifer Cornick
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Kondwani C Jambo
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi.
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
- University of Malawi-College of Medicine, Blantyre, Malawi.
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14
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Wiens KE, Mawien PN, Rumunu J, Slater D, Jones FK, Moheed S, Caflisch A, Bior BK, Jacob IA, Lako RL, Guyo AG, Olu OO, Maleghemi S, Baguma A, Hassen JJ, Baya SK, Deng L, Lessler J, Demby MN, Sanchez V, Mills R, Fraser C, Charles RC, Harris JB, Azman AS, Wamala JF. Seroprevalence of Severe Acute Respiratory Syndrome Coronavirus 2 IgG in Juba, South Sudan, 2020 1. Emerg Infect Dis 2021; 27:1598-1606. [PMID: 34013872 PMCID: PMC8153877 DOI: 10.3201/eid2706.210568] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Relatively few coronavirus disease cases and deaths have been reported from sub-Saharan Africa, although the extent of its spread remains unclear. During August 10-September 11, 2020, we recruited 2,214 participants for a representative household-based cross-sectional serosurvey in Juba, South Sudan. We found 22.3% of participants had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor binding domain IgG titers above prepandemic levels. After accounting for waning antibody levels, age, and sex, we estimated that 38.3% (95% credible interval 31.8%-46.5%) of the population had been infected with SARS-CoV-2. At this rate, for each PCR-confirmed SARS-CoV-2 infection reported by the Ministry of Health, 103 (95% credible interval 86-126) infections would have been unreported, meaning SARS-CoV-2 has likely spread extensively within Juba. We also found differences in background reactivity in Juba compared with Boston, Massachusetts, USA, where the immunoassay was validated. Our findings underscore the need to validate serologic tests in sub-Saharan Africa populations.
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Affiliation(s)
- Kirsten E. Wiens
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Pinyi Nyimol Mawien
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - John Rumunu
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Damien Slater
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Forrest K. Jones
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Serina Moheed
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Andrea Caflisch
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Bior K. Bior
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Iboyi Amanya Jacob
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Richard Lino Lako
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Argata Guracha Guyo
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Olushayo Oluseun Olu
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Sylvester Maleghemi
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Andrew Baguma
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Juma John Hassen
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Sheila K. Baya
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Lul Deng
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Justin Lessler
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Maya N. Demby
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Vanessa Sanchez
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Rachel Mills
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Clare Fraser
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
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15
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Henrion MYR. bootComb—an R package to derive confidence intervals for combinations of independent parameter estimates. Int J Epidemiol 2021. [PMCID: PMC8407867 DOI: 10.1093/ije/dyab049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Motivation To address the limits of facility- or study-based estimates, multiple independent parameter estimates may need to be combined. Specific examples include (i) adjusting an incidence rate for healthcare utilisation, (ii) deriving a disease prevalence from a conditional prevalence and the prevalence of the underlying condition, (iii) adjusting a seroprevalence for test sensitivity and specificity. Calculating combined parameter estimates is generally straightforward, but deriving corresponding confidence intervals often is not. bootComb is an R package using parametric bootstrap sampling to derive such intervals. Implementation bootComb is a package for the statistical computation environment R. General features Apart from a function returning confidence intervals for parameters combined from several independent estimates, bootComb provides auxiliary functions for 6 common distributions (beta, normal, exponential, gamma, Poisson and negative binomial) to derive best-fit distributions for parameters given their reported confidence intervals. Availability bootComb is available from the Comprehensive R Archive Network (https://CRAN.R-project.org/package=bootComb).
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Affiliation(s)
- Marc YR Henrion
- Malawi—Liverpool—Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, Blantyre, Malawi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
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16
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Serological surveys to inform SARS-CoV-2 epidemic curve: a cross-sectional study from Odisha, India. Sci Rep 2021; 11:10551. [PMID: 34006960 PMCID: PMC8131641 DOI: 10.1038/s41598-021-89877-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 04/28/2021] [Indexed: 12/18/2022] Open
Abstract
This was a population based cross-sectional study carried out to estimate and compare the seroprevalence, hidden prevalence and determine the demographic risk factors associated with SARS-CoV-2 infection among adults in the three largest cities of Odisha, India, and ascertain the association with the progression of the epidemic. The survey carried out in August 2020 in the three largest cities of the state of Odisha, India. Blood samples were collected from the residents using random sampling methods and tested for anti- SARS CoV-2 antibodies using an automated CLIA platform. A total of 4146 participants from the 3 cities of Bhubaneswar (BBS), Berhampur (BAM) and Rourkela (RKL) participated. The female to male participation ratio was 5.9:10 across the three cities. The gender weighted seroprevalence across the three cities was 20.78% (95% CI 19.56–22.05%). While females reported a higher seroprevalence (22.8%) as compared to males (18.8%), there was no significant difference in seroprevalence across age groups. A majority of the seropositive participants were asymptomatic (90.49%). The case to infection ratio on the date of serosurvey was 1:6.6 in BBS, 1:61 in BAM and 1:29.8 in RKL. The study found a high seroprevalence against COVID-19 in urban Odisha as well as high numbers of asymptomatic infections. The epidemic curves had a correlation with the seroprevalence.
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17
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Rice BL, Annapragada A, Baker RE, Bruijning M, Dotse-Gborgbortsi W, Mensah K, Miller IF, Motaze NV, Raherinandrasana A, Rajeev M, Rakotonirina J, Ramiadantsoa T, Rasambainarivo F, Yu W, Grenfell BT, Tatem AJ, Metcalf CJE. Variation in SARS-CoV-2 outbreaks across sub-Saharan Africa. Nat Med 2021; 27:447-453. [PMID: 33531710 PMCID: PMC8590469 DOI: 10.1038/s41591-021-01234-8] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/11/2021] [Indexed: 12/27/2022]
Abstract
A surprising feature of the SARS-CoV-2 pandemic to date is the low burdens reported in sub-Saharan Africa (SSA) countries relative to other global regions. Potential explanations (for example, warmer environments1, younger populations2-4) have yet to be framed within a comprehensive analysis. We synthesized factors hypothesized to drive the pace and burden of this pandemic in SSA during the period from 25 February to 20 December 2020, encompassing demographic, comorbidity, climatic, healthcare capacity, intervention efforts and human mobility dimensions. Large diversity in the probable drivers indicates a need for caution in interpreting analyses that aggregate data across low- and middle-income settings. Our simulation shows that climatic variation between SSA population centers has little effect on early outbreak trajectories; however, heterogeneity in connectivity, although rarely considered, is likely an important contributor to variance in the pace of viral spread across SSA. Our synthesis points to the potential benefits of context-specific adaptation of surveillance systems during the ongoing pandemic. In particular, characterizing patterns of severity over age will be a priority in settings with high comorbidity burdens and poor access to care. Understanding the spatial extent of outbreaks warrants emphasis in settings where low connectivity could drive prolonged, asynchronous outbreaks resulting in extended stress to health systems.
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Affiliation(s)
- Benjamin L Rice
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA.
- Madagascar Health and Environmental Research, Maroantsetra, Madagascar.
| | | | - Rachel E Baker
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
- Princeton Environmental Institute, Princeton University, Princeton, NJ, USA
| | - Marjolein Bruijning
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
| | | | - Keitly Mensah
- Centre Population et Développement (CEPED), Institut de Recherche pour le Développement (IRD) and Université de Paris, Inserm ERL 1244, Paris, France
| | - Ian F Miller
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
| | - Nkengafac Villyen Motaze
- Centre for Vaccines and Immunology, National Institute for Comnmunicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
- Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Antso Raherinandrasana
- Faculty of Medicine, University of Antananarivo, Antananarivo, Madagascar
- Teaching Hospital of Care and Public Health Analakely, Antananarivo, Madagascar
| | - Malavika Rajeev
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
| | - Julio Rakotonirina
- Faculty of Medicine, University of Antananarivo, Antananarivo, Madagascar
- Teaching Hospital of Care and Public Health Analakely, Antananarivo, Madagascar
| | - Tanjona Ramiadantsoa
- Department of Life Science, University of Fianarantsoa, Fianarantsoa, Madagascar
- Department of Mathematics, University of Fianarantsoa, Fianarantsoa, Madagascar
- Department of Integrative Biology, University of Wisconsin-Madison, Madison, WI, USA
| | - Fidisoa Rasambainarivo
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
- Mahaliana Labs SARL, Antananarivo, Madagascar
| | - Weiyu Yu
- School of Geography and Environmental Science, University of Southampton, Southampton, UK
| | - Bryan T Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
- Princeton School of Public and International Affairs, Princeton University, Princeton, NJ, USA
| | - Andrew J Tatem
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK
| | - C Jessica E Metcalf
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
- Princeton School of Public and International Affairs, Princeton University, Princeton, NJ, USA
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18
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Nkuba Ndaye A, Hoxha A, Madinga J, Mariën J, Peeters M, Leendertz FH, Ahuka Mundeke S, Ariën KK, Muyembe Tanfumu JJ, Mbala Kingebeni P, Vanlerberghe V. Challenges in interpreting SARS-CoV-2 serological results in African countries. LANCET GLOBAL HEALTH 2021; 9:e588-e589. [PMID: 33609481 PMCID: PMC7906714 DOI: 10.1016/s2214-109x(21)00060-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/27/2021] [Accepted: 02/02/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Antoine Nkuba Ndaye
- Department of Virology, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Institut de Recherche pour le Développement, University of Montpellier, Montpellier, France
| | - Ana Hoxha
- Tropical Infectious Diseases Unit, Department of Public Health, 2000 Antwerp, Belgium; Institute of Tropical Medicine, 2000 Antwerp, Belgium.
| | - Joule Madinga
- Department of Epidemiology, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Joachim Mariën
- Virology Unit, Department of Biomedical Sciences, 2000 Antwerp, Belgium; Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium
| | - Martine Peeters
- Institut de Recherche pour le Développement, University of Montpellier, Montpellier, France
| | - Fabian H Leendertz
- Epidemiology of Highly Pathogenic Microorganisms Project Group, Robert Koch Institute, Berlin, Germany
| | - Steve Ahuka Mundeke
- Department of Virology, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Department of Medical Microbiology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Kevin K Ariën
- Virology Unit, Department of Biomedical Sciences, 2000 Antwerp, Belgium; Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Jean-Jacques Muyembe Tanfumu
- Department of Virology, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Department of Medical Microbiology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Placide Mbala Kingebeni
- Department of Epidemiology, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Department of Medical Microbiology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Veerle Vanlerberghe
- Tropical Infectious Diseases Unit, Department of Public Health, 2000 Antwerp, Belgium
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19
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Mugunga JC, Tyagi K, Bernal-Serrano D, Correa N, Iberico M, Kateera F, Leandre F, Murray M, Suffrin JCD, Hedt-Gauthier B. SARS-CoV-2 serosurveys in low-income and middle-income countries. Lancet 2021; 397:353-355. [PMID: 33516323 PMCID: PMC7906745 DOI: 10.1016/s0140-6736(21)00188-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 12/16/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Jean Claude Mugunga
- Partners In Health, Boston, MA 02474, USA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Brigham and Women's Hospital, Boston, MA, USA; University of Global Health Equity, Boston, MA, USA.
| | - Kartik Tyagi
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Daniel Bernal-Serrano
- Partners In Health, Boston, MA 02474, USA; Instituto Tecnológico y de Estudios Superiores de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, México
| | | | | | | | - Fernet Leandre
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Brigham and Women's Hospital, Boston, MA, USA
| | - Megan Murray
- Partners In Health, Boston, MA 02474, USA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Harvard T H Chan School of Public Health, Boston, MA, USA
| | | | - Bethany Hedt-Gauthier
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Harvard T H Chan School of Public Health, Boston, MA, USA
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