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Yared S, Abera T, Ali SM, Muhummed AM, Ibrahim M, Hassan A, Hattendorf J, Zinsstag J, Tschopp R. A community based seroprevalence of SARS-CoV-2 antibodies in Somali Region, Eastern Ethiopia. Immun Inflamm Dis 2024; 12:e1148. [PMID: 38270297 PMCID: PMC10777752 DOI: 10.1002/iid3.1148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 12/25/2023] [Accepted: 12/28/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Coronavirus disease 19 (COVID-19) is life-threatening infectious disease caused by SARS-CoV-2 virus that caused a global pandemic. SARS-CoV-2 has been widely transmitted throughout Ethiopia, with over 501,060 cases confirmed and 7574 deaths until November 2023. This study assessed for the first time the seroprevalence SARS-CoV-2 in the general population of the Somali Region during the COVID-19 pandemic. METHODS A cross-sectional study design was conducted from May to June 2021 in 14 districts of Somali Region. Blood samples were collected in 820 participants in addition to administering a questionnaire that included sociodemographic characteristics and history of clinical symptoms of COVID-19. Blood samples were tested for the presence or absence of anti-SARS-CoV-2 using a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit (Euroimmun). RESULTS Overall, 477 (58.2%) were male and 343 (41.8%) were female. The majority of the participants (N = 581; 70.9%) were between 18 and 34 years old and not vaccinated against COVID-19 (N = 793; 96.7%). The overall seroprevalence of SARS-CoV-2 antibodies was 41.7% (95% CI: 33.3%-47.6%). The highest prevalence was found in Goljano district (70%) and the lowest in Gunagado district (22.5%). Only age was found to be associated with COVID-19 seropositivity. CONCLUSION Prevalence of SARS-CoV-2 antibodies was the highest ever reported in Ethiopia, indicating that a large proportion of the population had been infected 14 months after the start of the outbreak in the country. Such studies are important to swiftly reassess and improve specific COVID-19 preventive and control measures to reduce transmissions within the community in a given setting.
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Affiliation(s)
- Solomon Yared
- Department of Biology, College of Natural and Computational SciencesJigjiga UniversityJigjigaEthiopia
| | - Tsegalem Abera
- Department of Veterinary Microbiology and Public Health, College of Veterinary MedicineJigjiga UniversityJigjigaEthiopia
| | - Seid Mohammed Ali
- Department of Animal and Range Sciences, College of Dryland AgricultureJigjiga UniversityJigjigaEthiopia
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health InstituteUniversity of BaselBaselSwitzerland
| | - Abdifatah Muktar Muhummed
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health InstituteUniversity of BaselBaselSwitzerland
- School of Medicine, College of Medicine and Health SciencesJigjiga UniversityJigjigaEthiopia
| | - Mohammed Ibrahim
- Department of Veterinary Microbiology and Public Health, College of Veterinary MedicineJigjiga UniversityJigjigaEthiopia
| | - Abdullahi Hassan
- School of Medicine, College of Medicine and Health SciencesJigjiga UniversityJigjigaEthiopia
| | - Jan Hattendorf
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health InstituteUniversity of BaselBaselSwitzerland
| | - Jakob Zinsstag
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health InstituteUniversity of BaselBaselSwitzerland
| | - Rea Tschopp
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health InstituteUniversity of BaselBaselSwitzerland
- One Health UnitArmauer Hansen Research InstituteAddis AbabaEthiopia
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Zhao L, Zou Y, Li Y, Miyani B, Spooner M, Gentry Z, Jacobi S, David RE, Withington S, McFarlane S, Faust R, Sheets J, Kaye A, Broz J, Gosine A, Mobley P, Busch AWU, Norton J, Xagoraraki I. Five-week warning of COVID-19 peaks prior to the Omicron surge in Detroit, Michigan using wastewater surveillance. Sci Total Environ 2022; 844:157040. [PMID: 35779714 PMCID: PMC9239917 DOI: 10.1016/j.scitotenv.2022.157040] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 04/14/2023]
Abstract
Wastewater-based epidemiology (WBE) is useful in predicting temporal fluctuations of COVID-19 incidence in communities and providing early warnings of pending outbreaks. To investigate the relationship between SARS-CoV-2 concentrations in wastewater and COVID-19 incidence in communities, a 12-month study between September 1, 2020, and August 31, 2021, prior to the Omicron surge, was conducted. 407 untreated wastewater samples were collected from the Great Lakes Water Authority (GLWA) in southeastern Michigan. N1 and N2 genes of SARS-CoV-2 were quantified using RT-ddPCR. Daily confirmed COVID-19 cases for the City of Detroit, and Wayne, Macomb, Oakland counties between September 1, 2020, and October 4, 2021, were collected from a public data source. The total concentrations of N1 and N2 genes ranged from 714.85 to 7145.98 gc/L and 820.47 to 6219.05 gc/L, respectively, which were strongly correlated with the 7-day moving average of total daily COVID-19 cases in the associated areas, after 5 weeks of the viral measurement. The results indicate a potential 5-week lag time of wastewater surveillance preceding COVID-19 incidence for the Detroit metropolitan area. Four statistical models were established to analyze the relationship between SARS-CoV-2 concentrations in wastewater and COVID-19 incidence in the study areas. Under a 5-week lag time scenario with both N1 and N2 genes, the autoregression model with seasonal patterns and vector autoregression model were more effective in predicting COVID-19 cases during the study period. To investigate the impact of flow parameters on the correlation, the original N1 and N2 gene concentrations were normalized by wastewater flow parameters. The statistical results indicated the optimum models were consistent for both normalized and non-normalized data. In addition, we discussed parameters that explain the observed lag time. Furthermore, we evaluated the impact of the omicron surge that followed, and the impact of different sampling methods on the estimation of lag time.
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Affiliation(s)
- Liang Zhao
- Department of Civil and Environmental Engineering, Michigan State University, 1449 Engineering Research Ct, East Lansing, MI 48823, United States of America
| | - Yangyang Zou
- Department of Civil and Environmental Engineering, Michigan State University, 1449 Engineering Research Ct, East Lansing, MI 48823, United States of America
| | - Yabing Li
- Department of Civil and Environmental Engineering, Michigan State University, 1449 Engineering Research Ct, East Lansing, MI 48823, United States of America
| | - Brijen Miyani
- Department of Civil and Environmental Engineering, Michigan State University, 1449 Engineering Research Ct, East Lansing, MI 48823, United States of America
| | - Maddie Spooner
- Department of Civil and Environmental Engineering, Michigan State University, 1449 Engineering Research Ct, East Lansing, MI 48823, United States of America
| | - Zachary Gentry
- Department of Civil and Environmental Engineering, Michigan State University, 1449 Engineering Research Ct, East Lansing, MI 48823, United States of America
| | - Sydney Jacobi
- Department of Civil and Environmental Engineering, Michigan State University, 1449 Engineering Research Ct, East Lansing, MI 48823, United States of America
| | - Randy E David
- Detroit Health Department, 100 Mack Ave, Detroit, MI 48201, United States of America
| | - Scott Withington
- Detroit Health Department, 100 Mack Ave, Detroit, MI 48201, United States of America
| | - Stacey McFarlane
- Macomb County Health Division, 43525 Elizabeth Rd, Mount Clemens, MI 48043, United States of America
| | - Russell Faust
- Oakland County Health Division, 1200 Telegraph Rd, Pontiac, MI 48341, United States of America
| | - Johnathon Sheets
- CDM-Smith, 535 Griswold St, Detroit, MI 48226, United States of America
| | - Andrew Kaye
- CDM-Smith, 535 Griswold St, Detroit, MI 48226, United States of America
| | - James Broz
- CDM-Smith, 535 Griswold St, Detroit, MI 48226, United States of America
| | - Anil Gosine
- Detroit Water and Sewerage Department, 735 Randolph Street building, Detroit, MI 48226, United States of America
| | - Palencia Mobley
- Detroit Water and Sewerage Department, 735 Randolph Street building, Detroit, MI 48226, United States of America
| | - Andrea W U Busch
- Great Lakes Water Authority, 735 Randolph, Detroit, MI 48226, United States of America
| | - John Norton
- Great Lakes Water Authority, 735 Randolph, Detroit, MI 48226, United States of America
| | - Irene Xagoraraki
- Department of Civil and Environmental Engineering, Michigan State University, 1449 Engineering Research Ct, East Lansing, MI 48823, United States of America.
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Nyawale HA, Moremi N, Mohamed M, Njwalila J, Silago V, Krone M, Konje ET, Mirambo MM, Mshana SE. High Seroprevalence of SARS-CoV-2 in Mwanza, Northwestern Tanzania: A Population-Based Survey. Int J Environ Res Public Health 2022; 19:11664. [PMID: 36141938 PMCID: PMC9517516 DOI: 10.3390/ijerph191811664] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/03/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
The transmission of the SARS-CoV-2 virus, which causes COVID-19, has been documented worldwide. However, the evidence of the extent to which transmission has occurred in different countries is still to be established. Understanding the magnitude and distribution of SARS-CoV-2 through seroprevalence studies is important in designing control and preventive strategies in communities. This study investigated the seropositivity of the SARS-CoV-2 virus antibodies in the communities of three different districts in the Mwanza region, Tanzania. A household cross-sectional survey was conducted in September 2021 using the modified African Centre for Disease and Prevention (ACDC) survey protocol. A blood sample was obtained from one member of each of the selected households who consented to take part in the survey. Immunochromatographic rapid test kits were used to detect IgM and IgG SARS-CoV-2 antibodies, followed by descriptive data analysis. Overall, 805 participants were enrolled in the study with a median age of 35 (interquartile range (IQR):27-47) years. The overall SARS-CoV-2 seropositivity was 50.4% (95%CI: 46.9-53.8%). The IgG and IgM seropositivity of the SARS-CoV-2 antibodies was 49.3% and 7.2%, respectively, with 6.1% being both IgG and IgM seropositive. A history of runny nose (aOR: 1.84, 95%CI: 1.03-3.5, p = 0.036), loss of taste (aOR: 1.84, 95%CI: 1.12-4.48, p = 0.023), and living in Ukerewe (aOR: 3.55, 95%CI: 1.68-7.47, p = 0.001) and Magu (aOR: 2.89, 95%CI: 1.34-6.25, p= 0.007) were all independently associated with SARS-CoV-2 IgM seropositivity. Out of the studied factors, living in the Ukerewe district was independently associated with IgG seropositivity (aOR 1.29, CI 1.08-1.54, p = 0.004). Twenty months after the first case of COVID-19 in Tanzania, about half of the studied population in Mwanza was seropositive for SARS-CoV-2.
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Affiliation(s)
- Helmut A Nyawale
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania
| | - Nyambura Moremi
- National Public Health Laboratory, Dar es Salaam P.O. Box 9083, Tanzania
| | - Mohamed Mohamed
- East Central and Southern Africa Health Community, Arusha P.O. Box 1009, Tanzania
| | - Johnson Njwalila
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania
| | - Vitus Silago
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania
| | - Manuel Krone
- Infection Control and Antimicrobial Sterwardship Unit, University Hospital Wuerzburg, 97080 Wüerzburg, Germany
| | - Eveline T Konje
- Department of Epidemiology and Biostatistics, School of Public Health, Catholoic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania
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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] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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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5
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Koltai M, Warsame A, Bashiir F, Freemantle T, Reeve C, Williams C, Jit M, Flasche S, Davies NG, Aweis A, Ahmed M, Dalmar A, Checchi F. Date of introduction and epidemiologic patterns of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Mogadishu, Somalia: estimates from transmission modelling of satellite-based excess mortality data in 2020. Wellcome Open Res 2022; 6:255. [PMID: 35299709 PMCID: PMC8902262 DOI: 10.12688/wellcomeopenres.17247.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 11/20/2022] Open
Abstract
Background: In countries with weak surveillance systems, confirmed coronavirus disease 2019 (COVID-19) deaths are likely to underestimate the pandemic's death toll. Many countries also have incomplete vital registration systems, hampering excess mortality estimation. Here, we fitted a dynamic transmission model to satellite imagery data of cemeteries in Mogadishu, Somalia during 2020 to estimate the date of introduction and other epidemiologic parameters of the early spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in this low-income, crisis-affected setting. Methods: We performed Markov chain Monte Carlo (MCMC) fitting with an age-structured compartmental COVID-19 model to provide median estimates and credible intervals for the date of introduction, the basic reproduction number ( R 0 ) and the effect of non-pharmaceutical interventions (NPIs) up to August 2020. Results: Under the assumption that excess deaths in Mogadishu March-August 2020 were attributable to SARS-CoV-2 infections, we arrived at median estimates of November-December 2019 for the date of introduction and low R 0 estimates (1.4-1.7) reflecting the slow and early rise and long plateau of excess deaths. The date of introduction, the amount of external seeding, the infection fatality rate (IFR) and the effectiveness of NPIs are correlated parameters and not separately identifiable in a narrow range from deaths data. Nevertheless, to obtain introduction dates no earlier than November 2019 a higher population-wide IFR (≥0.7%) had to be assumed than obtained by applying age-specific IFRs from high-income countries to Somalia's age structure. Conclusions: Model fitting of excess mortality data across a range of plausible values of the IFR and the amount of external seeding suggests an early SARS-CoV-2 introduction event may have occurred in Somalia in November-December 2019. Transmissibility in the first epidemic wave was estimated to be lower than in European settings. Alternatively, there was another, unidentified source of sustained excess mortality in Mogadishu from March to August 2020.
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Affiliation(s)
- Mihaly Koltai
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - Farah Bashiir
- Somali Disaster Resilience Institute, Mogadishu, Somalia
| | | | | | | | - Mark Jit
- London School of Hygiene & Tropical Medicine, London, UK
| | - Stefan Flasche
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - CMMID COVID-19 working group
- London School of Hygiene & Tropical Medicine, London, UK
- Somali Disaster Resilience Institute, Mogadishu, Somalia
- Satellite Applications Catapult, Didcot, UK
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6
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Glennon EE, Bruijning M, Lessler J, Miller IF, Rice BL, Thompson RN, Wells K, Metcalf CJE. Challenges in modeling the emergence of novel pathogens. Epidemics 2021; 37:100516. [PMID: 34775298 DOI: 10.1016/j.epidem.2021.100516] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/29/2021] [Accepted: 10/22/2021] [Indexed: 01/24/2023] Open
Abstract
The emergence of infectious agents with pandemic potential present scientific challenges from detection to data interpretation to understanding determinants of risk and forecasts. Mathematical models could play an essential role in how we prepare for future emergent pathogens. Here, we describe core directions for expansion of the existing tools and knowledge base, including: using mathematical models to identify critical directions and paths for strengthening data collection to detect and respond to outbreaks of novel pathogens; expanding basic theory to identify infectious agents and contexts that present the greatest risks, over both the short and longer term; by strengthening estimation tools that make the most use of the likely range and uncertainties in existing data; and by ensuring modelling applications are carefully communicated and developed within diverse and equitable collaborations for increased public health benefit.
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Affiliation(s)
- Emma E Glennon
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK.
| | - Marjolein Bruijning
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA
| | - Justin Lessler
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Ian F Miller
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA; Rocky Mountain Biological Laboratory, Crested Butte, CO 81224, USA
| | - Benjamin L Rice
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA; Madagascar Health and Environmental Research (MAHERY), Maroantsetra, Madagascar
| | - Robin N Thompson
- Mathematics Institute, University of Warwick, Warwick CV4 7AL, UK; The Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, University of Warwick, Warwick CV4 7AL, UK
| | - Konstans Wells
- Department of Biosciences, Swansea University, Swansea SA28PP, UK
| | - C Jessica E Metcalf
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK; Princeton School of Public and International Affairs, Princeton University, Princeton, NJ, USA
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7
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Koltai M, Warsame A, Bashiir F, Freemantle T, Reeve C, Williams C, Jit M, Flasche S, Davies NG, Aweis A, Ahmed M, Dalmar A, Checchi F. Date of introduction and epidemiologic patterns of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Mogadishu, Somalia: estimates from transmission modelling of satellite-based excess mortality data in 2020. Wellcome Open Res 2021; 6:255. [PMID: 35299709 PMCID: PMC8902262 DOI: 10.12688/wellcomeopenres.17247.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 11/20/2022] Open
Abstract
Background: In countries with weak surveillance systems, confirmed coronavirus disease 2019 (COVID-19) deaths are likely to underestimate the pandemic's death toll. Many countries also have incomplete vital registration systems, hampering excess mortality estimation. Here, we fitted a dynamic transmission model to satellite imagery data of cemeteries in Mogadishu, Somalia during 2020 to estimate the date of introduction and other epidemiologic parameters of the early spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in this low-income, crisis-affected setting. Methods: We performed Markov chain Monte Carlo (MCMC) fitting with an age-structured compartmental COVID-19 model to provide median estimates and credible intervals for the date of introduction, the basic reproduction number ( R 0 ) and the effect of non-pharmaceutical interventions (NPIs) up to August 2020. Results: Under the assumption that excess deaths in Mogadishu March-August 2020 were attributable to SARS-CoV-2 infections, we arrived at median estimates of November-December 2019 for the date of introduction and low R 0 estimates (1.4-1.7) reflecting the slow and early rise and long plateau of excess deaths. The date of introduction, the amount of external seeding, the infection fatality rate (IFR) and the effectiveness of NPIs are correlated parameters and not separately identifiable in a narrow range from deaths data. Nevertheless, to obtain introduction dates no earlier than November 2019 a higher population-wide IFR (≥0.7%) had to be assumed than obtained by applying age-specific IFRs from high-income countries to Somalia's age structure. Conclusions: Model fitting of excess mortality data across a range of plausible values of the IFR and the amount of external seeding suggests an early SARS-CoV-2 introduction event may have occurred in Somalia in November-December 2019. Transmissibility in the first epidemic wave was estimated to be lower than in European settings. Alternatively, there was another, unidentified source of sustained excess mortality in Mogadishu from March to August 2020.
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Affiliation(s)
- Mihaly Koltai
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - Farah Bashiir
- Somali Disaster Resilience Institute, Mogadishu, Somalia
| | | | | | | | - Mark Jit
- London School of Hygiene & Tropical Medicine, London, UK
| | - Stefan Flasche
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - CMMID COVID-19 working group
- London School of Hygiene & Tropical Medicine, London, UK
- Somali Disaster Resilience Institute, Mogadishu, Somalia
- Satellite Applications Catapult, Didcot, UK
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8
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Irfan O, Li J, Tang K, Wang Z, Bhutta ZA. Risk of infection and transmission of SARS-CoV-2 among children and adolescents in households, communities and educational settings: A systematic review and meta-analysis. J Glob Health 2021; 11:05013. [PMID: 34326997 PMCID: PMC8285769 DOI: 10.7189/jogh.11.05013] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND There is uncertainty with respect to SARS-CoV-2 transmission in children (0-19 years) with controversy on effectiveness of school-closures in controlling the pandemic. It is of equal importance to evaluate the risk of transmission in children who are often asymptomatic or mildly symptomatic carriers that may incidentally transmit SARS-CoV-2 in different settings. We conducted this review to assess transmission and risks for SARS-CoV-2 in children (by age-groups or grades) in community and educational-settings compared to adults. METHODS Data for the review were retrieved from PubMed, EMBASE, Cochrane Library, WHO COVID-19 Database, China National Knowledge Infrastructure (CNKI) Database, WanFang Database, Latin American and Caribbean Health Sciences Literature (LILACS), Google Scholar, and preprints from medRixv and bioRixv) covering a timeline from December 1, 2019 to April 1, 2021. Population-screening, contact-tracing and cohort studies reporting prevalence and transmission of SARS-CoV-2 in children were included. Data were extracted according to PRISMA guidelines. Meta-analyses were performed using Review Manager 5.3. RESULTS Ninety studies were included. Compared to adults, children showed comparable national (risk ratio (RR) = 0.87, 95% confidence interval (CI) = 0.71-1.060 and subnational (RR = 0.81, 95% CI = 0.66-1.01) prevalence in population-screening studies, and lower odds of infection in community/household contact-tracing studies (odds ratio (OR) = 0.62, 95% CI = 0.46-0.84). On disaggregation, adolescents observed comparable risk (OR = 1.22, 95% CI = 0.74-2.04) with adults. In educational-settings, children attending daycare/preschools (OR = 0.53, 95% CI = 0.38-0.72) were observed to be at lower-risk when compared to adults, with odds of infection among primary (OR = 0.85, 95% CI = 0.55-1.31) and high-schoolers (OR = 1.30, 95% CI = 0.71-2.38) comparable to adults. Overall, children and adolescents had lower odds of infection in educational-settings compared to community and household clusters. CONCLUSIONS Children (<10 years) showed lower susceptibility to COVID-19 compared to adults, whereas adolescents in communities and high-schoolers had comparable risk. Risks of infection among children in educational-settings was lower than in communities. Evidence from school-based studies demonstrate it is largely safe for children (<10 years) to be at schools, however older children (10-19 years) might facilitate transmission. Despite this evidence, studies focusing on the effectiveness of mitigation measures in educational settings are urgently needed to support both public health and educational policy-making for school reopening.
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Affiliation(s)
- Omar Irfan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | - Jiang Li
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | - Kun Tang
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Zhicheng Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
- Institute for Global Health & Development, the Aga Khan University, Karachi, Pakistan
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Quashie PK, Mutungi JK, Dzabeng F, Oduro-Mensah D, Opurum PC, Tapela K, Udoakang AJ, Asante I, Paemka L, Kumi-Ansah F, Quaye O, Amoako E, Armah R, Kilba C, Boateng NA, Ofori M, Kyei GB, Bediako Y, Ndam N, Abugri J, Ansah P, Ampofo WK, Mutapi F, Awandare GA. Trends of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody prevalence in selected regions across Ghana. Wellcome Open Res 2021. [DOI: 10.12688/wellcomeopenres.16890.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: We set out to estimate the community-level exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Ghana. Methods: Phased seroprevalence studies of 2729 participants at selected locations across Ghana were conducted. Phase I (August 2020) sampled 1305 individuals at major markets/lorry stations, shopping malls, hospitals and research institutions involved in coronavirus disease 2019 (COVID-19) work. The study utilized a lateral flow rapid diagnostic test (RDT) which detected IgM and IgG antibodies against SARS-CoV-2 nucleocapsid protein. Results: During Phase I, 252/1305 (19%) tested positive for IgM or IgG or both. Exposure was significantly higher at markets/lorry stations (26.9%) compared to malls (9.4%), with 41–60-year group demonstrating highest seropositivity (27.2%). Exposure was higher in participants with no formal education (26.2%) than those with tertiary education (13.1%); and higher in informally employed workers (24.0%) than those in the formal sector (15.0%). Results from phases II and III, in October and December 2020 respectively, implied either reduced transmissions or loss of antibody expression in some participants. The Upper East region showed the lowest seropositivity (2%). Phase IV, in February 2021, showed doubled seropositivity in the upper income bracket (26.2%) since August 2020, reflective of Ghana’s second wave of symptomatic COVID-19 cases. This suggested that high transmission rates had overcome the initial socioeconomic stratification of exposure risk. Reflective of second wave hospitalisation trends, the 21-40 age group demonstrated modal seropositivity (24.9) in Phase IV whilst 40-60 years and 60+ previously demonstrated highest prevalence. Conclusions: Overall, the data indicates higher COVID-19 seroprevalence than officially acknowledged, likely implying a considerably lower-case fatality rate than the current national figure of 0.84%. The data also suggests that COVID-19 is predominantly asymptomatic COVID-19 in Ghana. The observed trends mimic clinical trends of infection and imply that the methodology used was appropriate.
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10
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Gégout Petit A, Jeulin H, Legrand K, Jay N, Bochnakian A, Vallois P, Schvoerer E, Guillemin F. Seroprevalence of SARS-CoV-2, Symptom Profiles and Sero-Neutralization in a Suburban Area, France. Viruses 2021; 13:v13061076. [PMID: 34200070 PMCID: PMC8230202 DOI: 10.3390/v13061076] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/29/2021] [Accepted: 06/01/2021] [Indexed: 01/28/2023] Open
Abstract
The World Health Organisation recommends monitoring the circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We investigated anti-SARS-CoV-2 total immunoglobulin (IgT) antibody seroprevalence and in vitro sero-neutralization in Nancy, France, in spring 2020. Individuals were randomly sampled from electoral lists and invited with household members over 5 years old to be tested for anti-SARS-CoV-2 (IgT, i.e., IgA/IgG/IgM) antibodies by ELISA (Bio-rad); the sero-neutralization activity was evaluated on Vero CCL-81 cells. Among 2006 individuals, the raw seroprevalence was 2.1% (95% confidence interval 1.5 to 2.9), was highest for 20- to 34-year-old participants (4.7% (2.3 to 8.4)), within than out of socially deprived area (2.5% vs. 1%, p = 0.02) and with than without intra-family infection (p < 10-6). Moreover, 25% of participants presented at least one COVID-19 symptom associated with SARS-CoV-2 positivity (p < 10-13), with highly discriminant anosmia or ageusia (odds ratio 27.8 [13.9 to 54.5]); 16.3% (6.8 to 30.7) of seropositive individuals were asymptomatic. Positive sero-neutralization was demonstrated in vitro for 31/43 seropositive subjects. Regarding the very low seroprevalence, a preventive effect of the lockdown in March 2020 can be assumed for the summer, but a second COVID-19 wave, as expected, could be subsequently observed in this poorly immunized population.
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Affiliation(s)
- Anne Gégout Petit
- IECL, Université de Lorraine, CNRS, Inria, F-54000 Nancy, France; (A.G.P.); (P.V.)
| | - Hélène Jeulin
- LCPME, Université de Lorraine, CNRS, F-54000 Nancy, France;
- Laboratoire de Virologie, CHRU de Nancy Brabois, F-54500 Vandoeuvre-lès-Nancy, France
- Correspondence: ; Tel.: +33-383-153-467
| | - Karine Legrand
- CIC Epidémiologie Clinique, CHRU-Nancy, Inserm, Université de Lorraine, F-54000 Nancy, France; (K.L.); (A.B.); (F.G.)
| | - Nicolas Jay
- LORIA, CHRU-Nancy, Université de Lorraine, CNRS, Inria, LORIA, F-54000 Nancy, France;
| | - Agathe Bochnakian
- CIC Epidémiologie Clinique, CHRU-Nancy, Inserm, Université de Lorraine, F-54000 Nancy, France; (K.L.); (A.B.); (F.G.)
| | - Pierre Vallois
- IECL, Université de Lorraine, CNRS, Inria, F-54000 Nancy, France; (A.G.P.); (P.V.)
| | - Evelyne Schvoerer
- LCPME, Université de Lorraine, CNRS, F-54000 Nancy, France;
- Laboratoire de Virologie, CHRU de Nancy Brabois, F-54500 Vandoeuvre-lès-Nancy, France
| | - Francis Guillemin
- CIC Epidémiologie Clinique, CHRU-Nancy, Inserm, Université de Lorraine, F-54000 Nancy, France; (K.L.); (A.B.); (F.G.)
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