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Bakari M, Aboud S, Kasubi M, Mmbando BP, Ntinginya NE, Sichalwe A, Ubuguyu OS, Magesa A, Rutananukwa NL, Nyawale H, Kisinda A, Beyanga M, Horumpende PG, Mhame PS, Vumilia LM, Mziray LS, Mkala R, Shao E, Makubi A, Mshana SE, Kishimba R. Humoral Immune Responses following COVID-19 Vaccinations among Adults in Tanzania. Vaccines (Basel) 2023; 12:22. [PMID: 38250835 PMCID: PMC10819524 DOI: 10.3390/vaccines12010022] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/07/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
COVID-19 vaccination remains to be the most important intervention in the fight against the pandemic. The immunity among the vaccinated population and its durability can significantly vary due to various factors. This study investigated the humoral immune responses among individuals who received any of the COVID-19 vaccines approved for use in Tanzania. A total of 1048 randomly selected adults who received COVID-19 vaccines at different time points were enrolled and humoral immune responses (IR) were tested at baseline and three months later (960, 91.6%). The level of SARS-CoV-2 anti-spike/receptor binding domain (RBD) IgG, anti-nucleocapsid IgG, and IgM antibodies were determined using a commercially available chemiluminescent microparticle immunoassay. Descriptive data analysis was performed using STATA version 18 and R. At baseline, serum IgG against anti-spike/RBD was detected in 1010/1048 (96.4%) participants (95%CI: 94.9-97.5) and 98.3% (95%CI: 97.3-99) three months later. The IgG against the SARS-CoV-2 nucleocapsid proteins were detected in 40.8% and 45.3% of participants at baseline and follow-up, respectively. The proportion of seroconverters following vaccination and mean titers of anti-spike/RBD antibodies were significantly more among those who had past SARS-CoV-2 infection than in those with no evidence of past infection, (p < 0.001). Only 0.5% of those who had detectable anti-spike/RBD antibodies at baseline were negative after three months of follow-up and 1.5% had breakthrough infections. The majority of participants (99.5%) had detectable anti-spike/RBD antibodies beyond 6 months post-vaccination. The proportion of Tanzanians who mounted humoral IR following COVID-19 vaccination was very high. Seroconversions, as well as the mean titers and durability of humoral IR, were significantly enhanced by exposure to natural SARS-CoV-2 infection. In view of the limited availability of COVID-19 vaccines as well as challenges to completing subsequent doses, booster doses could only be suggested to high-risk groups.
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Affiliation(s)
- Muhammad Bakari
- School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam P.O. Box 65001, Tanzania; (M.B.); (S.A.)
| | - Said Aboud
- School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam P.O. Box 65001, Tanzania; (M.B.); (S.A.)
- National Institute for Medical Research (NIMR), Dar es Salaam P.O. Box 9653, Tanzania; (B.P.M.); (N.E.N.); (N.L.R.); (A.K.)
| | - Mabula Kasubi
- Muhimbili National Hospital (MNH), Dar es Salaam P.O. Box 65000, Tanzania;
| | - Bruno P. Mmbando
- National Institute for Medical Research (NIMR), Dar es Salaam P.O. Box 9653, Tanzania; (B.P.M.); (N.E.N.); (N.L.R.); (A.K.)
| | - Nyanda Elias Ntinginya
- National Institute for Medical Research (NIMR), Dar es Salaam P.O. Box 9653, Tanzania; (B.P.M.); (N.E.N.); (N.L.R.); (A.K.)
| | - Aifello Sichalwe
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
| | - Omary S. Ubuguyu
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
| | - Alex Magesa
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
| | - Nancy Ladislaus Rutananukwa
- National Institute for Medical Research (NIMR), Dar es Salaam P.O. Box 9653, Tanzania; (B.P.M.); (N.E.N.); (N.L.R.); (A.K.)
| | - Helmut Nyawale
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences (CUHAS), Mwanza P.O. Box 1464, Tanzania;
| | - Abisai Kisinda
- National Institute for Medical Research (NIMR), Dar es Salaam P.O. Box 9653, Tanzania; (B.P.M.); (N.E.N.); (N.L.R.); (A.K.)
| | - Medard Beyanga
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
| | - Pius G. Horumpende
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
| | - Paulo S. Mhame
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
| | - Liggle M. Vumilia
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
| | - Lucy S. Mziray
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
| | - Reuben Mkala
- Benjamin Mkapa Hospital (BMH), Dodoma P.O. Box 11088, Tanzania;
| | - Elichilia Shao
- Kilimanjaro Christian Medical Centre (KCMC), Moshi P.O. Box 3010, Tanzania;
- Faculty of Medicine, Department of Internal Medicine, Kilimanjaro Christian Medical University College (KCMUCo), Moshi P.O. Box 2240, Tanzania
| | - Abel Makubi
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
- Muhimbili Orthopaedics Institute (MOI), Dar es Salaam P.O. Box 65474, Tanzania
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences (CUHAS), Mwanza P.O. Box 1464, Tanzania;
| | - Rogath Kishimba
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
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Ngowi K, Msoka P, Mtesha B, Kwayu J, Mappi T, Kiwango K, Kiwelu E, Mmasi T, Sichalwe A, Shayo BC, Maro E, Marion Sumari-de Boer I. "The phone number tells us good things we didn't know before." Use of interactive voice response calling for improving knowledge and uptake of family planning methods among Maasai in Tanzania. PLOS Digit Health 2023; 2:e0000254. [PMID: 37205646 DOI: 10.1371/journal.pdig.0000254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/11/2023] [Indexed: 05/21/2023]
Abstract
Maasai living in the Arusha region, Tanzania, face challenges in feeding their children because of decreasing grazing grounds for their cattle. Therefore, they requested birth control methods. Previous studies have shown that lack of knowledge about, and poor access to, family planning (FP) may worsen the situation. We developed an interactive voice response calling (IVRC) platform for Maasai and health care workers (HCW) to create a venue for communication about FP to increase knowledge and access to FP. The objective of this study was to explore the effect of the platform on knowledge, access and use of family planning methods. We applied a participatory action research approach using mixed methods for data collection to develop and pilot-test an mHealth-platform with IVRC using Maa language. We enrolled Maasai-couples and HCW in Monduli District (Esilalei ward), Arusha Region, and followed them for 20 months. A baseline assessment was done to explore knowledge about FP. Furthermore, we abstracted information on FP clinic visits. Based on that, we developed a system called Embiotishu. A toll-free number was provided to interact with the system by calling with their phone. The system offers pre-recorded voice messages with information about FP and reproductive health to educate Maasai. The system recorded the number of calls and the type of information accessed. We measured the outcome by (1) a survey investigating the knowledge of contraceptive methods before and after Embiotishu and (2) counting the number of clinic visits (2018-2020) from medical records and feedback from qualitative data for FP used among Maasai. The acceptability and feasibility were explored through focus group discussions (FGDs) with Maasai and in-depth interviews (IDIs) with HCW. We recruited 76 Maasai couples whom we interviewed during the baseline assessment. The overall knowledge of contraceptives increased significantly (p<0.005) in both men and women. The number of clinic visits rose from 137 in 2018 to 344 in 2019 and 228 in the first six months of 2020. Implants were the most prescribed family planning method, followed by injections and pills, as found in medical records. The number of incoming calls, missed calls, and questions were 24,033 over 20 months. Out of these calls, 14,547 topics were selected. The most selected topics were modern contraceptives (mainly implants, condoms, tubal ligation, and vasectomy). Natural methods of contraception (vaginal fluid observations, calendar, and temperature). Our study has shown that the IVRC system led to an improvement in knowledge about and access to contraceptives. Furthermore, it has potential to increase access to health information as well as improve dialogue between Health workers and Maasai.
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Affiliation(s)
- Kennedy Ngowi
- Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - Perry Msoka
- Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
- Amsterdam Institute for Social Science Research (AISSR), Amsterdam, The Netherlands
| | - Benson Mtesha
- Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
| | - Jacqueline Kwayu
- Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
- Kilimanjaro Christian Medical Center, Moshi, United Republic of Tanzania
| | - Tauta Mappi
- Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
| | - Krisanta Kiwango
- Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
| | - Ester Kiwelu
- Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
| | - Titus Mmasi
- The office of District Medical office, Monduli, Arusha, United Republic of Tanzania
| | - Aifello Sichalwe
- The office of Regional Medical office, Arusha, United Republic of Tanzania
| | - Benjamin C Shayo
- Kilimanjaro Christian Medical Center, Moshi, United Republic of Tanzania
- Baylor College of Medicine, Houston, Texas, United States of America
| | - Eusebious Maro
- Kilimanjaro Christian Medical Center, Moshi, United Republic of Tanzania
| | - I Marion Sumari-de Boer
- Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
- Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
- Knowledge, Technology and Innovation Group, Wageningen University & Research, Wageningen, the Netherlands
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