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Willem L, Abrams S, Franco N, Coletti P, Libin PJK, Wambua J, Couvreur S, André E, Wenseleers T, Mao Z, Torneri A, Faes C, Beutels P, Hens N. The impact of quality-adjusted life years on evaluating COVID-19 mitigation strategies: lessons from age-specific vaccination roll-out and variants of concern in Belgium (2020-2022). BMC Public Health 2024; 24:1171. [PMID: 38671366 PMCID: PMC11047051 DOI: 10.1186/s12889-024-18576-w] [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: 10/27/2023] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND When formulating and evaluating COVID-19 vaccination strategies, an emphasis has been placed on preventing severe disease that overburdens healthcare systems and leads to mortality. However, more conventional outcomes such as quality-adjusted life years (QALYs) and inequality indicators are warranted as additional information for policymakers. METHODS We adopted a mathematical transmission model to describe the infectious disease dynamics of SARS-COV-2, including disease mortality and morbidity, and to evaluate (non)pharmaceutical interventions. Therefore, we considered temporal immunity levels, together with the distinct transmissibility of variants of concern (VOCs) and their corresponding vaccine effectiveness. We included both general and age-specific characteristics related to SARS-CoV-2 vaccination. Our scenario study is informed by data from Belgium, focusing on the period from August 2021 until February 2022, when vaccination for children aged 5-11 years was initially not yet licensed and first booster doses were administered to adults. More specifically, we investigated the potential impact of an earlier vaccination programme for children and increased or reduced historical adult booster dose uptake. RESULTS Through simulations, we demonstrate that increasing vaccine uptake in children aged 5-11 years in August-September 2021 could have led to reduced disease incidence and ICU occupancy, which was an essential indicator for implementing non-pharmaceutical interventions and maintaining healthcare system functionality. However, an enhanced booster dose regimen for adults from November 2021 onward could have resulted in more substantial cumulative QALY gains, particularly through the prevention of elevated levels of infection and disease incidence associated with the emergence of Omicron VOC. In both scenarios, the need for non-pharmaceutical interventions could have decreased, potentially boosting economic activity and mental well-being. CONCLUSIONS When calculating the impact of measures to mitigate disease spread in terms of life years lost due to COVID-19 mortality, we highlight the impact of COVID-19 on the health-related quality of life of survivors. Our study underscores that disease-related morbidity could constitute a significant part of the overall health burden. Our quantitative findings depend on the specific setup of the interventions under review, which is open to debate or should be contextualised within future situations.
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Affiliation(s)
- Lander Willem
- Department of Family Medicine and Population Health, Antwerp, Belgium.
- Centre for Health Economic Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium.
| | - Steven Abrams
- Department of Family Medicine and Population Health, Antwerp, Belgium
- Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Nicolas Franco
- Data Science Institute, Hasselt University, Hasselt, Belgium
- Namur Institute for Complex Systems (naXys) and Department of Mathematics, University of Namur, Namur, Belgium
| | - Pietro Coletti
- Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Pieter J K Libin
- Data Science Institute, Hasselt University, Hasselt, Belgium
- Artificial Intelligence Lab, Vrije Universiteit Brussel, Brussels, Belgium
- Rega Institute for Medical Research, Clinical and Epidemiological Virology, University of Leuven, Leuven, Belgium
| | - James Wambua
- Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Simon Couvreur
- Department of Epidemiology and public health, Sciensano, Brussel, Belgium
| | - Emmanuel André
- National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, University of Leuven, Leuven, Belgium
| | - Tom Wenseleers
- Laboratory of Socioecology and Social Evolution, University of Leuven, Leuven, Belgium
| | - Zhuxin Mao
- Centre for Health Economic Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium
| | - Andrea Torneri
- Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Christel Faes
- Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Philippe Beutels
- Centre for Health Economic Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia
| | - Niel Hens
- Centre for Health Economic Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium
- Data Science Institute, Hasselt University, Hasselt, Belgium
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Denayer S, Dufrasne FE, Monsieurs B, van Eycken R, Houben S, Seyler L, Demuyser T, van Nedervelde E, Bourgeois M, Delaere B, Magerman K, Jouck D, Lissoir B, Sion C, Reynders M, Petit E, Dauby N, Hainaut M, Laenen L, Maes P, Baele G, Dellicour S, Cuypers L, André E, Couvreur S, Brondeel R, Barbezange C, Bossuyt N, van Gucht S. Genomic monitoring of SARS-CoV-2 variants using sentinel SARI hospital surveillance. Influenza Other Respir Viruses 2023; 17:e13202. [PMID: 37840842 PMCID: PMC10570899 DOI: 10.1111/irv.13202] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 10/17/2023] Open
Abstract
Background To support the COVID-19 pandemic response, many countries, including Belgium, implemented baseline genomic surveillance (BGS) programs aiming to early detect and characterize new SARS-CoV-2 variants. In parallel, Belgium maintained a sentinel network of six hospitals that samples patients with severe acute respiratory infections (SARI) and integrated SARS-CoV-2 detection within a broader range of respiratory pathogens. We evaluate the ability of the SARI surveillance to monitor general trends and early signals of viral genetic evolution of SARS-CoV-2 and compare it with the BGS as a reference model. Methods Nine-hundred twenty-five SARS-CoV-2 positive samples from patients fulfilling the Belgian SARI definition between January 2020 and December 2022 were sequenced using the ARTIC Network amplicon tiling approach on a MinION platform. Weekly variant of concern (VOC) proportions and types were compared to those that were circulating between 2021 and 2022, using 96,251 sequences of the BGS. Results SARI surveillance allowed timely detection of the Omicron (BA.1, BA.2, BA.4, and BA.5) and Delta (B.1.617.2) VOCs, with no to 2 weeks delay according to the start of their epidemic growth in the Belgian population. First detection of VOCs B.1.351 and P.1 took longer, but these remained minor in Belgium. Omicron BA.3 was never detected in SARI surveillance. Timeliness could not be evaluated for B.1.1.7, being already major at the start of the study period. Conclusions Genomic surveillance of SARS-CoV-2 using SARI sentinel surveillance has proven to accurately reflect VOCs detected in the population and provides a cost-effective solution for long-term genomic monitoring of circulating respiratory viruses.
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Affiliation(s)
- Sarah Denayer
- Viral Diseases, National Influenza Centre, Scientific Directorate of Infectious Diseases in HumansSciensanoUkkelBelgium
| | - François E. Dufrasne
- Viral Diseases, National Influenza Centre, Scientific Directorate of Infectious Diseases in HumansSciensanoUkkelBelgium
| | - Bert Monsieurs
- Viral Diseases, National Influenza Centre, Scientific Directorate of Infectious Diseases in HumansSciensanoUkkelBelgium
| | - Reinout van Eycken
- Viral Diseases, National Influenza Centre, Scientific Directorate of Infectious Diseases in HumansSciensanoUkkelBelgium
| | - Sarah Houben
- Observational Clinical Trials, Scientific Directorate of infectious Diseases in HumansSciensanoUkkelBelgium
| | - Lucie Seyler
- Department of Internal Medicine and Infectiology, Universitair Ziekenhuis Brussel (UZB)Vrije Universiteit Brussel (VUB)BrusselsBelgium
| | - Thomas Demuyser
- Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel (UZB)Vrije Universiteit Brussel (VUB)BrusselsBelgium
- AIMS Lab, Center for Neurosciences, Faculty of Medicine and PharmacyVrije Universiteit Brussel (VUB)BrusselsBelgium
| | - Els van Nedervelde
- Department of Internal Medicine and Infectiology, Universitair Ziekenhuis Brussel (UZB)Vrije Universiteit Brussel (VUB)BrusselsBelgium
| | | | | | - Koen Magerman
- Infection Control and Clinical LaboratoryJessa ZiekenhuisHasseltBelgium
- Department of Immunology and InfectionHasselt UniversityHasseltBelgium
| | - Door Jouck
- Infection ControlJessa ZiekenhuisHasseltBelgium
| | | | - Catherine Sion
- Laboratory Site St‐JosephGrand Hôpital de CharleroiGillyBelgium
| | | | - Evelyn Petit
- Laboratory MedicineAZ Sint‐Jan Brugge‐Oostende AVBrugesBelgium
| | - Nicolas Dauby
- Department of Infectious Diseases, Centre Hospitalier Universitaire Saint‐PierreUniversité Libre de Bruxelles (ULB)BrusselsBelgium
- Institute for Medical Immunology, ULB Center for Research in Immunology (U‐CRI)Université Libre de Bruxelles (ULB)BrusselsBelgium
- School of Public HealthUniversité Libre de Bruxelles (ULB)BrusselsBelgium
| | - Marc Hainaut
- Pediatrics Department, CHU Saint‐PierreUniversité Libre de Bruxelles (ULB)BrusselsBelgium
| | - Lies Laenen
- National Reference Center for Respiratory Pathogens, UZ LeuvenUniversity Hospitals LeuvenLeuvenBelgium
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and TransplantationKU LeuvenLeuvenBelgium
| | - Piet Maes
- Department of Microbiology, Immunology and Transplantation, Rega InstituteKU LeuvenLeuvenBelgium
| | - Guy Baele
- Department of Microbiology, Immunology and Transplantation, Rega InstituteKU LeuvenLeuvenBelgium
| | - Simon Dellicour
- Department of Microbiology, Immunology and Transplantation, Rega InstituteKU LeuvenLeuvenBelgium
- Spatial Epidemiology Lab (SpELL)Université Libre de BruxellesBrusselsBelgium
| | - Lize Cuypers
- National Reference Center for Respiratory Pathogens, UZ LeuvenUniversity Hospitals LeuvenLeuvenBelgium
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and TransplantationKU LeuvenLeuvenBelgium
| | - Emmanuel André
- National Reference Center for Respiratory Pathogens, UZ LeuvenUniversity Hospitals LeuvenLeuvenBelgium
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and TransplantationKU LeuvenLeuvenBelgium
| | - Simon Couvreur
- Epidemiology and public Health, Epidemiology of Infectious DiseasesSciensanoBrusselsBelgium
| | - Ruben Brondeel
- Epidemiology and public Health, Epidemiology of Infectious DiseasesSciensanoBrusselsBelgium
| | - Cyril Barbezange
- Viral Diseases, National Influenza Centre, Scientific Directorate of Infectious Diseases in HumansSciensanoUkkelBelgium
| | - Nathalie Bossuyt
- Epidemiology and public Health, Epidemiology of Infectious DiseasesSciensanoBrusselsBelgium
| | - Steven van Gucht
- Viral Diseases, National Influenza Centre, Scientific Directorate of Infectious Diseases in HumansSciensanoUkkelBelgium
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3
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Lafort Y, Cornelissen L, Van Cauteren D, Verboven B, Drieskens S, Couvreur S, Hermans L, Straetmans K, Lernout T. Were SARS-CoV-2 self-tests used for their intended purpose? The experience in Belgium. BMC Health Serv Res 2023; 23:709. [PMID: 37386558 DOI: 10.1186/s12913-023-09704-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 06/15/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Self-testing has been promoted as a means of increasing COVID-19 test coverage. In Belgium, self-testing was recommended as a complement to the formal, provider-administered indications, such as out of courtesy before meeting others and when feared to be infected. More than a year after the introduction of self-testing their place in the test strategy was evaluated. METHODS We assessed trends in the number of self-tests sold, the number of positive self-tests reported, the proportion sold self-tests/total tests, and the proportion of all positive tests that were confirmed self-tests. To evaluate the reason why people use self-tests, we used the results of two online surveys among members of the general population: one among 27,397 people, held in April 2021, and one among 22,354 people, held in December 2021. RESULTS The use of self-tests became substantial from end 2021 onwards. In the period mid-November 2021 - end-of-June 2022, the average proportion of reported sold self-tests to all COVID-19 tests was 37% and 14% of all positive tests were positive self-tests. In both surveys, the main reported reasons for using a self-test were having symptoms (34% of users in April 2021 and 31% in December 2021) and after a risk contact (27% in both April and December). Moreover, the number of self-tests sold, and the number of positive self-tests reported closely followed the same trend as the provider-administered tests in symptomatic people and high risk-contacts, which reinforces the hypothesis that they were mainly used for these two indications. CONCLUSIONS From end 2021 onwards, self-testing covered a significant part of COVID-19 testing in Belgium, which increased without doubt the testing coverage. However, the available data seem to indicate that self-testing was mostly used for indications outside of official recommendations. If and how this affected the control of the epidemic remains unknown.
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Affiliation(s)
- Yves Lafort
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
| | - Laura Cornelissen
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | | | | | - Sabine Drieskens
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Simon Couvreur
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Lize Hermans
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | | | - Tinne Lernout
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
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4
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Acke S, Couvreur S, Bramer WM, Schmickler MN, De Schryver A, Haagsma JA. Global infectious disease risks associated with occupational exposure among non-healthcare workers: a systematic review of the literature. Occup Environ Med 2021; 79:63-71. [PMID: 34035182 PMCID: PMC8685622 DOI: 10.1136/oemed-2020-107164] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/07/2021] [Accepted: 02/12/2021] [Indexed: 12/03/2022]
Abstract
Objectives Employees in non-healthcare occupations may be in several ways exposed to infectious agents. Improved knowledge about the risks is needed to identify opportunities to prevent work-related infectious diseases. The objective of the current study was to provide an updated overview of the published evidence on the exposure to pathogens among non-healthcare workers. Because of the recent SARS-CoV-2 outbreaks, we also aimed to gain more evidence about exposure to several respiratory tract pathogens. Methods Eligible studies were identified in MEDLINE, Embase and Cochrane between 2009 and 8 December 2020. The protocol was registered with International Prospective Register of Systematic Reviews (CRD42019107265). An additional quality assessment was applied according to the Equator network guidelines. Results The systematic literature search yielded 4620 papers of which 270 met the selection and quality criteria. Infectious disease risks were described in 37 occupational groups; 18 of them were not mentioned before. Armed forces (n=36 pathogens), livestock farm labourers (n=31), livestock/dairy producers (n=26), abattoir workers (n=22); animal carers and forestry workers (both n=16) seemed to have the highest risk. In total, 111 pathogen exposures were found. Many of these occupational groups (81.1%) were exposed to respiratory tract pathogens. Conclusion Many of these respiratory tract pathogens were readily transmitted where employees congregate (workplace risk factors), while worker risk factors seemed to be of increasing importance. By analysing existing knowledge of these risk factors, identifying new risks and susceptible risk groups, this review aimed to raise awareness of the issue and provide reliable information to establish more effective preventive measures.
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Affiliation(s)
- Sofie Acke
- Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.,Research and Development, Mensura Occupational Health Services, Brussel, Belgium
| | - Simon Couvreur
- Department of Twin Research, King's College London, London, UK
| | | | | | - Antoon De Schryver
- Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
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5
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Piaggeschi G, Rolla S, Rossi N, Brusa D, Naccarati A, Couvreur S, Spector TD, Roederer M, Mangino M, Cordero F, Falchi M, Visconti A. Immune Trait Shifts in Association With Tobacco Smoking: A Study in Healthy Women. Front Immunol 2021; 12:637974. [PMID: 33767708 PMCID: PMC7985448 DOI: 10.3389/fimmu.2021.637974] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 02/09/2021] [Indexed: 12/22/2022] Open
Abstract
Tobacco smoking is known to impact circulating levels of major immune cells populations, but its effect on specific immune cell subsets remains poorly understood. Here, using high-resolution data from 223 healthy women (25 current and 198 never smokers), we investigated the association between smoking status and 35,651 immune traits capturing immune cell subset frequencies. Our results confirmed that active tobacco smoking is associated with increased frequencies of circulating CD8+ T cells expressing the CD25 activation marker. Moreover, we identified novel associations between smoking status and relative abundances of CD8+ CD25+ memory T cells, CD8+ memory T cells expressing the CCR4 chemokine receptor, and CD4+CD8+ (double-positive) CD25+ T cells. We also observed, in current smokers, a decrease in the relative frequencies of CD4+ T cells expressing the CD38 activation marker and an increase in class-switched memory B cell isotypes IgA, IgG, and IgE. Finally, using data from 135 former female smokers, we showed that the relative frequencies of immune traits associated with active smoking are usually completely restored after smoking cessation, with the exception of subsets of CD8+ and CD8+ memory T cells, which persist partially altered. Our results are consistent with previous findings and provide further evidence on how tobacco smoking shapes leukocyte cell subsets proportion toward chronic inflammation.
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Affiliation(s)
- Giulia Piaggeschi
- Italian Institute for Genomic Medicine, c/o IRCCS Candiolo, Turin, Italy.,Department of Computer Science, University of Turin, Turin, Italy
| | - Simona Rolla
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Niccolò Rossi
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Davide Brusa
- Institute of Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium
| | - Alessio Naccarati
- Italian Institute for Genomic Medicine, c/o IRCCS Candiolo, Turin, Italy.,Candiolo Cancer Institute, Fondazione del Piemonte per l'Oncologia-Istituto di Ricovero e Cura a Carattere Scientifico (FPO-IRCCS), Turin, Italy
| | - Simon Couvreur
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Mario Roederer
- Vaccine Research Center, National Institutes of Health, Bethesda, MD, United States
| | - Massimo Mangino
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom.,National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St Thomas' Foundation Trust, London, United Kingdom
| | | | - Mario Falchi
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Alessia Visconti
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
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6
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Wells PM, Doores KJ, Couvreur S, Nunez RM, Seow J, Graham C, Acors S, Kouphou N, Neil SJD, Tedder RS, Matos PM, Poulton K, Lista MJ, Dickenson RE, Sertkaya H, Maguire TJA, Scourfield EJ, Bowyer RCE, Hart D, O'Byrne A, Steel KJA, Hemmings O, Rosadas C, McClure MO, Capedevilla-Pujol J, Wolf J, Ourselin S, Brown MA, Malim MH, Spector T, Steves CJ. Estimates of the rate of infection and asymptomatic COVID-19 disease in a population sample from SE England. J Infect 2020; 81:931-936. [PMID: 33068628 PMCID: PMC7557299 DOI: 10.1016/j.jinf.2020.10.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 10/11/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Understanding of the true asymptomatic rate of infection of SARS-CoV-2 is currently limited, as is understanding of the population-based seroprevalence after the first wave of COVID-19 within the UK. The majority of data thus far come from hospitalised patients, with little focus on general population cases, or their symptoms. METHODS We undertook enzyme linked immunosorbent assay characterisation of IgM and IgG responses against SARS-CoV-2 spike glycoprotein and nucleocapsid protein of 431 unselected general-population participants of the TwinsUK cohort from South-East England, aged 19-86 (median age 48; 85% female). 382 participants completed prospective logging of 14 COVID-19 related symptoms via the COVID Symptom Study App, allowing consideration of serology alongside individual symptoms, and a predictive algorithm for estimated COVID-19 previously modelled on PCR positive individuals from a dataset of over 2 million. FINDINGS We demonstrated a seroprevalence of 12% (51 participants of 431). Of 48 seropositive individuals with full symptom data, nine (19%) were fully asymptomatic, and 16 (27%) were asymptomatic for core COVID-19 symptoms: fever, cough or anosmia. Specificity of anosmia for seropositivity was 95%, compared to 88% for fever cough and anosmia combined. 34 individuals in the cohort were predicted to be Covid-19 positive using the App algorithm, and of those, 18 (52%) were seropositive. INTERPRETATION Seroprevalence amongst adults from London and South-East England was 12%, and 19% of seropositive individuals with prospective symptom logging were fully asymptomatic throughout the study. Anosmia demonstrated the highest symptom specificity for SARS-CoV-2 antibody response. FUNDING NIHR BRC, CDRF, ZOE global LTD, RST-UKRI/MRC.
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Affiliation(s)
- Philippa M Wells
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK
| | - Katie J Doores
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Simon Couvreur
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK
| | - Rocio Martinez Nunez
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Jeffrey Seow
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Carl Graham
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Sam Acors
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Neophytos Kouphou
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Stuart J D Neil
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | | | - Pedro M Matos
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Kate Poulton
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Maria Jose Lista
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Ruth E Dickenson
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Helin Sertkaya
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Thomas J A Maguire
- Centre for Inflammation Biology and Cancer Immunology, Department of Inflammation Biology, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Edward J Scourfield
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Ruth C E Bowyer
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK
| | - Deborah Hart
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK
| | - Aoife O'Byrne
- Centre for Inflammation Biology and Cancer Immunology, Department of Inflammation Biology, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Kathryn J A Steel
- Centre for Inflammation Biology and Cancer Immunology, Department of Inflammation Biology, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Oliver Hemmings
- Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
| | | | - Myra O McClure
- Department of Infectious Disease, Imperial College London, UK
| | | | | | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Matthew A Brown
- Department of Medical & Molecular Genetics, Guy's and St Thomas' Hospital NHS Trust and King's College London NIHR Biomedical Research Centre, London, UK
| | - Michael H Malim
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Tim Spector
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK
| | - Claire J Steves
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK.
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7
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Mukendi D, Tepage F, Akonda I, Siewe JNF, Rotsaert A, Ndibmun CN, Laudisoit A, Couvreur S, Kabutako B, Menon S, Hotterbeekx A, Colebunders R. High prevalence of epilepsy in an onchocerciasis endemic health zone in the Democratic Republic of the Congo, despite 14 years of community-directed treatment with ivermectin: A mixed-method assessment. Int J Infect Dis 2019; 79:187-194. [PMID: 30711145 PMCID: PMC6353816 DOI: 10.1016/j.ijid.2018.10.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 10/14/2018] [Accepted: 10/26/2018] [Indexed: 11/24/2022] Open
Abstract
A high epilepsy prevalence in the Aketi health zone was observed despite 14 years of community-directed treatment with ivermectin. The high prevalence of OV16 antibodies in children is indicative of high ongoing onchocerciasis transmission. High onchocerciasis transmission is the consequence of high exposure to blackflies and low intake of ivermectin. Head nodding seizures were observed in 13.8% of the persons with epilepsy. Ivermectin coverage needs to be increased and bi-annual distribution should be considered.
Objectives To investigate the reasons for the high prevalence of epilepsy (>6%) discovered in 2015 in the Aketi health zone in the north of the Democratic Republic of the Congo. Methods Persons with epilepsy (PWE) diagnosed in a door-to-door survey in 2015 were traced and re-examined in 2017 by a neurologist. Confirmed PWE were paired with matched controls. For onchocerciasis assessment, children 7–10 years old were tested for IgG4 Onchocerca volvulus (OV16) antibodies, a rapid epidemiological mapping of onchocerciasis (REMO) study was performed, and ivermectin coverage was investigated. Results Forty-three (61.4%) previously diagnosed PWE were traced; the neurologist confirmed the epilepsy diagnosis in all of them. The overall OV16 positivity rate was 64.5%. Poor ivermectin coverage (55.9%) and a high prevalence of onchocercal nodules (>70%) were observed. The prevalence of epilepsy was 5.7% in Aketi rural town, with nine PWE (13.8%) experiencing head nodding seizures. A case-control study showed that PWE had lower body weight and higher ivermectin coverage in 2017 than healthy controls. Conclusions The high prevalence of epilepsy in the Aketi health zone, despite 14 years of community-directed treatment with ivermectin (CDTI), was found to be associated with high onchocerciasis transmission and low ivermectin use. An awareness programme to increase ivermectin coverage and the introduction of a bi-annual CDTI programme should be considered.
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Affiliation(s)
- Deby Mukendi
- Neuropsychopathologic Centre of Mont Amba, University of Kinshasa, Kinshasa, Congo.
| | | | | | | | - Anke Rotsaert
- Global Health Institute, University of Antwerp, Antwerp, Belgium.
| | | | - Anne Laudisoit
- Global Health Institute, University of Antwerp, Antwerp, Belgium; EcoHealth Alliance, New York, USA.
| | - Simon Couvreur
- Global Health Institute, University of Antwerp, Antwerp, Belgium.
| | - Blandine Kabutako
- School of Medicine, Bel-Campus Technological University, Kinshasa, Congo.
| | - Sonia Menon
- Global Health Institute, University of Antwerp, Antwerp, Belgium.
| | - An Hotterbeekx
- Global Health Institute, University of Antwerp, Antwerp, Belgium.
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Mosca AL, Callier P, Faivre L, Laurent N, Rousseau T, Marle N, Payet M, Guy H, Couvreur S, Masurel-Paulet A, Sagot P, Thauvin-Robinet C, Mugneret F. A prenatal case of inverted duplication with terminal deletion of 5p not including the cat-like cry critical region. Am J Med Genet A 2011; 155A:2031-4. [PMID: 21739595 DOI: 10.1002/ajmg.a.34105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Accepted: 04/18/2011] [Indexed: 11/07/2022]
Affiliation(s)
- A L Mosca
- Laboratoire de Cytogénétique, CHU le Bocage, Dijon, France
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Hurtaud C, Faucon F, Couvreur S, Peyraud JL. Linear relationship between increasing amounts of extruded linseed in dairy cow diet and milk fatty acid composition and butter properties. J Dairy Sci 2010; 93:1429-43. [DOI: 10.3168/jds.2009-2839] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Accepted: 12/21/2009] [Indexed: 11/19/2022]
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Couvreur S, Hurtaud C, Marnet PG, Faverdin P, Peyraud JL. Composition of milk fat from cows selected for milk fat globule size and offered either fresh pasture or a corn silage-based diet. J Dairy Sci 2008; 90:392-403. [PMID: 17183107 DOI: 10.3168/jds.s0022-0302(07)72640-1] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The objective of this study was to examine the synthesis and composition of milk produced by dairy cows that secrete either small milk fat globules (SMFG) or large milk fat globules (LMFG), and to study their response to diets known to alter milk composition. Four groups of 3 multiparous dairy cows were assigned to 2 isoenergetic feeding treatments: a corn silage treatment supplemented with soybean meal, and fresh pasture supplemented with cereal concentrate. The 4 groups comprised 2 groups of 3 dairy cows that produced SMFG (3.44 microm) and 2 groups of 3 dairy cows that produced LMFG (4.53 microm). The SMFG dairy cows produced higher yields of milk, protein, and calcium. Nevertheless, their milk had lower fat and protein contents. Both SMFG and LMFG cows secreted similar amounts of milk fat; therefore, higher globule membrane contents in milk fat were observed in SMFG cows. Higher calcium mineralization of the casein micelles in SMFG cows suggests that it may be possible to improve cheese-making properties even if the lower protein content may lead to lower cheese yields. The SMFG cows secrete milk fat with a higher concentration of monounsaturated fatty acids and a lower concentration of short-chain fatty acids. They also have a higher C18:1/C18:0 ratio than LMFG cows. This suggests that SMFG cows have more significant fatty acid elongation and desaturation. The pasture treatment led to an increase in milk and protein yields because of increased energy intake. It also resulted in lower milk fat yield and fat and protein contents. The pasture treatment led to a decrease in milk fat globule size and, as expected, an increase in monounsaturated and polyunsaturated fatty acid contents. However, it induced a decrease in the protein content, and in calcium mineralization of casein micelles, which suggests that this type of milk would be less suitable for making cheese. This study also shows that there is no correlation between the cows, based on milk fat globule size and diet. These results open up possibilities for improving milk fat quality based on milk fat globule size, and composition. The mechanisms involved in milk fat globule secretion are still to be determined.
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Affiliation(s)
- S Couvreur
- Unité Mixte de Recherches INRA-Agrocampus Rennes Production du Lait, Domaine de la Prise, 35590 Saint-Gilles, France
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Couvreur S, Hurtaud C, Lopez C, Delaby L, Peyraud JL. The Linear Relationship Between the Proportion of Fresh Grass in the Cow Diet, Milk Fatty Acid Composition, and Butter Properties. J Dairy Sci 2006; 89:1956-69. [PMID: 16702259 DOI: 10.3168/jds.s0022-0302(06)72263-9] [Citation(s) in RCA: 180] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Fresh grass in the cow diet improves the rheological and nutritional properties of butter. However, the relationship between the proportion of fresh grass in the diet and these properties is still unknown. The objective of the study was to determine the relationship between the proportion of fresh grass in the diet and the properties of milk and butter. Four groups of 2 cows were fed 4 isoenergetic diets characterized by increasing amounts of fresh grass (0, 30, 60, and 100% dry matter of forage) according to a Youden square design. Energy levels were similar among all diets. Thus, no effect of mobilization was observed and the results were only due to the proportion of fresh grass in the diet. Milk yield linearly increased with the proportion of fresh grass in the diet (+0.21 kg/d per 10% of grass). Fat yield remained unchanged. Thus, by effect of dilution, increasing the proportion of fresh grass in the diet induced a linear decrease in fat content. Milk fat globule size decreased by 0.29 mum when the proportion of grass reached 30% in the diet. Increasing the proportion of fresh grass in the diet induced a linear increase in unsaturated fatty acids percentages at the expense of saturated fatty acids. Relationships were +0.38, +0.12, +0.05 and -0.69 points/10% of fresh grass in the diet for C18:1 trans-11, C18:2 cis-9,trans-11, C18:3n-3, and C16:0, respectively. These modifications in fatty acid composition, and in particular in the spreadability index, C16:0/C18:1, were responsible for linear decreases in final melting temperature and solid fat content in butter fat, perceived in sensory analysis by a linear decrease in firmness in mouth. The nutritional value of butter was also linearly improved by the proportion of fresh grass in the diet by halving the atherogenicity index.
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Affiliation(s)
- S Couvreur
- Unité Mixte de Recherches I.N.R.A.-Agrocampus Production du Lait, Domaine de la Prise, 35590 Saint-Gilles, France
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