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Ugwu CA, Alao O, John OG, Akinnawo B, Ajayi I, Odebode O, Bejide I, Campbell A, Campbell J, Adole JA, B. Olawoye I, Akano K, Okolie J, Eromon P, Olaitan P, Olagunoye A, Adebayo I, Adebayo V, Babalola E, Abioye O, Ajayi N, Ogah E, Ukwaja K, Okoro S, Oje O, Kingsley OC, Eke M, Onyia V, Achonduh-Atijegbe O, Ewah FE, Obasi M, Igwe V, Ayodeji O, Chukwuyem A, Owhin S, Oyejide N, Abah S, Ingbian W, Osoba M, Alebiosu A, Nadesalingam A, Aguinam ET, Carnell G, Krause N, Chan A, George C, Kinsley R, Tonks P, Temperton N, Heeney J, Happi C. Immunological insights into COVID-19 in Southern Nigeria. Front Immunol 2024; 15:1305586. [PMID: 38322252 PMCID: PMC10844438 DOI: 10.3389/fimmu.2024.1305586] [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: 10/02/2023] [Accepted: 01/04/2024] [Indexed: 02/08/2024] Open
Abstract
Introduction One of the unexpected outcomes of the COVID-19 pandemic was the relatively low levels of morbidity and mortality in Africa compared to the rest of the world. Nigeria, Africa's most populous nation, accounted for less than 0.01% of the global COVID-19 fatalities. The factors responsible for Nigeria's relatively low loss of life due to COVID-19 are unknown. Also, the correlates of protective immunity to SARS-CoV-2 and the impact of pre-existing immunity on the outcome of the COVID-19 pandemic in Africa are yet to be elucidated. Here, we evaluated the natural and vaccine-induced immune responses from vaccinated, non-vaccinated and convalescent individuals in Southern Nigeria throughout the three waves of the COVID-19 pandemic in Nigeria. We also examined the pre-existing immune responses to SARS-CoV-2 from samples collected prior to the COVID-19 pandemic. Methods We used spike RBD and N- IgG antibody ELISA to measure binding antibody responses, SARS-CoV-2 pseudotype assay protocol expressing the spike protein of different variants (D614G, Delta, Beta, Omicron BA1) to measure neutralizing antibody responses and nucleoprotein (N) and spike (S1, S2) direct ex vivo interferon gamma (IFNγ) T cell ELISpot to measure T cell responses. Result Our study demonstrated a similar magnitude of both binding (N-IgG (74% and 62%), S-RBD IgG (70% and 53%) and neutralizing (D614G (49% and 29%), Delta (56% and 47%), Beta (48% and 24%), Omicron BA1 (41% and 21%)) antibody responses from symptomatic and asymptomatic survivors in Nigeria. A similar magnitude was also seen among vaccinated participants. Interestingly, we revealed the presence of preexisting binding antibodies (N-IgG (60%) and S-RBD IgG (44%)) but no neutralizing antibodies from samples collected prior to the pandemic. Discussion These findings revealed that both vaccinated, non-vaccinated and convalescent individuals in Southern Nigeria make similar magnitude of both binding and cross-reactive neutralizing antibody responses. It supported the presence of preexisting binding antibody responses among some Nigerians prior to the COVID-19 pandemic. Lastly, hybrid immunity and heterologous vaccine boosting induced the strongest binding and broadly neutralizing antibody responses compared to vaccine or infection-acquired immunity alone.
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Affiliation(s)
- Chinedu A. Ugwu
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede, Osun, Nigeria
| | - Oluwasina Alao
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede, Osun, Nigeria
| | - Oluwagboadurami G. John
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede, Osun, Nigeria
| | - Blossom Akinnawo
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede, Osun, Nigeria
| | - Israel Ajayi
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede, Osun, Nigeria
| | - Ooreofe Odebode
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede, Osun, Nigeria
| | - Ifeoluwa Bejide
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede, Osun, Nigeria
| | - Allan Campbell
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede, Osun, Nigeria
| | - Julian Campbell
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede, Osun, Nigeria
| | - Jolly A. Adole
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede, Osun, Nigeria
| | - Idowu B. Olawoye
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede, Osun, Nigeria
| | - Kazeem Akano
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede, Osun, Nigeria
| | - Johnson Okolie
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
| | - Philomena Eromon
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
| | - Peter Olaitan
- Osun State University Teaching Hospital (UNIOSUNTH), Osogbo, Nigeria
| | - Ajibola Olagunoye
- Osun State University Teaching Hospital (UNIOSUNTH), Osogbo, Nigeria
| | - Ibukun Adebayo
- Osun State University Teaching Hospital (UNIOSUNTH), Osogbo, Nigeria
| | - Victor Adebayo
- Osun State University Teaching Hospital (UNIOSUNTH), Osogbo, Nigeria
| | | | - Omowumi Abioye
- Osun State University Teaching Hospital (UNIOSUNTH), Osogbo, Nigeria
| | - Nnennaya Ajayi
- Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | - Emeka Ogah
- Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | - Kingsley Ukwaja
- Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | - Sylvanus Okoro
- Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | - Ogbonnaya Oje
- Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | | | - Matthew Eke
- Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | - Venatius Onyia
- Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | - Olivia Achonduh-Atijegbe
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
| | - Friday Elechi Ewah
- Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | - Mary Obasi
- Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | - Violet Igwe
- Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Abakaliki, Nigeria
| | | | | | | | - Nicholas Oyejide
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
| | | | - Winifred Ingbian
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
| | - Moyosoore Osoba
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
| | - Ahmed Alebiosu
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
| | - Angalee Nadesalingam
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Ernest T. Aguinam
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - George Carnell
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Nina Krause
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Andrew Chan
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Charlotte George
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Rebecca Kinsley
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Paul Tonks
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Nigel Temperton
- Viral Pseudotype Unit, Medway School of Pharmacy, The Universities of Greenwich and Kent, Kent, United Kingdom
| | - Jonathan Heeney
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Christian Happi
- The Africa Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Ede, Osun, Nigeria
- Department of Biological Sciences, Faculty of Natural Sciences, Redeemer’s University, Ede, Osun, Nigeria
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Dan-Nwafor CC, Ipadeola O, Smout E, Ilori E, Adeyemo A, Umeokonkwo C, Nwidi D, Nwachukwu W, Ukponu W, Omabe E, Anaebonam U, Igwenyi N, Igbodo G, Eteng W, Uzoma I, Saleh M, Agboeze J, Mutbam S, de Gooyer T, Short R, Aniaku E, Onoh R, Ogah E, Nguku P, Oladejo J, Peter C, Ojo O, Ihekweazu C. A cluster of nosocomial Lassa fever cases in a tertiary health facility in Nigeria: Description and lessons learned, 2018. Int J Infect Dis 2019; 83:88-94. [PMID: 30930184 DOI: 10.1016/j.ijid.2019.03.030] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [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: 12/02/2018] [Revised: 03/22/2019] [Accepted: 03/23/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Lassa fever is an acute viral haemorrhagic disease endemic in Nigeria. The 2018 Lassa fever outbreak in Nigeria was unprecedented, with 8% of all cases occurring among healthcare workers (HCWs). A disproportionately high number of these infections occurred in HCWs working in a tertiary health facility in Nigeria. This paper describes the cluster of Lassa fever infections among HCWs in a treatment centre and the lessons learnt. METHODS We analysed clinical, epidemiological and laboratory data from surveillance and laboratory records kept during the 2018 outbreak. Interviews were conducted with surviving HCWs using a questionnaire developed specifically for the investigation of Lassa fever infections in HCWs. Descriptive analysis of the data was performed in Microsoft excel. RESULTS The index case was a 15-year-old male who presented at the health facility with fever and uncontrolled nasopharyngeal bleeding, following a recent uvulectomy by a traditional healer. Overall, 16 HCWs were affected (15 confirmed and 1 probable) with five deaths (CFR-31.6%). Of the 15 confirmed cases, five (33.3%) were asymptomatic. Nine HCWs were direct contacts of the index case; the remaining six HCWs had no direct contact with the index case. HCW interviews identified a low index of suspicion for Lassa fever leading to inadequate infection prevention and control (IPC) practices as possible contributing factors to nosocomial transmission. CONCLUSION Maintaining a high index of suspicion for Lassa fever in all patients, especially in endemic areas, is essential in adhering to adequate IPC practices in health facilities in order to prevent nosocomial transmission of Lassa fever among HCWs. There is a need to continually train and sensitise HCWs on strict adherence to IPC measures while providing care, irrespective of a patient's provisional diagnosis.
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Affiliation(s)
- Chioma C Dan-Nwafor
- Nigeria Centre for Disease Control, Abuja, Nigeria; African Field Epidemiology Network, Nigeria.
| | | | | | - Elsie Ilori
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | | | - Damian Nwidi
- Federal Teaching hospital Abakiliki Ebonyi State, Nigeria
| | - Williams Nwachukwu
- Nigeria Centre for Disease Control, Abuja, Nigeria; African Field Epidemiology Network, Nigeria
| | - Winifred Ukponu
- University of Maryland Abuja, Nigeria; Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Emeka Omabe
- Federal Teaching hospital Abakiliki Ebonyi State, Nigeria
| | | | - Nneka Igwenyi
- Federal Teaching hospital Abakiliki Ebonyi State, Nigeria
| | | | - Womi Eteng
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | | | - Joseph Agboeze
- Federal Teaching hospital Abakiliki Ebonyi State, Nigeria
| | | | | | | | | | - Robinson Onoh
- Federal Teaching hospital Abakiliki Ebonyi State, Nigeria
| | - Emeka Ogah
- Federal Teaching hospital Abakiliki Ebonyi State, Nigeria
| | | | - John Oladejo
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | - Olubunmi Ojo
- Nigeria Centre for Disease Control, Abuja, Nigeria
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