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Fokam J, Essomba RG, Njouom R, Okomo MCA, Eyangoh S, Godwe C, Tegomoh B, Otshudiema JO, Nwobegahay J, Ndip L, Akenji B, Takou D, Moctar MMM, Mbah CK, Ndze VN, Maidadi-Foudi M, Kouanfack C, Tonmeu S, Ngono D, Nkengasong J, Ndembi N, Bissek ACZK, Mouangue C, Ndongo CB, Epée E, Mandeng N, Kamso Belinga S, Ayouba A, Fernandez N, Tongo M, Colizzi V, Halle-Ekane GE, Perno CF, Ndjolo A, Ndongmo CB, Shang J, Esso L, de-Tulio O, Diagne MM, Boum Y, Mballa GAE, Njock LR. Genomic surveillance of SARS-CoV-2 reveals highest severity and mortality of delta over other variants: evidence from Cameroon. Sci Rep 2023; 13:21654. [PMID: 38066020 PMCID: PMC10709425 DOI: 10.1038/s41598-023-48773-3] [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: 12/22/2022] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
While the SARS-CoV-2 dynamic has been described globally, there is a lack of data from Sub-Saharan Africa. We herein report the dynamics of SARS-CoV-2 lineages from March 2020 to March 2022 in Cameroon. Of the 760 whole-genome sequences successfully generated by the national genomic surveillance network, 74% were viral sub-lineages of origin and non-variants of concern, 15% Delta, 6% Omicron, 3% Alpha and 2% Beta variants. The pandemic was driven by SARS-CoV-2 lineages of origin in wave 1 (16 weeks, 2.3% CFR), the Alpha and Beta variants in wave 2 (21 weeks, 1.6% CFR), Delta variants in wave 3 (11 weeks, 2.0% CFR), and omicron variants in wave 4 (8 weeks, 0.73% CFR), with a declining trend over time (p = 0.01208). Even though SARS-CoV-2 heterogeneity did not seemingly contribute to the breadth of transmission, the viral lineages of origin and especially the Delta variants appeared as drivers of COVID-19 severity in Cameroon.
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Affiliation(s)
- Joseph Fokam
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon.
- COVID-19 Genomic Surveillance Platform (PSG), Ministry of Public Health, Yaoundé, Cameroon.
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon.
- Faculty of Health Sciences (FHS), University of Buea, Buea, Cameroon.
| | - Rene Ghislain Essomba
- COVID-19 Genomic Surveillance Platform (PSG), Ministry of Public Health, Yaoundé, Cameroon
- National Public Health Laboratory (NPHL), Ministry of Public Health, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaounde I, Yaounde, Cameroon
| | - Richard Njouom
- COVID-19 Genomic Surveillance Platform (PSG), Ministry of Public Health, Yaoundé, Cameroon
- Centre Pasteur du Cameroun (CPC), Yaoundé, Cameroon
| | - Marie-Claire A Okomo
- COVID-19 Genomic Surveillance Platform (PSG), Ministry of Public Health, Yaoundé, Cameroon
- National Public Health Laboratory (NPHL), Ministry of Public Health, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaounde I, Yaounde, Cameroon
| | - Sara Eyangoh
- COVID-19 Genomic Surveillance Platform (PSG), Ministry of Public Health, Yaoundé, Cameroon
- Centre Pasteur du Cameroun (CPC), Yaoundé, Cameroon
| | - Celestin Godwe
- Centre de Recherche en Maladies Emergentes et Re-emergentes (CREMER), Yaounde, Cameroon
| | - Bryan Tegomoh
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - John O Otshudiema
- World Health Organization (WHO), Cameroon Country Office, Yaounde, Cameroon
| | - Julius Nwobegahay
- COVID-19 Genomic Surveillance Platform (PSG), Ministry of Public Health, Yaoundé, Cameroon
- Centre de Recherche Pour la Santé des Armées (CRESAR), Ministry of Defence, Yaoundé, Cameroon
| | - Lucy Ndip
- Faculty of Health Sciences (FHS), University of Buea, Buea, Cameroon
| | - Blaise Akenji
- National Public Health Laboratory (NPHL), Ministry of Public Health, Yaoundé, Cameroon
| | - Desire Takou
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
| | - Mohamed M M Moctar
- USAID's Infectious Diseases Detection and Surveillance, Yaounde, Cameroon
| | | | - Valantine Ngum Ndze
- Faculty of Health Sciences (FHS), University of Buea, Buea, Cameroon
- African Society for Laboratory Medicine (ASLM), Yaounde, Cameroon
| | - Martin Maidadi-Foudi
- Centre de Recherche en Maladies Emergentes et Re-emergentes (CREMER), Yaounde, Cameroon
| | - Charles Kouanfack
- Centre de Recherche en Maladies Emergentes et Re-emergentes (CREMER), Yaounde, Cameroon
| | - Sandrine Tonmeu
- National Public Health Laboratory (NPHL), Ministry of Public Health, Yaoundé, Cameroon
| | - Dorine Ngono
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - John Nkengasong
- Africa Centres for Disease Control and Prevention (Africa CDC), Addis-Ababa, Ethiopia
| | - Nicaise Ndembi
- Africa Centres for Disease Control and Prevention (Africa CDC), Addis-Ababa, Ethiopia
| | - Anne-Cecile Z K Bissek
- Faculty of Health Sciences (FHS), University of Buea, Buea, Cameroon
- Division for Operational Health Research (DROS), Ministry of Public Health, Yaoundé, Cameroon
| | - Christian Mouangue
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon
- Department of Disease, Epidemic and Pandemic Control (DLMEP), Ministry of Public Health, Yaounde, Cameroon
| | - Chanceline B Ndongo
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon
- Department of Disease, Epidemic and Pandemic Control (DLMEP), Ministry of Public Health, Yaounde, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences (FMPS), University of Douala, Douala, Cameroon
| | - Emilienne Epée
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaounde I, Yaounde, Cameroon
- Department of Disease, Epidemic and Pandemic Control (DLMEP), Ministry of Public Health, Yaounde, Cameroon
| | - Nadia Mandeng
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon
- Department of Disease, Epidemic and Pandemic Control (DLMEP), Ministry of Public Health, Yaounde, Cameroon
- Faculty of Health Sciences (FHS), University of Bamenda, Bamenda, Cameroon
| | - Sandrine Kamso Belinga
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon
- Department of Disease, Epidemic and Pandemic Control (DLMEP), Ministry of Public Health, Yaounde, Cameroon
| | - Ahidjo Ayouba
- Institut de Recherche Pour le Developpement (IRD), Montpellier, France
| | - Nicolas Fernandez
- Institut de Recherche Pour le Developpement (IRD), Montpellier, France
| | - Marcel Tongo
- Centre de Recherche en Maladies Emergentes et Re-emergentes (CREMER), Yaounde, Cameroon
| | - Vittorio Colizzi
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
- Chair of UNESCO Biotechnology, University of Rome Tor Vergata, Rome, Italy
| | | | - Carlo-Federico Perno
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
- Bambino Gesu Pediatric Hospital, Rome, Italy
| | - Alexis Ndjolo
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaounde I, Yaounde, Cameroon
| | - Clement B Ndongmo
- US Centres for Disease Control and Prevention (CDC), Cameroon Country Office, Yaounde, Cameroon
| | - Judith Shang
- US Centres for Disease Control and Prevention (CDC), Cameroon Country Office, Yaounde, Cameroon.
| | - Linda Esso
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon
- Department of Disease, Epidemic and Pandemic Control (DLMEP), Ministry of Public Health, Yaounde, Cameroon
| | - Oliviera de-Tulio
- University of KwaZulu-Natal and Stellenbosch University, Stellenbosch, South Africa
| | | | - Yap Boum
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaounde I, Yaounde, Cameroon
- Epicentre, Medecins Sans Frontières (MSF), Yaounde, Cameroon
| | - Georges A E Mballa
- National Public Health Emergencies Operations Coordination Centre (NPHEOCC), Ministry of Public Health, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaounde I, Yaounde, Cameroon
- Department of Disease, Epidemic and Pandemic Control (DLMEP), Ministry of Public Health, Yaounde, Cameroon
| | - Louis R Njock
- COVID-19 Genomic Surveillance Platform (PSG), Ministry of Public Health, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences (FMBS), University of Yaounde I, Yaounde, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences (FMPS), University of Douala, Douala, Cameroon
- General Secretariat, Ministry of Public Health, Yaounde, Cameroon
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Fai KN, Corine TM, Bebell LM, Mboringong AB, Nguimbis EBPT, Nsaibirni R, Mbarga NF, Eteki L, Nikolay B, Essomba RG, Ndifon M, Ntone R, Hamadou A, Matchim L, Tchiasso D, Abah Abah AS, Essaka R, Peppa S, Crescence F, Ouamba JP, Koku MT, Mandeng N, Fanne M, Eyangoh S, Mballa GAE, Esso L, Epée E, Njouom R, Okomo Assoumou MC, Boum Y. Serologic response to SARS-CoV-2 in an African population. Sci Afr 2021; 12:e00802. [PMID: 34095639 PMCID: PMC8164732 DOI: 10.1016/j.sciaf.2021.e00802] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 11/19/2020] [Revised: 04/15/2021] [Accepted: 05/02/2021] [Indexed: 01/04/2023] Open
Abstract
Official case counts suggest Africa has not seen the expected burden of COVID-19 as predicted by international health agencies, and the proportion of asymptomatic patients, disease severity, and mortality burden differ significantly in Africa from what has been observed elsewhere. Testing for SARS-CoV-2 was extremely limited early in the pandemic and likely led to under-reporting of cases leaving important gaps in our understanding of transmission and disease characteristics in the African context. SARS-CoV-2 antibody prevalence and serologic response data could help quantify the burden of COVID-19 disease in Africa to address this knowledge gap and guide future outbreak response, adapted to the local context. However, such data are widely lacking in Africa. We conducted a cross-sectional seroprevalence survey among 1,192 individuals seeking COVID-19 screening and testing in central Cameroon using the Innovita antibody-based rapid diagnostic. Overall immunoglobulin prevalence was 32%, IgM prevalence was 20%, and IgG prevalence was 24%. IgM positivity gradually increased, peaking around symptom day 20. IgG positivity was similar, gradually increasing over the first 10 days of symptoms, then increasing rapidly to 30 days and beyond. These findings highlight the importance of diagnostic testing and asymptomatic SARS-CoV-2 transmission in Cameroon, which likely resulted in artificially low case counts. Rapid antibody tests are a useful diagnostic modality for seroprevalence surveys and infection diagnosis starting 5-7 days after symptom onset. These results represent the first step towards better understanding the SARS-CoV-2 immunological response in African populations.
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Affiliation(s)
| | | | - Lisa M Bebell
- Massachussetts General Hospital, Boston, United States
| | | | | | | | | | | | | | - Rene Ghislain Essomba
- National Public Health Laboratory, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Cameroon
| | | | | | - Achta Hamadou
- Public Health Emergency Operation Center, Ministry of Health, Yaoundé, Cameroon
| | | | | | | | | | - Solange Peppa
- National Public Health Laboratory, Yaoundé, Cameroon
| | | | | | | | - Nadia Mandeng
- Public Health Emergency Operation Center, Ministry of Health, Yaoundé, Cameroon
| | - Mahamat Fanne
- Public Health Emergency Operation Center, Ministry of Health, Yaoundé, Cameroon
| | | | | | - Linda Esso
- Public Health Emergency Operation Center, Ministry of Health, Yaoundé, Cameroon
| | - Emilienne Epée
- Public Health Emergency Operation Center, Ministry of Health, Yaoundé, Cameroon
| | | | - Marie-Claire Okomo Assoumou
- National Public Health Laboratory, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Cameroon
| | - Yap Boum
- Epicentre, Yaoundé, Cameroon
- Public Health Emergency Operation Center, Ministry of Health, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Cameroon
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Boum Y, Fai KN, Nikolay B, Mboringong AB, Bebell LM, Ndifon M, Abbah A, Essaka R, Eteki L, Luquero F, Langendorf C, Mbarga NF, Essomba RG, Buri BD, Corine TM, Kameni BT, Mandeng N, Fanne M, Bisseck ACZK, Ndongmo CB, Eyangoh S, Hamadou A, Ouamba JP, Koku MT, Njouom R, Claire OM, Esso L, Epée E, Mballa GAE. Performance and operational feasibility of antigen and antibody rapid diagnostic tests for COVID-19 in symptomatic and asymptomatic patients in Cameroon: a clinical, prospective, diagnostic accuracy study. Lancet Infect Dis 2021; 21:1089-1096. [PMID: 33773618 PMCID: PMC7993929 DOI: 10.1016/s1473-3099(21)00132-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/05/2021] [Accepted: 02/19/2021] [Indexed: 12/16/2022]
Abstract
Background Real-time PCR is recommended to detect SARS-CoV-2 infection. However, PCR availability is restricted in most countries. Rapid diagnostic tests are considered acceptable alternatives, but data are lacking on their performance. We assessed the performance of four antibody-based rapid diagnostic tests and one antigen-based rapid diagnostic test for detecting SARS-CoV-2 infection in the community in Cameroon. Methods In this clinical, prospective, diagnostic accuracy study, we enrolled individuals aged at least 21 years who were either symptomatic and suspected of having COVID-19 or asymptomatic and presented for screening. We tested peripheral blood for SARS-CoV-2 antibodies using the Innovita (Biological Technology; Beijing, China), Wondfo (Guangzhou Wondfo Biotech; Guangzhou, China), SD Biosensor (SD Biosensor; Gyeonggi-do, South Korea), and Runkun tests (Runkun Pharmaceutical; Hunan, China), and nasopharyngeal swabs for SARS-CoV-2 antigen using the SD Biosensor test. Antigen rapid diagnostic tests were compared with Abbott PCR testing (Abbott; Abbott Park, IL, USA), and antibody rapid diagnostic tests were compared with Biomerieux immunoassays (Biomerieux; Marcy l'Etoile, France). We retrospectively tested two diagnostic algorithms that incorporated rapid diagnostic tests for symptomatic and asymptomatic patients using simulation modelling. Findings 1195 participants were enrolled in the study. 347 (29%) tested SARS-CoV-2 PCR-positive, 223 (19%) rapid diagnostic test antigen-positive, and 478 (40%) rapid diagnostic test antibody-positive. Antigen-based rapid diagnostic test sensitivity was 80·0% (95% CI 71·0–88·0) in the first 7 days after symptom onset, but antibody-based rapid diagnostic tests had only 26·8% sensitivity (18·3–36·8). Antibody rapid diagnostic test sensitivity increased to 76·4% (70·1–82·0) 14 days after symptom onset. Among asymptomatic participants, the sensitivity of antigen-based and antibody-based rapid diagnostic tests were 37·0% (27·0–48·0) and 50·7% (42·2–59·1), respectively. Cohen's κ showed substantial agreement between Wondfo antibody rapid diagnostic test and gold-standard ELISA (κ=0·76; sensitivity 0·98) and between Biosensor and ELISA (κ=0·60; sensitivity 0·94). Innovita (κ=0·47; sensitivity 0·93) and Runkun (κ=0·43; sensitivity 0·76) showed moderate agreement. An antigen-based retrospective algorithm applied to symptomatic patients showed 94·0% sensitivity and 91·0% specificity in the first 7 days after symptom onset. For asymptomatic participants, the algorithm showed a sensitivity of 34% (95% CI 23·0–44·0) and a specificity of 92·0% (88·0–96·0). Interpretation Rapid diagnostic tests had good overall sensitivity for diagnosing SARS-CoV-2 infection. Rapid diagnostic tests could be incorporated into efficient testing algorithms as an alternative to PCR to decrease diagnostic delays and onward viral transmission. Funding Médecins Sans Frontières WACA and Médecins Sans Frontières OCG. Translations For the French and Spanish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Yap Boum
- Epicentre, Yaoundé, Cameroon; Public Health Emergency Operation Center, Ministry of Public Health, Yaoundé, Cameroon.
| | | | | | | | - Lisa M Bebell
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Aristide Abbah
- Public Health Emergency Operation Center, Ministry of Public Health, Yaoundé, Cameroon
| | | | | | | | | | | | | | | | | | | | - Nadia Mandeng
- Public Health Emergency Operation Center, Ministry of Public Health, Yaoundé, Cameroon
| | - Mahamat Fanne
- Public Health Emergency Operation Center, Ministry of Public Health, Yaoundé, Cameroon
| | | | | | | | | | | | | | | | | | - Linda Esso
- Public Health Emergency Operation Center, Ministry of Public Health, Yaoundé, Cameroon
| | - Emilienne Epée
- Public Health Emergency Operation Center, Ministry of Public Health, Yaoundé, Cameroon
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