1
|
Diarra YM, Wimba PM, Katchunga PB, Bengehya J, Miganda B, Oyimangirwe M, Tshilolo L, Ahuka SM, Iwaz J, Étard JF, Écochard R, Vanhems P, Rabilloud M. Estimating the number of probable new SARS-CoV-2 infections among tested subjects from the number of confirmed cases. BMC Med Res Methodol 2023; 23:272. [PMID: 37978439 PMCID: PMC10655282 DOI: 10.1186/s12874-023-02077-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 10/20/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVES In most African countries, confirmed COVID-19 case counts underestimate the number of new SARS-CoV-2 infection cases. We propose a multiplying factor to approximate the number of biologically probable new infections from the number of confirmed cases. METHODS Each of the first thousand suspect (or alert) cases recorded in South Kivu (DRC) between 29 March and 29 November 2020 underwent a RT-PCR test and an IgM and IgG serology. A latent class model and a Bayesian inference method were used to estimate (i) the incidence proportion of SARS-CoV-2 infection using RT-PCR and IgM test results, (ii) the prevalence using RT-PCR, IgM and IgG test results; and, (iii) the multiplying factor (ratio of the incidence proportion on the proportion of confirmed -RT-PCR+- cases). RESULTS Among 933 alert cases with complete data, 218 (23%) were RT-PCR+; 434 (47%) IgM+; 464 (~ 50%) RT-PCR+, IgM+, or both; and 647 (69%) either IgG + or IgM+. The incidence proportion of SARS-CoV-2 infection was estimated at 58% (95% credibility interval: 51.8-64), its prevalence at 72.83% (65.68-77.89), and the multiplying factor at 2.42 (1.95-3.01). CONCLUSIONS In monitoring the pandemic dynamics, the number of biologically probable cases is also useful. The multiplying factor helps approximating it.
Collapse
Affiliation(s)
- Y M Diarra
- Université de Lyon, Lyon, France.
- Université Claude Bernard Lyon 1, Villeurbanne, France.
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.
- Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, CNRS UMR 5558, Villeurbanne, France.
| | - P M Wimba
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Université Officielle de Bukavu, Democratic Republic of the Congo, Bukavu, Congo
- Cliniques Universitaires de Bukavu, Democratic Republic of the Congo, Bukavu, Congo
- Centre International de Recherche en Infectiologie (CIRI), INSERM U1111-CNRS UMR 5308, Lyon, France
| | - P B Katchunga
- Université Officielle de Bukavu, Democratic Republic of the Congo, Bukavu, Congo
- Cliniques Universitaires de Bukavu, Democratic Republic of the Congo, Bukavu, Congo
| | - J Bengehya
- Université Officielle de Mbujimayi (UOM), Mbuji-Mayi, Democratic Republic of the Congo
| | - B Miganda
- Bureau Information Sanitaire, Division provinciale de la Santé Sud-Kivu, Democratic Republic of the Congo, Bukavu, Congo
| | - M Oyimangirwe
- Université Officielle de Bukavu, Democratic Republic of the Congo, Bukavu, Congo
| | - L Tshilolo
- Université Officielle de Mbujimayi (UOM), Mbuji-Mayi, Democratic Republic of the Congo
| | - S M Ahuka
- Department of Virology, National Institute for Biomedical Research (INRB), Democratic Republic of the Congo, Kinshasa, Congo
- Service of Microbiology, Department of Medical Biology, Kinshasa teaching School of Medecine, Faculty of Medecine, University of Kinshasa, Democratic Republic of the Congo, Kinshasa, Congo
| | - J Iwaz
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, CNRS UMR 5558, Villeurbanne, France
| | - J F Étard
- IRD UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
- EpiGreen, Paris, France
| | - R Écochard
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, CNRS UMR 5558, Villeurbanne, France
| | - P Vanhems
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, CNRS UMR 5558, Villeurbanne, France
- Centre International de Recherche en Infectiologie (CIRI), INSERM U1111-CNRS UMR 5308, Lyon, France
- Service d'Hygiène Hospitalière, Infectiovigilance et Prévention, Hospices Civils de Lyon, Épidémiologie, Lyon, France
| | - M Rabilloud
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, CNRS UMR 5558, Villeurbanne, France
| |
Collapse
|
2
|
Simons E, Nikolay B, Ouedraogo P, Pasquier E, Tiemeni C, Adjaho I, Badjo C, Chamman K, Diomandé M, Dosso M, Doumbia M, Izia YA, Kakompe H, Katsomya AM, Kij V, Akissi VK, Mambula C, Mbala-Kingebeni P, Muzinga J, Ngoy B, Penali L, Pini A, Porten K, Salou H, Sevede D, Luquero F, Gignoux E. Seroprevalence of SARS-CoV-2 antibodies and retrospective mortality in two African settings: Lubumbashi, Democratic Republic of the Congo and Abidjan, Côte d'Ivoire. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001457. [PMID: 37289736 DOI: 10.1371/journal.pgph.0001457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/10/2023] [Indexed: 06/10/2023]
Abstract
Although seroprevalence studies have demonstrated the wide circulation of SARS-COV-2 in African countries, the impact on population health in these settings is still poorly understood. Using representative samples of the general population, we evaluated retrospective mortality and seroprevalence of anti-SARS-CoV-2 antibodies in Lubumbashi and Abidjan. The studies included retrospective mortality surveys and nested anti-SARS-CoV-2 antibody prevalence surveys. In Lubumbashi the study took place during April-May 2021 and in Abidjan the survey was implemented in two phases: July-August 2021 and October-November 2021. Crude mortality rates were stratified between pre-pandemic and pandemic periods and further investigated by age group and COVID waves. Anti-SARS-CoV-2 seroprevalence was quantified by rapid diagnostic testing (RDT) and laboratory-based testing (ELISA in Lubumbashi and ECLIA in Abidjan). In Lubumbashi, the crude mortality rate (CMR) increased from 0.08 deaths per 10 000 persons per day (pre-pandemic) to 0.20 deaths per 10 000 persons per day (pandemic period). Increases were particularly pronounced among <5 years old. In Abidjan, no overall increase was observed during the pandemic period (pre-pandemic: 0.05 deaths per 10 000 persons per day; pandemic: 0.07 deaths per 10 000 persons per day). However, an increase was observed during the third wave (0.11 deaths per 10 000 persons per day). The estimated seroprevalence in Lubumbashi was 15.7% (RDT) and 43.2% (laboratory-based). In Abidjan, the estimated seroprevalence was 17.4% (RDT) and 72.9% (laboratory-based) during the first phase of the survey and 38.8% (RDT) and 82.2% (laboratory-based) during the second phase of the survey. Although circulation of SARS-CoV-2 seems to have been extensive in both settings, the public health impact varied. The increases, particularly among the youngest age group, suggest indirect impacts of COVID and the pandemic on population health. The seroprevalence results confirmed substantial underdetection of cases through the national surveillance systems.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Hugues Kakompe
- Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | | | - Vicky Kij
- Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | | | | | | | - Jacques Muzinga
- Laboratoire National de Lubumbashi, Lubumbashi, Democratic Republic of the Congo
| | - Basile Ngoy
- Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Lou Penali
- Institut Pasteur Cote d'Ivoire, Abidjan, Cote d'Ivoire
| | | | | | | | - Daouda Sevede
- Institut Pasteur Cote d'Ivoire, Abidjan, Cote d'Ivoire
| | | | | |
Collapse
|
3
|
Chong YP, Choy KW, Doerig C, Lim CX. SARS-CoV-2 Testing Strategies in the Diagnosis and Management of COVID-19 Patients in Low-Income Countries: A Scoping Review. Mol Diagn Ther 2023; 27:303-320. [PMID: 36705912 PMCID: PMC9880944 DOI: 10.1007/s40291-022-00637-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2022] [Indexed: 01/28/2023]
Abstract
The accuracy of diagnostic laboratory tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can impact downstream clinical procedures in managing and controlling the outbreak of coronavirus disease 2019 (COVID-19). To assess the effectiveness of laboratory tools for managing COVID-19 patients in low-income countries (LICs), we systematically searched the PubMed, Embase, Scopus and CINHAL databases for reports published between January 2020 and June 2022. We found that 22 of 1303 articles reported the performance of various SARS-CoV-2 detection tools across 10 LICs. These tools were (1) real-time reverse transcriptase polymerase chain reaction (RT-PCR); (2) reverse transcription loop-mediated isothermal amplification (RT-LAMP); (3) rapid diagnostic tests (RDTs); (4) enzyme-linked immunosorbent assay (ELISA); and (5) dot-blot immunoassay. The detection of COVID-19 is largely divided into two main streams-direct virus (antigen) detection and serology (immunoglobulin)-based detection. Point-of-care testing using antigen-based RDTs is preferred in LICs because of cost effectiveness and simplicity in the test procedures. The nucleic acid amplification technology (RT-PCR and RT-LAMP) has the highest diagnostic performance among the available tests, but it is not broadly used in this context due to costs and shortage of facilities/trained staff. The serology-based test method is affected by antibody interferences and varying amounts of SARS-CoV-2 immunoglobulins expressed at different stages of disease onset. We further discuss the effectiveness and shortcomings of each of these tools in the diagnosis and management of COVID-19. Using the LICs as the study model, our findings highlight ways to improve the quality and turnaround time of COVID-19 testing in resource-constrained settings, notably through local/international collaborative efforts to refine the molecular-based or immunoassay-based testing technologies.
Collapse
Affiliation(s)
- Yuh Ping Chong
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia.
| | - Kay Weng Choy
- Northern Pathology Victoria, Northern Health, Epping, VIC, 3076, Australia
| | - Christian Doerig
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia
| | - Chiao Xin Lim
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia.
| |
Collapse
|
4
|
Hoang VT, Pham TD, Nguyen QT, Nguyen DC, Nguyen DT, Nguyen TB, Tran TKT, Phan TL, Vo PLN, Dao TL, Fenollar F, Gautret P. Seroprevalence of SARS-CoV-2 among high-density communities and hyper-endemicity of COVID-19 in Vietnam. Trop Med Int Health 2022; 27:515-521. [PMID: 35303386 PMCID: PMC9115418 DOI: 10.1111/tmi.13744] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess the magnitude of active and recovering COVID-19 patients among at-risk communities and to identify the factors associated with positive serology. METHODS Four hundred and eighty-three close contacts of COVID-19 patients residing in Ho Chi Minh City, Vietnam, during the fourth wave of the COVID-19 epidemic (September and October 2021) were included. Five weeks after exposure to a COVID-19 patient, they underwent a serology test using the BIOSYNEX COVID-19 BSS kit. RESULTS The median age of participants was 37 years. A total of 34.6% individuals presented at least one clinical symptom between the time of contact with the COVID-19 patient and inclusion in study. A total of 1.7% unvaccinated individuals tested positive for SARS-CoV-2 using real-time PCR, and 9.5% had evidence of recent infection (positive PCR and/or IgM). A further 26.7% unvaccinated individuals presented evidence of a past infection (positive IgG only). Socio-demographic characteristics, vaccination status and clinical symptoms were not associated with a positive IgM test. CONCLUSION This is the first serosurvey conducted during the fourth wave of the epidemic in Vietnam. It revealed a seropositivity rate higher than in previous studies and confirmed the hyperendemicity of SARS-CoV-2. Testing using rapid serological tests proved to be a reliable, easy-to-use method and enabled a rapid estimation of the burden of COVID-19.
Collapse
Affiliation(s)
- Van Thuan Hoang
- Thai Binh University of Medicine and PharmacyThai BinhVietnam
| | - Thi Dung Pham
- Thai Binh University of Medicine and PharmacyThai BinhVietnam
| | | | | | | | | | | | - Trong Lan Phan
- General Department of Preventive MedicineMinistry of HealthHa NoiVietnam
| | | | - Thi Loi Dao
- Thai Binh University of Medicine and PharmacyThai BinhVietnam
| | - Florence Fenollar
- Aix Marseille UnivIRDAP‐HMSSA, VITROMEMarseilleFrance
- IHU‐Méditerranée InfectionMarseilleFrance
| | - Philippe Gautret
- Aix Marseille UnivIRDAP‐HMSSA, VITROMEMarseilleFrance
- IHU‐Méditerranée InfectionMarseilleFrance
| |
Collapse
|
5
|
Traoré A, Guindo MA, Konaté D, Traoré B, Diakité SA, Kanté S, Dembélé A, Cissé A, Incandela NC, Kodio M, Coulibaly YI, Faye O, Kajava AV, Pratesi F, Migliorini P, Papini AM, Pacini L, Rovero P, Errante F, Diakité M, Arevalo-Herrera M, Herrera S, Corradin G, Balam S. Seroreactivity of the Severe Acute Respiratory Syndrome Coronavirus 2 Recombinant S Protein, Receptor-Binding Domain, and Its Receptor-Binding Motif in COVID-19 Patients and Their Cross-Reactivity With Pre-COVID-19 Samples From Malaria-Endemic Areas. Front Immunol 2022; 13:856033. [PMID: 35585976 PMCID: PMC9109707 DOI: 10.3389/fimmu.2022.856033] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/28/2022] [Indexed: 12/23/2022] Open
Abstract
Despite the global interest and the unprecedented number of scientific studies triggered by the COVID-19 pandemic, few data are available from developing and low-income countries. In these regions, communities live under the threat of various transmissible diseases aside from COVID-19, including malaria. This study aims to determine the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroreactivity of antibodies from COVID-19 and pre-COVID-19 samples of individuals in Mali (West Africa). Blood samples from COVID-19 patients (n = 266) at Bamako Dermatology Hospital (HDB) and pre-COVID-19 donors (n = 283) from a previous malaria survey conducted in Dangassa village were tested by ELISA to assess IgG antibodies specific to the full-length spike (S) protein, the receptor-binding domain (RBD), and the receptor-binding motif (RBM436-507). Study participants were categorized by age, gender, treatment duration for COVID-19, and comorbidities. In addition, the cross-seroreactivity of samples from pre-COVID-19, malaria-positive patients against the three antigens was assessed. Recognition of the SARS-CoV-2 proteins by sera from COVID-19 patients was 80.5% for S, 71.1% for RBD, and 31.9% for RBM (p < 0.001). While antibody responses to S and RBD tended to be age-dependent, responses to RBM were not. Responses were not gender-dependent for any of the antigens. Higher antibody levels to S, RBD, and RBM at hospital entry were associated with shorter treatment durations, particularly for RBD (p < 0.01). In contrast, higher body weights negatively influenced the anti-S antibody response, and asthma and diabetes weakened the anti-RBM antibody responses. Although lower, a significant cross-reactive antibody response to S (21.9%), RBD (6.7%), and RBM (8.8%) was detected in the pre-COVID-19 and malaria samples. Cross-reactive antibody responses to RBM were mostly associated (p < 0.01) with the absence of current Plasmodium falciparum infection, warranting further study.
Collapse
Affiliation(s)
- Abdouramane Traoré
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Merepen A. Guindo
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Drissa Konaté
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Bourama Traoré
- Department of Ministry of Health and Social Development, Hopital de Dermatologie de Bamako (HDB), Bamako, Mali
| | - Seidina A. Diakité
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Salimata Kanté
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Assitan Dembélé
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Abdourhamane Cissé
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Nathan C. Incandela
- Center for Polymers and Organic Solids, Department of Chemistry and Biochemistry, University of California Santa Barbara, Santa Barbara, CA, United States
| | - Mamoudou Kodio
- Department of Ministry of Health and Social Development, Hopital de Dermatologie de Bamako (HDB), Bamako, Mali
| | - Yaya I. Coulibaly
- Department of Ministry of Health and Social Development, Hopital de Dermatologie de Bamako (HDB), Bamako, Mali
| | - Ousmane Faye
- Department of Ministry of Health and Social Development, Hopital de Dermatologie de Bamako (HDB), Bamako, Mali
| | - Andrey V. Kajava
- Montpellier Cell Biology Research Center (CRBM), University of Montpellier, CNRS, Montpellier, France
| | - Federico Pratesi
- Immuno-Allergology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Paola Migliorini
- Immuno-Allergology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Anna Maria Papini
- Interdepartmental Research Unit of Peptide and Protein Chemistry and Biology, Department of Chemistry “Ugo Schiff”, University of Florence, Florence, Italy
| | - Lorenzo Pacini
- Interdepartmental Research Unit of Peptide and Protein Chemistry and Biology, Department of Chemistry “Ugo Schiff”, University of Florence, Florence, Italy
| | - Paolo Rovero
- Interdepartmental Research Unit of Peptide and Protein Chemistry and Biology, Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmaceutical Sciences and Nutraceutics, University of Florence, Florence, Italy
| | - Fosca Errante
- Interdepartmental Research Unit of Peptide and Protein Chemistry and Biology, Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmaceutical Sciences and Nutraceutics, University of Florence, Florence, Italy
| | - Mahamadou Diakité
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Myriam Arevalo-Herrera
- Department of Immunology, Malaria Vaccine and Drug Development Center, Cali, Colombia
- Department of Immunology, Caucaseco Scientific Research Center, Cali, Colombia
| | - Socrates Herrera
- Department of Immunology, Malaria Vaccine and Drug Development Center, Cali, Colombia
- Department of Immunology, Caucaseco Scientific Research Center, Cali, Colombia
| | | | - Saidou Balam
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
| |
Collapse
|
6
|
Gignoux E, Athanassiadis F, Garat Yarrow A, Jimale A, Mubuto N, Déglise C, Onsongo Mosoti D, Azman AS, Mwau M, Luquero F, Ciglenecki I. Seroprevalence of SARS-CoV-2 antibodies and retrospective mortality in a refugee camp, Dagahaley, Kenya. PLoS One 2021; 16:e0260989. [PMID: 34919545 PMCID: PMC8683031 DOI: 10.1371/journal.pone.0260989] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/19/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Camps of forcibly displaced populations are considered to be at risk of large COVID-19 outbreaks. Low screening rates and limited surveillance led us to conduct a study in Dagahaley camp, located in the Dadaab refugee complex in Kenya to estimate SARS-COV-2 seroprevalence and, mortality and to identify changes in access to care during the pandemic. METHODS To estimate seroprevalence, a cross-sectional survey was conducted among a sample of individuals (n = 587) seeking care at the two main health centres and among all household members (n = 619) of community health workers and traditional birth attendants working in the camp. A rapid immunologic assay was used (BIOSYNEX® COVID-19 BSS [IgG/IgM]) and adjusted for test performance and mismatch between the sampled population and that of the general camp population. To estimate mortality, all households (n = 12860) were exhaustively interviewed in the camp about deaths occurring from January 2019 through March 2021. RESULTS In total 1206 participants were included in the seroprevalence study, 8% (95% CI: 6.6%-9.7%) had a positive serologic test. After adjusting for test performance and standardizing on age, a seroprevalence of 5.8% was estimated (95% CI: 1.6%-8.4%). The mortality rate for 10,000 persons per day was 0.05 (95% CI 0.05-0.06) prior to the pandemic and 0.07 (95% CI 0.06-0.08) during the pandemic, representing a significant 42% increase (p<0.001). Médecins Sans Frontières health centre consultations and hospital admissions decreased by 38% and 37% respectively. CONCLUSION The number of infected people was estimated 67 times higher than the number of reported cases. Participants aged 50 years or more were among the most affected. The mortality survey shows an increase in the mortality rate during the pandemic compared to before the pandemic. A decline in attendance at health facilities was observed and sustained despite the easing of restrictions.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Andrew S. Azman
- Médecins Sans Frontières, Geneva, Switzerland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Institute for Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Matilu Mwau
- Kenya Medical Research Institute, Nairobi, Kenya
| | | | | |
Collapse
|
7
|
Vanroye F, den Bossche DV, Brosius I, Tack B, Esbroeck MV, Jacobs J. COVID-19 Antibody Detecting Rapid Diagnostic Tests Show High Cross-Reactivity When Challenged with Pre-Pandemic Malaria, Schistosomiasis and Dengue Samples. Diagnostics (Basel) 2021; 11:diagnostics11071163. [PMID: 34202195 PMCID: PMC8305106 DOI: 10.3390/diagnostics11071163] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/23/2021] [Accepted: 06/23/2021] [Indexed: 12/13/2022] Open
Abstract
COVID-19 Antibody Detecting Rapid Diagnostic Tests (COVID-19 Ab RDTs) are the preferred tool for SARS-CoV-2 seroprevalence studies, particularly in low- and middle-income countries. The present study challenged COVID-19 Ab RDTs with pre-pandemic samples of patients exposed to tropical pathogens. A retrospective study was performed on archived serum (n = 94) and EDTA whole blood (n = 126) samples obtained during 2010–2018 from 196 travelers with malaria (n = 170), schistosomiasis (n = 25) and dengue (n = 25). COVID-19 Ab RDTs were selected based on regulatory approval status, independent evaluation results and detecting antigens. Among 13 COVID-19 Ab RDT products, overall cross-reactivity was 18.5%; cross-reactivity for malaria, schistosomiasis and dengue was 20.3%, 18.1% and 7.5%, respectively. Cross-reactivity for current and recent malaria, malaria antibodies, Plasmodium species and parasite densities was similar. Cross-reactivity among the different RDT products ranged from 2.7% to 48.9% (median value 14.5%). IgM represented 67.9% of cross-reactive test lines. Cross-reactivity was not associated with detecting antigens, patient categories or disease (sub)groups, except for schistosomiasis (two products with ≥60% cross-reactivity). The high cross-reactivity for malaria, schistosomiasis and—to a lesser extent—dengue calls for risk mitigation when using COVID-19 Ab RDTs in co-endemic regions.
Collapse
Affiliation(s)
- Fien Vanroye
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
- Correspondence:
| | - Dorien Van den Bossche
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
| | - Isabel Brosius
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
| | - Bieke Tack
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
- Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
| | - Jan Jacobs
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
- Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| |
Collapse
|
8
|
Differential Performance of CoronaCHEK SARS-CoV-2 Lateral Flow Antibody Assay by Geographic Origin of Samples. J Clin Microbiol 2021; 59:e0083721. [PMID: 33903166 DOI: 10.1128/jcm.00837-21] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
We assessed the performance of the CoronaCHEK lateral flow assay on samples from Uganda and Baltimore to determine the impact of geographic origin on assay performance. Plasma samples from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR-positive individuals (Uganda, 78 samples from 78 individuals, and Baltimore, 266 samples from 38 individuals) and from prepandemic individuals (Uganda, 1,077, and Baltimore, 532) were evaluated. Prevalence ratios (PR) were calculated to identify factors associated with a false-positive test. After the first positive PCR in Ugandan samples, the sensitivity was 45% (95% confidence interval [CI], 24,68) at 0 to 7 days, 79% (95% CI, 64 to 91) at 8 to 14 days, and 76% (95% CI, 50 to 93) at >15 days. In samples from Baltimore, sensitivity was 39% (95% CI, 30 to 49) at 0 to 7 days, 86% (95% CI, 79 to 92) at 8 to 14 days, and 100% (95% CI, 89 to 100) at 15 days after positive PCR. The specificity of 96.5% (95% CI, 97.5 to 95.2) in Ugandan samples was significantly lower than that in samples from Baltimore, 99.3% (95% CI, 98.1 to 99.8; P < 0.01). In Ugandan samples, individuals with a false-positive result were more likely to be male (PR, 2.04; 95% CI, 1.03,3.69) or individuals who had had a fever more than a month prior to sample acquisition (PR, 2.87; 95% CI, 1.12 to 7.35). Sensitivity of the CoronaCHEK was similar in samples from Uganda and Baltimore. The specificity was significantly lower in Ugandan samples than in Baltimore samples. False-positive results in Ugandan samples appear to correlate with a recent history of a febrile illness, potentially indicative of a cross-reactive immune response in individuals from East Africa.
Collapse
|
9
|
Baker OR, Grabowski MK, Galiwango RM, Nalumansi A, Serwanga J, Clarke W, Hsieh YH, Rothman RE, Fernandez RE, Serwadda D, Kagaayi J, Lutalo T, Reynolds SJ, Kaleebu P, Quinn TC, Laeyendecker O. Differential Performance of CoronaCHEK SARS-CoV-2 Lateral Flow Antibody Assay by Geographic Origin of Samples. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.04.12.21255284. [PMID: 33880484 PMCID: PMC8057252 DOI: 10.1101/2021.04.12.21255284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background We assessed the performance of CoronaCHEK lateral flow assay on samples from Uganda and Baltimore to determine the impact of geographic origin on assay performance. Methods Serum samples from SARS-CoV-2 PCR+ individuals (Uganda: 78 samples from 78 individuals and Baltimore: 266 samples from 38 individuals) and from pre-pandemic individuals (Uganda 1077 and Baltimore 532) were evaluated. Prevalence ratios (PR) were calculated to identify factors associated with a false-positive test. Results After first positive PCR in Ugandan samples the sensitivity was: 45% (95% CI 24,68) at 0-7 days; 79% (95%CI 64,91) 8-14 days; and 76% (95%CI 50,93) >15 days. In samples from Baltimore, sensitivity was: 39% (95% CI 30, 49) 0-7 days; 86% (95% CI 79,92) 8-14 days; and 100% (95% CI 89,100) 15 days post positive PCR. The specificity of 96.5% (95% CI 97.5,95.2) in Ugandan samples was significantly lower than samples from Baltimore 99.3% (95% CI 98.1,99.8), p<0.01. In Ugandan samples, individuals with a false positive result were more likely to be male (PR 2.04, 95% CI 1.03,3.69) or individuals who had a fever more than a month prior to sample acquisition (PR 2.87, 95% CI 1.12,7.35). Conclusions Sensitivity of the CoronaCHEK was similar in samples from Uganda and Baltimore. The specificity was significantly lower in Ugandan samples than in Baltimore samples. False positive results in Ugandan samples appear to correlate with a recent history of a febrile illness, potentially indicative of a cross-reactive immune response in individuals from East Africa.
Collapse
Affiliation(s)
- Owen R. Baker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, USA
| | - M. Kate Grabowski
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Rakai Health Sciences Program, Kalisizo, Uganda
| | | | | | - Jennifer Serwanga
- Uganda Virus Research Institute, Entebbe, Uganda
- Medical Research Council, Uganda Virus Research Institute and London School of hygiene and Tropical Medicine Uganda Research Unit
| | - William Clarke
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yu-Hsiang Hsieh
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | - David Serwadda
- Rakai Health Sciences Program, Kalisizo, Uganda
- Makerere University School of Public Health, Kampala, Uganda
| | | | - Tom Lutalo
- Rakai Health Sciences Program, Kalisizo, Uganda
- Uganda Virus Research Institute, Entebbe, Uganda
| | - Steven J. Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Rakai Health Sciences Program, Kalisizo, Uganda
| | - Pontiano Kaleebu
- Uganda Virus Research Institute, Entebbe, Uganda
- Medical Research Council, Uganda Virus Research Institute and London School of hygiene and Tropical Medicine Uganda Research Unit
| | - Thomas C. Quinn
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|