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Perez-Guzman PN, Chanda SL, Schaap A, Shanaube K, Baguelin M, Nyangu ST, Kanyanga MK, Walker P, Ayles H, Chilengi R, Verity R, Hauck K, Knock ES, Cori A. Pandemic burden in low-income settings and impact of limited and delayed interventions: A granular modelling analysis of COVID-19 in Kabwe, Zambia. Int J Infect Dis 2024; 147:107182. [PMID: 39067669 DOI: 10.1016/j.ijid.2024.107182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 07/04/2024] [Accepted: 07/15/2024] [Indexed: 07/30/2024] Open
Abstract
OBJECTIVES Pandemic response in low-income countries (LICs) or settings often suffers from scarce epidemic surveillance and constrained mitigation capacity. The drivers of pandemic burden in such settings, and the impact of limited and delayed interventions remain poorly understood. METHODS We analysed COVID-19 seroprevalence and all-cause excess deaths data from the peri-urban district of Kabwe, Zambia between March 2020 and September 2021 with a novel mathematical model. Data encompassed three consecutive waves caused by the wild-type, Beta and Delta variants. RESULTS Across all three waves, we estimated a high cumulative attack rate, with 78% (95% credible interval [CrI] 71-85) of the population infected, and a high all-cause excess mortality, at 402 (95% CrI 277-473) deaths per 100,000 people. Ambitiously improving health care to a capacity similar to that in high-income settings could have averted up to 46% (95% CrI 41-53) of accrued excess deaths, if implemented from June 2020 onward. An early and accelerated vaccination rollout could have achieved the highest reductions in deaths. Had vaccination started as in some high-income settings in December 2020 and with the same daily capacity (doses per 100 population), up to 68% (95% CrI 64-71) of accrued excess deaths could have been averted. Slower rollouts would have still averted 62% (95% CrI 58-68), 54% (95% CrI 49-61) or 26% (95% CrI 20-38) of excess deaths if matching the average vaccination capacity of upper-middle-, lower-middle- or LICs, respectively. CONCLUSIONS Robust quantitative analyses of pandemic data are of pressing need to inform future global pandemic preparedness commitments.
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Affiliation(s)
- Pablo N Perez-Guzman
- Imperial College London, Medical Research Council Centre for Global Infectious Disease Analysis, and Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, London, UK.
| | | | - Albertus Schaap
- Zambart, Lusaka, Zambia; London School of Hygiene & Tropical Medicine, Faculty of Infectious and Tropical Diseases, London, UK
| | | | - Marc Baguelin
- Imperial College London, Medical Research Council Centre for Global Infectious Disease Analysis, and Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, London, UK; National Institute for Health and Care Research, Health Protection Research Unit in Modelling and Health Economics, London, UK; London School of Hygiene & Tropical Medicine, Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London, UK
| | | | | | - Patrick Walker
- Imperial College London, Medical Research Council Centre for Global Infectious Disease Analysis, and Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, London, UK
| | - Helen Ayles
- Zambart, Lusaka, Zambia; London School of Hygiene & Tropical Medicine, Faculty of Infectious and Tropical Diseases, London, UK
| | - Roma Chilengi
- Zambia National Public Health Institute, Lusaka, Zambia
| | - Robert Verity
- Imperial College London, Medical Research Council Centre for Global Infectious Disease Analysis, and Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, London, UK
| | - Katharina Hauck
- Imperial College London, Medical Research Council Centre for Global Infectious Disease Analysis, and Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, London, UK
| | - Edward S Knock
- Imperial College London, Medical Research Council Centre for Global Infectious Disease Analysis, and Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, London, UK
| | - Anne Cori
- Imperial College London, Medical Research Council Centre for Global Infectious Disease Analysis, and Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, London, UK
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Munyeku-Bazitama Y, Okitale-Talunda P, Nsio-Mbeta J, Mpingabo-Ilunga P, Tshiminyi-Munkamba P, Umba-Phuati A, Kimfuta J, Ango-Phukuta F, Makindu G, Mufwaya-Nsene R, Asari R, Makimoto S, Ahuka-Mundeke S, Isono M, Makiala-Mandanda S, Muyembe-Tamfum JJ. Knowledge, attitudes, practices, and perception of COVID-19 preventive measures among adult residents of Matadi (Democratic Republic of the Congo) after the third epidemic wave. Front Public Health 2024; 12:1363717. [PMID: 39005989 PMCID: PMC11239358 DOI: 10.3389/fpubh.2024.1363717] [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: 12/31/2023] [Accepted: 06/17/2024] [Indexed: 07/16/2024] Open
Abstract
Background Several governments from African countries, including the Democratic Republic of the Congo (DRC), implemented stringent public health measures to curb COVID-19 transmission in the early phases of the pandemic. While these restrictive measures are believed to have contributed to lowering case incidence and related mortality in DRC, data on the population's knowledge and adherence are limited. This study aimed to assess the knowledge, perception, attitudes, and practices of COVID-19 preventive measures and associated factors among adult residents of Matadi, thereby generating evidence for a strategy adjustment as the COVID-19 response is transitioning from emergency to control status. Methods We used data from a population-based cross-sectional study conducted in October 2021. Consenting participants were enrolled through a multi-stage cluster sampling approach and administered a pre-tested structured questionnaire using a mobile application (Epicollect 5). We analyzed adult participants' data using STATA 15.1. Univariable and multivariable analyses were applied to identify factors associated with good knowledge, good perception, positive attitude and good practice. Results We included 1,269 adult respondents for the secondary analysis. One respondent in six was female. The median age was 36 years (IQR 24-50). Most respondents (76.5%) had good knowledge. Respondents aged 40-49 years and those with vocational education level were 1.7 time (AOR 1.75, 95% CI 1.07-2.87) and twice as likely (AOR 2.06, 95% CI 1.01-4.21) to have good knowledge. Preventive measures were perceived as efficient by 45% of respondents. Good perception was associated with education level, profession, average household monthly income and good knowledge. Only 40% of respondents had a positive attitude. A positive attitude was associated with age, education level, and good knowledge. Respondents having good practice represented 5.8%. Good practice was associated with good knowledge, attitude and perception. Conclusion Most respondents were knowledgeable, had a good perception of government-related COVID-19 preventive measures, a moderately positive attitude and an extremely low level of good practice. Current COVID-19 preventive strategies, including vaccination rollout, need adjustment into high-efficiency, context-based and risk group-specific interventions. Evidence generated by this study will improve preparedness and response to future outbreaks.
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Affiliation(s)
- Yannick Munyeku-Bazitama
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Division of Global Epidemiology, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Patient Okitale-Talunda
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Justus Nsio-Mbeta
- Direction de Surveillance Epidémiologique, Ministère de la Santé, Hygiène et Prévention, Kinshasa, Democratic Republic of the Congo
| | - Patrick Mpingabo-Ilunga
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Paul Tshiminyi-Munkamba
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Aimé Umba-Phuati
- Division Provinciale de Santé du Kongo Central, Matadi, Democratic Republic of the Congo
| | - Jacques Kimfuta
- Division Provinciale de Santé du Kongo Central, Matadi, Democratic Republic of the Congo
| | - Ferdinand Ango-Phukuta
- Division Provinciale de Santé du Kongo Central, Matadi, Democratic Republic of the Congo
| | - Goethe Makindu
- Division Provinciale de Santé du Kongo Central, Matadi, Democratic Republic of the Congo
| | | | - Ryoko Asari
- Japan International Cooperation Agency, Tokyo, Japan
- Departments of Virology and Parasitology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | | | - Steve Ahuka-Mundeke
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Mitsuo Isono
- Japan International Cooperation Agency, Tokyo, Japan
| | - Sheila Makiala-Mandanda
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean-Jacques Muyembe-Tamfum
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
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Altare C, Kostandova N, Basadia LM, Petry M, Gankpe GF, Crockett H, Morfin NH, Bruneau S, Antoine C, Spiegel PB. COVID-19 epidemiology, health services utilisation and health care seeking behaviour during the first year of the COVID-19 pandemic in Mweso health zone, Democratic Republic of Congo. J Glob Health 2024; 14:05016. [PMID: 38665056 PMCID: PMC11047223 DOI: 10.7189/jogh.14.05016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
Background Although the evidence about coronavirus disease 2019 (COVID-19) has increased exponentially since the beginning of the pandemic, less is known about the direct and indirect effects of the pandemic in humanitarian settings. In the Democratic Republic of the Congo (DRC), most studies occurred in Kinshasa and other cities. Limited research was conducted in remote conflict-affected settings. We investigated the COVID-19 epidemiology, health service utilisation, and health care-seeking behaviour during the first year of the pandemic (March 2020-March 2021) in the Mweso health zone, North Kivu, DRC. Methods This mixed-methods study includes a descriptive epidemiological analysis of reported COVID-19 cases data extracted from the provincial line list, interrupted time series analysis of health service utilisation using routine health service data, qualitative perceptions of health care workers about how health services were affected, and community members' health care seeking behaviour from a representative household survey and focus group discussions. Results The COVID-19 epidemiology in North Kivu aligns with evidence reported globally, yet case fatality rates were high due to underreporting. Testing capacity was limited and initially mainly available in the province's capital. Health service utilisation showed different patterns - child measles vaccinations experienced a decrease at the beginning of the pandemic, while outpatient consultations, malaria, and pneumonia showed an increase over time. Such increases might have been driven by insecurity and population displacements rather than COVID-19. Community members continued seeking care during the first months of the COVID-19 pandemic and visited the same health facilities as before COVID-19. Financial constraints, not COVID-19, were the main barrier reported to accessing health care. Conclusions The first year of the COVID-19 pandemic in the Mweso health zone was characterised by low testing capacity and an underestimation of reported COVID-19 infections. The increase in health care utilisation should be further explored to understand the role of factors unrelated to COVID-19, such as insecurity, population displacement, and poverty, which remain major challenges to successfully providing health services and improving the population's health. Measles vaccination coverage dropped, which exacerbated the ongoing measles outbreak. Improved decentralised testing capacity will be crucial for future epidemics and enhanced efforts to maintain child vaccination coverage.
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Affiliation(s)
- Chiara Altare
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Johns Hopkins Center for Humanitarian Health, Baltimore, Maryland, USA
| | - Natalya Kostandova
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Linda Matadi Basadia
- Health and Nutrition Department, Action Contre la Faim, Kinshasa, Democratic Republic of Congo
| | - Marie Petry
- Health and Nutrition Department, Action Contre la Faim, Kinshasa, Democratic Republic of Congo
| | - Gbètoho Fortuné Gankpe
- Health and Nutrition Department, Action Contre la Faim, Kinshasa, Democratic Republic of Congo
| | - Hannah Crockett
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Natalia Hernandez Morfin
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sophie Bruneau
- Operations Department, Action Contre la Faim, Paris, France
| | - Caroline Antoine
- Technical and Advocacy Department, Action Contre la Faim, Paris, France
| | - Paul B Spiegel
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Johns Hopkins Center for Humanitarian Health, Baltimore, Maryland, USA
| | - IMPACT DRC TeamMullafirozeRoxanaLinkeJasperCecchiOlivierDasNayanaRickardKatieMushamalirwaJean-PaulRuhindaDestinLehmannNadiaAmandineMarieHenzlerElioraGallecierAudreyBesnardeauBenoitGerritsmaNoortje
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Johns Hopkins Center for Humanitarian Health, Baltimore, Maryland, USA
- Health and Nutrition Department, Action Contre la Faim, Kinshasa, Democratic Republic of Congo
- Operations Department, Action Contre la Faim, Paris, France
- Technical and Advocacy Department, Action Contre la Faim, Paris, France
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de Aguirre PM, Carlos S, Pina-Sánchez M, Mbikayi S, Burgueño E, Tendobi C, Chiva L, Holguín Á, Reina G. High pre-Delta and early-Omicron SARS-CoV-2 seroprevalence detected in dried blood samples from Kinshasa (D.R. Congo). J Med Virol 2024; 96:e29529. [PMID: 38516764 DOI: 10.1002/jmv.29529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 02/02/2024] [Accepted: 03/01/2024] [Indexed: 03/23/2024]
Abstract
Studies on the impact of the COVID-19 pandemic in sub-Saharan Africa have yielded varying results, although authors universally agree the real burden surpasses reported cases. The primary objective of this study was to determine SARS-CoV-2 seroprevalence among patients attending Monkole Hospital in Kinshasa (D.R. Congo). The secondary objective was to evaluate the analytic performance of two chemiluminescence platforms: Elecsys® (Roche) and VirClia® (Vircell) on dried blood spot samples (DBS). The study population (N = 373) was recruited in two stages: a mid-2021 blood donor cohort (15.5% women) and a mid-2022 women cohort. Crude global seroprevalence was 61% (53.9%-67.8%) pre-Delta in 2021 and 90.2% (84.7%-94.2%) post-Omicron in 2022. Anti-spike (S) antibody levels significantly increased from 53.1 (31.8-131.3) U/mL in 2021 to 436.5 (219.3-950.5) U/mL in 2022 and were significantly higher above 45 years old in the 2022 population. Both platforms showed good analytic performance on DBS samples: sensitivity was 96.8% for IgG (antiN/S) (93.9%-98.5%) and 96.0% (93.0%-98.0%) for anti-S quantification. These results provide additional support for the notion that exposure to SARS-CoV-2 is more widespread than indicated by case-based surveillance and will be able to guide the pandemic response and strategy moving forward. Likewise, this study contributes evidence to the reliability of DBS as a tool for serological testing and diagnosis in resource-limited settings.
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Affiliation(s)
| | - Silvia Carlos
- Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA) Irunlarrea, 3, Pamplona, Spain
| | | | - Samclide Mbikayi
- Centre Hospitalier Monkole, Kinshasa, Democratic Republic of Congo
| | - Eduardo Burgueño
- Centre Hospitalier Monkole, Kinshasa, Democratic Republic of Congo
| | - Céline Tendobi
- Centre Hospitalier Monkole, Kinshasa, Democratic Republic of Congo
| | - Luis Chiva
- Clínica Universidad de Navarra, Pamplona, Spain
| | - África Holguín
- Laboratorio Epidemiología Molecular VIH-1, Hospital Ramón y Cajal -IRYCIS y CIBERESP-RITIP, Madrid, Spain
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Nzaji MK, Kamenga JDD, Lungayo CL, Bene ACM, Meyou SF, Kapit AM, Fogarty AS, Sessoms D, MacDonald PDM, Standley CJ, Stolka KB. Factors associated with COVID-19 vaccine uptake and hesitancy among healthcare workers in the Democratic Republic of the Congo. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002772. [PMID: 38300940 PMCID: PMC10833569 DOI: 10.1371/journal.pgph.0002772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/27/2023] [Indexed: 02/03/2024]
Abstract
Vaccination is a critical intervention to reduce morbidity and mortality and limit strain on health systems caused by COVID-19. The slow pace of COVID-19 vaccination uptake observed in some settings raises concerns about COVID-19 vaccine hesitancy. The Democratic Republic of the Congo experienced logistical challenges and low uptake at the start of vaccine distribution, leading to one of the lowest overall COVID-19 vaccine coverage rates in the world in 2021. This study assessed the magnitude and associated factors of COVID-19 vaccine uptake among healthcare workers (HCWs) in seven provinces in DRC. We implemented a cross-sectional Knowledge, Attitudes, and Practices (KAP) questionnaire targeting HCWs, administered by trained data collectors in Haut-Katanga, Kasaï Orientale, Kinshasa, Kongo Centrale, Lualaba, North Kivu, and South Kivu provinces. Data were summarized and statistical tests were performed to assess factors associated with vaccine uptake. HCWs across the seven provinces completed the questionnaire (N = 5,102), of whom 46.3% had received at least one dose of COVID-19 vaccine. Older age, being married, being a medical doctor, being a rural resident, and having access to or having previously worked in a COVID-19 vaccination site were all strongly associated with vaccination uptake. Vaccinated individuals most frequently cited protection of themselves, their families, and their communities as motivations for being vaccinated, whereas unvaccinated individuals were most concerned about safety, effectiveness, and risk of severe side effects. The findings suggest an opinion divide between vaccine-willing and vaccine-hesitant HCWs. A multidimensional approach may be needed to increase the acceptability of the COVID-19 vaccine for HCWs. Future vaccine campaign messaging could center around the positive impact of vaccination on protecting friends, family, and the community, and also emphasize the safety and very low risk of adverse effects. These types of messages may further be useful when planning future immunization campaigns with new vaccines.
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Affiliation(s)
- Michel K. Nzaji
- Social, Statistical and Environmental Sciences, RTI International, Kinshasa, Democratic Republic of Congo
| | - Jean de Dieu Kamenga
- Social, Statistical and Environmental Sciences, RTI International, Kinshasa, Democratic Republic of Congo
| | - Christophe Luhata Lungayo
- Expanded Programme on Immunization, Ministry of Public Health, Kinshasa, Democratic Republic of Congo
| | - Aime Cikomola Mwana Bene
- Expanded Programme on Immunization, Ministry of Public Health, Kinshasa, Democratic Republic of Congo
| | - Shanice Fezeu Meyou
- Social, Statistical and Environmental Sciences, RTI International, Research Triangle Park, North Carolina, United States of America
| | - Anselme Manyong Kapit
- Social, Statistical and Environmental Sciences, RTI International, Kinshasa, Democratic Republic of Congo
| | - Alanna S. Fogarty
- Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, United States of America
| | - Dana Sessoms
- Social, Statistical and Environmental Sciences, RTI International, Research Triangle Park, North Carolina, United States of America
| | - Pia D. M. MacDonald
- Social, Statistical and Environmental Sciences, RTI International, Research Triangle Park, North Carolina, United States of America
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Claire J. Standley
- Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, United States of America
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Kristen B. Stolka
- Social, Statistical and Environmental Sciences, RTI International, Research Triangle Park, North Carolina, United States of America
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Nlandu Y, Makulo JR, Essig M, Sumaili E, Lumaka A, Engole Y, Mboliasa MF, Mokoli V, Tshiswaka T, Nkodila A, Bukabau J, Longo A, Kajingulu F, Zinga C, Nseka N. Factors associated with acute kidney injury (AKI) and mortality in COVID-19 patients in a Sub-Saharan African intensive care unit: a single-center prospective study. Ren Fail 2023; 45:2263583. [PMID: 37870858 PMCID: PMC11001370 DOI: 10.1080/0886022x.2023.2263583] [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: 04/30/2023] [Accepted: 09/21/2023] [Indexed: 10/24/2023] Open
Abstract
INTRODUCTION Acute kidney injury (AKI) is a complication of severe coronavirus disease 2019 (COVID-19). Kidney damage associated with COVID-19 could take specific features due to environmental and socio-cultural factors. This study evaluates the incidence of AKI, the associated factors, and mortality in COVID-19 patients in a Sub-Saharan African intensive care unit. METHODS In a prospective cohort study conducted in the intensive care unit (ICU) of the Centre Médical de Kinshasa (CMK), consecutive patients admitted for COVID-19 were screened for the presence of AKI between 27 March, 2020 and 27 January 2022. AKI was defined according to Kidney Disease Improving Global Outcomes (KDIGO) guidelines. The primary outcome was occurrence of AKI. The secondary outcome was 48 days' mortality and recovery of the renal function at intensive care unit (ICU) discharge. Survival (time-to death) curves were built using the Kaplan Meier methods. Multivariate analyses were performed by logistic regression to identify factors associated with AKI and Cox regression to explore the association between AKI and in-hospital mortality. The significance level of the p-value was set at 0.05. RESULTS The median(IQR) sequential organ failure assessment score (SOFA) score and mean age of patients (215) including in our cohort were respectively 3(2-4) and 58.9 ± 14.9 years. The incidence of AKI was 28.4% with stages 1, 2, or 3 AKI accounted for 39.3%, 11.5%, and 49.2%, respectively. Hemodialysis was required in 16 out 215 (7.4%) patients. Dyspnea (adjusted odds ratio (aOR):2.27 [1.1--4.57] p = 0.021), SOFA ≥5 (aOR:3.11[1.29-7.53] p = 0.012), AST/ALT ratio (aOR: 1.53 [1.09-1.79] p = 0.015), N/L ratio (aOR:2.09 [1.09-3.20] p = 0.016), mechanical ventilation (aOR: 3.20 [1.66-10.51] p = 0.005) and Amikacin (aOR: 2.91 [1.37-6.18] p = 0.006) were the main factors associated with AKI. Patients with AKI had a mortality rate of 52.5% and 67.2% of the survivors did not recover kidney function at the end of hospitalization. Adjusted Cox regression analysis revealed that COVID-19-associated AKI was independently associated with in-hospital death (HR:2.96 [1.93-4.65] p = 0.013) compared to non-AKI patients. CONCLUSIONS AKI was present in three out of ten COVID-19 patients. The most significant factors associated with AKI were dyspnea, SOFA ≥ 5, AST/ALT and N/L ratio, mechanical ventilation and Amikacin. AKI has been associated with an almost threefold increase in overall mortality and seven out of ten survivors did not recover kidney function after AKI.
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Affiliation(s)
- Yannick Nlandu
- Nephrology Unit, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo
- Intensive Care Unit, Centre Médical de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Jean-Robert Makulo
- Nephrology Unit, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Marie Essig
- Nephrology Department, Ambroise Paré Hospital, AP-HP University Paris-Saclay, Boulogne-Billancourt, France
| | - Ernest Sumaili
- Nephrology Unit, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Aimé Lumaka
- Center for Human Genetics, Department of Pediatrics, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Yannick Engole
- Nephrology Unit, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo
- Intensive Care Unit, Centre Médical de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Marie-France Mboliasa
- Nephrology Unit, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo
- Intensive Care Unit, Centre Médical de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Vieux Mokoli
- Nephrology Unit, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Trésor Tshiswaka
- Nephrology Unit, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Aliocha Nkodila
- Department of Family Medicine and Primary Care, Protestant University in Congo, Kinshasa, Democratic Republic of Congo
| | - Justine Bukabau
- Nephrology Unit, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo
- Intensive Care Unit, Centre Médical de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Augustin Longo
- Nephrology Unit, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - François Kajingulu
- Nephrology Unit, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Chantal Zinga
- Nephrology Unit, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Nazaire Nseka
- Nephrology Unit, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo
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Lodge S, Lawler NG, Gray N, Masuda R, Nitschke P, Whiley L, Bong SH, Yeap BB, Dwivedi G, Spraul M, Schaefer H, Gil-Redondo R, Embade N, Millet O, Holmes E, Wist J, Nicholson JK. Integrative Plasma Metabolic and Lipidomic Modelling of SARS-CoV-2 Infection in Relation to Clinical Severity and Early Mortality Prediction. Int J Mol Sci 2023; 24:11614. [PMID: 37511373 PMCID: PMC10380980 DOI: 10.3390/ijms241411614] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/10/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
An integrative multi-modal metabolic phenotyping model was developed to assess the systemic plasma sequelae of SARS-CoV-2 (rRT-PCR positive) induced COVID-19 disease in patients with different respiratory severity levels. Plasma samples from 306 unvaccinated COVID-19 patients were collected in 2020 and classified into four levels of severity ranging from mild symptoms to severe ventilated cases. These samples were investigated using a combination of quantitative Nuclear Magnetic Resonance (NMR) spectroscopy and Mass Spectrometry (MS) platforms to give broad lipoprotein, lipidomic and amino acid, tryptophan-kynurenine pathway, and biogenic amine pathway coverage. All platforms revealed highly significant differences in metabolite patterns between patients and controls (n = 89) that had been collected prior to the COVID-19 pandemic. The total number of significant metabolites increased with severity with 344 out of the 1034 quantitative variables being common to all severity classes. Metabolic signatures showed a continuum of changes across the respiratory severity levels with the most significant and extensive changes being in the most severely affected patients. Even mildly affected respiratory patients showed multiple highly significant abnormal biochemical signatures reflecting serious metabolic deficiencies of the type observed in Post-acute COVID-19 syndrome patients. The most severe respiratory patients had a high mortality (56.1%) and we found that we could predict mortality in this patient sub-group with high accuracy in some cases up to 61 days prior to death, based on a separate metabolic model, which highlighted a different set of metabolites to those defining the basic disease. Specifically, hexosylceramides (HCER 16:0, HCER 20:0, HCER 24:1, HCER 26:0, HCER 26:1) were markedly elevated in the non-surviving patient group (Cliff's delta 0.91-0.95) and two phosphoethanolamines (PE.O 18:0/18:1, Cliff's delta = -0.98 and PE.P 16:0/18:1, Cliff's delta = -0.93) were markedly lower in the non-survivors. These results indicate that patient morbidity to mortality trajectories is determined relatively soon after infection, opening the opportunity to select more intensive therapeutic interventions to these "high risk" patients in the early disease stages.
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Affiliation(s)
- Samantha Lodge
- Australian National Phenome Center, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia; (S.L.); (N.G.L.); (N.G.); (R.M.); (P.N.); (L.W.); (S.-H.B.); (E.H.)
- Center for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
| | - Nathan G. Lawler
- Australian National Phenome Center, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia; (S.L.); (N.G.L.); (N.G.); (R.M.); (P.N.); (L.W.); (S.-H.B.); (E.H.)
- Center for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
| | - Nicola Gray
- Australian National Phenome Center, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia; (S.L.); (N.G.L.); (N.G.); (R.M.); (P.N.); (L.W.); (S.-H.B.); (E.H.)
- Center for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
| | - Reika Masuda
- Australian National Phenome Center, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia; (S.L.); (N.G.L.); (N.G.); (R.M.); (P.N.); (L.W.); (S.-H.B.); (E.H.)
| | - Philipp Nitschke
- Australian National Phenome Center, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia; (S.L.); (N.G.L.); (N.G.); (R.M.); (P.N.); (L.W.); (S.-H.B.); (E.H.)
| | - Luke Whiley
- Australian National Phenome Center, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia; (S.L.); (N.G.L.); (N.G.); (R.M.); (P.N.); (L.W.); (S.-H.B.); (E.H.)
- Center for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
| | - Sze-How Bong
- Australian National Phenome Center, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia; (S.L.); (N.G.L.); (N.G.); (R.M.); (P.N.); (L.W.); (S.-H.B.); (E.H.)
| | - Bu B. Yeap
- Medical School, University of Western Australia, Perth, WA 6150, Australia; (B.B.Y.); (G.D.)
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, WA 6150, Australia
| | - Girish Dwivedi
- Medical School, University of Western Australia, Perth, WA 6150, Australia; (B.B.Y.); (G.D.)
- Department of Cardiology, Fiona Stanley Hospital, Perth, WA 6150, Australia
| | | | | | - Rubén Gil-Redondo
- Precision Medicine and Metabolism Laboratory, CIC bioGUNE, Parque Tecnológico de Bizkaia, Bld. 800, 48160 Derio, Spain; (R.G.-R.); (N.E.); (O.M.)
| | - Nieves Embade
- Precision Medicine and Metabolism Laboratory, CIC bioGUNE, Parque Tecnológico de Bizkaia, Bld. 800, 48160 Derio, Spain; (R.G.-R.); (N.E.); (O.M.)
| | - Oscar Millet
- Precision Medicine and Metabolism Laboratory, CIC bioGUNE, Parque Tecnológico de Bizkaia, Bld. 800, 48160 Derio, Spain; (R.G.-R.); (N.E.); (O.M.)
| | - Elaine Holmes
- Australian National Phenome Center, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia; (S.L.); (N.G.L.); (N.G.); (R.M.); (P.N.); (L.W.); (S.-H.B.); (E.H.)
- Center for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, Sir Alexander Fleming Building, South Kensington, London SW7 2AZ, UK
| | - Julien Wist
- Australian National Phenome Center, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia; (S.L.); (N.G.L.); (N.G.); (R.M.); (P.N.); (L.W.); (S.-H.B.); (E.H.)
- Center for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Chemistry Department, Universidad del Valle, Cali 76001, Colombia
| | - Jeremy K. Nicholson
- Australian National Phenome Center, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia; (S.L.); (N.G.L.); (N.G.); (R.M.); (P.N.); (L.W.); (S.-H.B.); (E.H.)
- Center for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, WA 6150, Australia
- Institute of Global Health Innovation, Faculty of Medicine, Imperial College London, Faculty Building, South Kensington Campus, London SW7 2NA, UK
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Otshudiema JO, Folefack GLT, Nsio JM, Kakema CH, Minikulu L, Bafuana A, Kosianza JB, Mfumu AK, Nkwembe E, Munyeku-Bazitama Y, Makiala-Mandanda S, Guinko N, Mbuyi G, Tshilumbu JMK, Saidi GN, Umba-di-Masiala MS, Ebondo AK, Mutonj JJ, Kalombo S, Kabeya J, Mawanda TK, Bile FN, Kasereka GK, Mbala-Kingebeni P, Ahuka-Mundeke S, Karamagi HC, Fai KN, Djiguimde AP. Community-based COVID-19 active case finding and rapid response in the Democratic Republic of the Congo: Improving case detection and response. PLoS One 2023; 18:e0278251. [PMID: 37200322 PMCID: PMC10194859 DOI: 10.1371/journal.pone.0278251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 04/25/2023] [Indexed: 05/20/2023] Open
Abstract
A community-based coronavirus disease (COVID-19) active case-finding strategy using an antigen-detecting rapid diagnostic test (Ag-RDT) was implemented in the Democratic Republic of Congo (DRC) to enhance COVID-19 case detection. With this pilot community-based active case finding and response program that was designed as a clinical, prospective testing performance, and implementation study, we aimed to identify insights to improve community diagnosis and rapid response to COVID-19. This pilot study was modeled on the DRC's National COVID-19 Response Plan and the COVID-19 Ag-RDT screening algorithm defined by the World Health Organization (WHO), with case findings implemented in 259 health areas, 39 health zones, and 9 provinces. In each health area, a 7-member interdisciplinary field team tested the close contacts (ring strategy) and applied preventive and control measures to each confirmed case. The COVID-19 testing capacity increased from 0.3 tests per 10,000 inhabitants per week in the first wave to 0.4, 1.6, and 2.2 in the second, third, and fourth waves, respectively. From January to November 2021, this capacity increase contributed to an average of 10.5% of COVID-19 tests in the DRC, with 7,110 positive Ag-RDT results for 40,226 suspected cases and close contacts who were tested (53.6% female, median age: 37 years [interquartile range: 26.0-50.0)]. Overall, 79.7% (n = 32,071) of the participants were symptomatic and 7.6% (n = 3,073) had comorbidities. The Ag-RDT sensitivity and specificity were 55.5% and 99.0%, respectively, based on reverse transcription polymerase chain reaction analysis, and there was substantial agreement between the tests (k = 0.63). Despite its limited sensitivity, the Ag-RDT has improved COVID-19 testing capacity, enabling earlier detection, isolation, and treatment of COVID-19 cases. Our findings support the community testing of suspected cases and asymptomatic close contacts of confirmed cases to reduce disease spread and virus transmission.
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Affiliation(s)
| | | | - Justus M. Nsio
- COVID-19 Response, Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Cathy H. Kakema
- COVID-19 Response, World Health Organization, Kinshasa, Democratic Republic of the Congo
| | - Luigino Minikulu
- COVID-19 Response, Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Aimé Bafuana
- COVID-19 Response, Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Joel B. Kosianza
- COVID-19 Response, World Health Organization, Kinshasa, Democratic Republic of the Congo
| | - Antoine K. Mfumu
- COVID-19 Response, World Health Organization, Kinshasa, Democratic Republic of the Congo
| | - Edith Nkwembe
- COVID-19 Laboratory and Epidemiology Team, National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - Yannick Munyeku-Bazitama
- COVID-19 Laboratory and Epidemiology Team, National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - Sheila Makiala-Mandanda
- COVID-19 Laboratory and Epidemiology Team, National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - Noé Guinko
- COVID-19 Response, World Health Organization, Kinshasa, Democratic Republic of the Congo
| | - Gisèle Mbuyi
- COVID-19 Response, Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | | | - Guy N. Saidi
- COVID-19 Response, World Health Organization, Kinshasa, Democratic Republic of the Congo
| | | | - Amos K. Ebondo
- COVID-19 Response, World Health Organization, Kinshasa, Democratic Republic of the Congo
| | - Jean-Jacques Mutonj
- COVID-19 Response, World Health Organization, Kinshasa, Democratic Republic of the Congo
| | - Serge Kalombo
- COVID-19 Response, World Health Organization, Kinshasa, Democratic Republic of the Congo
| | - Jad Kabeya
- COVID-19 Response, World Health Organization, Kinshasa, Democratic Republic of the Congo
| | - Taty K. Mawanda
- COVID-19 Response, World Health Organization, Kinshasa, Democratic Republic of the Congo
| | - Faustin N. Bile
- COVID-19 Response, World Health Organization, Kinshasa, Democratic Republic of the Congo
| | - Gaby K. Kasereka
- COVID-19 Response, World Health Organization, Kinshasa, Democratic Republic of the Congo
| | - Placide Mbala-Kingebeni
- COVID-19 Laboratory and Epidemiology Team, National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - Steve Ahuka-Mundeke
- COVID-19 Laboratory and Epidemiology Team, National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - Humphrey Cyprian Karamagi
- Data Analytics and Knowledge Management, World Health Organization Regional Office for Africa, Brazzaville, Democratic Republic of Congo
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Makulo JR, Wumba R, Mandina MN, Mbala P, Aziza AA, Nlandu YM, Kabwe B, Mangala D, Bepouka BI, Odio JO, Longokolo M, Mukenge E, Kamwiziku G, Kingand EL, Bashengezi C, Kabanda G, Longo-Mbenza B. SARS-CoV2 mutations and impact on mortality: observational study in a sub-saharan Africa hospital. Virol J 2023; 20:56. [PMID: 36998042 PMCID: PMC10062261 DOI: 10.1186/s12985-023-02014-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/19/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND One year after the coronavirus disease 2019 (COVID-19) pandemic, the focus of attention has shifted to the emergence and spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants of concern (VOCs). The aim of the study was to assess the frequency of VOCs in patients followed for COVID-19 at Kinshasa university hospital (KUH) during the 3rd and 4th waves of the pandemic in Kinshasa. Hospital mortality was compared to that of the first two waves. METHOD The present study included all patients in whom the diagnosis of SARS-CoV-2 infection was confirmed by the polymerase chain reaction (PCR). The laboratory team sequenced a subset of all SARS-CoV-2 positive samples with high viral loads define as Ct < 25 to ensure the chances to generate complete genome sequence. RNA extraction was performed using the Viral RNA Mini Kit (Qiagen). Depending on the platform, we used the iVar bioinformatics or artic environments to generate consensus genomes from the raw sequencing output in FASTQ format. RESULTS During the study period, the original strain of the virus was no longer circulating. The Delta VOC was predominant from June (92%) until November 2021 (3rd wave). The Omicron VOC, which appeared in December 2021, became largely predominant one month later (96%) corresponding the 4th wave. In-hospital mortality associated with COVID-19 fell during the 2nd wave (7% vs. 21% 1st wave), had risen during the 3rd (16%) wave before falling again during the 4th wave (7%) (p < 0.001). CONCLUSION The Delta (during the 3rd wave) and Omicron VOCs (during the 4th wave) were very predominant among patients followed for Covid-19 in our hospital. Contrary to data in the general population, hospital mortality associated with severe and critical forms of COVID-19 had increased during the 3rd wave of the pandemic in Kinshasa.
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Affiliation(s)
- Jean-Robert Makulo
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, République démocratique du Congo, Kinshasa, Congo.
| | - Roger Wumba
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, République démocratique du Congo, Kinshasa, Congo
| | - Madone Ndona Mandina
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, République démocratique du Congo, Kinshasa, Congo
| | - Placide Mbala
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, République démocratique du Congo, Kinshasa, Congo
- Institut National de Recherche Biomédicale (INRB), République démocratique, Kinshasa, Congo
- Secrétariat technique de la riposte contre la COVID-19, République démocratique du Congo, Kinshasa, Congo
| | - Adrienne Amuri Aziza
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, République démocratique du Congo, Kinshasa, Congo
- Institut National de Recherche Biomédicale (INRB), République démocratique, Kinshasa, Congo
| | - Yannick Mayamba Nlandu
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, République démocratique du Congo, Kinshasa, Congo
| | - Benjanmin Kabwe
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, République démocratique du Congo, Kinshasa, Congo
- Centre de Recherche en phytothérapie, pharmacopée africaine et technologie pharmaceutique a (CREPPAT), Kinshasa, Congo
| | - Donatien Mangala
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, République démocratique du Congo, Kinshasa, Congo
| | - Ben Izizag Bepouka
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, République démocratique du Congo, Kinshasa, Congo
| | - Jerome Ossam Odio
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, République démocratique du Congo, Kinshasa, Congo
| | - Murielle Longokolo
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, République démocratique du Congo, Kinshasa, Congo
| | - Eric Mukenge
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, République démocratique du Congo, Kinshasa, Congo
| | - Guyguy Kamwiziku
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, République démocratique du Congo, Kinshasa, Congo
| | - Eddy Lusamaki Kingand
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, République démocratique du Congo, Kinshasa, Congo
| | - Constantin Bashengezi
- Centre de Recherche en phytothérapie, pharmacopée africaine et technologie pharmaceutique a (CREPPAT), Kinshasa, Congo
| | - Gilbert Kabanda
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, République démocratique du Congo, Kinshasa, Congo
- Centre de Recherche en phytothérapie, pharmacopée africaine et technologie pharmaceutique a (CREPPAT), Kinshasa, Congo
| | - Benjamin Longo-Mbenza
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, République démocratique du Congo, Kinshasa, Congo
- Centre de Recherche en phytothérapie, pharmacopée africaine et technologie pharmaceutique a (CREPPAT), Kinshasa, Congo
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10
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Munyeku-Bazitama Y, Okitale-Talunda P, Mpingabo-Ilunga P, Yambayamba MK, Tshiminyi PM, Umba-Phuati A, Kimfuta J, Phukuta FA, Makindu G, Mufwaya-Nsene R, Asari R, Makimoto S, Baketana LK, Ahuka-Mundeke S, Isono M, Nsio-Mbeta J, Makiala-Mandanda S, Muyembe-Tamfum JJ. High Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Prevalence After the Third Epidemic Wave (May-October 2021) in Matadi, Democratic Republic of the Congo. Open Forum Infect Dis 2023; 10:ofad023. [PMID: 36726537 PMCID: PMC9887263 DOI: 10.1093/ofid/ofad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/16/2023] [Indexed: 01/19/2023] Open
Abstract
Background By the end of the third wave of the coronavirus disease 2019 (COVID-19) epidemic (May-October 2021), only 3130 of the 57 268 confirmed cases of coronavirus disease 2019 (COVID-19) in the Democratic Republic of the Congo (DRC) were reported in Kongo Central. This province, and especially its capital city, Matadi, has essential trade and exchanges with Kinshasa, the epicenter of the COVID-19 epidemic in DRC. Kinshasa accounted for 60.0% of all cases during the same period. The true burden of COVID-19 in Matadi is likely underestimated. In this study, we aimed to determine the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence and associated risk factors after the third wave in Matadi. Methods We conducted a population-based cross-sectional study in October 2021. Consenting participants were interviewed and tested using an enzyme-linked immunosorbent assay commercial kit. We applied univariable and multivariable analysis to evaluate factors associated with seropositivity and adjusted the seroprevalence for the test kit performance. Results We included 2210 participants from 489 households. Female participants represented 59.1%. The median age was 27 years (interquartile range, 16-45 years). The crude SARS-CoV-2 seroprevalence was 82.3%. Age was identified as the main risk factor as younger age decreased the seropositivity odds. Accounting for clustering at the household level increased the seroprevalence to 83.2%. The seroprevalence increased further to 88.1% (95% confidence interval, 86.2%-90.1%) after correcting for the laboratory test kit performance. Conclusions The SARS-CoV-2 seroprevalence was very high, contrasting with reported cases. Evidence generated from this population-based survey remains relevant in guiding the local COVID-19 response, especially vaccination strategies.
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Affiliation(s)
- Yannick Munyeku-Bazitama
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Division of Global Epidemiology, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Patient Okitale-Talunda
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Patrick Mpingabo-Ilunga
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Marc K Yambayamba
- Département d’Epidémiologie et Biostatistiques, Ecole de Santé Publique, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Paul M Tshiminyi
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Aimé Umba-Phuati
- Division Provinciale de Santé du Kongo Central, Matadi, Democratic Republic of the Congo
| | - Jacques Kimfuta
- Division Provinciale de Santé du Kongo Central, Matadi, Democratic Republic of the Congo
| | - Ferdinand A Phukuta
- Division Provinciale de Santé du Kongo Central, Matadi, Democratic Republic of the Congo
| | - Goethe Makindu
- Division Provinciale de Santé du Kongo Central, Matadi, Democratic Republic of the Congo
| | | | - Ryoko Asari
- Japan International Cooperation Agency, Tokyo, Japan
| | | | - Lionel K Baketana
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Steve Ahuka-Mundeke
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Mitsuo Isono
- Japan International Cooperation Agency, Tokyo, Japan
| | - Justus Nsio-Mbeta
- Direction de Surveillance Epidémiologique, Ministère de la Santé, Hygiène et Prévention, Kinshasa, Democratic Republic of the Congo
| | - Sheila Makiala-Mandanda
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean-Jacques Muyembe-Tamfum
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Département de Biologie Médicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
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11
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Khamis F, Al Awaidy S, Ba’Omar M, Osman W, Chhetri S, Ambusaid Z, Al Fahdi Z, Al Lawati J, Al Sulaimi K, Al Bulushi SA, Al Bahrani M, Al-Zakwani I. The Impact of Demographic, Clinical Characteristics and the Various COVID-19 Variant Types on All-Cause Mortality: A Case-Series Retrospective Study. Diseases 2022; 10:100. [PMID: 36412594 PMCID: PMC9680441 DOI: 10.3390/diseases10040100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly evolved into a pandemic affecting virtually every country in the world. We evaluated the demographic, clinical, laboratory, and all-cause mortality of moderate and severe COVID-19 patients admitted to a tertiary care hospital in Oman during the different COVID-19 waves and variant types. (2) Methods: A case-series retrospective study was carried out between 12 March 2020 and 30 June 2022. All adults over the age of 18 with laboratory-confirmed COVID-19 were enrolled. Analyses were performed using univariate and multivariate statistics. (3) Results: A total of 1462 confirmed cases enrolled with the mean age of the cohort was 55 ± 17 years with significant differences among the groups (p = 0.006). A total of 63% and 80% of the patients were males and citizens of Oman, respectively. Patients infected with the Alpha COVID-19 variant type were more likely to have acute respiratory distress syndrome (ARDS) (p < 0.001), stay longer in the hospital (p < 0.001), and get admitted to the intensive care unit (ICU) (p < 0.001). At the same time, those who had the Omicron COVID-19 type were more likely to have renal impairment (p < 0.001) and less likely to be associated with non-invasive ventilation (NIV) (p = 0.001) compared with other COVID-19 variant types. The Delta (adjusted odds ratio (aOR), 1.8; 95% confidence interval (CI): 1.22−2.66; p = 0.003) and Omicron (aOR, 1.88; 95% CI: 1.09−3.22; p = 0.022) COVID-19 variant types were associated with higher all-cause mortality when compared to the initial COVID-19 variant. Old age (aOR, 1.05; 95% CI: 1.04−1.06; p < 0.001), the presence of respiratory disease (aOR, 1.58; 95% CI: 1.02−2.44; p = 0.04), ICU admission (aOR, 3.41; 95% CI: 2.16−5.39; p < 0.001), lower eGFR (aOR, 1.61; 95% CI: 1.17−2.23; p = 0.004), and ARDS (aOR, 5.75; 95% CI: 3.69−8.98; p < 0.001) were also associated with higher mortality while NIV requirements were associated with lower odds of dying (aOR, 0.65; 95% CI: 0.46−0.91; p = 0.012). (4) Conclusions: Alpha and Delta variants were associated with a longer hospital stay, need for intensive care, mechanical ventilation, and increased mortality. Old age, cardiac renal dysfunction were commonly associated with Omicron variants. Large-scale national studies to further assess the risk factors for mortality related to COVID-19 waves are warranted.
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Affiliation(s)
- Faryal Khamis
- Department of Infectious Disease, The Royal Hospital, Muscat, PC 111, Oman
| | | | - Muna Ba’Omar
- Department of Infectious Disease, The Royal Hospital, Muscat, PC 111, Oman
| | - Wessam Osman
- Department of Medicine, Royal Hospital, Ministry of Health, Muscat, PC 111, Oman
| | - Shabnam Chhetri
- Department of Infectious Disease, The Royal Hospital, Muscat, PC 111, Oman
| | - Zaiyana Ambusaid
- Department of Medicine, Royal Hospital, Ministry of Health, Muscat, PC 111, Oman
| | - Zakariya Al Fahdi
- Department of Medicine, Nizwa Hospital, Ministry of Health, Nizwa, PC 611, Oman
| | - Jaber Al Lawati
- Department of Medicine, Royal Hospital, Ministry of Health, Muscat, PC 111, Oman
| | - Khalsa Al Sulaimi
- Department of Medicine, Royal Hospital, Ministry of Health, Muscat, PC 111, Oman
| | | | - Maher Al Bahrani
- Department of Anaesthesia, Royal Hospital, Ministry of Health, Muscat, PC 111, Oman
| | - Ibrahim Al-Zakwani
- Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Al Khoudh, PC 123, Oman
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