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Yared S, Abera T, Ali SM, Muhummed AM, Ibrahim M, Hassan A, Hattendorf J, Zinsstag J, Tschopp R. A community based seroprevalence of SARS-CoV-2 antibodies in Somali Region, Eastern Ethiopia. Immun Inflamm Dis 2024; 12:e1148. [PMID: 38270297 PMCID: PMC10777752 DOI: 10.1002/iid3.1148] [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: 03/21/2023] [Revised: 12/25/2023] [Accepted: 12/28/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Coronavirus disease 19 (COVID-19) is life-threatening infectious disease caused by SARS-CoV-2 virus that caused a global pandemic. SARS-CoV-2 has been widely transmitted throughout Ethiopia, with over 501,060 cases confirmed and 7574 deaths until November 2023. This study assessed for the first time the seroprevalence SARS-CoV-2 in the general population of the Somali Region during the COVID-19 pandemic. METHODS A cross-sectional study design was conducted from May to June 2021 in 14 districts of Somali Region. Blood samples were collected in 820 participants in addition to administering a questionnaire that included sociodemographic characteristics and history of clinical symptoms of COVID-19. Blood samples were tested for the presence or absence of anti-SARS-CoV-2 using a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit (Euroimmun). RESULTS Overall, 477 (58.2%) were male and 343 (41.8%) were female. The majority of the participants (N = 581; 70.9%) were between 18 and 34 years old and not vaccinated against COVID-19 (N = 793; 96.7%). The overall seroprevalence of SARS-CoV-2 antibodies was 41.7% (95% CI: 33.3%-47.6%). The highest prevalence was found in Goljano district (70%) and the lowest in Gunagado district (22.5%). Only age was found to be associated with COVID-19 seropositivity. CONCLUSION Prevalence of SARS-CoV-2 antibodies was the highest ever reported in Ethiopia, indicating that a large proportion of the population had been infected 14 months after the start of the outbreak in the country. Such studies are important to swiftly reassess and improve specific COVID-19 preventive and control measures to reduce transmissions within the community in a given setting.
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Affiliation(s)
- Solomon Yared
- Department of Biology, College of Natural and Computational SciencesJigjiga UniversityJigjigaEthiopia
| | - Tsegalem Abera
- Department of Veterinary Microbiology and Public Health, College of Veterinary MedicineJigjiga UniversityJigjigaEthiopia
| | - Seid Mohammed Ali
- Department of Animal and Range Sciences, College of Dryland AgricultureJigjiga UniversityJigjigaEthiopia
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health InstituteUniversity of BaselBaselSwitzerland
| | - Abdifatah Muktar Muhummed
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health InstituteUniversity of BaselBaselSwitzerland
- School of Medicine, College of Medicine and Health SciencesJigjiga UniversityJigjigaEthiopia
| | - Mohammed Ibrahim
- Department of Veterinary Microbiology and Public Health, College of Veterinary MedicineJigjiga UniversityJigjigaEthiopia
| | - Abdullahi Hassan
- School of Medicine, College of Medicine and Health SciencesJigjiga UniversityJigjigaEthiopia
| | - Jan Hattendorf
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health InstituteUniversity of BaselBaselSwitzerland
| | - Jakob Zinsstag
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health InstituteUniversity of BaselBaselSwitzerland
| | - Rea Tschopp
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health InstituteUniversity of BaselBaselSwitzerland
- One Health UnitArmauer Hansen Research InstituteAddis AbabaEthiopia
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Aldawish S, Abusaris R, Almohammadi E, Althobiti F, Albarrag A. Effectiveness of COVID-19 vaccines against ICU admission during Omicron surge in Saudi Arabia: a nationwide retrospective cohort study. BMC Infect Dis 2023; 23:746. [PMID: 37907859 PMCID: PMC10617033 DOI: 10.1186/s12879-023-08686-y] [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: 04/16/2023] [Accepted: 10/09/2023] [Indexed: 11/02/2023] Open
Abstract
INTRODUCTION Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused significant economic damage and forced a slew of limitations to be placed by regulatory bodies worldwide. As the SARS-CoV-2 virus continuously mutates over time, it's crucial to understand how well the vaccines are effective against a new variant. OBJECTIVES To measure COVID-19 vaccine effectiveness against ICU admission with the Omicron variant in Saudi Arabia regions. METHODS AND MATERIALS A retrospective cohort study was conducted of vaccinated and non-vaccinated individuals who tested positive during Omicron dominant period (Jan 1, 2020- Jun 11, 2022). We used a Cox proportional hazards model based on calendar time to assess the vaccine's effectiveness while controlling for age and gender. RESULTS A total of 14103 individuals who were divided into fully vaccinated included 8388 (59.5%) individuals, partially vaccinated included 1851 (13.5%) individuals, and un-vaccinated included 3864 (27.4%) individuals. Higher age was associated with a higher risk of ICU admission (HR = 1.03, 95% CI: 1.02, 1.04). Three doses are associated with a lower risk of ICU admission compared to the single dose (HR = 0.09, 95% CI: 0.04, 0.20). By studying the distribution of Omicron infection among different regions, Al-Madinah Al-Monawarah had the highest proportion at 60.23 per 100,000 population (95% CI: 57.05, 63.53). In contrast, Al-jouf had the lowest proportion at 4.51 per 100,000 population (95%CI: 2.891, 6.713). The vaccination status was significantly different in different regions, as the highest proportion of fully vaccinated participants inhabited in Tabouk region, with 71.8% of its cases. Out of all regions, Najran had the highest proportion of ICU admission among Omicron cases with 20% (95% CI: 9.94%, 34.22%). While the lowest rates existed in Riyadh with 0.86% (95%CI: 0.61%, 1.17%). CONCLUSION We found that a booster significantly enhanced protection against severe COVID-19. The partially vaccinated and unvaccinated participants were at significantly higher risk of ICU admission when compared to the fully vaccinated participants. Furthermore, in future, it is worth investigating the effectiveness of a booster when other potential factors (e.g., region, comorbidities, etc.) are included, particularly among future variants of COVID-19.
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Affiliation(s)
- Shaymah Aldawish
- Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
- Public Health Authority, Riyadh, Saudi Arabia.
| | - Raghib Abusaris
- Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMARC), Riyadh, Saudi Arabia
| | | | | | - Ahmed Albarrag
- Public Health Authority, Riyadh, Saudi Arabia
- Collage of Medicine, King Saud University, Riyadh, Saudi Arabia
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Seroprevalence of SARS-CoV-2 among Children Visiting a Tertiary Hospital during the Prevaccination Period, Southwest Region, Saudi Arabia. Vaccines (Basel) 2022; 10:vaccines10081344. [PMID: 36016232 PMCID: PMC9415489 DOI: 10.3390/vaccines10081344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background: In the early days of the COVID-19 pandemic, tests to ascertain whether individuals were infected with SARS-CoV-2 were often unavailable. One method to deal with this issue is to test for SARS-CoV-2 antibodies. This study sought to determine the seroprevalence of SARS-CoV-2 in children in Saudi Arabia before vaccines were available to them. Methods: This study was conducted among children who visited the tertiary Maternity and Children Hospital in Abha city, Saudi Arabia. Serum samples were screened for SARS-CoV-2-specific IgG, IgM, and IgA antibodies using ELISA. The crude and adjusted seroprevalence values among the studied children were calculated. Results: Among the 413 children studied, the ages of enrolled patients ranged from newborn to 12 years, with a median age of three years. We identified 127 (30.7%) seropositive children. IgG was exclusively positive in 43 (10.4%); IgM was exclusively positive in 8 (1.9%), and IgA was exclusively positive in 15 (3.6%) children. Conclusions: This study is the first to estimate the seroprevalence of SARS-CoV-2 among the pediatric population seeking medical care in southwestern Saudi Arabia. The findings shed light on the dynamics of virus transmission in the community and provide a good reference for future studies. Future research should examine factors related to SARS-CoV-2 infection and seroprevalence among pediatric populations.
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Mushcab H, Al-Tawfiq JA, Ghamdi M, Babgi A, Amir A, Sheikh SS, Darwisheh A, Alobaid A, Jebakumar AZ, Qahtani S, Al Sagheir A. A Cohort Study of Seroprevalence of Antibodies Against SARS-CoV-2 Infection Among Healthcare Workers at a Tertiary Hospital in Saudi Arabia. Infect Drug Resist 2022; 15:4393-4406. [PMID: 35974896 PMCID: PMC9375977 DOI: 10.2147/idr.s369755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/12/2022] [Indexed: 11/24/2022] Open
Abstract
Background The nature of the healthcare workers’ jobs standing at the frontline against the coronavirus disease 2019 (COVID-19) puts them at a higher risk of unknowingly contracting the disease and potentially contributing to the spread. This study aims to assess the overall positive seroconversion prevalence of SARS-CoV-2. Methods This is a longitudinal cohort study of healthcare workers at Johns Hopkins Aramco Healthcare (JHAH). JHAH is a tertiary hospital located in Dhahran serving patients in several districts in the Eastern Province of Saudi Arabia. Participants were recruited between June and December 2020. Each participant had a serology blood test and completed the World Health Organization’s risk factor assessment questionnaire. Results This study included 682 participants working in JHAH, representing 15.7% of our population. Out of the 682 participants, 15.2% had a positive SARS-CoV-2 rt-PCR before taking part in the study. However, only 87 tested positive for SARS-CoV-2 antibodies, a prevalence of 12.7% of all participants. Out of the 87 positives for SARS-CoV-2 antibodies, 17 participants never tested positive for COVID-19 rt-PCR, a prevalence of 2.9%. Moreover, not properly using alcohol-based hand rub or soap and water after the risk of body fluid exposure and wearing personal protective equipment when indicated were found to be statistically significant to having a positive SARS-CoV-2 IgG assay. Conclusion Positive seroconversion rate was considerably low during the first wave of COVID-19 amongst JHAH’s healthcare workers and similar to other healthcare organizations in Saudi Arabia. Seropositivity correlated significantly with following infection prevention and control recommendations. Clinicaltrials.gov Identifier NCT04469647.
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Affiliation(s)
- Hayat Mushcab
- Research Office, Johns Hopkins Aramco Healthcare, Dhahran, Eastern Province, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Infectious Disease Unit - Specialty Internal Medicine, and Quality and Patient Safety Department, Johns Hopkins Aramco Healthcare, Dhahran, Eastern Province, Saudi Arabia.,Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.,Infectious Disease Division, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mohammed Ghamdi
- Population Health Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Amani Babgi
- Clinical Practice Education & Research, Johns Hopkins Aramco Healthcare, Dhahran, Eastern Province, Saudi Arabia
| | - Abdulrazack Amir
- Office of Academic Affairs, Johns Hopkins Aramco Healthcare, Dhahran, Eastern Province, Saudi Arabia
| | - Salwa S Sheikh
- Pathology Department, Johns Hopkins Aramco Healthcare, Dhahran, Eastern Province, Saudi Arabia
| | - Adel Darwisheh
- Laboratory Services Department, Johns Hopkins Aramco Healthcare, Dhahran, Eastern Province, Saudi Arabia
| | - Abrar Alobaid
- Laboratory Services Department, Johns Hopkins Aramco Healthcare, Dhahran, Eastern Province, Saudi Arabia
| | - Arulanantham Zechariah Jebakumar
- Vice Deanship of Postgraduate Studies Research, Prince Sultan Military College of Health Sciences, Dhahran, Eastern Province, Saudi Arabia
| | - Saeed Qahtani
- Wellness Institute, Johns Hopkins Aramco Healthcare, Dhahran, Eastern Province, Saudi Arabia
| | - Ahmed Al Sagheir
- Research Office, Johns Hopkins Aramco Healthcare, Dhahran, Eastern Province, Saudi Arabia
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High Seroprevalence of SARS-CoV-2 IgG and RNA among Asymptomatic Blood Donors in Makkah Region, Saudi Arabia. Vaccines (Basel) 2022; 10:vaccines10081279. [PMID: 36016167 PMCID: PMC9414004 DOI: 10.3390/vaccines10081279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/23/2022] [Accepted: 08/04/2022] [Indexed: 01/08/2023] Open
Abstract
The gold-standard approach for diagnosing and confirming Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) infection is reverse transcription-polymerase chain reaction (RT-PCR). This method, however, is inefficient in detecting previous or dormant viral infections. The presence of antigen-specific antibodies is the fingerprint and cardinal sign for diagnosis and determination of exposure to infectious agents including Corona virus disease-2019 (COVID-19). This cross-sectional study examined the presence of SARS-CoV-2 spike-specific immunoglobulin G (IgG) among asymptomatic blood donors in Makkah region. A total of 4368 asymptomatic blood donors were enrolled. They were screened for spike-specific IgG using ELISA and COVID-19 RNA by real-time PCR. COVID-19 IgG was detected among 2248 subjects (51.5%) while COVID-19-RNA was detected among 473 (10.8%) subjects. The IgG frequency was significantly higher among males and non-Saudi residents (p < 0.001 each) with no significant variation in IgG positivity among blood donors with different blood groups. In addition, COVID-19 RNA frequency was significantly higher among donors below 40-years old (p = 0.047, χ2 = 3.95), and non-Saudi residents (p = 0.001, χ2 = 304.5). The COVID-19 IgG levels were significantly higher among the RNA-positive donors (p = 001), and non-Saudi residents (p = 0.041), with no variations with age or blood group (p > 0.05). This study reveals a very high prevalence of COVID-19 IgG and RNA among asymptomatic blood donors in Makkah, Saudi Arabia indicating a high exposure rate of the general population to COVID-19; particularly foreign residents. It sheds light on the spread on COVID-19 among apparently healthy individuals at the beginning of the pandemic and could help in designing various control measures to minimize viral spread.
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Nourmohammadi H, Dehkordi AH, Adibi A, Amin Hashemipour SM, Abdan M, Fakhri M, Abdan Z, Sarokhani D. Seroprevalence of COVID-19 in Blood Donors: A Systematic Review and Meta-Analysis. Adv Virol 2022; 2022:9342680. [PMID: 35910542 PMCID: PMC9334089 DOI: 10.1155/2022/9342680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Determining the prevalence of SARS-CoV-2 in blood donors makes the control of virus circulation possible in healthy people and helps implement strategies to reduce virus transmission. The purpose of the study was to examine the seroprevalence of COVID-19 in blood donors using systematic review and meta-analysis. Materials and Methods The electronic databases PubMed, Scopus, Web of Science, and the Google Scholar search engine were searched using standard keywords up to 2022-04-26. The variance of each study was calculated according to the binomial distribution. Studies were combined according to the sample size and variance. Q Cochrane test and I2 index were used to examine the heterogeneity of the studies. Data analysis was performed in STATA 14 software, and the significance level of the tests was P < 0.05. Results In the 28 papers examined with 227894 samples, the seroprevalence of COVID-19 in blood donors was 10% (95% CI: 9%, 11%), estimated 5% (95% CI: 4%, 7%) among men and 6% (95% CI: 4%, 7%) among women. This rate in different blood groups was as follows: A 12% (95% CI: 10%-14%), B 12% (95% CI: 10%-15%), AB 9% (95% CI: 7%-12%), and O 13% (95% CI: 11%-16%). The seroprevalence of COVID-19 in blood donors in North America 10%, Europe 7%, Asia 23%, South America 5%, and Africa was 4%; Moreover, the seroprevalence of IgG antibodies was estimated to be 23% (95% CI: 18%-29%) and IgM 29% (95% CI: 9%-49%). Conclusion The highest prevalence of COVID-19 serum in women blood donors was among blood group O and Asia. The seroprevalence of IgG and IgM antibodies was high too.
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Affiliation(s)
| | - Ali Hasanpour Dehkordi
- Social Determinants of Health Research Center, School of Allied Medical Sciences, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Amir Adibi
- Department of Child and Adolescent Psychiatry, Ilam University of Medical Sciences, Ilam, Iran
| | | | - Mohsen Abdan
- Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Moloud Fakhri
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Abdan
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Diana Sarokhani
- Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Housawi AA, Qazi SJS, Jan AA, Osman RA, Alshamrani MM, AlFaadhel TA, AlHejaili FF, Al-Tawfiq JA, Wafa AA, Hamza AE, Hassan MA, Alharbi SA, Albasheer H, Almohmmdi MM, Alsisi SA, Mankowski M, Van de Klundert J, Alhelal AM, Sala FH, Kheyami A, Alhomayeed BA. Prevalence of anti-SARS-CoV-2 antibody in hemodialysis facilities: a cross-sectional multicenter study from Madinah. Ann Saudi Med 2022; 42:246-251. [PMID: 35933611 PMCID: PMC9357293 DOI: 10.5144/0256-4947.2022.229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Since the occurrence of coronavirus disease in 2019 (COVID-19), the global community has witnessed its exponential spread with devastating outcomes within the general population and specifically within hemodialysis patients. OBJECTIVES Compare the state of immunity to SARS-CoV-2 among hemodialysis patients and staff. DESIGN Cross-sectional study with a prospective follow-up period. SETTING Hemodialysis centers in Madinah region. PATIENTS AND METHODS We prospectively tested for SARS-CoV-2 antibodies in dialysis patients using dialysis centers staff as controls. The participants were tested on four occasions when feasible for the presence of anti-SARS-CoV-2 antibodies. We also analyzed factors that might be associated with seropositivity. MAIN OUTCOME MEASURES SARS-CoV-2 positivity using immunoglobulin G (IgG) levels SAMPLE SIZE: 830 participants, 677 patients and 153 dialysis centers staff as controls. RESULTS Of the total participants, 325 (257 patients and 68 staff) were positive for SARS-CoV-2 IgG antibodies, for a prevalence of 38.0% and 44.4% among patients and staff, respectively (P=.1379). Participants with a history of COVID-19 or related symptoms were more likely to have positive IgG (P<.0001). Surprisingly, positivity was also center-dependent. In a multivariable logistic regression, a history of infection and related symptoms contributed significantly to developing immunity. CONCLUSION The high prevalence of SARS-CoV-2 antibody among hemodialysis patients and previously asymptomatic staff suggested past asymptomatic infection. Some centers showed more immunity effects than others. LIMITATIONS Unable to collect four samples for each participant; limited to one urban center. CONFLICT OF INTEREST None.
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Affiliation(s)
| | | | - Abdulhalem A Jan
- From the Ministry of Health, King Fahad Hospital, Madinah, Saudi Arabia
| | - Rashid A Osman
- From the Internal Medicine Department, Karary University, Omdurman, Sudan
| | | | - Talal A AlFaadhel
- From the Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fayez F AlHejaili
- From the Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- From the Internal Medicine and Quality Department, Dhahran Health Center, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Ahmed A Wafa
- From the Department of Nephrology, NE Medina Clinic, Madinah, Saudi Arabia
| | | | - Moustafa A Hassan
- From the Department of Internal Medicine, Hassan Taher Dialysis Center, Madinah, Saudi Arabia
| | - Suliman A Alharbi
- From the Ministry of Health, King Fahad Hospital, Madinah, Saudi Arabia
| | - Hamza Albasheer
- From the Ministry of Health, King Fahad Hospital, Madinah, Saudi Arabia
| | - Majed M Almohmmdi
- From the Ministry of Health, King Fahad Hospital, Madinah, Saudi Arabia
| | - Salem A Alsisi
- From the Ministry of Health, King Fahad Hospital, Madinah, Saudi Arabia
| | - Michal Mankowski
- From the King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | | | | | | | - Ali Kheyami
- From the Laboratories and Blood Banks Administration, General Directorate of Health Affairs of Medina, Madinah, Saudi Arabia
| | - Bader A Alhomayeed
- From the Nephrology Department, Ministry of Health - King Abdulaziz Dialysis Center, Madinah, Saudi Arabia
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Azami M, Moradi Y, Moradkhani A, Aghaei A. SARS-CoV-2 seroprevalence around the world: an updated systematic review and meta-analysis. Eur J Med Res 2022; 27:81. [PMID: 35655237 PMCID: PMC9160514 DOI: 10.1186/s40001-022-00710-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/16/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Covid-19 has been one of the major concerns around the world in the last 2 years. One of the challenges of this disease has been to determine its prevalence. Conflicting results of the serology test in Covid explored the need for an updated meta-analysis on this issue. Thus, this systematic review aimed to estimate the prevalence of global SARS-CoV-2 serology in different populations and geographical areas. METHODS To identify studies evaluating the seroprevalence of SARS-CoV-2, a comprehensive literature search was performed from international databases, including Medline (PubMed), Web of Sciences, Scopus, EMBASE, and CINHAL. RESULTS In this meta-analysis, the results showed that SARS-CoV-2 seroprevalence is between 3 and 15% worldwide. In Eastern Mediterranean, the pooled estimate of seroprevalence SARS-CoV-2 was 15% (CI 95% 5-29%), and in Africa, the pooled estimate was 6% (CI 95% 1-13%). In America, the pooled estimate was 8% (CI 95% 6-11%), and in Europe, the pooled estimate was 5% (CI 95% 4-6%). Also the last region, Western Pacific, the pooled estimate was 3% (CI 95% 2-4%). Besides, we analyzed three of these areas separately. This analysis estimated the prevalence in subgroups such as study population, diagnostic methods, sampling methods, time, perspective, and type of the study. CONCLUSION The present meta-analysis showed that the seroprevalence of SARS-CoV-2 has been between 3 and 15% worldwide. Even considering the low estimate of this rate and the increasing vaccination in the world, many people are still susceptible to SARS-CoV-2.
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Affiliation(s)
- Mobin Azami
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Yousef Moradi
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Science, Sanandaj, Iran
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Asra Moradkhani
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Abbas Aghaei
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Science, Sanandaj, Iran.
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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Alenazi MW, Algaisi A, Zowawi HM, Aldibasi O, Hashem AM, Khalaf Alharbi N. Seroprevalence of COVID-19 in Riyadh City during the early increase of COVID-19 infections in Saudi Arabia, June 2020. Saudi J Biol Sci 2022; 29:103282. [PMID: 35475117 PMCID: PMC9027288 DOI: 10.1016/j.sjbs.2022.103282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 03/14/2022] [Accepted: 04/17/2022] [Indexed: 12/15/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus (SARS-CoV-2) emerged in December 2019 and caused a global pandemic of the Coronavirus Disease 2019 (COVID-19). More than 170 million cases have been reported worldwide with mortality rate of 1–3%. The detection of SARS-CoV-2 by molecular testing is limited to acute infections, therefore serological studies provide a better estimation of the virus spread in a population. This study aims to evaluate the seroprevalence of SARS-CoV-2 in the major city of Riyadh, Saudi Arabia during the sharp increase of the pandemic, in June 2020. Serum samples from non-COVID patients (n = 432), patients visiting hospitals for other complications and confirmed negative for COVID-19, and healthy blood donors (n = 350) were collected and evaluated using an in-house enzyme-linked immunosorbent assay (ELISA). The overall percentage of positive samples was 7.80% in the combined two populations (n = 782). The seroprevalence was lower in the blood donors (6%) than non-COVID-19 patients (9.25%), p = 0.0004. This seroprevalence rate is higher than the documented cases, indicating asymptomatic or mild unreported COVID-19 infections in these two populations. This warrants further national sero-surveys and highlights the importance of real-time serological surveillance during pandemics.
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Mahallawi WH, Alsarani MA, Aljohani RH, Alluhaibi AA, Alamri TH, Ibrahim NA, Mahallawi KH, Khabourd OF. Seroprevalence of SARS-Cov-2 IgG antibodies in patients at a single center in Saudi Arabia. Ann Saudi Med 2022; 42:69-74. [PMID: 35380058 PMCID: PMC8981997 DOI: 10.5144/0256-4947.2022.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has had a massive impact on public health as well as the economy. Understanding the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among undiagnosed individuals is important for developing an informed pandemic response. OBJECTIVE Investigate the prevalence of undiagnosed COVID-19 disease. DESIGN Cross-sectional. SETTING Tertiary care center in Madinah, Saudi Arabia. SUBJECTS AND METHODS All participants were on follow-up visits to various clinics and had not been previously diagnosed with COVID-19. Enzyme-linked immunosorbent assay was used to specifically assess the anti-spike IgG antibody seropositivity in serum samples. We associated the seropositivity rates of the participants with age, body mass index (BMI), nationality, blood groups, and sex with uni- and multivariate analyses. MAIN OUTCOME MEASURES Seropositivity for IgG anti-spike antibodies against SARS-CoV-2. SAMPLE SIZE AND CHARACTERISTICS 527 subjects, with a median (interquartile percentiles) age of the 527 subjects was 34 (24-41). RESULTS Of the 527 samples, about one-fourth (n=124, 23.5%) were positive for anti-spike IgG antibody against SARS CoV-2. Age was associated with anti-spike IgG antibody positivity (P<.002). Participants >30 years were more likely to be seropositive (28-29%) than younger participants (15.4%). Additionally, seropositivity was associated with female gender (P<.001) and a higher BMI (P<.006). In the multivariate logistic regression, age >30, female gender and BMI >40 were associated with seropositivity. CONCLUSION The percentage of seropositive individuals reflects the high level of undiagnosed COVID-19 patients among the population. Our results will help in a better evaluation of the public health measures applied during the COVID-19 pandemic and any future public health crises. LIMITATIONS Sample size was small, single-center study and no rural areas were included. CONFLICT OF INTEREST None.
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Affiliation(s)
- Waleed H Mahallawi
- From the Medical Laboratory Technology Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | | | - Rami H Aljohani
- From the Medical Services, Taibah University, Madinah, Saudi Arabia
| | | | - Turki H Alamri
- From the Medical Services, Taibah University, Madinah, Saudi Arabia
| | - Nadir A Ibrahim
- From the Medical Laboratory Technology Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Khalid H Mahallawi
- From the General Directorate of Health Affairs, Rehabilitation Hospital, Ministry of Health, Madina, Saudi Arabia
| | - Omar F Khabourd
- From the Department of Medical Laboratory Services, Jordan University of Science and Technology, Irbid, Jordan
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11
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Amer HA, Abdallah HA, Alkheledan HS, Alzarzour SH, Shrahily A, Tamim H, Alqahtani SA, Memish ZA. SARS-CoV-2 Antibody Prevalence among Healthcare Workers: A Cross-Sectional Study at a Quaternary Healthcare Center in Saudi Arabia. J Infect Public Health 2022; 15:343-348. [PMID: 35167996 PMCID: PMC8802145 DOI: 10.1016/j.jiph.2022.01.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 12/22/2022] Open
Affiliation(s)
- Hala A Amer
- Prevention and Control of Infection Administration, King Saud Medical City, Riyadh, Saudi Arabia; Community Medicine Research Department, National Research Center, Egypt
| | - Hassan A Abdallah
- Prevention and Control of Infection Administration, King Saud Medical City, Riyadh, Saudi Arabia
| | - Haifa S Alkheledan
- Prevention and Control of Infection Administration, King Saud Medical City, Riyadh, Saudi Arabia
| | - Shaimaa H Alzarzour
- Prevention and Control of Infection Administration, King Saud Medical City, Riyadh, Saudi Arabia
| | - Ahmad Shrahily
- Prevention and Control of Infection Administration, King Saud Medical City, Riyadh, Saudi Arabia
| | - Hani Tamim
- Biostatistics Unit, Clinical Research Institute, American University of Beirut, Medical Center, Beirut, Lebanon
| | - Saleh A Alqahtani
- Liver Transplantation Unit, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia & Department of Medicine, The Johns Hopkins University, Hospital, Baltimore, Maryland, USA
| | - Ziad A Memish
- Research and Innovation Center, King Saud Medical City & College of Medicine, AlFaisal University, Riyadh, Saudi Arabia & Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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12
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Moya Rios do Vale N, Roche Moreira Latini F, Prisco Arnoni C, Martins Parreira R, Batista Castelo Girão MJ, Pereira Cortez AJ, Carvalho de Souza Bonetti T. Increasing rate of anti-SARS-CoV-2 antibodies between the first and second waves of COVID-19 in São Paulo, Brazil: A cross-sectional blood donors-based study. Clinics (Sao Paulo) 2022; 77:100016. [PMID: 35272203 PMCID: PMC8853752 DOI: 10.1016/j.clinsp.2022.100016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/16/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND SARS-CoV-2 infections rapidly spread along with Brazilian territory with heterogeneous transmission and mortality rates, mostly depending on region and period. Investigation of SARS-CoV-2 antibodies is an important tool to understand virus circulation. Given that blood donors are a representative casuistic of a healthy population, the authors evaluated the seroprevalence of IgG and IgM COVID-19 antibodies in 2,806 blood donors from a blood bank located in São Paulo, Brazil. METHODS Aiming to evaluate viral behavior over time, the authors selected samples from blood donors who donated in June and October 2020, and February 2021. To determine whether socio-demographic features affected the seroprevalence, the authors analyzed samples from three different regions from São Paulo (capital, metropolitan and countryside regions) and evaluated predictors as gender, age, educational level, race, and use of public transportation. RESULTS As expected, the authors observed that seroprevalence increased over time. Seroprevalence was greater in São Paulo city compared to metropolitan and countryside regions, being smallest in the countryside. Characteristics associated with a lower percentage of antibodies were age above 50 years, higher educational level, self-declared Caucasian, and use of individual transportation. CONCLUSION In conclusion, blood donors' samples proved to accurately reflect virus circulation in the healthy population.
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Affiliation(s)
- Nayara Moya Rios do Vale
- Colsan ‒ Associação Beneficente de Coleta de Sangue, São Paulo, SP, Brazil; Departamento de Ginecologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | | | | | | | - Manoel João Batista Castelo Girão
- Colsan ‒ Associação Beneficente de Coleta de Sangue, São Paulo, SP, Brazil; Departamento de Ginecologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Alandijany TA, Faizo AA. Development of Serological Assays and Seroprevalence Studies of the New Coronavirus 2019 (COVID-19): Reports from Saudi Arabia. Healthcare (Basel) 2021; 9:healthcare9121730. [PMID: 34946456 PMCID: PMC8701666 DOI: 10.3390/healthcare9121730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/09/2021] [Accepted: 12/11/2021] [Indexed: 12/30/2022] Open
Abstract
Serological assays are valuable tools for tracking COVID-19 spread, estimation of herd immunity, and evaluation of vaccine effectiveness. Several reports from Saudi Arabia describe optimized in-house protocols that enable detection of SARS-CoV-2 specific antibodies and measurement of their neutralizing activity. Notably, there were variations in the approaches utilized to develop and validate these immunoassays in term of sample size, validation methodologies, and statistical analyses. The developed enzyme-linked immunoassays (ELISAs) were based on the viral full-length spike (S), S1 subunit, and nucleocapsid (NP), and enabled detection of IgM and/or IgG. ELISAs were evaluated and validated against a microneutralization assay utilizing a local SARS-CoV-2 clinical isolate, FDA-approved commercially available immunoassays, and/or real-time polymerase chain reaction (RT-PCR). Overall, the performance of the described assays was high, reaching up to 100% sensitivity and 98.9% specificity with no cross-reactivity with other coronaviruses. In-house immunoassays, along with commercially available kits, were subsequently applied in a number of sero-epidemiological studies aiming to estimate sero-positivity status among local populations including healthcare workers, COVID-19 patients, non-COVID-19 patients, and healthy blood donors. The reported seroprevalence rates differed widely among these studies, ranging from 0.00% to 32.2%. These variations are probably due to study period, targeted population, sample size, and performance of the immunoassays utilized. Indeed, lack of sero-positive cases were reported among healthy blood donors during the lockdown, while the highest rates were reported when the number of COVID-19 cases peaked in the country, particularly among healthcare workers working in referral hospitals and quarantine sites. In this review, we aim to (1) provide a critical discussion about the developed in-house immunoassays, and (2) summarize key findings of the sero-epidemiological studies and highlight strengths and weaknesses of each study.
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Affiliation(s)
- Thamir A. Alandijany
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, P.O. Box 128442, Jeddah 21362, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80324, Jeddah 21589, Saudi Arabia
- Correspondence: (T.A.A.); (A.A.F.)
| | - Arwa A. Faizo
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, P.O. Box 128442, Jeddah 21362, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80324, Jeddah 21589, Saudi Arabia
- Correspondence: (T.A.A.); (A.A.F.)
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14
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Almudarra S, Kamel S, Saleh E, Alaswad R, Alruwaily A, Almowald S, Alqunaibet AM, Almudiaheem A, Almutlaq H, Alserehi H, Almalki S, Bahlaq MA, Alsahafi AJ, Alsaif F, Khojah AT, Al-Tawfiq JA, Asiri SI, Assiri A, Jokhdar H. High seroprevalence of SARS-CoV-2 among high-density communities in Saudi Arabia. Infection 2021; 50:643-649. [PMID: 34881415 PMCID: PMC8653801 DOI: 10.1007/s15010-021-01726-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/26/2021] [Indexed: 12/23/2022]
Abstract
Background The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) infection had been investigated utilizing serology. Materials and methods This community-based sero-survey was carried out in the neighborhoods of three cities in Saudi Arabia. Results Of 5629 participants, 2766 (49.1%) were women; and 2148 (38.1%) were 18–34 years of age, and 3645 (64.7%) were from South East Asia. Positive serology was seen in 2825 (50.2% (95% CI: 48.8–51.5%) for SARS-CoV-2 anti-S1 IgG antibodies by ECLIA. Being in the age category of 18–34 years and being from Eastern Mediterranean Region (country A) were associated with higher COVID-19 seropositivity with estimated odds ratio of 1.3 [95% CI 1.1–1.8] and 2.5 [95% CI 1.1.5–4.2] respectively. Gender, social status, education, nationality, symptoms, presence of comorbidities and activity style were positively associated with increased seropositivity. Factors associated negatively with the rate of seropositivity were higher education and having outdoor activity with estimated OR of 0.92 [95% CI 0.46–0.95] and 0.59 [95% CI 0.47–0.74], respectively. Conclusion The study showed high seroprevalence of SARS-CoV-2 among high density population. Health education campaigns should target middle-aged, those with low education, those living in lower standards and indoor workers.
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Affiliation(s)
- Sami Almudarra
- Public Health Agency, Saudi Ministry of Health, Riyadh, Saudi Arabia
| | - Shady Kamel
- Field Epidemiology Training Program, Public Health Agency, Saudi Ministry of Health, Riyadh, Saudi Arabia
| | - Eman Saleh
- Department of Public Health and Community Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Rehab Alaswad
- Saudi Center of Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Amaal Alruwaily
- Saudi Center of Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Shaza Almowald
- Saudi Center of Disease Prevention and Control, Riyadh, Saudi Arabia
| | | | | | - Hind Almutlaq
- Saudi Center of Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Haleema Alserehi
- Saudi Center of Disease Prevention and Control, Riyadh, Saudi Arabia
| | - Safar Almalki
- Ministry of Health Laboratories, Saudi Ministry of Health, Riyadh, Saudi Arabia
| | - Mohannad Abdulhafiz Bahlaq
- Public Health Deputy, Madinah Directorate of Health Affairs, Saudi Ministry of Health, Riyadh, Saudi Arabia
| | - Abdullah Jaber Alsahafi
- Public Health Deputy, Jeddah Directorate of Health Affairs, Saudi Ministry of Health, Riyadh, Saudi Arabia
| | - Faisal Alsaif
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah T Khojah
- Faculty of Medicine, Al Imam Muhammad ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.
- Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
- Infectious Disease Division, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
| | | | - Abdullah Assiri
- Public Health Agency, Saudi Ministry of Health, Riyadh, Saudi Arabia
| | - Hani Jokhdar
- Public Health Agency, Saudi Ministry of Health, Riyadh, Saudi Arabia
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Jaiswal R, Sharma S, Singla A, Devpura N, Vohra R, Kakkar M, Rijhwani P, Sureka R. Seroprevalence of SARS-CoV-2 IgG antibody among healthy blood donors: a single centre study. Transfus Apher Sci 2021; 61:103338. [PMID: 34933819 PMCID: PMC8645505 DOI: 10.1016/j.transci.2021.103338] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 11/27/2021] [Accepted: 11/29/2021] [Indexed: 12/30/2022]
Abstract
Background Severe acute respiratory syndrome corona virus 2(SARS-CoV-2), the causative agent of corona virus disease-2019(COVID- 19) which has led to a global pandemic. The true extent of the burden of COVID-19 may be underestimated, and there is need to know the current prevalence of SARS-CoV-2 antibody in population. Methods The present study was a cross-sectional study to assess prevalence of SARS-CoV- 2 IgG antibody among 586 healthy voluntary blood donors who donated whole blood between mid-December 2020 to January 2021. A chemiluminescence assay was used to detect the presence of SARS-CoV-2 IgG antibody in serum samples in addition to recommended transfusion transmitted infections tests and Signal to Cut Off (S/C) > 1 was considered as reactive for antibody as per manufacturer’s instructions. Results In the present study, 586 healthy voluntary blood donors were enrolled and were screened for SARS- CoV-2 IgG antibody. Out of 586 donors, 52 donors had indeterminate values of SARS-CoV-2 IgG antibody. A total of 534 healthy voluntary blood donors’ samples were included in the present study for analysis. Out of total 534 healthy blood donors, 42.88% (229) were found to be seropositive while 57.11% (305) were found to be seronegative. Conclusion A 43% positivity of SARS-CoV-2 IgG antibody among healthy blood donors was detected which is an indication of presence of infection at community level and majority of the population already has been exposed to SARS-CoV-2 infection. However, there was no statistically significant association of type of blood group and age with seropositivity.
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Affiliation(s)
- Ram Jaiswal
- Dept. of Transfusion Medicine, Mahatma Gandhi Medical College & Hospital, Jaipur, India.
| | - Shweta Sharma
- Dept. of Transfusion Medicine, Mahatma Gandhi Medical College & Hospital, Jaipur, India
| | - Ashina Singla
- Dept. of Microbiology, Mahatma Gandhi Medical College & Hospital, Jaipur, India
| | - Nimisha Devpura
- Dept. of Pathology, Mahatma Gandhi Medical College & Hospital, Jaipur, India
| | - Rajat Vohra
- Dept. of Community Medicine, Mahatma Gandhi Medical College & Hospital, Jaipur, India
| | - Munish Kakkar
- Dept. of Pediatrics, Mahatma Gandhi Medical College & Hospital, Jaipur, India
| | - Puneet Rijhwani
- Dept. of General Medicine, Mahatma Gandhi Medical College & Hospital, Jaipur, India
| | - Rajendra Sureka
- Dept. of Neurology, Mahatma Gandhi Medical College & Hospital, Jaipur, India
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16
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Community-Based Seroprevalence of SARS-CoV-2 Antibodies following the First Wave of the COVID-19 Pandemic in Jazan Province, Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312451. [PMID: 34886175 PMCID: PMC8657111 DOI: 10.3390/ijerph182312451] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 12/30/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread globally, causing unprecedented effects on global health and economies. Community-based serological data are essential for understanding the true prevalence of infections, specifically the subclinical infections, as COVID-19 asymptomatic infections are common. Such data would also be important for decision making around choosing appropriate epidemiological control measures, as well as for the true estimation of mortality rates in the population. Further, determining the seroprevalence of anti-SARS-CoV-2 antibodies in the population would provide important information on herd immunity. In this study, we conducted a population-based age-stratified serological study to understand the prevalence of SARS-CoV-2 in Jazan Province, Saudi Arabia. Out of 594 participants who were recruited from 29 August to 30 December 2020, just before the vaccination rollout program in Saudi Arabia, about 157 were seropositive for SARS-CoV-2, indicating an estimated seropositivity rate of 26%. Although no significant difference in seropositivity was seen between male and female participants, we found that lower seroprevalence was associated with the younger (below 18 years old) and older populations (older than 56 years) compared with other age groups (19-55 years). These data indicate a high prevalence of SARS-CoV-2 antibodies following the peak of COVID-19 spread in Jazan province; however, most of the population (three-quarters) remains susceptible to SARS-CoV-2 infection.
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Sebastião CS, Galangue M, Gaston C, Van-Dunen R, Quivinja J, Lunbungululo E, Alfredo D, Sozinho A, Teixeira A, Manico E, Machado D, Mateus A, David Z, Paixão J, Neto Z, de Vasconcelos JN, Morais J. Seroprevalence of anti-SARS-CoV-2 antibodies and risk factors among healthy blood donors in Luanda, Angola. BMC Infect Dis 2021; 21:1131. [PMID: 34727874 PMCID: PMC8562364 DOI: 10.1186/s12879-021-06814-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 10/25/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND SARS-CoV-2 emerged in China and spread throughout the world due to its rapid transmission. The exposure rate in the healthy population is unknown, mainly in resource-limited countries. Herein, we estimated the seroprevalence of anti-SARS-CoV-2 antibodies and risk factors among blood donors in Luanda, the capital city of Angola. METHODS This was a retrospective study conducted with 343 blood donors. Chi-square and logistic regression were calculated to predict the independent variable for SARS-CoV-2 infection and deemed significant when p < 0.05. RESULTS Seroprevalence of anti-SARS-CoV-2 was 4.7%. Positivity rates varied to age groups (3.5-14.3%), gender (0-5%), area of residence (3.1-.6%), educational level (5.1-10.2%), occupation (4.4-7.7%), and the blood donor category (2.0-5.1%). Past and recent infections were detected in 3.2% and 1.5%, respectively. Blood donors under the age of 20 years (OR: 4.58, p = 0.241) and from non-urbanized areas (OR: 1.86, p = 0.293) presented a high risk related to infection. The infection was higher in blood group A and lower in blood group O. The risk of SARS-CoV-2 infection has increased from January 2020 (OR: 0.03, p = 0.001) to August 2020 (OR: 0.57, p = 0.426). CONCLUSIONS We provide an estimate of the exposure of healthy blood donors in Luanda. Also, we detected anti-SARS-CoV-2 in January 2020, indicating that the SARS-CoV-2 could have been imported during the first month of 2020. Further studies should be performed to assess the exposure rate in different groups from Angola.
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Affiliation(s)
- Cruz S Sebastião
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
- Centro de Investigação em Saúde de Angola (CISA), Caxito, Angola
- Instituto Superior de Ciências da Saúde (ISCISA), Universidade Agostinho Neto (UAN), Luanda, Angola
| | - Manuela Galangue
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Celestina Gaston
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Rui Van-Dunen
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Joltim Quivinja
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | | | | | - Alberto Sozinho
- Instituto Nacional de Sangue, Ministry of Health, Luanda, Angola
| | | | - Eunice Manico
- Instituto Nacional de Sangue, Ministry of Health, Luanda, Angola
| | - Deodete Machado
- Instituto Nacional de Sangue, Ministry of Health, Luanda, Angola
| | - António Mateus
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Zinga David
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Joana Paixão
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Zoraima Neto
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Jocelyne Neto de Vasconcelos
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
- Centro de Investigação em Saúde de Angola (CISA), Caxito, Angola
| | - Joana Morais
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola.
- Faculdade de Medicina, Universidade Agostinho Neto (UAN), Luanda, Angola.
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Barry M, Temsah MH, Aljamaan F, Saddik B, Al-Eyadhy A, Alenezi S, Alamro N, Alhuzaimi AN, Alhaboob A, Alhasan K, Alsohime F, Alaraj A, Halwani R, Jamal A, Temsah O, Alzamil F, Somily A, Al-Tawfiq JA. COVID-19 vaccine uptake among healthcare workers in the fourth country to authorize BNT162b2 during the first month of rollout. Vaccine 2021; 39:5762-5768. [PMID: 34481700 PMCID: PMC8410227 DOI: 10.1016/j.vaccine.2021.08.083] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 08/15/2021] [Accepted: 08/24/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND The Kingdom of Saudi Arabia (KSA) was the fourth country in the world to authorize the BNT162b2 coronavirus disease 2019 (COVID-19) vaccine, which it rolled out on December 17, 2020 and first targeted at healthcare workers (HCWs). This study assesses vaccine uptake among this group during the first month of its availability. METHODS A national cross-sectional, pilot-validated, self-administered survey was conducted among HCWs in the KSA between December 27, 2020 and January 3, 2021. The survey included sociodemographic details, previous contact with COVID-19 patients, previous infection with COVID-19, receiving (or registering with the Ministry of Health website to receive) the COVID-19 vaccine, sources of HCWs' information on vaccines, awareness of emerging variants of concern, and anxiety level using the 7-item Generalized Anxiety Disorder assessment. A descriptive bivariate analysis and multivariate logistic binary regression analysis were performed. The primary evaluated outcome was vaccine uptake. RESULTS Of the 1058 participants who completed the survey, 704 (66.5%) were female, and 626 (59.2%) were nurses. Of all the respondents, 352 (33.27%) were enrolled to receive or had already received the vaccine, while 706 (66.73%) had not enrolled. In a bivariate analysis, not enrolling for vaccination was more likely in females than males (78.5% vs. 21.5%, P < 0.001), HCWs between the ages of 20 and 40 years than those >40 years (70.4% vs. 29.6%, P = 0.005), Saudi HCWs than expatriates (78% vs 22%, P < 0.001), and among HCWs who used social media as a source of information than those who did not (69.8% vs. 38.6%, P < 0.001). In a multivariate analysis, independent factors associated with uptake were being a Saudi national (aOR = 1.918, 95 %CI = 1.363-2.698, P < 0.001), working in an intensive care unit (aOR = 1.495, 95 %CI = 1.083-2.063, P = 0.014), and working at a university hospital (aOR = 1.867, 95 %CI = 1.380-2.525, P < 0.001). CONCLUSIONS A low level of vaccine uptake was observed especially in female HCWs, those younger than 40 years old, and those who used social media as their source of vaccine information. This survey provides important information for public health authorities in order to scale up vaccination campaigns targeting these HCWs to increase vaccine enrollment and uptake.
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Affiliation(s)
- Mazin Barry
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia.
| | - Mohamad-Hani Temsah
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fadi Aljamaan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Critical Care Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Basema Saddik
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates; Department of Family and Community Medicine, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Ayman Al-Eyadhy
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Shuliweeh Alenezi
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Nurah Alamro
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah N Alhuzaimi
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Division of Pediatric Cardiology, Department of Cardiac Sciences, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Ali Alhaboob
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Alhasan
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali Alaraj
- Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia; Department of Medicine, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Rabih Halwani
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates; Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Amr Jamal
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia; Evidence-Based Health Care & Knowledge Translation Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Omar Temsah
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Fahad Alzamil
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali Somily
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Hallal PC, Silveira MF, Menezes AMB, Horta BL, Barros AJD, Pellanda LC, Victora GD, Dellagostin OA, Struchiner CJ, Burattini MN, Mesenburg MA, Jacques N, Vidaletti LP, Ambros EL, Berlezi EM, Schirmer H, Renner JDP, Collares K, Ikeda MLR, Ardenghi TM, Gasperi PD, Hartwig FP, Barros FC, Victora CG. Slow Spread of SARS-CoV-2 in Southern Brazil Over a 6-Month Period: Report on 8 Sequential Statewide Serological Surveys Including 35 611 Participants. Am J Public Health 2021; 111:1542-1550. [PMID: 34185552 DOI: 10.2105/ajph.2021.306351] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To evaluate the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) over 6 months in the Brazilian State of Rio Grande do Sul (population 11.3 million), based on 8 serological surveys. Methods. In each survey, 4151 participants in round 1 and 4460 participants in round 2 were randomly sampled from all state regions. We assessed presence of antibodies against SARS-CoV-2 using a validated lateral flow point-of-care test; we adjusted figures for the time-dependent decay of antibodies. Results. The SARS-CoV-2 antibody prevalence increased from 0.03% (95% confidence interval [CI] = 0.00%, 0.34%; 1 in every 3333 individuals) in mid-April to 1.89% (95% CI = 1.36%, 2.54%; 1 in every 53 individuals) in early September. Prevalence was similar across gender and skin color categories. Older adults were less likely to be infected than younger participants. The proportion of the population who reported leaving home daily increased from 21.4% (95% CI = 20.2%, 22.7%) to 33.2% (95% CI = 31.8%, 34.5%). Conclusions. SARS-CoV-2 infection increased slowly during the first 6 months in the state, differently from what was observed in other Brazilian regions. Future survey rounds will continue to document the spread of the pandemic.
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Affiliation(s)
- Pedro C Hallal
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Mariângela F Silveira
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Ana M B Menezes
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Bernardo L Horta
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Aluísio J D Barros
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Lúcia C Pellanda
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Gabriel D Victora
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Odir A Dellagostin
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Claudio J Struchiner
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Marcelo N Burattini
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Marilia A Mesenburg
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Nadege Jacques
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Luís Paulo Vidaletti
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Emanuele L Ambros
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Evelise M Berlezi
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Helena Schirmer
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Jane D P Renner
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Kaue Collares
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Maria Letícia R Ikeda
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Thiago M Ardenghi
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Patricia de Gasperi
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Fernando P Hartwig
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Fernando C Barros
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
| | - Cesar G Victora
- Pedro C. Hallal, Mariângela F. Silveira, Ana M. B. Menezes, Bernardo L. Horta, Aluísio J. D. Barros, Nadege Jacques, Luís Paulo Vidaletti, Fernando P. Hartwig, Fernando C. Barros, and Cesar G. Victora are with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Brazil. Lúcia C. Pellanda and Helena Schirmer are with the Universidade Federal de Ciências de Saúde de Porto Alegre, Brazil. Gabriel D. Victora is with the Laboratory of Lymphocyte Dynamics, Rockefeller University, New York, NY. Odir A. Dellagostin is with the Postgraduate Program in Biotechnology, Universidade Federal de Pelotas. Claudio J. Struchiner is with the Fundação Getúlio Vargas, Rio de Janeiro, Brazil. Marcelo N. Burattini is with the Universidade Federal de São Paulo, Brazil. Marilia A. Mesenburg is with the Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, and the Universidade Federal de Ciências de Saúde de Porto Alegre. Emanuele L. Ambros is with the Secretaria Municipal de Saúde de Uruguaiana, Brazil. Evelise M. Berlezi is with the Universidade de Ijuí, Brazil. Jane D. P. Renner is with the Universidade de Santa Cruz do Sul, Brazil. Kaue Collares is with the Universidade de Passo Fundo, Brazil. Maria Letícia R. Ikeda is with the Universidade do Vale do Rio dos Sinos, Sao Leopoldo, Brazil. Thiago M. Ardenghi is with the Universidade Federal de Santa Maria, Brazil. Patricia de Gasperi is with the Universidade de Caxias do Sul, Brazil
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20
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Assiri A, Al-Tawfiq JA, Alkhalifa M, Al Duhailan H, Al Qahtani S, Dawas RA, El Seoudi AA, Alomran N, Omar OA, Alotaibi N, Almudarra SS, Alabdulkarim K, Alqahtani S, Jokhdar H. Launching COVID-19 vaccination in Saudi Arabia: Lessons learned, and the way forward. Travel Med Infect Dis 2021; 43:102119. [PMID: 34133965 PMCID: PMC8197679 DOI: 10.1016/j.tmaid.2021.102119] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/30/2021] [Accepted: 06/11/2021] [Indexed: 12/24/2022]
Abstract
The Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCoV- 2) emerged in Wuhan City, China. The SARS-CoV-2 crossed borders and quickly transformed into a "Public health emergency of international concern". Countries around the globe are in the race to achieve herd immunity. We describe the steps taken by Saudi Arabia to achieve this goal.
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Affiliation(s)
- Abdullah Assiri
- Deputy Ministry for Public Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Infectious Disease Division, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
| | - Monira Alkhalifa
- Vaccination Operation Center, Ministry of Health, Riyadh, Saudi Arabia
| | - Hessa Al Duhailan
- Vaccination Operation Center, Ministry of Health, Riyadh, Saudi Arabia
| | - Sara Al Qahtani
- Vaccination Operation Center, Ministry of Health, Riyadh, Saudi Arabia
| | - Reema Abu Dawas
- Vaccination Operation Center, Ministry of Health, Riyadh, Saudi Arabia
| | | | - Najd Alomran
- Vaccination Operation Center, Ministry of Health, Riyadh, Saudi Arabia
| | - Omar Abu Omar
- Vaccination Operation Center, Ministry of Health, Riyadh, Saudi Arabia
| | - Nawaf Alotaibi
- Vaccination Operation Center, Ministry of Health, Riyadh, Saudi Arabia
| | - Sami S Almudarra
- Deputy Ministry for Public Health, Ministry of Health, Riyadh, Saudi Arabia; Vaccination Operation Center, Ministry of Health, Riyadh, Saudi Arabia
| | - Khalid Alabdulkarim
- Deputy Ministry for Public Health, Ministry of Health, Riyadh, Saudi Arabia; Vaccination Operation Center, Ministry of Health, Riyadh, Saudi Arabia
| | - Saleh Alqahtani
- Liver Transplant Center, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia; Division ofGastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA
| | - Hani Jokhdar
- Deputy Ministry for Public Health, Ministry of Health, Riyadh, Saudi Arabia
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21
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Sughayer MA, Mansour A, Al Nuirat A, Souan L, Ghanem M, Siag M. Dramatic rise in seroprevalence rates of SARS-CoV-2 antibodies among healthy blood donors: The evolution of a pandemic. Int J Infect Dis 2021; 107:116-120. [PMID: 33892190 PMCID: PMC8057684 DOI: 10.1016/j.ijid.2021.04.059] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Seroprevalence studies of SARS-CoV-2 antibodies are useful in assessing the epidemiological status in the community, and the degree of spread. OBJECTIVE To study the seroprevalence rates of SARS-CoV-2 antibodies among healthy blood donors in Jordan, at various points of time and as the pandemic evolves in the community. METHODS In total, 1374 blood donor samples, from three groups, were tested for SARS-CoV-2 total immunoglobulin antibodies. In the first group, samples from 734 individuals (from donations made between January and June 2020) were tested in June. In the second group, 348 individuals were tested in September 2020. The third group of 292 individuals was tested in February 2021. A qualitative assay was used for testing (specificity 99.8%, sensitivity 100%). RESULTS The first two groups, from January-June and September 2020, when confirmed Covid-19 cases numbered between several hundred and 3000, showed a seroprevalence rate of 0% (95% CI 0.00-0.51%). The third group (early February 2021), when the number of confirmed cases had reached 100 times that of September 2020, revealed a seroprevalence of 27.4% (95% CI 22.5-32.9%). CONCLUSIONS A dramatic rise in seroprevalence of SARS-CoV-2 antibodies was seen among healthy blood donors in Jordan, in parallel with widespread intracommunity transmission of the disease. This information is useful for assessing the degree of herd immunity, and provides for better understanding of the pandemic.
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Affiliation(s)
- Maher A Sughayer
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan.
| | - Asem Mansour
- Department of Radiology, and CEO, King Hussein Cancer Center, Jordan
| | - Abeer Al Nuirat
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Lina Souan
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Mohammad Ghanem
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Mahmoud Siag
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan
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22
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Dramatic rise in seroprevalence rates of SARS-CoV-2 antibodies among healthy blood donors: The evolution of a pandemic. INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES : IJID : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR INFECTIOUS DISEASES 2021. [PMID: 33892190 DOI: 10.1016/j.ijid.2021.04.059.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Seroprevalence studies of SARS-CoV-2 antibodies are useful in assessing the epidemiological status in the community, and the degree of spread. OBJECTIVE To study the seroprevalence rates of SARS-CoV-2 antibodies among healthy blood donors in Jordan, at various points of time and as the pandemic evolves in the community. METHODS In total, 1374 blood donor samples, from three groups, were tested for SARS-CoV-2 total immunoglobulin antibodies. In the first group, samples from 734 individuals (from donations made between January and June 2020) were tested in June. In the second group, 348 individuals were tested in September 2020. The third group of 292 individuals was tested in February 2021. A qualitative assay was used for testing (specificity 99.8%, sensitivity 100%). RESULTS The first two groups, from January-June and September 2020, when confirmed Covid-19 cases numbered between several hundred and 3000, showed a seroprevalence rate of 0% (95% CI 0.00-0.51%). The third group (early February 2021), when the number of confirmed cases had reached 100 times that of September 2020, revealed a seroprevalence of 27.4% (95% CI 22.5-32.9%). CONCLUSIONS A dramatic rise in seroprevalence of SARS-CoV-2 antibodies was seen among healthy blood donors in Jordan, in parallel with widespread intracommunity transmission of the disease. This information is useful for assessing the degree of herd immunity, and provides for better understanding of the pandemic.
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