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Charles H, Fátima CV, Lucio V, María KA, Johar C, Kevin P, Luz BV, Guido GA, Eduarda BC, Sebastian MN, Heber QJ, Matilde QY, Karla ZV, Liesbeth HF, Javier RE, Juan SR, Antonio BO. Differences in SARS-COV-2 seroprevalence in the population of Cusco, Peru. GLOBAL EPIDEMIOLOGY 2024; 7:100131. [PMID: 38188037 PMCID: PMC10767270 DOI: 10.1016/j.gloepi.2023.100131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 11/22/2023] [Accepted: 11/27/2023] [Indexed: 01/09/2024] Open
Abstract
Background The spread of the coronavirus disease 2019 (COVID-19) in Peru has been reported at the regional level, few studies have evaluated its spread at the provincial level, in which the mechanisms could be different. Methods We conducted an analytical, cross-sectional, multistage observational population study to assess the seroprevalence of SARS-COV-2 at the provincial and urban/rural levels in a high-altitude setting. The sampling unit was the household, including a randomly selected family member. Sampling was performed using a data collection sheet on clinical and epidemiological variables. Chemiluminescence tests were used to detect total anti-SARS-COV-2 antibodies (IgG and IgM simultaneously). The percentages were adjusted to the sampling design. Results The overall prevalence in the region of Cusco was 25.9%, with considerably different prevalence between the 13 provinces (from 15.9% in Acomayo to 40.1% in Canchis) and between rural (21.1%) and urban (31.7%) areas. In multivariable model, living in a rural area was a protective factor (adjusted prevalence ratio [aPR], 0.68; 95% confidence interval [CI], 0.61-0.76). Conclusions Geographic diversity and population density determine different prevalence rates, typically lower in rural areas, possibly due to natural social distancing or limited interaction with people at risk.
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Affiliation(s)
| | - Concha-Velasco Fátima
- Dirección de Epidemiología e Investigación - Gerencia Regional de Salud del Cusco, Cusco, Peru
- Universidad Continental, Cusco, Peru
| | - Velásquez Lucio
- Universidad Andina del Cusco, Cusco, Peru
- Unidad de Epidemiología, Hospital Nacional Adolfo Guevara Velasco, Cusco, Peru
| | - K. Antich María
- Dirección de Epidemiología e Investigación - Gerencia Regional de Salud del Cusco, Cusco, Peru
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Cassa Johar
- Dirección de Epidemiología e Investigación - Gerencia Regional de Salud del Cusco, Cusco, Peru
- Universidad Nacional San Antonio Abad del Cusco, Cusco, Peru
| | - Palacios Kevin
- Dirección de Epidemiología e Investigación - Gerencia Regional de Salud del Cusco, Cusco, Peru
| | | | | | | | | | - Quispe-Jihuallanca Heber
- Dirección de Inteligencia Sanitaria, Red de Servicios de Salud de Canas Canchis Espinar, Cusco, Peru
| | - Quispe-Yana Matilde
- Dirección de Inteligencia Sanitaria, Red de Servicios de La Convención, Cusco, Peru
| | - Zavala-Vargas Karla
- Dirección de Inteligencia Sanitaria – Gerencia Regional de Salud Cusco, Peru
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Tejiokem MC, Abessolo HA, Nkodo JM, Ouethy M, Mayaka GB, Touha Y, Dikoume UA, Tchatchueng‐Mbougua JB, Noumbissi DC, Ndjeukam WT, Mbarga HOO, Ngoupo PAT, Moussi C, Garoua BH, Njouom R, Richard V. High seroprevalence of severe acute respiratory syndrome coronavirus 2 among healthcare workers in Yaoundé, Cameroon after the first wave of Covid-19 pandemic and associated factors. Influenza Other Respir Viruses 2024; 18:e13239. [PMID: 38342486 PMCID: PMC10859237 DOI: 10.1111/irv.13239] [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: 06/01/2023] [Revised: 11/19/2023] [Accepted: 11/27/2023] [Indexed: 02/13/2024] Open
Abstract
BACKGROUND Healthcare workers (HWs) are at a high risk of exposure to emerging health threats. Following the first wave of the coronavirus disease 2019 pandemic in Cameroon, we explored the presence and persistence of naturally acquired antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the factors associated with seropositivity in HWs. METHODS Staff at two referral hospitals in Yaoundé or two Health District Hospitals in Obala and Mbalmayo were included in a 6-month prospective cohort analysis or cross-sectional survey, respectively. Seroprevalence and associated factors were determined, and Kaplan-Meier curves and Cox proportional hazards models were used to assess antibody persistence or positive seroconversion over time. RESULTS From August 2020 to March 2021, 426 HWs (median age: 31 years, interquartile range: 27-37 years; 66.4% female) were enrolled. The overall seroprevalence of anti-SARS-CoV-2 antibodies was 54.0% (95% confidence interval [CI]: 49.1-58.8) and was significantly different between study sites (p = 0.04). Of the 216 HWs included in the 6-month cohort, 109 (50.5%) HWs were seropositive at inclusion; the probability of persistent antibodies or of becoming seropositive was 93.8% (95% CI: 84.2-100) and 78.9% (95% CI: 61.7-88.4), respectively. Seroconversion was associated with study site and occupation but not with infection prevention and control (IPC) practices. CONCLUSIONS We observed high seroprevalence of SARS-CoV-2 antibody and seroconversion among HWs associated with occupational risk. This suggests low compliance to the COVID-19 control measures. Continued training and implementation of IPC measures and accelerated preparedness are needed to better tackle future threats.
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Affiliation(s)
| | - Hermine Abessolo Abessolo
- Centre Spécialisé de Prise en Charge des Patients Covid‐19annexe 2 Hôpital Central de YaoundéYaoundéCameroon
| | | | | | | | | | | | | | | | | | | | | | - Charlotte Moussi
- Délégation Régionale de la Santé Publique du CentreYaoundéCameroon
| | - Bonaventure Hollong Garoua
- Centre Spécialisé de Prise en Charge des Patients Covid‐19annexe 2 Hôpital Central de YaoundéYaoundéCameroon
| | - Richard Njouom
- Service de virologieCentre Pasteur du CamerounYaoundéCameroon
| | - Vincent Richard
- Direction Internationale, Institut Pasteur, Réseau International des Instituts PasteurParisFrance
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Dias NJD, da Silva MS, Barbosa MS, Pereira GR, Silva DR. Severe acute respiratory syndrome coronavirus 2 seroprevalence among patients with pulmonary tuberculosis. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230661. [PMID: 37729381 PMCID: PMC10508950 DOI: 10.1590/1806-9282.20230661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE The objective of this study was to estimate the seroprevalence of severe acute respiratory syndrome coronavirus 2 antibodies in patients with tuberculosis. METHODS This cross-sectional study was conducted at an outpatient tuberculosis clinic in Alvorada, RS, Brazil, with data collection between October and December 2020. Outpatients aged>18 years with active pulmonary tuberculosis, no prior history of coronavirus disease 2019, and no suspected coronavirus disease 2019 were included in the study. Whole blood samples were collected to perform the severe acute respiratory syndrome coronavirus 2 antibodies test. RESULTS During the study period, 52 patients met the inclusion and were included in the analysis. Severe acute respiratory syndrome coronavirus 2 antibodies were positive in 16 (30.8%) patients. Male sex was more frequent among patients with negative severe acute respiratory syndrome coronavirus 2 antibodies than in patients with positive severe acute respiratory syndrome coronavirus 2 antibodies (86.1 vs. 56.3%, p=0.031). Contact with coronavirus disease 2019 case was more common in patients with positive severe acute respiratory syndrome coronavirus 2 antibodies compared with patients with negative severe acute respiratory syndrome coronavirus 2 antibodies (87.5 vs. 8.3%, p<0.0001). In a multivariate analysis, in a model including the variables such as male sex and contact with coronavirus disease 2019 case, only contact with coronavirus disease 2019 was independently associated with positive severe acute respiratory syndrome coronavirus 2 antibodies (OR 77.0, 95%CI 11.5-512.4, p<0.0001). CONCLUSION This study revealed a seroprevalence of 30.8% severe acute respiratory syndrome coronavirus 2 among patients with tuberculosis.
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Affiliation(s)
- Natan José Dutra Dias
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Pneumológicas – Porto Alegre, Brazil
| | | | - Márcia Silva Barbosa
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Pneumológicas – Porto Alegre, Brazil
| | - Giovana Rodrigues Pereira
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Pneumológicas – Porto Alegre, Brazil
- Laboratório Municipal de Alvorada – Alvorada, Brazil
| | - Denise Rossato Silva
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Pneumológicas – Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre – Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina – Porto Alegre, Brazil
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Kodera S, Ueta H, Unemi T, Nakata T, Hirata A. Population-Level Immunity for Transient Suppression of COVID-19 Waves in Japan from April 2021 to September 2022. Vaccines (Basel) 2023; 11:1457. [PMID: 37766133 PMCID: PMC10537865 DOI: 10.3390/vaccines11091457] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/24/2023] [Accepted: 09/02/2023] [Indexed: 09/29/2023] Open
Abstract
Multiple COVID-19 waves have been observed worldwide, with varying numbers of positive cases. Population-level immunity can partly explain a transient suppression of epidemic waves, including immunity acquired after vaccination strategies. In this study, we aimed to estimate population-level immunity in 47 Japanese prefectures during the three waves from April 2021 to September 2022. For each wave, characterized by the predominant variants, namely, Delta, Omicron, and BA.5, the estimated rates of population-level immunity in the 10-64-years age group, wherein the most positive cases were observed, were 20%, 35%, and 45%, respectively. The number of infected cases in the BA.5 wave was inversely associated with the vaccination rates for the second and third injections. We employed machine learning to replicate positive cases in three Japanese prefectures to validate the reliability of our model for population-level immunity. Using interpolation based on machine learning, we estimated the impact of behavioral factors and vaccination on the fifth wave of new positive cases that occurred during the Tokyo 2020 Olympic Games. Our computational results highlighted the critical role of population-level immunity, such as vaccination, in infection suppression. These findings underscore the importance of estimating and monitoring population-level immunity to predict the number of infected cases in future waves. Such estimations that combine numerical derivation and machine learning are of utmost significance for effective management of medical resources, including the vaccination strategy.
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Affiliation(s)
- Sachiko Kodera
- Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Nagoya 466-8555, Japan
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan
| | - Haruto Ueta
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan
| | - Tatsuo Unemi
- Glycan and Life Systems Integration Center, Soka University, Tokyo 192-8577, Japan
| | - Taisuke Nakata
- Graduate School of Economics, University of Tokyo, Tokyo 113-0033, Japan
- Graduate School of Public Policy, University of Tokyo, Tokyo 113-0033, Japan
| | - Akimasa Hirata
- Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Nagoya 466-8555, Japan
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan
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Caniza H, Forriol F, Pangrazio O, Gil-Conesa M. Safety of International Professional Sports Competitions During the COVID-19 Pandemic: The Association Football Experience. Sports Med 2023; 53:765-768. [PMID: 36167919 PMCID: PMC9514706 DOI: 10.1007/s40279-022-01763-3] [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] [Accepted: 09/05/2022] [Indexed: 11/26/2022]
Abstract
Major sporting events were suspended during the most acute phase of the COVID-19 pandemic. Competitions are resuming with enhanced hygiene protocols and altered mechanics. While risks for players and staff have been studied, the impact of large-scale tournaments on the communities that host them remains largely unstudied. CONMEBOL Copa América is one of the first wide-scale international tournaments to be conducted in its original format since the beginning of the COVID-19 pandemic. The tournament saw 10 national teams compete in four Brazilian cities during a period of heightened viral transmission. The analysis of over 28,000 compulsory PCR tests showed that positive cases did not lead to the uncontrolled spread of the disease among staff and players. More importantly, the data indicate that locally hired staff were not exposed to increased risk while working. The Copa América experience shows that international sporting competitions can be conducted safely even under unfavourable epidemiological situations.
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Silva-Valencia J, Soto-Becerra P, Escobar-Agreda S, Fernandez-Navarro M, Moscoso-Porras M, Solari L, Mayta-Tristán P. Effectiveness of the BBIBP-CorV vaccine in preventing infection and death in health care workers in Peru 2021. Travel Med Infect Dis 2023; 53:102565. [PMID: 36933851 PMCID: PMC10019038 DOI: 10.1016/j.tmaid.2023.102565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/03/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND During 2021, Peru started the vaccination against SARS-CoV-2 using the BBIBP-CorV inactivated virus vaccine for health care workers (HCW). We aim to evaluate the effectiveness of the BBIBP-CorV vaccine to prevent SARS-CoV-2 infection and deaths among HCWs. METHODS Retrospective cohort study, from February 9 to June 30, 2021, using national registries of health care workers, laboratory tests for SARS-CoV-2 and deaths. We calculated the vaccine effectiveness for preventing laboratory-confirmed SARS-CoV-2 infection, COVID-19-mortality, and all-cause mortality among partially immunized and fully immunized HCWs. An extension of Cox proportional hazards regression was used to model the mortality results, and Poisson regression was used to model SARS-CoV-2 infection. RESULTS The study included 606,772 eligible HCWs, the mean age was 40 (IQR: 33.0, 51.0). In fully immunized HCW, the effectiveness for preventing all-cause mortality was 83.6 (95% CI: 80.2 to 86.4), 88.7 (95% CI: 85.1 to 91.4) for preventing COVID-19 mortality, and 40.3 (95% CI 38.9 to 41.6) for preventing SARS-CoV-2 infection. CONCLUSION The BBIBP-CorV vaccine showed high levels of effectiveness for preventing all-cause and COVID-19 deaths among fully immunized HCW. These results were consistent within different subgroups and sensitivity analyses. However, the effectiveness for preventing infection was suboptimal in this particular setting.
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Affiliation(s)
| | - Percy Soto-Becerra
- Universidad Continental, Av San Carlos 1980, Huancayo, 12000, Peru; Seguro Social en Salud (EsSalud), Instituto de Evaluación de Tecnologías Sanitarias e Investigación - IETSI, EsSalud, Domingo Cueto 109, Jesus Maria, Lima, Peru
| | | | | | - Miguel Moscoso-Porras
- Instituto Nacional de Salud (INS), Jr. Capac Yupanqui 1400, Jesus Maria, Lima, Peru; Universidad Continental, Av San Carlos 1980, Huancayo, 12000, Peru
| | - Lely Solari
- Instituto Nacional de Salud (INS), Jr. Capac Yupanqui 1400, Jesus Maria, Lima, Peru.
| | - Percy Mayta-Tristán
- Universidad Científica del Sur, Dirección General de Investigación, Desarrollo e Innovación, Antigua panamericana Sur Km19, Lima, Peru
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LaRotta J, Escobar O, Ávila-Aguero ML, Torres JP, Sini de Almeida R, Morales GDC, Srivastava A. COVID-19 in Latin America: A Snapshot in Time and the Road Ahead. Infect Dis Ther 2023; 12:389-410. [PMID: 36633818 PMCID: PMC9835740 DOI: 10.1007/s40121-022-00748-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/14/2022] [Indexed: 01/13/2023] Open
Abstract
Since its initial detection in Brazil in February 2020, SARS-CoV-2 and the associated COVID-19 pandemic have continued to devastate Latin America. Specific comorbidities, as well as sociodemographic and lifestyle factors that may be more prevalent in underserved areas, have been identified as risk factors for COVID-19 infection or associated adverse outcomes. Dynamics of infections and deaths in Latin America have varied by country and temporally, as has SARS-CoV-2 variant prevalence; however, more recently, the Delta and subsequent Omicron variants have become ubiquitous. Successful pandemic responses have involved robust infection mitigation measures, testing, and smart deployment of healthcare resourcing. While in some Latin American countries up to 90% of the population is fully vaccinated (i.e., 2 doses) against COVID-19, other countries have failed to reach the World Health Organization's 70% target. Continued focus on comprehensive surveillance, strategies to maximize vaccine availability and uptake, and mitigation of collateral damage on other aspects of public health and social services are critical for managing the COVID-19 pandemic. This review summarizes the COVID-19 experience in Latin America, including epidemiology and vaccination. Key learnings and future considerations for the ongoing pandemic response are also discussed.
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Affiliation(s)
- Jorge LaRotta
- Vaccines Medical and Scientific Affairs, Pfizer SAS, AV Suba 95-66, Bogotá, Colombia.
| | - Omar Escobar
- Vaccines Medical and Scientific Affairs, Pfizer SAS, AV Suba 95-66, Bogotá, Colombia
| | - María L Ávila-Aguero
- Pediatric Infectious Diseases, Hospital Nacional de Niños, San José, Costa Rica
- Center for Infectious Disease Modeling and Analysis, Yale University, New Haven, CT, USA
| | - Juan Pablo Torres
- Departamento de Pediatría y Cirugía Infantil Oriente, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | | | | | - Amit Srivastava
- Vaccines, Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Cambridge, MA, USA
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Lucero-Prisno DE, Shomuyiwa DO, Vicente CR, Méndez MJG, Qaderi S, Lopez JC, Mogessie YG, Alacapa J, Chamlagai L, Ndayizeye R, Kinay P. Achieving herd immunity in South America. Glob Health Res Policy 2023; 8:2. [PMID: 36726143 PMCID: PMC9891655 DOI: 10.1186/s41256-023-00286-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/06/2023] [Indexed: 02/03/2023] Open
Abstract
South America, once an epicenter of COVID-19, has stayed on the road of continued management of the pandemic. The region initially struggled to cope with the pandemic as it experienced spiraling numbers of infections and overwhelmed public health systems. South America has risen in its pandemic response to be the region with the highest global vaccination rate. The region posed a strong vaccination drive, with over 76% of its population fully vaccinated with the initial protocol. South America leveraged its deeply rooted vaccination culture and public health confidence among its population. Herd immunity is an integral concept in population infectious disease management. Attaining herd immunity is presently not feasible with available vaccines, but the high vaccination rate in the region depicts the acceptance of vaccination as a strategy for population protection. The availability of effective transmission-blocking vaccines, the continuous implementation of strategies that will enable the undisrupted supply of the vaccines, equity in access to the vaccines, improved vaccine acceptance, and trust in the vaccination and public health systems will help shepherd the region towards herd immunity. Local vaccine production backed with investment in infrastructure and international collaboration for research and knowledge development will also drive population safety.
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Affiliation(s)
- Don Eliseo Lucero-Prisno
- grid.8991.90000 0004 0425 469XDepartment of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK ,grid.449732.f0000 0001 0164 8851Faculty of Management and Development Studies, University of the Philippines Open University, Los Banos, Laguna Philippines ,grid.10223.320000 0004 1937 0490Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | | | - Creuza Rachel Vicente
- grid.412371.20000 0001 2167 4168Department of Social Medicine, Federal University of Espírito Santo, Vitória, Brazil ,grid.412371.20000 0001 2167 4168Postgraduate Program in Infectious Diseases, Federal University of Espírito Santo, Vitória, Brazil
| | | | - Shohra Qaderi
- grid.2515.30000 0004 0378 8438Maternal Fetal Care Center, Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
| | - Jaifred Christian Lopez
- grid.26009.3d0000 0004 1936 7961Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC USA
| | - Yidnekachew Girma Mogessie
- grid.21107.350000 0001 2171 9311Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA ,Johns Hopkins Carey Business School, Baltimore, MD USA
| | - Jason Alacapa
- grid.21107.350000 0001 2171 9311Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Lila Chamlagai
- grid.40263.330000 0004 1936 9094School of Public Health, Brown University, Providence, RI USA
| | - Remy Ndayizeye
- grid.253615.60000 0004 1936 9510George Washington University, Washington, DC USA
| | - Pelin Kinay
- grid.139596.10000 0001 2167 8433School of Climate Change and Adaptation, University of Prince Edward Island, Charlottetown, Canada
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Arias-Uriona AM, Pérez E, Llanos J, Cuellar R, Galarza PY. [Social determinants associated with self-reporting of symptoms and access to COVID-19 testing and diagnosis in the Plurinational State of BoliviaDeterminantes sociais associados ao autorrelato de sintomas, acesso a testagem e diagnóstico de COVID-19 no Estado Plurinacional da Bolívia]. Rev Panam Salud Publica 2022; 46:e114. [PMID: 36177303 PMCID: PMC9512684 DOI: 10.26633/rpsp.2022.114] [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: 12/01/2021] [Accepted: 05/02/2022] [Indexed: 11/24/2022] Open
Abstract
Objective To identify the prevalence of self-reporting of symptoms and access to testing and diagnosis of coronavirus-19 disease (COVID-19), as well as its association with social determinants of health (SDH). Methods Cross-sectional study with a sample of 11 728 men and 12 612 women over the age of 17, based on the National Household Survey 2020. The dependent variables were the self-reporting of symptoms, access to testing, and a positive COVID-19 test. The independent variables were age, educational level, area of residence and geographic area, ethnicity, type of household, income per capita, occupation, and health insurance. Prevalences, bivariate associations, and binomial logistical regression models (odds ratio (OR), and 95% confidence interval (CI95%) were calculated. Results Of the total individuals included, 16% reported symptoms, 10% a test, and 4.2% a positive COVID-19 test. Inequalities were observed in the reporting of COVID-19 symptoms, with a higher probability in women whose income had fallen (OR: 1.7; CI95%: 1.2-2.4) and unemployed persons (OR: 1.2; CI95%: 1.1-1.4 for men and OR: 1.3; CI95%: 1.5-1.5 for women). In contrast, with respect to access to diagnostic tests, the highest probability was observed in people with higher education (OR: 2.4; CI95%: 1.9-2.9 for men and OR: 2.7; CI95%: 2.2-3.4 for women), whose income was maintained (OR: 1.5; CI95%: 1.3-1.9 for men and OR: 1.7; CI95%: 1.4-2.0 for women) and those in the highest quartile of per capita household income (OR: 2.0; CI95%: 1.6-2.5 for men and OR: 1.6; CI95%: 1.3-2.0 for women). The probability of reporting symptoms and getting tested, and being diagnosed with COVID-19 increased with age for people with health insurance and those living in the llanos region; however, it decreased for residents of rural areas. Conclusions There are inequalities in access to testing and the reporting of COVID-19 symptoms.
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Affiliation(s)
- Ana M. Arias-Uriona
- Instituto de Investigaciones en Ciencias del Comportamiento (IICC)Universidad Católica Boliviana San PabloLa PazEstado Plurinacional de BoliviaInstituto de Investigaciones en Ciencias del Comportamiento (IICC), Universidad Católica Boliviana San Pablo, La Paz, Estado Plurinacional de Bolivia.
| | - Esdenka Pérez
- Universidad Católica Boliviana San PabloLa PazEstado Plurinacional de BoliviaUniversidad Católica Boliviana San Pablo, La Paz, Estado Plurinacional de Bolivia
| | - Javier Llanos
- Universidad Católica Boliviana San PabloLa PazEstado Plurinacional de BoliviaUniversidad Católica Boliviana San Pablo, La Paz, Estado Plurinacional de Bolivia
| | - Rafael Cuellar
- Universidad Católica Boliviana San PabloLa PazEstado Plurinacional de BoliviaUniversidad Católica Boliviana San Pablo, La Paz, Estado Plurinacional de Bolivia
| | - Pamela Y. Galarza
- Universidad Católica Boliviana San PabloLa PazEstado Plurinacional de BoliviaUniversidad Católica Boliviana San Pablo, La Paz, Estado Plurinacional de Bolivia
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Zarabanda D, Gonzales SC, Nakayama T, Moya AP, Garzón MF, Rengifo PA, Alvarez-Moreno CA. Impact of SARS-CoV-2 vaccination in healthcare workers in a network of clinics in Latin America. IJID REGIONS 2022; 3:275-277. [PMID: 35720144 PMCID: PMC9098418 DOI: 10.1016/j.ijregi.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 04/11/2022] [Accepted: 05/09/2022] [Indexed: 11/17/2022]
Abstract
Frontline employees have been severely affected by COVID-19. This study assessed the effect of vaccination among healthcare staff in Colombia. COVID-19 infections in Colombia increased dramatically during early 2021. Vaccination rollout in frontline personnel reduced the incidence of new cases among healthcare workers, in contrast to the general population.
Objectives Healthcare workers (HCWs) have been severely affected in terms of both morbidity and mortality since the beginning of the COVID-19 pandemic. During the first few months of 2021, Colombia experienced a surge in positive cases. This study aimed to evaluate the effect of vaccination on the incidence of new positive cases in HCWs. Design This was a retrospective cohort study of frontline employees in a network of clinics in Colombia, who were prioritized for COVID-19 vaccination from February to March 2021. Results Our findings were consistent with recent reports. During early 2020, the incidence of HCWs positively diagnosed with COVID-19 in Colombia was higher than that for the general population. With the start of the national vaccination program, the incidence among HCWs decreased from April 2021, while that for the general population remained relatively unchanged. Our study identified lower infection rates among HCWs during April (odds ratio [OR], 0.72 [95% CI 0.58–0.90]; p < 0.01) and May (odds ratio [OR], 0.25 [95% CI 0.18–0.36]; p < 0.01). Conclusions COVID-19 vaccination rollout in Colombia during early 2021 led to a decrease in the incidence of new positive cases among HCWs, in contrast to a continuing surge in the general population. Our findings suggested that COVID-19 vaccination provided adequate immunity, which guaranteed protection to HCWs.
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Dzinamarira T, Murewanhema G, Mhango M, Iradukunda PG, Chitungo I, Mashora M, Makanda P, Atwine J, Chimene M, Mbunge E, Mapingure MP, Chingombe I, Musuka G, Nkambule SJ, Ngara B. COVID-19 Prevalence among Healthcare Workers. A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010146. [PMID: 35010412 PMCID: PMC8750782 DOI: 10.3390/ijerph19010146] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 12/16/2022]
Abstract
Understanding the burden of SARS-CoV-2 infections among healthcare workers is a critical component to inform occupational health policy and strategy. We conducted a systematic review and meta-analysis to map and analayse the available global evidence on the prevalence of SARS-CoV-2 infections among healthcare workers. The random-effects adjusted pooled prevalence of COVID-19 among those studies that conducted the test using the antibody (Ab) method was 7% [95% CI: 3 to 17%]. The random-effects adjusted pooled prevalence of COVID-19 among those studies that conducted the test using the PCR method was 11% [95% CI: 7 to 16%]. We found the burden of COVID-19 among healthcare workers to be quite significant and therefore a cause for global health concern. Furthermore, COVID-19 infections among healthcare workers affect service delivery through workers’ sick leave, the isolation of confirmed cases and quarantine of contacts, all of which place significant strain on an already shrunken health workforce.
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Affiliation(s)
- Tafadzwa Dzinamarira
- School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa
- ICAP at Columbia University, Harare, Zimbabwe; (M.P.M.); (I.C.); (G.M.)
- Correspondence:
| | - Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe;
| | - Malizgani Mhango
- School of Public Health, University of Western Cape, Cape Town 7535, South Africa;
| | - Patrick Gad Iradukunda
- London School of Hygiene and Tropical Medicine, University of London, London WC1E 7HT, UK;
| | - Itai Chitungo
- Faculty of Medicine, College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe; (I.C.); (B.N.)
| | | | - Pelagia Makanda
- Department of Medicine, Jinzhou Medical University, Jinzhou 121001, China; (P.M.); (J.A.)
| | - James Atwine
- Department of Medicine, Jinzhou Medical University, Jinzhou 121001, China; (P.M.); (J.A.)
| | - Munashe Chimene
- Department of Health Sciences, Africa University, Mutare, Zimbabwe;
| | - Elliot Mbunge
- Department of Information Technology, Faculty of Accounting and Informatics, Durban University of Technology, Durban 4000, South Africa;
| | | | | | - Godfrey Musuka
- ICAP at Columbia University, Harare, Zimbabwe; (M.P.M.); (I.C.); (G.M.)
| | - Sphamandla Josias Nkambule
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4001, South Africa;
| | - Bernard Ngara
- Faculty of Medicine, College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe; (I.C.); (B.N.)
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12
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Prevalence and Factors Associated with Parents' Non-Intention to Vaccinate Their Children and Adolescents against COVID-19 in Latin America and the Caribbean. Vaccines (Basel) 2021; 9:vaccines9111303. [PMID: 34835233 PMCID: PMC8624413 DOI: 10.3390/vaccines9111303] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/20/2021] [Accepted: 10/30/2021] [Indexed: 01/22/2023] Open
Abstract
We aimed to estimate the prevalence and factors associated with parents' non-intention to vaccinate their children and adolescents against COVID-19 in Latin America and the Caribbean (LAC). We performed a secondary analysis using a database generated by the University of Maryland and Facebook (Facebook, Inc., Menlo Park, CA, USA). We included adult (18 and over) Facebook users residing in LAC who responded to the survey between 20 May 2021 and 14 July 2021. We included sociodemographic characteristics, comorbidities, mental health, economic and food insecurity, compliance with mitigation strategies against COVID-19, and practices related to vaccination against this disease. We estimated the crude (cPR) and adjusted (aPR) prevalence ratios with their respective 95%CI. We analyzed a sample of 227,740 adults from 20 LAC countries. The prevalence of parents' non-intention to vaccinate their children and adolescents against COVID-19 was 7.8% (n = 15,196). An age above 35 years old, educational level above college, compliance with physical distancing, use of masks, having economic insecurity, having had COVID-19, anxiety symptoms, depressive symptoms, having a chronic condition or two or more comorbidities, and being vaccinated were associated with a lower prevalence of non-intention to vaccinate children and adolescents against COVID-19. Living in a town, a village, or a rural area was associated with a higher prevalence of non-intention to vaccinate children and adolescents against COVID-19. Approximately nine out of ten parents in LAC intended to vaccinate their children and adolescents against COVID-19. Our results allow for understanding parents' intentions to vaccinate children and adolescents and help promote and develop education strategies for national vaccination plans against COVID-19.
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13
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Flamand C, Alves Sarmento C, Enfissi A, Bailly S, Beillard E, Gaillet M, Michaud C, Servas V, Clement N, Perilhou A, Carage T, Musso D, Carod JF, Eustache S, Tourbillon C, Boizon E, James S, Djossou F, Salje H, Cauchemez S, Rousset D. Seroprevalence of anti-SARS-CoV-2 IgG at the first epidemic peak in French Guiana, July 2020. PLoS Negl Trop Dis 2021; 15:e0009945. [PMID: 34767549 PMCID: PMC8639096 DOI: 10.1371/journal.pntd.0009945] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/02/2021] [Accepted: 10/22/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND While Latin America has been heavily affected by the pandemic, only a few seroprevalence studies have been conducted there during the first epidemic wave in the first half of 2020. METHODOLOGY/PRINCIPAL FINDINGS A cross-sectional survey was performed between 15 July 2020 and 23 July 2020 among individuals who visited 4 medical laboratories or 5 health centers for routine screening or clinical management, with the exception of symptomatic suggestive cases of covid-19. Samples were screened for the presence of anti-SARS-CoV-2 IgG directed against domain S1 of the SARS-CoV-2 spike protein using the anti-SARS-CoV-2 enzyme-linked immunosorbent assay (ELISA) from Euroimmun. CONCLUSIONS/SIGNIFICANCE The overall seroprevalence was 15.4% [9.3%-24.4%] among 480 participants, ranging from 4.0% to 25.5% across the different municipalities. The seroprevalence did not differ according to gender (p = 0.19) or age (p = 0.51). Among SARS-CoV-2 positive individuals, we found that 24.6% [11.5%-45.2%] reported symptoms consistent with COVID-19. Our findings revealed high levels of infection across the territory but a low number of resulting deaths, which can be explained by French Guiana's young population structure.
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Affiliation(s)
- Claude Flamand
- Epidemiology unit, Institut Pasteur in French Guiana, Cayenne, French Guiana
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | | | - Antoine Enfissi
- Laboratory of Virology, Institut Pasteur in French Guiana, Cayenne, French Guiana
| | - Sarah Bailly
- Epidemiology unit, Institut Pasteur in French Guiana, Cayenne, French Guiana
| | - Emmanuel Beillard
- Medical Biology Laboratory, Institut Pasteur in French Guiana, Cayenne, French Guiana
| | - Mélanie Gaillet
- Health Centers Department, Cayenne Hospital Center, Cayenne, French Guiana
| | - Céline Michaud
- Health Centers Department, Cayenne Hospital Center, Cayenne, French Guiana
| | - Véronique Servas
- Health Centers Department, Cayenne Hospital Center, Cayenne, French Guiana
| | - Nathalie Clement
- Clinical Core of the Center for Translational Sciences, Institut Pasteur, Paris, France
| | - Anaïs Perilhou
- Clinical Core of the Center for Translational Sciences, Institut Pasteur, Paris, France
| | - Thierry Carage
- Carage Medical Biology Laboratory, Kourou, French Guiana
| | - Didier Musso
- Laboratoires Eurofins Labazur Guyane, Remire, French Guiana
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
| | - Jean-françois Carod
- Medical Biology laboratory, Centre Hospitalier de l’Ouest Guyanais, Saint-Laurent du Maroni, French Guiana
| | - Stéphanie Eustache
- Epidemiology unit, Institut Pasteur in French Guiana, Cayenne, French Guiana
| | - Céline Tourbillon
- Epidemiology unit, Institut Pasteur in French Guiana, Cayenne, French Guiana
| | - Elodie Boizon
- Epidemiology unit, Institut Pasteur in French Guiana, Cayenne, French Guiana
| | - Samantha James
- Epidemiology unit, Institut Pasteur in French Guiana, Cayenne, French Guiana
| | - Félix Djossou
- Infectious and Tropical Diseases Unit, Cayenne Hospital Center, Cayenne, French Guiana
| | - Henrik Salje
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
- Department of Genetics, University of Cambridge, Cambridge, United Kingdom
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
| | - Dominique Rousset
- Laboratory of Virology, Institut Pasteur in French Guiana, Cayenne, French Guiana
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14
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Al-Abri SS, Al-Wahaibi A, Al-Kindi H, Kurup PJ, Al-Maqbali A, Al-Mayahi Z, Al-Tobi MH, Al-Katheri SH, Albusaidi S, Al-Sukaiti MH, Al Balushi AYM, Abdelgadir IO, Al-Shehi N, Morkos E, Al-Maani A, Al-Rawahi B, Alyaquobi F, Alqayoudhi A, Al-Harthy K, Al-Khalili S, Al-Rashdi A, Al-Shukri I, Al Ghafri TS, Al-Hashmi F, Al Jassasi SM, Alshaqsi N, Mitra N, Al Aamry HS, Shah P, Al Marbouai HH, Al Araimi AH, Kair IM, Al Manji AM, Almallak AS, Al Alawi FK, Vaidya V, Muqeetullah M, Alrashdi H, Al Jamoudi SSN, Alshaqsi A, Al Sharji A, Al Shukeiri H, Al-Abri B, Al-Rawahi S, Al-Lamki SH, Al-Manji A, Al-Jardani A. Seroprevalence of SARS-CoV-2 antibodies in the general population of Oman: results from four successive nationwide sero-epidemiological surveys. Int J Infect Dis 2021; 112:269-277. [PMID: 34601146 PMCID: PMC8482550 DOI: 10.1016/j.ijid.2021.09.062] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 09/24/2021] [Accepted: 09/24/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To assess the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Oman and longitudinal changes in antibody levels over time within the first 11 months of the coronavirus disease 2019 (COVID-19) pandemic. METHODS This nationwide cross-sectional study was conducted as a four-cycle serosurvey using a multi-stage stratified sampling method from July to November 2020. A questionnaire was used and included demographics, history of acute respiratory infection and list of symptoms, COVID-19 contact, previous diagnosis or admission, travel history and risk factors. RESULTS In total, 17,457 participants were surveyed. Thirty percent were female and 66.3% were Omani. There was a significant increase in seroprevalence throughout the study cycles, from 5.5% (4.8-6.2%) in Cycle 1 to 22% (19.6-24.6%) in Cycle 4. There was no difference in seroprevalence between genders, but significant differences were found between age groups. There was a transition of seroprevalence from being higher in non-Omanis than Omanis in Cycle 1 [9.1% (7.6-10.9%) vs 3.2% (2.6-3.9%)] to being higher in Omanis than non-Omanis in Cycle 4 [24.3% (21.0-27.9%) vs 16.8% (14.9-18.9%)]. There was remarkable variation in the seroprevalence of SARS-CoV-2 according to governorate. Close contacts of people with COVID-19 had a 96% higher risk of having the disease [adjusted odds ratio (AOR) 1.96, 95% confidence intervals (CI) 1.64-2.34]. Labourers had 58% higher risk of infection compared with office workers (AOR 1.58, 95% CI 1.04-2.35). CONCLUSION This study showed a wide variation in the spread of SARS-CoV-2 across governorates in Oman, with higher estimated seroprevalence in migrants in the first two cycles. Prevalence estimates remain low and are insufficient to provide herd immunity.
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Affiliation(s)
- Seif Salem Al-Abri
- Directorate General for Disease Surveillance and Control, Ministry of Health Muscat, Oman.
| | - Adil Al-Wahaibi
- Directorate General for Disease Surveillance and Control, Ministry of Health Muscat, Oman
| | - Hanan Al-Kindi
- Central Public Health Laboratories, Directorate General for Disease Surveillance and Control, Ministry of Health Muscat, Oman
| | - Padmamohan J Kurup
- Department of Disease Surveillance and Control, Directorate General of Health Services, Muscat Governorate, Ministry of Health, Muscat, Oman
| | - Ali Al-Maqbali
- Department of Disease Surveillance and Control, Directorate General of Health Services, North Batinah Governorate, Ministry of Health, Sohar, Oman
| | - Zayid Al-Mayahi
- Department of Disease Surveillance and Control, Directorate General of Health Services, South Batinah Governorate, Ministry of Health, Rustaq, Oman
| | - Mohammed Hamed Al-Tobi
- Department of Disease Surveillance and Control, Directorate General of Health Services, Al-Dhakhiliya Governorate, Ministry of Health, Nizwa, Oman
| | - Salim Habbash Al-Katheri
- Department of Disease Surveillance and Control, Directorate General of Health Services, Dhofar Governorate, Ministry of Health, Salalah, Oman
| | - Sultan Albusaidi
- Department of Disease Surveillance and Control, Directorate General of Health Services, North Sharqiah Governorate, Ministry of Health, Ibra, Oman
| | - Mahmood Humaid Al-Sukaiti
- Department of Disease Surveillance and Control, Directorate General of Health Services, Al-Dhahira Governorate, Ministry of Health, Ibri, Oman
| | - Ahmed Yar Mohammed Al Balushi
- Department of Disease Surveillance and Control, Directorate General of Health Services, Al-Buraimi Governorate, Ministry of Health, Buraimi, Oman
| | - Iyad Omer Abdelgadir
- Department of Disease Surveillance and Control, Directorate General of Health Services, South Sharqiah Governorate, Ministry of Health, Sur, Oman
| | - Nawal Al-Shehi
- Department of Disease Surveillance and Control, Directorate General of Health Services, Musandam Governorate, Ministry of Health, Khasab, Oman
| | - Essam Morkos
- Department of Disease Surveillance and Control, Directorate General of Health Services, Al-Wusta Governorate, Ministry of Health, Haima, Oman
| | - Amal Al-Maani
- Directorate General for Disease Surveillance and Control, Ministry of Health Muscat, Oman
| | - Bader Al-Rawahi
- Directorate General for Disease Surveillance and Control, Ministry of Health Muscat, Oman
| | - Fatma Alyaquobi
- Directorate General for Disease Surveillance and Control, Ministry of Health Muscat, Oman
| | - Abdullah Alqayoudhi
- Directorate General for Disease Surveillance and Control, Ministry of Health Muscat, Oman
| | - Khalid Al-Harthy
- Directorate General for Disease Surveillance and Control, Ministry of Health Muscat, Oman
| | - Sulien Al-Khalili
- Directorate General for Disease Surveillance and Control, Ministry of Health Muscat, Oman
| | - Azza Al-Rashdi
- Central Public Health Laboratories, Directorate General for Disease Surveillance and Control, Ministry of Health Muscat, Oman
| | - Intisar Al-Shukri
- Central Public Health Laboratories, Directorate General for Disease Surveillance and Control, Ministry of Health Muscat, Oman
| | - Thamra S Al Ghafri
- Directorate General of Health Services, Muscat Governorate, Ministry of Health, Muscat, Oman
| | - Fatma Al-Hashmi
- Department of Disease Surveillance and Control, Directorate General of Health Services, North Batinah Governorate, Ministry of Health, Sohar, Oman
| | - Saeed Mussalam Al Jassasi
- Department of Disease Surveillance and Control, Directorate General of Health Services, Al-Dhahira Governorate, Ministry of Health, Ibri, Oman
| | - Nasser Alshaqsi
- Department of Disease Surveillance and Control, Directorate General of Health Services, South Batinah Governorate, Ministry of Health, Rustaq, Oman
| | - Nilanjan Mitra
- Department of Disease Surveillance and Control, Directorate General of Health Services, Musandam Governorate, Ministry of Health, Khasab, Oman
| | - Humaid Suhail Al Aamry
- Department of Disease Surveillance and Control, Directorate General of Health Services, Al-Dhakhiliya Governorate, Ministry of Health, Nizwa, Oman
| | - Parag Shah
- Department of Disease Surveillance and Control, Directorate General of Health Services, North Sharqiah Governorate, Ministry of Health, Ibra, Oman
| | - Hanan Hassan Al Marbouai
- Department of Disease Surveillance and Control, Directorate General of Health Services, Al-Buraimi Governorate, Ministry of Health, Buraimi, Oman
| | - Amany Hamed Al Araimi
- Department of Disease Surveillance and Control, Directorate General of Health Services, South Sharqiah Governorate, Ministry of Health, Sur, Oman
| | - Ismail Mohammed Kair
- Department of Disease Surveillance and Control, Directorate General of Health Services, Dhofar Governorate, Ministry of Health, Salalah, Oman
| | - Asim Mohammed Al Manji
- Department of Disease Surveillance and Control, Directorate General of Health Services, Muscat Governorate, Ministry of Health, Muscat, Oman
| | - Ahmed Said Almallak
- Department of Disease Surveillance and Control, Directorate General of Health Services, Dhofar Governorate, Ministry of Health, Salalah, Oman
| | - Fatma Khamis Al Alawi
- Department of Disease Surveillance and Control, Directorate General of Health Services, South Sharqiah Governorate, Ministry of Health, Sur, Oman
| | - Vidyanand Vaidya
- Department of Disease Surveillance and Control, Directorate General of Health Services, North Batinah Governorate, Ministry of Health, Sohar, Oman
| | - Muhammad Muqeetullah
- Department of Disease Surveillance and Control, Directorate General of Health Services, Al-Buraimi Governorate, Ministry of Health, Buraimi, Oman
| | - Hanan Alrashdi
- Department of Disease Surveillance and Control, Directorate General of Health Services, North Sharqiah Governorate, Ministry of Health, Ibra, Oman
| | - Saud Said Nassir Al Jamoudi
- Department of Disease Surveillance and Control, Directorate General of Health Services, Al-Dhakhiliya Governorate, Ministry of Health, Nizwa, Oman
| | - Asila Alshaqsi
- Department of Disease Surveillance and Control, Directorate General of Health Services, South Batinah Governorate, Ministry of Health, Rustaq, Oman
| | - Abdullah Al Sharji
- Department of Disease Surveillance and Control, Directorate General of Health Services, Muscat Governorate, Ministry of Health, Muscat, Oman
| | - Hamida Al Shukeiri
- Department of Disease Surveillance and Control, Directorate General of Health Services, Muscat Governorate, Ministry of Health, Muscat, Oman
| | - Badr Al-Abri
- Directorate General for Disease Surveillance and Control, Ministry of Health Muscat, Oman
| | | | - Said H Al-Lamki
- Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman
| | - Abdulla Al-Manji
- Directorate General for Disease Surveillance and Control, Ministry of Health Muscat, Oman
| | - Amina Al-Jardani
- Central Public Health Laboratories, Directorate General for Disease Surveillance and Control, Ministry of Health Muscat, Oman
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