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Leon-Rojas JE, Veloz T, Teran J, Perez M, Arias-Erazo F, Villacis L, Velez J, Recalde R, Jiménez P, Martin M, Chis Ster I, Cooper P, Romero N. The dynamics and determinants of specific systemic and mucosal antibody responses to SARS-CoV-2 in three adult cohorts in the Ecuadorian Andes: a study protocol. F1000Res 2024; 11:1392. [PMID: 38434000 PMCID: PMC10905138 DOI: 10.12688/f1000research.126577.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction There are limited longitudinal data on the systemic and mucosal antibody responses to SARS-CoV-2 from Latin America, a region severely affected by COVID-19, and where vaccine strategies have been implemented during the evolving pandemic. Objective To evaluate determinants of seroprevalence and changes in levels of anti-SARS-CoV-2 antibodies longitudinally in adults with different levels of exposure to SARS-CoV-2 (defined a priori as low, medium, and high based on presumed occupational risk), in two Andean cities in Ecuador. Methods Longitudinal cohort study of 1,000 adults aged 18 years and older with questionnaire data and sample collection done at 0, 3, 6, and 12 months during the period 2020-2023. Observations collected included WHO-ISARIC questionnaire and peripheral blood and saliva samples for measurement of IgG and IgA antibodies, respectively. Planned analyses are tailored to the longitudinal nature of the outcomes defined by participants' antibody levels and aim at estimating their average trends with time since infection in each of the occupational groups, adjusted for demographics and calendar-time levels of SARS-CoV-2 infection in the general population. The latter reflect the impact of the national control measures such as vaccinations and movement restrictions. Importance Understanding the duration and the dynamics of waning immunity to SARS-CoV-2, in the context of exposures to emerging virus variants and immunization, will inform the implementation of targeted public health strategies in the Latin American region. Ethics and Dissemination This study will observe the bioethical principles of the Declaration of Helsinki. Informed written consent will be obtained. Samples from participants will be stored for up to three years after which they will be destroyed. The study protocol was approved by the Ecuadorian Ministry of Public Health Ethics Committee for COVID-19 Research. Antibody results will be provided to participants and participating institutions and to the national health authorities.
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Affiliation(s)
- Jose E. Leon-Rojas
- Departamento de Pediatría, Obstetricia y Ginecología y Medicina Preventiva, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain
- Red Grups de Recerca d’Amèrica i Àfrica Llatines (GRAAL),, Quito, Ecuador
| | - Tatiana Veloz
- Medical School, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Jair Teran
- Medical School, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Monica Perez
- Medical School, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Fernanda Arias-Erazo
- Medical School, Universidad Internacional del Ecuador, Quito, Ecuador
- Departamento de Ciencias de la Vida y de la Agricultura, Universidad de las Fuerzas Armadas ESPE, Sangolquí, Ecuador
| | - Lizet Villacis
- Medical School, Universidad Técnica de Ambato, Ambato, Ecuador
| | - Jorge Velez
- Hospital de Especialidades Eugenio Espejo, Quito, Ecuador
| | - Ricardo Recalde
- Red Grups de Recerca d’Amèrica i Àfrica Llatines (GRAAL),, Quito, Ecuador
- Medical School, Universidad Técnica de Ambato, Ambato, Ecuador
| | - Patricia Jiménez
- Departamento de Ciencias de la Vida y de la Agricultura, Universidad de las Fuerzas Armadas ESPE, Sangolquí, Ecuador
- Grupo de Investigación en Sanidad Animal y Humana (GISAH), Quito, Ecuador
| | - Miguel Martin
- Departamento de Pediatría, Obstetricia y Ginecología y Medicina Preventiva, Universitat Autonoma de Barcelona (UAB), Barcelona, Spain
- Red Grups de Recerca d’Amèrica i Àfrica Llatines (GRAAL),, Quito, Ecuador
- Medical School, Universidad Internacional del Ecuador, Quito, Ecuador
| | | | - Philip Cooper
- Medical School, Universidad Internacional del Ecuador, Quito, Ecuador
- St George's University of London, London, UK
| | - Natalia Romero
- Red Grups de Recerca d’Amèrica i Àfrica Llatines (GRAAL),, Quito, Ecuador
- Medical School, Universidad Internacional del Ecuador, Quito, Ecuador
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Moguem Soubgui AF, Ndeme Mboussi WS, Kojom Foko LP, Embolo Enyegue EL, Koanga Mogtomo ML. Serological surveillance reveals a high exposure to SARS-CoV-2 and altered immune response among COVID-19 unvaccinated Cameroonian individuals. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002380. [PMID: 38346064 PMCID: PMC10861046 DOI: 10.1371/journal.pgph.0002380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/22/2024] [Indexed: 02/15/2024]
Abstract
Surveillance of COVID-19/SARS-CoV-2 dynamics is crucial to understanding natural history and providing insights into the population's exposure risk and specific susceptibilities. This study investigated the seroprevalence of SARS-CoV-2 antibodies, its predictors, and immunological status among unvaccinated patients in Cameroon. A multicentre cross-sectional study was conducted between January and September 2022 in the town of Douala. Patients were consecutively recruited, and data of interest were collected using a questionnaire. Blood samples were collected to determine Immunoglobin titres (IgM and IgG), interferon gamma (IFN- γ) and interleukin-6 (IL-6) by ELISA, and CD4+ cells by flow cytometry. A total of 342 patients aged 41.5 ± 13.9 years were included. Most participants (75.8%) were asymptomatic. The overall crude prevalence of IgM and IgG was 49.1% and 88.9%, respectively. After adjustment, the seroprevalence values were 51% for IgM and 93% for IgM. Ageusia and anosmia have displayed the highest positive predictive values (90.9% and 82.4%) and specificity (98.9% and 98.3%). The predictors of IgM seropositivity were being diabetic (aOR = 0.23, p = 0.01), frequently seeking healthcare (aOR = 1.97, p = 0.03), and diagnosed with ageusia (aOR = 20.63, p = 0.005), whereas those of IgG seropositivity included health facility (aOR = 0.15, p = 0.01), age of 40-50 years (aOR = 8.78, p = 0.01), married (aOR = 0.21, p = 0.02), fever (aOR = 0.08, p = 0.01), and ageusia (aOR = 0.08, p = 0.01). CD4+, IFN-γ, and IL-6 were impaired in seropositive individuals, with a confounding role of socio-demographic factors or comorbidities. Although the WHO declared the end of COVID-19 as a public health emergency, the findings of this study indicate the need for continuous surveillance to adequately control the disease in Cameroon.
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Affiliation(s)
- Arlette Flore Moguem Soubgui
- Faculty of Science, Department of Biochemistry, The University of Douala, Douala, Cameroon
- Centre de Recherche et d’Expertise en Biologie, Douala, Cameroon
| | - Wilfred Steve Ndeme Mboussi
- Faculty of Science, Department of Biochemistry, The University of Douala, Douala, Cameroon
- Centre de Recherche et d’Expertise en Biologie, Douala, Cameroon
| | - Loick Pradel Kojom Foko
- Centre de Recherche et d’Expertise en Biologie, Douala, Cameroon
- Department of Animal Biology, Faculty of Science, The University of Douala, Douala, Cameroon
| | - Elisée Libert Embolo Enyegue
- Center for Research on Health and Priority Diseases, Ministry of Scientific Research and Innovation, Yaoundé, Centre Region, Cameroon
| | - Martin Luther Koanga Mogtomo
- Faculty of Science, Department of Biochemistry, The University of Douala, Douala, Cameroon
- Centre de Recherche et d’Expertise en Biologie, Douala, Cameroon
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Ng QX, Koh NYK, Xin X, Zainal H, Tan JT, Thumboo J, Fong KY. Experiences of environmental services workers in a tertiary hospital in Asia during the COVID-19 pandemic: a qualitative study. Front Public Health 2023; 11:1178054. [PMID: 37342279 PMCID: PMC10277473 DOI: 10.3389/fpubh.2023.1178054] [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: 03/02/2023] [Accepted: 05/16/2023] [Indexed: 06/22/2023] Open
Abstract
Background The Coronavirus Disease 2019 (COVID-19) pandemic has had a significant impact on all walks of life, in particular, environmental services workers in healthcare settings had higher workload, increased stress and greater susceptibility to COVID-19 infections during the pandemic. Despite extensive literature describing the impact of the pandemic on healthcare workers such as doctors and nurses, studies on the lived experiences of environmental services workers in healthcare settings are sparse and none has been conducted in the Asian context. This qualitative study thus aimed to examine the experiences of those who worked for a year of the COVID-19 pandemic. Methods A purposive sample of environmental services workers was recruited from a major tertiary hospital in Singapore. Semi-structured interviews were conducted in-person, lasting around 30min, and included open-ended questions pertaining to five main domains: work experiences during COVID-19, training and education needs, resource and supplies availability, communication with management and other healthcare staff, and perceived stressors and support. These domains were identified based on team discussions and literature review. The interviews were recorded and transcribed for thematic analysis, as guided by Braun and Clarke. Results A total of 12 environmental services workers were interviewed. After the first seven interviews, no new themes emerged but an additional five interviews were done to ensure data saturation. The analysis yielded three main themes and nine subthemes, including (1) practical and health concerns, (2) coping and resilience, and (3) occupational adaptations during the pandemic. Many expressed confidence in the preventive efficacy of proper PPE, infection control practice and COVID-19 vaccination in protecting them against COVID-19 and severe illness. Having prior experience with infectious disease outbreaks and previous training in infection control and prevention appeared to be useful as well for these workers. Despite the various challenges presented by the pandemic, they could still find meaning in their everyday work by positively impacting the wellbeing of patients and other healthcare workers in the hospital. Conclusion Besides uncovering the concerns shared by these workers, we identified helpful coping strategies, resilience factors and certain occupational adaptations, which have implications for future pandemic planning and readiness.
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Affiliation(s)
- Qin Xiang Ng
- Singapore General Hospital, Singapore, Singapore
| | - Nicholas Ye Kai Koh
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xiaohui Xin
- Singapore General Hospital, Singapore, Singapore
| | | | | | - Julian Thumboo
- Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Kok Yong Fong
- Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
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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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Ng QX, Yau CE, Yaow CYL, Lim YL, Xin X, Thumboo J, Fong KY. Impact of COVID-19 on Environmental Services Workers in Healthcare Settings: A Scoping Review. J Hosp Infect 2022; 130:95-103. [PMID: 36116538 PMCID: PMC9474977 DOI: 10.1016/j.jhin.2022.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/01/2022] [Accepted: 09/05/2022] [Indexed: 11/15/2022]
Abstract
Background In the wake of the coronavirus disease 2019 (COVID-19) pandemic, demand for deep cleaning and environmental services workers grew exponentially. Although there is extant literature examining the impact of the COVID-19 pandemic on healthcare workers, less emphasis has been placed on environmental services workers, who play an equally important front-line role. Aim To examine the impact of the COVID-19 pandemic on environmental services workers employed in healthcare settings. Methods Scoping review methodology. A search strategy was developed, in consultation with a medical information specialist, employing various combinations of the keywords [(environmental services worker OR health attendant OR housekeeping) AND (COVID OR coronavirus OR pandemic OR epidemic)]. Four bibliographical databases were searched from inception to 5th July 2022: OVID Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Cochrane Database. Results In total, 24 studies were included in this review. The studies were generally cross-sectional in design. Seroprevalence studies highlighted significantly higher rates of COVID-19 among environmental services workers (housekeeping, cleaning and janitorial staff) compared with other clinical and non-clinical staff in the same institutions. In addition, based on qualitative interviews, environmental services workers experienced greater psychological stress working during the pandemic. Conclusions Environmental services workers were particularly vulnerable to increased work stress and COVID-19 during the pandemic. Health systems need to do more to support these workers. Further research could investigate specific policy and procedural changes to benefit this under-recognized group in the greater healthcare workforce.
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Affiliation(s)
- Qin Xiang Ng
- Health Services Research Unit, Singapore General Hospital, Singapore 168582, Singapore; MOH Holdings Pte Ltd, 1 Maritime Square, Singapore 099253, Singapore.
| | - Chun En Yau
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Clyve Yu Leon Yaow
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Yu Liang Lim
- MOH Holdings Pte Ltd, 1 Maritime Square, Singapore 099253, Singapore
| | - Xiaohui Xin
- Health Services Research Unit, Singapore General Hospital, Singapore 168582, Singapore
| | - Julian Thumboo
- Health Services Research Unit, Singapore General Hospital, Singapore 168582, Singapore; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore 168582, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore
| | - Kok Yong Fong
- Health Services Research Unit, Singapore General Hospital, Singapore 168582, Singapore; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore 168582, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore
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