1
|
Macharia Z, Ogoti B, Otieno M, Gitonga P, Bosco-Lauth A, Maritim M, Lemarkoko E, Keya A, Sankok J, Gitao G, Onono J, Oyugi J, Bowen RA. Transmission of SARS-CoV-2 among underserved pastoralist communities in Kajiado County, Kenya: 2020-2022. PLoS One 2024; 19:e0308318. [PMID: 39116080 PMCID: PMC11309416 DOI: 10.1371/journal.pone.0308318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 07/22/2024] [Indexed: 08/10/2024] Open
Abstract
Initial transmission of severe acute respiratory syndrome virus-2 (SARS-CoV-2) was highest in densely populated regions of Kenya. Transmission gradually trickled down to the less densely populated, remote and underserved regions such as the pastoral regions of Kajiado County which are characterized by poor healthcare systems. Molecular assays that were pivotal for COVID-19 diagnosis were not available in these regions. Serology is an alternative method for retrospectively tracking the transmission of SARS-CoV-2 in such populations. Dry blood spots (DBS) were prepared from consenting patients attending six health facilities in Kajiado County from March 2020 to March 2022. Upon elution, we conducted an enzyme-linked immunosorbent assay (ELISA) for the detection of SARS-Cov-2 IgG antibodies. Of the 908 DBSs we analyzed, 706 (78%) were from female participants. The overall seropositivity to SARS-Cov-2 antibodies was 7.3% (95% CI 5.7-9.1). The elderly (over 60 years) and male participants had a high likelihood of testing positive for SAR-CoV-2 infections. Mashuru (15.6%, 14/90) and Meto (15%, 19/127) health facilities registered the highest proportion of seropositive participants. Evidence of SARS-CoV-2 transmission among pastoralists in the remote and underserved regions of Kajiado County was established by DBS sampling and serologic testing.
Collapse
Affiliation(s)
- Zipporah Macharia
- Institute of Tropical and Infectious Diseases (UNITID), University of Nairobi, Nairobi, Kenya
- Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi, Kenya
| | - Brian Ogoti
- Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi, Kenya
- Center of Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | - Magdaline Otieno
- Institute of Tropical and Infectious Diseases (UNITID), University of Nairobi, Nairobi, Kenya
| | - Pauline Gitonga
- Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States of America
| | - Angela Bosco-Lauth
- Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States of America
| | - Marybeth Maritim
- Department of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya
| | | | - Aggrey Keya
- Kajiado County Referral Hospital, Kajiado Town, Kajiado, Kenya
| | - Joseph Sankok
- Kajiado County Referral Hospital, Kajiado Town, Kajiado, Kenya
| | - George Gitao
- Department of Pathology, Microbiology and Parasitology, University of Nairobi, Nairobi, Kenya
| | - Joshua Onono
- Department of Public Health Pharmacology and Toxicology, University of Nairobi, Nairobi, Kenya
| | - Julius Oyugi
- Institute of Tropical and Infectious Diseases (UNITID), University of Nairobi, Nairobi, Kenya
- Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi, Kenya
| | - Richard A. Bowen
- Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States of America
| |
Collapse
|
2
|
Garchitorena A, Rasoloharimanana LT, Rakotonanahary RJ, Evans MV, Miller AC, Finnegan KE, Cordier LF, Cowley G, Razafinjato B, Randriamanambintsoa M, Andrianambinina S, Popper SJ, Hotahiene R, Bonds MH, Schoenhals M. Morbidity and mortality burden of COVID-19 in rural Madagascar: results from a longitudinal cohort and nested seroprevalence study. Int J Epidemiol 2023; 52:1745-1755. [PMID: 37793001 DOI: 10.1093/ije/dyad135] [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: 03/14/2023] [Accepted: 09/18/2023] [Indexed: 10/06/2023] Open
Abstract
INTRODUCTION Three years into the pandemic, there remains significant uncertainty about the true infection and mortality burden of COVID-19 in the World Health Organization Africa region. High quality, population-representative studies in Africa are rare and tend to be conducted in national capitals or large cities, leaving a substantial gap in our understanding of the impact of COVID-19 in rural, low-resource settings. Here, we estimated the spatio-temporal morbidity and mortality burden associated with COVID-19 in a rural health district of Madagascar until the first half of 2021. METHODS We integrated a nested seroprevalence study within a pre-existing longitudinal cohort conducted in a representative sample of 1600 households in Ifanadiana District, Madagascar. Socio-demographic and health information was collected in combination with dried blood spots for about 6500 individuals of all ages, which were analysed to detect IgG and IgM antibodies against four specific proteins of SARS-CoV-2 in a bead-based multiplex immunoassay. We evaluated spatio-temporal patterns in COVID-19 infection history and its associations with several geographic, socio-economic and demographic factors via logistic regressions. RESULTS Eighteen percent of people had been infected by April-June 2021, with seroprevalence increasing with individuals' age. COVID-19 primarily spread along the only paved road and in major towns during the first epidemic wave, subsequently spreading along secondary roads during the second wave to more remote areas. Wealthier individuals and those with occupations such as commerce and formal employment were at higher risk of being infected in the first wave. Adult mortality increased in 2020, particularly for older men for whom it nearly doubled up to nearly 40 deaths per 1000. Less than 10% of mortality in this period would be directly attributed to COVID-19 deaths if known infection fatality ratios are applied to observed seroprevalence in the district. CONCLUSION Our study provides a very granular understanding on COVID-19 transmission and mortality in a rural population of sub-Saharan Africa and suggests that the disease burden in these areas may have been substantially underestimated.
Collapse
Affiliation(s)
- Andres Garchitorena
- MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
- Institut Pasteur de Madagascar, Antananarivo, Madagascar
- NGO Pivot, Ifanadiana, Madagascar
| | | | - Rado Jl Rakotonanahary
- NGO Pivot, Ifanadiana, Madagascar
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Michelle V Evans
- MIVEGEC, Université de Montpellier, CNRS, IRD, Montpellier, France
| | - Ann C Miller
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Karen E Finnegan
- NGO Pivot, Ifanadiana, Madagascar
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | | | | | | | - Marius Randriamanambintsoa
- Direction de la Démographie et des Statistiques Sociales, Institut National de la Statistique, Antananarivo, Madagascar
| | - Samuel Andrianambinina
- Direction de la Démographie et des Statistiques Sociales, Institut National de la Statistique, Antananarivo, Madagascar
| | - Stephen J Popper
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, CA, USA
| | - Raphaël Hotahiene
- Direction de lutte contre les maladies transmissibles, Ministère de la Santé Publique, Antananarivo, Madagascar
| | - Matthew H Bonds
- NGO Pivot, Ifanadiana, Madagascar
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | | |
Collapse
|
3
|
Koech A, Omuse G, Mugo AG, Mwaniki IG, Mutunga JM, Mukhanya MW, Wanje O, Mwashigadi GM, Katana GG, Craik R, von Dadelszen P, Le Doare K, Temmerman M. SARS-CoV-2 seroprevalence in pregnant women in Kilifi, Kenya from March 2020 to March 2022. Front Public Health 2023; 11:1292932. [PMID: 38169905 PMCID: PMC10760635 DOI: 10.3389/fpubh.2023.1292932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/20/2023] [Indexed: 01/05/2024] Open
Abstract
Background Seroprevalence studies are an alternative approach to estimating the extent of transmission of SARS-CoV-2 and the evolution of the pandemic in different geographical settings. We aimed to determine the SARS-CoV-2 seroprevalence from March 2020 to March 2022 in a rural and urban setting in Kilifi County, Kenya. Methods We obtained representative random samples of stored serum from a pregnancy cohort study for the period March 2020 to March 2022 and tested for antibodies against the spike protein using a qualitative SARS-CoV-2 ELISA kit (Wantai, total antibodies). All positive samples were retested for anti-SARS-CoV-2 anti-nucleocapsid antibodies (Euroimmun, ELISA kits, NCP, qualitative, IgG) and anti-spike protein antibodies (Euroimmun, ELISA kits, QuantiVac; quantitative, IgG). Results A total of 2,495 (of 4,703 available) samples were tested. There was an overall trend of increasing seropositivity from a low of 0% [95% CI 0-0.06] in March 2020 to a high of 89.4% [95% CI 83.36-93.82] in Feb 2022. Of the Wantai test-positive samples, 59.7% [95% CI 57.06-62.34] tested positive by the Euroimmun anti-SARS-CoV-2 NCP test and 37.4% [95% CI 34.83-40.04] tested positive by the Euroimmun anti-SARS-CoV-2 QuantiVac test. No differences were observed between the urban and rural hospital but villages adjacent to the major highway traversing the study area had a higher seroprevalence. Conclusion Anti-SARS-CoV-2 seroprevalence rose rapidly, with most of the population exposed to SARS-CoV-2 within 23 months of the first cases. The high cumulative seroprevalence suggests greater population exposure to SARS-CoV-2 than that reported from surveillance data.
Collapse
Affiliation(s)
- Angela Koech
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
- Department of Obstetrics and Gynaecology, Aga Khan University, Nairobi, Kenya
| | - Geoffrey Omuse
- Department of Pathology, Aga Khan University, Nairobi, Kenya
| | - Alex G. Mugo
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Isaac G. Mwaniki
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Joseph M. Mutunga
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Moses W. Mukhanya
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Onesmus Wanje
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Grace M. Mwashigadi
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Geoffrey G. Katana
- Kilifi County Department of Health and Sanitation Services, Kilifi, Kenya
| | - Rachel Craik
- Department of Women and Children’s Health, Kings College London, London, United Kingdom
| | - Peter von Dadelszen
- Department of Women and Children’s Health, Kings College London, London, United Kingdom
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Marleen Temmerman
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
- Department of Obstetrics and Gynaecology, Aga Khan University, Nairobi, Kenya
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
4
|
Munywoki PK, Bigogo G, Nasimiyu C, Ouma A, Aol G, Oduor CO, Rono S, Auko J, Agogo GO, Njoroge R, Oketch D, Odhiambo D, Odeyo VW, Kikwai G, Onyango C, Juma B, Hunsperger E, Lidechi S, Ochieng CA, Lo TQ, Munyua P, Herman-Roloff A. Heterogenous transmission and seroprevalence of SARS-CoV-2 in two demographically diverse populations with low vaccination uptake in Kenya, March and June 2021. Gates Open Res 2023; 7:101. [PMID: 37990692 PMCID: PMC10661969 DOI: 10.12688/gatesopenres.14684.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2023] [Indexed: 11/23/2023] Open
Abstract
Background SARS-CoV-2 has extensively spread in cities and rural communities, and studies are needed to quantify exposure in the population. We report seroprevalence of SARS-CoV-2 in two well-characterized populations in Kenya at two time points. These data inform the design and delivery of public health mitigation measures. Methods Leveraging on existing population based infectious disease surveillance (PBIDS) in two demographically diverse settings, a rural site in western Kenya in Asembo, Siaya County, and an urban informal settlement in Kibera, Nairobi County, we set up a longitudinal cohort of randomly selected households with serial sampling of all consenting household members in March and June/July 2021. Both sites included 1,794 and 1,638 participants in the March and June/July 2021, respectively. Individual seroprevalence of SARS-CoV-2 antibodies was expressed as a percentage of the seropositive among the individuals tested, accounting for household clustering and weighted by the PBIDS age and sex distribution. Results Overall weighted individual seroprevalence increased from 56.2% (95%CI: 52.1, 60.2%) in March 2021 to 63.9% (95%CI: 59.5, 68.0%) in June 2021 in Kibera. For Asembo, the seroprevalence almost doubled from 26.0% (95%CI: 22.4, 30.0%) in March 2021 to 48.7% (95%CI: 44.3, 53.2%) in July 2021. Seroprevalence was highly heterogeneous by age and geography in these populations-higher seroprevalence was observed in the urban informal settlement (compared to the rural setting), and children aged <10 years had the lowest seroprevalence in both sites. Only 1.2% and 1.6% of the study participants reported receipt of at least one dose of the COVID-19 vaccine by the second round of serosurvey-none by the first round. Conclusions In these two populations, SARS-CoV-2 seroprevalence increased in the first 16 months of the COVID-19 pandemic in Kenya. It is important to prioritize additional mitigation measures, such as vaccine distribution, in crowded and low socioeconomic settings.
Collapse
Affiliation(s)
- Patrick K. Munywoki
- Division for Global Health Protection, Global Health Center, U.S. Centers for Disease Control and Prevention (CDC)-Kenya, Nairobi, Kenya
| | - Godfrey Bigogo
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Carolyne Nasimiyu
- Global Health Program, Washington State University – Global Health Kenya (WSU-GH Kenya), Nairobi, Kenya
- Paul G. Allen School of Global Health, Washington State University, Pullman, Washington, USA
| | - Alice Ouma
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - George Aol
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Clifford O. Oduor
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Samuel Rono
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Joshua Auko
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - George O. Agogo
- Division for Global Health Protection, Global Health Center, U.S. Centers for Disease Control and Prevention (CDC)-Kenya, Nairobi, Kenya
| | - Ruth Njoroge
- Global Health Program, Washington State University – Global Health Kenya (WSU-GH Kenya), Nairobi, Kenya
| | - Dismas Oketch
- Global Health Program, Washington State University – Global Health Kenya (WSU-GH Kenya), Nairobi, Kenya
| | - Dennis Odhiambo
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Victor W. Odeyo
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Gilbert Kikwai
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Clayton Onyango
- Division for Global Health Protection, Global Health Center, U.S. Centers for Disease Control and Prevention (CDC)-Kenya, Nairobi, Kenya
| | - Bonventure Juma
- Division for Global Health Protection, Global Health Center, U.S. Centers for Disease Control and Prevention (CDC)-Kenya, Nairobi, Kenya
| | - Elizabeth Hunsperger
- Division for Global Health Protection, Global Health Center, U.S. Centers for Disease Control and Prevention (CDC)-Kenya, Nairobi, Kenya
| | - Shirley Lidechi
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | | | - Terrence Q. Lo
- Division for Global Health Protection, Global Health Center, U.S. Centers for Disease Control and Prevention (CDC)-Kenya, Nairobi, Kenya
| | - Peninah Munyua
- Division for Global Health Protection, Global Health Center, U.S. Centers for Disease Control and Prevention (CDC)-Kenya, Nairobi, Kenya
| | - Amy Herman-Roloff
- Division for Global Health Protection, Global Health Center, U.S. Centers for Disease Control and Prevention (CDC)-Kenya, Nairobi, Kenya
| |
Collapse
|
5
|
Fish CS, Owiti P, Begnel ER, Itell HL, Ojee E, Adhiambo J, Ogweno V, Holland LA, Richardson BA, Khan AK, Maqsood R, Gantt S, Lim ES, Slyker J, Kinuthia J, Overbaugh J, Wamalwa D, Lehman DA, Chohan BH. Comparison of nucleocapsid and spike antibody ELISAs for determining SARS-CoV-2 seropositivity in Kenyan women and infants. J Med Virol 2023; 95:e28221. [PMID: 36251533 PMCID: PMC9839577 DOI: 10.1002/jmv.28221] [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: 08/01/2022] [Revised: 09/23/2022] [Accepted: 10/03/2022] [Indexed: 01/29/2023]
Abstract
A multitude of enzyme-linked immunosorbent assays (ELISAs) has been developed to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies since the coronavirus disease 2019 pandemic started in late 2019. Assessing the reliability of these assays in diverse global populations is critical. This study compares the use of the commercially available Platelia Total Ab Assay (Bio-Rad) nucleocapsid ELISA to the widely used Mount Sinai spike IgG ELISA in a Kenyan population seroprevalence study. Using longitudinal plasma specimens collected from a mother-infant cohort living in Nairobi, Kenya between May 2019 and December 2020, this study demonstrates that the two assays have a high qualitative agreement (92.7%) and strong correlation of antibody levels (R2 = 0.973) in repeated measures. Within this cohort, seroprevalence detected by either ELISA closely resembled previously published seroprevalence estimates for Kenya during the sampling period and no significant difference in the incidence of SARS-CoV-2 antibody detection by either assay was observed. Assay comparability was not affected by HIV exposure status. These data support the use of the Platelia SARS-CoV-2 Total Ab ELISA as a suitable high-throughput method for seroprevalence studies in Kenya.
Collapse
Affiliation(s)
- Carolyn S. Fish
- Division of Human Biology, Fred Hutchinson Cancer CenterSeattleWashingtonUSA
| | - Prestone Owiti
- Department of Paediatrics and Child HealthUniversity of NairobiNairobiKenya
| | - Emily R. Begnel
- Department of Global Health, Hans Rosling CenterUniversity of WashingtonSeattleWashingtonUSA
| | - Hannah L. Itell
- Division of Human Biology, Fred Hutchinson Cancer CenterSeattleWashingtonUSA,Molecular and Cellular Biology Graduate ProgramUniversity of Washington and Fred Hutchinson Cancer CenterSeattleWashingtonUSA
| | - Ednah Ojee
- Department of Paediatrics and Child HealthUniversity of NairobiNairobiKenya
| | - Judith Adhiambo
- Department of Paediatrics and Child HealthUniversity of NairobiNairobiKenya
| | - Vincent Ogweno
- Department of Paediatrics and Child HealthUniversity of NairobiNairobiKenya
| | - LaRinda A. Holland
- Center for Fundamental and Applied Microbiomics, Biodesign InstituteArizona State UniversityTempeArizonaUSA
| | - Barbra A. Richardson
- Department of Global Health, Hans Rosling CenterUniversity of WashingtonSeattleWashingtonUSA,Department of BiostatisticsUniversity of WashingtonSeattleWashingtonUSA
| | - Adam K. Khan
- School of Life SciencesArizona State UniversityTempeArizonaUSA
| | - Rabia Maqsood
- Center for Fundamental and Applied Microbiomics, Biodesign InstituteArizona State UniversityTempeArizonaUSA
| | - Soren Gantt
- Département de Microbiologie, Infectiologie et Immunologie, Centre de Recherche du CHU St‐JustineUniversité de MontréalMontréalQuébecCanada
| | - Efrem S. Lim
- Center for Fundamental and Applied Microbiomics, Biodesign InstituteArizona State UniversityTempeArizonaUSA,School of Life SciencesArizona State UniversityTempeArizonaUSA
| | - Jennifer Slyker
- Department of Global Health, Hans Rosling CenterUniversity of WashingtonSeattleWashingtonUSA,Department of EpidemiologyUniversity of WashingtonSeattleWashingtonUSA
| | - John Kinuthia
- Department of Global Health, Hans Rosling CenterUniversity of WashingtonSeattleWashingtonUSA,Department of Research and Programs, Kenyatta National HospitalNairobiKenya
| | - Julie Overbaugh
- Division of Human Biology, Fred Hutchinson Cancer CenterSeattleWashingtonUSA,Division of Public Health SciencesFred Hutchinson Cancer CenterSeattleWashingtonUSA
| | - Dalton Wamalwa
- Department of Paediatrics and Child HealthUniversity of NairobiNairobiKenya,Department of Global Health, Hans Rosling CenterUniversity of WashingtonSeattleWashingtonUSA
| | - Dara A. Lehman
- Division of Human Biology, Fred Hutchinson Cancer CenterSeattleWashingtonUSA,Department of Global Health, Hans Rosling CenterUniversity of WashingtonSeattleWashingtonUSA
| | - Bhavna H. Chohan
- Department of Global Health, Hans Rosling CenterUniversity of WashingtonSeattleWashingtonUSA,Kenya Medical Research InstituteNairobiKenya
| |
Collapse
|
6
|
Lapidus S, Liu F, Casanovas-Massana A, Dai Y, Huck JD, Lucas C, Klein J, Filler RB, Strine MS, Sy M, Deme AB, Badiane AS, Dieye B, Ndiaye IM, Diedhiou Y, Mbaye AM, Diagne CT, Vigan-Womas I, Mbengue A, Sadio BD, Diagne MM, Moore AJ, Mangou K, Diallo F, Sene SD, Pouye MN, Faye R, Diouf B, Nery N, Costa F, Reis MG, Muenker MC, Hodson DZ, Mbarga Y, Katz BZ, Andrews JR, Campbell M, Srivathsan A, Kamath K, Baum-Jones E, Faye O, Sall AA, Vélez JCQ, Cappello M, Wilson M, Ben-Mamoun C, Tedder R, McClure M, Cherepanov P, Somé FA, Dabiré RK, Moukoko CEE, Ouédraogo JB, Boum Y, Shon J, Ndiaye D, Wisnewski A, Parikh S, Iwasaki A, Wilen CB, Ko AI, Ring AM, Bei AK. Plasmodium infection is associated with cross-reactive antibodies to carbohydrate epitopes on the SARS-CoV-2 Spike protein. Sci Rep 2022; 12:22175. [PMID: 36550362 PMCID: PMC9778468 DOI: 10.1038/s41598-022-26709-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Sero-surveillance can monitor and project disease burden and risk. However, SARS-CoV-2 antibody test results can produce false positive results, limiting their efficacy as a sero-surveillance tool. False positive SARS-CoV-2 antibody results are associated with malaria exposure, and understanding this association is essential to interpret sero-surveillance results from malaria-endemic countries. Here, pre-pandemic samples from eight malaria endemic and non-endemic countries and four continents were tested by ELISA to measure SARS-CoV-2 Spike S1 subunit reactivity. Individuals with acute malaria infection generated substantial SARS-CoV-2 reactivity. Cross-reactivity was not associated with reactivity to other human coronaviruses or other SARS-CoV-2 proteins, as measured by peptide and protein arrays. ELISAs with deglycosylated and desialated Spike S1 subunits revealed that cross-reactive antibodies target sialic acid on N-linked glycans of the Spike protein. The functional activity of cross-reactive antibodies measured by neutralization assays showed that cross-reactive antibodies did not neutralize SARS-CoV-2 in vitro. Since routine use of glycosylated or sialated assays could result in false positive SARS-CoV-2 antibody results in malaria endemic regions, which could overestimate exposure and population-level immunity, we explored methods to increase specificity by reducing cross-reactivity. Overestimating population-level exposure to SARS-CoV-2 could lead to underestimates of risk of continued COVID-19 transmission in sub-Saharan Africa.
Collapse
Affiliation(s)
- Sarah Lapidus
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Feimei Liu
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Arnau Casanovas-Massana
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Yile Dai
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - John D Huck
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Carolina Lucas
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Jon Klein
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Renata B Filler
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Madison S Strine
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Mouhamad Sy
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Awa B Deme
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Aida S Badiane
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Baba Dieye
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Ibrahima Mbaye Ndiaye
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Younous Diedhiou
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Amadou Moctar Mbaye
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Cheikh Tidiane Diagne
- DiaTROPIX Rapid Diagnostic Tests Facility, Institut Pasteur de Dakar, Dakar, Senegal
| | - Inés Vigan-Womas
- Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Alassane Mbengue
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Bacary D Sadio
- Pôle Virologie, Institut Pasteur de Dakar, Dakar, Senegal
| | | | - Adam J Moore
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Khadidiatou Mangou
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Fatoumata Diallo
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Seynabou D Sene
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Mariama N Pouye
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Rokhaya Faye
- Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Babacar Diouf
- Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Nivison Nery
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brazil
- Department of Internal Medicine, Yale Occupational and Environmental Medicine Program, Yale School of Medicine, New Haven, CT, USA
| | - Federico Costa
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil
| | - Mitermayer G Reis
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil
- Faculty of Medicine, Federal University of Bahia, Salvador, Brazil
| | - M Catherine Muenker
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Daniel Z Hodson
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | | | - Ben Z Katz
- Division of Infectious Diseases, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, USA
| | - Jason R Andrews
- Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Melissa Campbell
- Yale Center for Clinical Investigation, Yale School of Medicine, New Haven, CT, USA
| | - Ariktha Srivathsan
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | | | | | - Ousmane Faye
- Pôle Virologie, Institut Pasteur de Dakar, Dakar, Senegal
| | | | - Juan Carlos Quintero Vélez
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Grupo de Investigación Ciencias Veterinarias Centauro, University of Antioquia, Medellín, Colombia
- Grupo de Investigación Microbiología Básica y Aplicada, University of Antioquia, Medellín, Colombia
| | - Michael Cappello
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | - Michael Wilson
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Choukri Ben-Mamoun
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Richard Tedder
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
- South London Specialist Virology Centre, Kings College Hospital NHS Foundation Trust, London, UK
| | - Myra McClure
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Peter Cherepanov
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, NW1 1AT, UK
- Crick COVID19 Consortium, Francis Crick Institute, London, NW1 1AT, UK
| | - Fabrice A Somé
- Institut de Recherche en Sciences de La Santé (IRSS)/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Roch K Dabiré
- Institut de Recherche en Sciences de La Santé (IRSS)/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Carole Else Eboumbou Moukoko
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, 2701, BP, Cameroon
- Malaria Research Unit, Center Pasteur Cameroon, Yaoundé, Cameroon
| | - Jean Bosco Ouédraogo
- Institut de Recherche en Sciences de La Santé (IRSS)/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Yap Boum
- Médecins Sans Frontières, University of Yaoundé and Epicentre, Yaoundé, Cameroon
| | | | - Daouda Ndiaye
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Adam Wisnewski
- Department of Internal Medicine, Yale Occupational and Environmental Medicine Program, Yale School of Medicine, New Haven, CT, USA
| | - Sunil Parikh
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Akiko Iwasaki
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
- Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - Craig B Wilen
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Albert I Ko
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil
| | - Aaron M Ring
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Amy K Bei
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA.
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal.
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal.
| |
Collapse
|
7
|
Awandu SS, Ochieng Ochieng A, Onyango B, Magwanga RO, Were P, Atieno Ochung’ A, Okumu F, Oloo MA, Katieno JS, Lidechi S, Ogutu F, Awuor D, Kirungu JN, Orata F, Achieng J, Oure B, Nyunja R, Muok EMO, Munga S, Estambale B. High seroprevalence of Immunoglobulin G (IgG) and IgM antibodies to SARS-CoV-2 in asymptomatic and symptomatic individuals amidst vaccination roll-out in western Kenya. PLoS One 2022; 17:e0272751. [PMID: 36548358 PMCID: PMC9778630 DOI: 10.1371/journal.pone.0272751] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022] Open
Abstract
The population's antibody response is a key factor in comprehending SARS-CoV-2 epidemiology. This is especially important in African settings where COVID-19 impact, and vaccination rates are relatively low. This study aimed at characterizing the Immunoglobulin G (IgG) and Immunoglobulin M (IgM) in both SARS-CoV-2 asymptomatic and symptomatic individuals in Kisumu and Siaya counties in western Kenya using enzyme linked immunosorbent assays. The IgG and IgM overall seroprevalence in 98 symptomatic and asymptomatic individuals in western Kenya between December 2021-March 2022 was 76.5% (95% CI = 66.9-84.5) and 29.6% (95% CI = 20.8-39.7) respectively. In terms of gender, males had slightly higher IgG positivity 87.5% (35/40) than females 68.9% (40/58). Amidst the ongoing vaccination roll-out during the study period, over half of the study participants (55.1%, 95% CI = 44.7-65.2) had not received any vaccine. About one third, (31.6%, 95% CI = 22.6-41.8) of the study participants had been fully vaccinated, with close to a quarter (13.3% 95% CI = 7.26-21.6) partially vaccinated. When considering the vaccination status and seroprevalence, out of the 31 fully vaccinated individuals, IgG seropositivity was 81.1% (95% CI = 70.2-96.3) and IgM seropositivity was 35.5% (95% CI = 19.22-54.6). Out of the participants that had not been vaccinated at all, IgG seroprevalence was 70.4% (95% CI 56.4-82.0) with 20.4% (95% CI 10.6-33.5) seropositivity for IgM antibodies. On PCR testing, 33.7% were positive, with 66.3% negative. The 32 positive individuals included 12(37.5%) fully vaccinated, 8(25%) partially vaccinated and 12(37.5%) unvaccinated. SARs-CoV-2 PCR positivity did not significantly predict IgG (p = 0.469 [95% CI 0.514-4.230]) and IgM (p = 0.964 [95% CI 0.380-2.516]) positivity. These data indicate a high seroprevalence of antibodies to SARS-CoV-2 in western Kenya. This suggests that a larger fraction of the population was infected with SARS-CoV-2 within the defined period than what PCR testing could cover.
Collapse
Affiliation(s)
- Shehu Shagari Awandu
- School of Health Sciences, Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
- School of Biological, Physical, Mathematics and Actuarial Sciences, Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
| | - Alfred Ochieng Ochieng
- School of Biological, Physical, Mathematics and Actuarial Sciences, Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
| | - Benson Onyango
- School of Biological, Physical, Mathematics and Actuarial Sciences, Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
| | - Richard Odongo Magwanga
- School of Biological, Physical, Mathematics and Actuarial Sciences, Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
- State Key Laboratory of Cotton Biology/Institute of Cotton Research, Chinese Academy of Agricultural Science, Anyang, Henan, China
| | - Pamela Were
- School of Biological, Physical, Mathematics and Actuarial Sciences, Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
| | - Angeline Atieno Ochung’
- School of Biological, Physical, Mathematics and Actuarial Sciences, Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
| | - Fredrick Okumu
- School of Biological, Physical, Mathematics and Actuarial Sciences, Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
| | - Marceline Adhiambo Oloo
- School of Biological, Physical, Mathematics and Actuarial Sciences, Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
| | - Jim Seth Katieno
- Kenya Medical Research Institute Centre for Global Health Research (CGHR), Kisumu, Kenya
| | - Shirley Lidechi
- Kenya Medical Research Institute Centre for Global Health Research (CGHR), Kisumu, Kenya
| | - Fredrick Ogutu
- Kenya Industrial Research and Development Institute (KIRDI), Kisumu, Kenya
| | - Dorothy Awuor
- School of Biological, Physical, Mathematics and Actuarial Sciences, Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
| | - Joy Nyangasi Kirungu
- State Key Laboratory of Cotton Biology/Institute of Cotton Research, Chinese Academy of Agricultural Science, Anyang, Henan, China
| | - Francis Orata
- Masinde Muliro University of Science and Technology (MMUST), Kakamega, Kenya
| | - Justine Achieng
- Kenya Industrial Research and Development Institute (KIRDI), Kisumu, Kenya
| | - Bonface Oure
- Kenya Industrial Research and Development Institute (KIRDI), Kisumu, Kenya
| | - Regina Nyunja
- School of Biological, Physical, Mathematics and Actuarial Sciences, Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
| | - Eric M. O. Muok
- Kenya Medical Research Institute Centre for Global Health Research (CGHR), Kisumu, Kenya
| | - Stephen Munga
- Kenya Medical Research Institute Centre for Global Health Research (CGHR), Kisumu, Kenya
| | - Benson Estambale
- School of Health Sciences, Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
| |
Collapse
|
8
|
Seroprevalence, correlates and kinetics of SARS-CoV-2 nucleocapsid IgG antibody in healthcare workers and nonclinical staff at a tertiary hospital: A prevaccine census study. PLoS One 2022; 17:e0267619. [PMID: 36301926 PMCID: PMC9612503 DOI: 10.1371/journal.pone.0267619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/12/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Healthcare workers and nonclinical staff in medical facilities are perceived to be a high-risk group for acquiring SAR-CoV-2 infection, and more so in countries where COVID-19 vaccination uptake is low. Serosurveillance may best determine the true extent of SARS-CoV-2 infection since most infected HCWs and other staff may be asymptomatic or present with only mild symptoms. Over time, determining the true extent of SARS-CoV-2 infection could inform hospital management and staff whether the preventive measures instituted are effective and valuable in developing targeted solutions. METHODS This was a census survey study conducted at the Aga Khan University Hospital, Nairobi, between November 2020 and February 2021 before the implementation of the COVID-19 vaccination. The SARS-CoV-2 nucleocapsid IgG test was performed using a chemiluminescent assay. RESULTS One thousand six hundred thirty-one (1631) staff enrolled, totalling 60% of the workforce. The overall crude seroprevalence was 18.4% and the adjusted value (for assay sensitivity of 86%) was 21.4% (95% CI; 19.2-23.7). The staff categories with higher prevalence included pharmacy (25.6%), outreach (24%), hospital- based nursing (22.2%) and catering staff (22.6%). Independent predictors of a positive IgG result after adjusting for age, sex and comorbidities included prior COVID-19 like symptoms, odds ratio (OR) 2.0 [95% confidence interval (CI) 1.3-3.0, p = 0.001], a prior positive SARS-CoV-2 PCR result OR 12.0 (CI: 7.7-18.7, p<0.001) and working in a clinical COVID-19 designated area, OR 1.9 (CI 1.1-3.3, p = 0.021). The odds of testing positive for IgG after a positive PCR test were lowest if the antibody test was performed more than 2 months later; OR 0.7 (CI: 0.48-0.95, p = 0.025). CONCLUSIONS The prevalence of anti- SARS-CoV-2 nucleocapsid IgG among HCWs and nonclinical staff was lower than in the general population. Staff working in clinical areas were not at increased risk when compared to staff working in non-clinical areas.
Collapse
|
9
|
Etyang AO, Adetifa I, Omore R, Misore T, Ziraba AK, Ng’oda MA, Gitau E, Gitonga J, Mugo D, Kutima B, Karanja H, Toroitich M, Nyagwange J, Tuju J, Wanjiku P, Aman R, Amoth P, Mwangangi M, Kasera K, Ng’ang’a W, Akech D, Sigilai A, Karia B, Karani A, Voller S, Agoti CN, Ochola-Oyier LI, Otiende M, Bottomley C, Nyaguara A, Uyoga S, Gallagher K, Kagucia EW, Onyango D, Tsofa B, Mwangangi J, Maitha E, Barasa E, Bejon P, Warimwe GM, Scott JAG, Agweyu A. SARS-CoV-2 seroprevalence in three Kenyan health and demographic surveillance sites, December 2020-May 2021. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000883. [PMID: 36962821 PMCID: PMC10021917 DOI: 10.1371/journal.pgph.0000883] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/12/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Most of the studies that have informed the public health response to the COVID-19 pandemic in Kenya have relied on samples that are not representative of the general population. We conducted population-based serosurveys at three Health and Demographic Surveillance Systems (HDSSs) to determine the cumulative incidence of infection with SARS-CoV-2. METHODS We selected random age-stratified population-based samples at HDSSs in Kisumu, Nairobi and Kilifi, in Kenya. Blood samples were collected from participants between 01 Dec 2020 and 27 May 2021. No participant had received a COVID-19 vaccine. We tested for IgG antibodies to SARS-CoV-2 spike protein using ELISA. Locally-validated assay sensitivity and specificity were 93% (95% CI 88-96%) and 99% (95% CI 98-99.5%), respectively. We adjusted prevalence estimates using classical methods and Bayesian modelling to account for the sampling scheme and assay performance. RESULTS We recruited 2,559 individuals from the three HDSS sites, median age (IQR) 27 (10-78) years and 52% were female. Seroprevalence at all three sites rose steadily during the study period. In Kisumu, Nairobi and Kilifi, seroprevalences (95% CI) at the beginning of the study were 36.0% (28.2-44.4%), 32.4% (23.1-42.4%), and 14.5% (9.1-21%), and respectively; at the end they were 42.0% (34.7-50.0%), 50.2% (39.7-61.1%), and 24.7% (17.5-32.6%), respectively. Seroprevalence was substantially lower among children (<16 years) than among adults at all three sites (p≤0.001). CONCLUSION By May 2021 in three broadly representative populations of unvaccinated individuals in Kenya, seroprevalence of anti-SARS-CoV-2 IgG was 25-50%. There was wide variation in cumulative incidence by location and age.
Collapse
Affiliation(s)
| | - Ifedayo Adetifa
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Richard Omore
- Kenya Medical Research Institute Centre for Global Health Research, Kisumu, Kenya
| | - Thomas Misore
- Kenya Medical Research Institute Centre for Global Health Research, Kisumu, Kenya
| | | | | | - Evelyn Gitau
- African Population and Health Research Center, Nairobi, Kenya
| | - John Gitonga
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Daisy Mugo
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Henry Karanja
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | | | - James Tuju
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | | | | | | | | | - Wangari Ng’ang’a
- Presidential Policy and Strategy Unit, The Presidency, Government of Kenya, Nairobi, Kenya
| | - Donald Akech
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | | | - Angela Karani
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Shirine Voller
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | - Mark Otiende
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Amek Nyaguara
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Sophie Uyoga
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | | | | | | | | | | | - Edwine Barasa
- Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | - Philip Bejon
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | - George M. Warimwe
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | - J. Anthony G. Scott
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | |
Collapse
|
10
|
SARS-CoV-2 Seroprevalence among Healthcare Workers after the First and Second Pandemic Waves. Viruses 2022; 14:v14071535. [PMID: 35891515 PMCID: PMC9322964 DOI: 10.3390/v14071535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/08/2022] [Accepted: 07/11/2022] [Indexed: 02/01/2023] Open
Abstract
Background: The Grand Hôpital de Charleroi is a large non-academic Belgian hospital that treated a large number of COVID-19 inpatients. In the context of this pandemic, all professions-combined healthcare workers (HCWs), and not only direct caregivers, are a frontline workforce in contact with suspected and confirmed COVID-19 cases and seem to be a high-risk group for exposure. The aim of our study was to estimate the prevalence of anti-SARS-CoV-2 antibodies in HCWs in our hospital after the first and second pandemic waves and to characterize the distribution of this seroprevalence in relation to various criteria. Methods: At the end of the two recruitment periods, a total of 4008 serological tests were performed in this single-center cross-sectional study. After completing a questionnaire including demographic and personal data, possible previous COVID-19 diagnostic test results and/or the presence of symptoms potentially related to COVID-19, the study participants underwent blood sampling and serological testing using DiaSorin’s LIAISON® SARS-CoV-2 S1/S2 IgG test for the first phase and LIAISON® SARS-CoV-2 TrimericS IgG test for the second phase of this study. Results: In total, 302 study participants (10.72%) in the first round of the study and 404 (33.92%) in the second round were positive for SARS-CoV-2-IgG antibodies. The prevalence of seropositivity observed after the second wave was 3.16 times higher than after the first wave. We confirmed that direct, prolonged, and repeated contact with patients or their environment was a predominant seroconversion factor, but more unexpectedly, that this was the case for all HCWs and not only caregivers. Finally, the notion of high-risk contact seemed more readily identifiable in one’s workplace than in one’s private life. Conclusions: Our study confirmed that HCWs are at a significantly higher risk of contracting COVID-19 than the general population, and suggests that repeated contacts with at-risk patients, regardless of the HCWs’ professions, represents the most important risk factor for seroconversion (Clinicaltrials.gov number, NCT04723290).
Collapse
|
11
|
Ratovoson R, Raberahona M, Razafimahatratra R, Randriamanantsoa L, Andriamasy EH, Herindrainy P, Razanajatovo N, Andriamandimby SF, Rakotonaivo A, Randrianarisaona F, Dussart P, Heraud JM, de Randria MJDD, Schoenhals M, Randremanana RV. SARS-CoV-2 infection rate in Antananarivo frontline health care workers, Madagascar. Influenza Other Respir Viruses 2022; 16:994-1003. [PMID: 35754109 PMCID: PMC9350202 DOI: 10.1111/irv.13022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Health care workers (HCWs) represent a vulnerable population during epidemic periods. Our cohort study aimed to estimate the risk of infection and associated factors among HCWs during the first wave of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Madagascar. METHODS A prospective cohort study was carried out in three hospitals that oversaw the first cases of COVID-19. Monthly ELISA-based serological tests were conducted, and nasopharyngeal swabs were collected in the case of symptoms linked to COVID-19 for RT-PCR analysis. Survival analyses were used to determine factors associated with SARS-CoV-2 infection. RESULTS The study lasted 7 months from May 2020. We included 122 HCWs, 61.5% of whom were women. The median age was 31.9 years (IQR: 26.4-42.3). In total, 42 (34.4%) had SARS-CoV-2 infections, of which 20 were asymptomatic (47.6%). The incidence of SARS-CoV-2 infection was 9.3% (95% CI [6.5-13.2]) person-months. Sixty-five HCWs presented symptoms, of which 19 were positive by RT-PCR. When adjusted for exposure to deceased cases, infection was more frequent in HCWs younger than 30 years of age (RR = 4.9, 95% CI [1.4-17.2]). CONCLUSION Our results indicate a high incidence of infection with SARS-CoV-2 among HCWs, with a high proportion of asymptomatic cases. Young HCWs are more likely to be at risk than others. Greater awareness among young people is necessary to reduce the threat of infection among HCWs.
Collapse
Affiliation(s)
- Rila Ratovoson
- Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Mihaja Raberahona
- Centre Hospitalier Universitaire Joseph Raseta Befelatanana, Antananarivo, Madagascar
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Hajissa K, Islam MA, Hassan SA, Zaidah AR, Ismail N, Mohamed Z. Seroprevalence of SARS-CoV-2 Antibodies in Africa: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127257. [PMID: 35742506 PMCID: PMC9223681 DOI: 10.3390/ijerph19127257] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 02/06/2023]
Abstract
A reliable estimate of SARS-CoV-2-specific antibodies is increasingly important to track the spread of infection and define the true burden of the ongoing COVID-19 pandemic. A systematic review and a meta-analysis were conducted with the objective of estimating the seroprevalence of SARS-CoV-2 infection in Africa. A systematic search of the PubMed, Scopus, Web of Science and Google Scholar electronic databases was conducted. Thirty-five eligible studies were included. Using meta-analysis of proportions, the overall seroprevalence of anti-SARS-CoV-2 antibodies was calculated as 16% (95% CI 13.1-18.9%). Based on antibody isotypes, 14.6% (95% CI 12.2-17.1%) and 11.5% (95% CI 8.7-14.2%) were seropositive for SARS-CoV-2 IgG and IgM, respectively, while 6.6% (95% CI 4.9-8.3%) were tested positive for both IgM and IgG. Healthcare workers (16.3%) had higher seroprevalence than the general population (11.7%), blood donors (7.5%) and pregnant women (5.7%). The finding of this systematic review and meta-analysis (SRMA) may not accurately reflect the true seroprevalence status of SARS-CoV-2 infection in Africa, hence, further seroprevalence studies across Africa are required to assess and monitor the growing COVID-19 burden.
Collapse
Affiliation(s)
- Khalid Hajissa
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Department of Zoology, Faculty of Science and Technology, Omdurman Islamic University, P.O. Box 382, Omdurman 14415, Sudan
| | - Md Asiful Islam
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK
- Correspondence: or (M.A.I.); (Z.M.)
| | - Siti Asma Hassan
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Abdul Rahman Zaidah
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Nabilah Ismail
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Zeehaida Mohamed
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (K.H.); (S.A.H.); (A.R.Z.); (N.I.)
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
- Correspondence: or (M.A.I.); (Z.M.)
| |
Collapse
|
13
|
Bwire G, Ario AR, Eyu P, Ocom F, Wamala JF, Kusi KA, Ndeketa L, Jambo KC, Wanyenze RK, Talisuna AO. The COVID-19 pandemic in the African continent. BMC Med 2022; 20:167. [PMID: 35501853 PMCID: PMC9059455 DOI: 10.1186/s12916-022-02367-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/05/2022] [Indexed: 01/13/2023] Open
Abstract
In December 2019, a new coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and associated disease, coronavirus disease 2019 (COVID-19), was identified in China. This virus spread quickly and in March, 2020, it was declared a pandemic. Scientists predicted the worst scenario to occur in Africa since it was the least developed of the continents in terms of human development index, lagged behind others in achievement of the United Nations sustainable development goals (SDGs), has inadequate resources for provision of social services, and has many fragile states. In addition, there were relatively few research reporting findings on COVID-19 in Africa. On the contrary, the more developed countries reported higher disease incidences and mortality rates. However, for Africa, the earlier predictions and modelling into COVID-19 incidence and mortality did not fit into the reality. Therefore, the main objective of this forum is to bring together infectious diseases and public health experts to give an overview of COVID-19 in Africa and share their thoughts and opinions on why Africa behaved the way it did. Furthermore, the experts highlight what needs to be done to support Africa to consolidate the status quo and overcome the negative effects of COVID-19 so as to accelerate attainment of the SDGs.
Collapse
Affiliation(s)
- Godfrey Bwire
- grid.415705.2Department of Integrated Epidemiology Surveillance and Public Health Emergencies, Ministry of Health, P.O Box 7272, Kampala, Uganda
- grid.11194.3c0000 0004 0620 0548School of Public Health, Makerere University, P.O. Box 7072, Kampala, Uganda
| | | | - Patricia Eyu
- Uganda National Institute of Public Health, Kampala, Uganda
| | - Felix Ocom
- Uganda National Institute of Public Health, Kampala, Uganda
| | | | - Kwadwo A. Kusi
- grid.8652.90000 0004 1937 1485Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Latif Ndeketa
- grid.419393.50000 0004 8340 2442Malawi-Liverpool-Wellcome Programme (MLW), Blantyre, Malawi
| | - Kondwani C. Jambo
- grid.419393.50000 0004 8340 2442Malawi-Liverpool-Wellcome Programme (MLW), Blantyre, Malawi
- grid.48004.380000 0004 1936 9764Liverpool School of Tropical Medicine, Liverpool, UK
| | - Rhoda K. Wanyenze
- grid.11194.3c0000 0004 0620 0548School of Public Health, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Ambrose O. Talisuna
- grid.463718.f0000 0004 0639 2906Epidemic Preparedness and Response Cluster, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| |
Collapse
|
14
|
Munywoki PK, Nasimiyu C, Alando MD, Otieno N, Ombok C, Njoroge R, Kikwai G, Odhiambo, D, Osita MP, Ouma A, Odour C, Juma B, Ochieng CA, Mutisya I, Ngere I, Dawa J, Osoro E, Njenga MK, Bigogo G, Munyua P, Lo TQ, Hunsperger E, Herman-Roloff A. Seroprevalence and risk factors of SARS-CoV-2 infection in an urban informal settlement in Nairobi, Kenya, December 2020. F1000Res 2022; 10:853. [PMID: 35528961 PMCID: PMC9065925 DOI: 10.12688/f1000research.72914.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/07/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction: Urban informal settlements may be disproportionately affected by the COVID-19 pandemic due to overcrowding and other socioeconomic challenges that make adoption and implementation of public health mitigation measures difficult. We conducted a seroprevalence survey in the Kibera informal settlement, Nairobi, Kenya, to determine the extent of SARS-CoV-2 infection. Methods: Members of randomly selected households from an existing population-based infectious disease surveillance (PBIDS) provided blood specimens between 27
th November and 5
th December 2020. The specimens were tested for antibodies to the SARS-CoV-2 spike protein. Seroprevalence estimates were weighted by age and sex distribution of the PBIDS population and accounted for household clustering. Multivariable logistic regression was used to identify risk factors for individual seropositivity. Results: Consent was obtained from 523 individuals in 175 households, yielding 511 serum specimens that were tested. The overall weighted seroprevalence was 43.3% (95% CI, 37.4 – 49.5%) and did not vary by sex. Of the sampled households, 122(69.7%) had at least one seropositive individual. The individual seroprevalence increased by age from 7.6% (95% CI, 2.4 – 21.3%) among children (<5 years), 32.7% (95% CI, 22.9 – 44.4%) among children 5 – 9 years, 41.8% (95% CI, 33.0 – 51.1%) for those 10-19 years, and 54.9%(46.2 – 63.3%) for adults (≥20 years). Relative to those from medium-sized households (3 and 4 individuals), participants from large (≥5 persons) households had significantly increased odds of being seropositive, aOR, 1.98(95% CI, 1.17 – 1.58), while those from small-sized households (≤2 individuals) had increased odds but not statistically significant, aOR, 2.31 (95% CI, 0.93 – 5.74). Conclusion: In densely populated urban settings, close to half of the individuals had an infection to SARS-CoV-2 after eight months of the COVID-19 pandemic in Kenya. This highlights the importance to prioritize mitigation measures, including COVID-19 vaccine distribution, in the crowded, low socioeconomic settings.
Collapse
Affiliation(s)
- Patrick K Munywoki
- Center for Global Health, Division of Public Health Protection, U.S. Centers for Disease Control and Prevention, Nairobi, USA
| | - Caroline Nasimiyu
- Global Health Kenya, Washington State University, Nairobi, USA
- Paul G. Allen School of Global Health, Washington State University, Pullman, USA
| | - Moshe Dayan Alando
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Nancy Otieno
- Centre for Global Health Research,, Kenya Medical Research Institute, Kisumu, Kenya
| | - Cynthia Ombok
- Global Health Kenya, Washington State University, Nairobi, USA
| | - Ruth Njoroge
- Global Health Kenya, Washington State University, Nairobi, USA
| | - Gilbert Kikwai
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Dennis Odhiambo,
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Mike Powel Osita
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Alice Ouma
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Clifford Odour
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Bonventure Juma
- Center for Global Health, Division of Public Health Protection, U.S. Centers for Disease Control and Prevention, Nairobi, USA
| | - Caroline A Ochieng
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Immaculate Mutisya
- Center for Global Health, Division of Public Health Protection, U.S. Centers for Disease Control and Prevention, Nairobi, USA
| | - Isaac Ngere
- Global Health Kenya, Washington State University, Nairobi, USA
- Paul G. Allen School of Global Health, Washington State University, Pullman, USA
| | - Jeanette Dawa
- Global Health Kenya, Washington State University, Nairobi, USA
- Paul G. Allen School of Global Health, Washington State University, Pullman, USA
| | - Eric Osoro
- Global Health Kenya, Washington State University, Nairobi, USA
- Paul G. Allen School of Global Health, Washington State University, Pullman, USA
| | - M Kariuki Njenga
- Global Health Kenya, Washington State University, Nairobi, USA
- Paul G. Allen School of Global Health, Washington State University, Pullman, USA
| | - Godfrey Bigogo
- Centre for Global Health Research,, Kenya Medical Research Institute, Kisumu, Kenya
| | - Peninah Munyua
- Center for Global Health, Division of Public Health Protection, U.S. Centers for Disease Control and Prevention, Nairobi, USA
| | - Terrence Q Lo
- Center for Global Health, Division of Public Health Protection, U.S. Centers for Disease Control and Prevention, Nairobi, USA
| | - Elizabeth Hunsperger
- Center for Global Health, Division of Public Health Protection, U.S. Centers for Disease Control and Prevention, Nairobi, USA
| | - Amy Herman-Roloff
- Center for Global Health, Division of Public Health Protection, U.S. Centers for Disease Control and Prevention, Nairobi, USA
| |
Collapse
|
15
|
Adebisi YA, Rabe A, Lucero-Prisno Iii DE. COVID-19 surveillance systems in African countries. Health Promot Perspect 2022; 11:382-392. [PMID: 35079582 PMCID: PMC8767077 DOI: 10.34172/hpp.2021.49] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/08/2021] [Indexed: 12/29/2022] Open
Abstract
Background: Surveillance forms the basis for response to disease outbreaks, including COVID-19. Herein, we identified the COVID-19 surveillance systems and the associated challenges in 13 African countries. Methods: We conducted a comprehensive narrative review of peer-reviewed literature published between January 2020 and April 2021 in PubMed, Medline, PubMed Central, and Google Scholar using predetermined search terms. Relevant studies from the search and other data sources on COVID-19 surveillance strategies and associated challenges in 13 African countries (Mauritius, Algeria, Nigeria, Angola, Cote d’Ivoire, the Democratic Republic of the Congo, Ghana, Ethiopia, South Africa, Kenya, Zambia, Tanzania, and Uganda) were identified and reviewed. Results: Our findings revealed that the selected African countries have ramped up COVID-19 surveillance ranging from immediate case notification, virological surveillance, hospital-based surveillance to mortality surveillance among others. Despite this, there exist variations in the level of implementation of the surveillance systems across countries. Integrated Disease Surveillance and Response (IDSR) strategy is also being leveraged in some African countries, but the implementation across countries remains uneven. Our study also revealed various challenges facing surveillance which included shortage of skilled human resources resulting in poor data management, weak health systems, complexities of ethical considerations, diagnostic insufficiency, the burden of co-epidemic surveillance, and geographical barriers, among others. Conclusion: With the variations in the level of implementation of COVID-19 surveillance strategies seen across countries, it is pertinent to ensure proper coordination of the surveillance activities in the African countries and address all the challenges facing COVID-19 surveillance using tailored strategies.
Collapse
Affiliation(s)
- Yusuff Adebayo Adebisi
- Global Health Focus Africa, Nigeria.,African Young Leaders for Global Health, Abuja, Nigeria.,Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Adrian Rabe
- Global Health Focus Africa, Nigeria.,Faculty of Medicine, School of Public Health, Imperial College London, UK
| | - Don Eliseo Lucero-Prisno Iii
- Global Health Focus Africa, Nigeria.,Department of Global Health and Development, London School of Hygiene and Tropical Medicine, UK
| |
Collapse
|
16
|
Assefa N, Regassa LD, Teklemariam Z, Oundo J, Madrid L, Dessie Y, Scott J. Seroprevalence of anti-SARS-CoV-2 antibodies in women attending antenatal care in eastern Ethiopia: a facility-based surveillance. BMJ Open 2021; 11:e055834. [PMID: 34819290 PMCID: PMC8613670 DOI: 10.1136/bmjopen-2021-055834] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 11/01/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE We conducted serosurveillance of anti-SARS-CoV-2 antibodies among pregnant women attending their first antenatal care. SETTING The surveillance was set in one referral hospital in Harar, one district hospital and one health centre located in Haramaya district in rural eastern Ethiopia. PARTICIPANTS We collected questionnaire data and a blood sample from 3312 pregnant women between 1 April 2020 and 31 March 2021. We selected 1447 blood samples at random and assayed these for anti-SARS-CoV-2 antibodies at Hararghe Health Research laboratory using WANTAI SARS-CoV-2 Rapid Test for total immunoglobulin. OUTCOME We assayed for anti-SARS-CoV-2 antibodies and temporal trends in seroprevalence were analysed with a χ2 test for trend and multivariable binomial regression. RESULTS Among 1447 sera tested, 83 were positive for anti-SARS-CoV-2 antibodies giving a crude seroprevalence of 5.7% (95% CI 4.6% to 7.0%). Of 160 samples tested in April-May 2020, none was seropositive; the first seropositive sample was identified in June and seroprevalence rose steadily thereafter (χ2 test for trend, p=0.003) reaching a peak of 11.8% in February 2021. In the multivariable model, seroprevalence was approximately 3% higher in first-trimester mothers compared with later presentations, and rose by 0.75% (95% CI 0.31% to 1.20%) per month of calendar time. CONCLUSIONS This clinical convenience sample illustrates the dynamic of the SARS-CoV-2 epidemic in pregnant women in eastern Ethiopia; infection was rare before June 2020 but it spread in a linear fashion thereafter, rather than following intermittent waves, and reached 10% by the beginning of 2021. After 1 year of surveillance, most pregnant mothers remained susceptible.
Collapse
Affiliation(s)
- Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - Zelalem Teklemariam
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Joseph Oundo
- London School of Hygiene & Tropical Medicine, London, UK
| | - Lola Madrid
- London School of Hygiene & Tropical Medicine, London, UK
| | - Yadeta Dessie
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Jag Scott
- London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
17
|
Müller SA, Wood RR, Hanefeld J, El-Bcheraoui C. Seroprevalence and Risk Factors of COVID-19 in Healthcare Workers From Eleven African Countries: A Scoping Review and Appraisal of Existing Evidence. Health Policy Plan 2021; 37:505-513. [PMID: 34726740 PMCID: PMC8689910 DOI: 10.1093/heapol/czab133] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/27/2021] [Accepted: 11/01/2021] [Indexed: 12/17/2022] Open
Abstract
A better understanding of serological data and risk factors for COVID-19 infection in healthcare workers are especially important in African countries where human resources and health services are more constrained. We reviewed and appraised the evidence of SARS-CoV-2 seroprevalence and its risk factors in healthcare workers in Africa to inform response and preparedness strategies during the SARS CoV-2 pandemic. We followed the PRISMA-ScR guidelines in this scoping review. Databases including PubMed, Embase and preprint servers were searched accordingly from the start of the COVID-19 pandemic to 19th April 2021. Our search yielded twelve peer-reviewed and four pre-print articles comprising data on 9,223 HCWs from eleven countries in Africa. Seroprevalence varied widely and ranged from 0% to 45.1%. Seropositivity was associated with older age, lower education, working as a nurse/non- clinical HCW, or in gynaecology, emergency, outpatient or surgery departments. Asymptomatic rates were high and half of the studies recommended routine testing of HCWs. This scoping review found a varying, but often high SARS-CoV-2 seroprevalence in HCWs in eleven African countries and identified certain risk factors. COVID-19 public health strategies for policy and planning should consider these risk factors and the potential for high seroprevalence among HCWs when prioritizing infection prevention and control measures and vaccine deployment.
Collapse
Affiliation(s)
- Sophie Alice Müller
- Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Rebekah Ruth Wood
- Evidence- based Public Health, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Johanna Hanefeld
- Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Charbel El-Bcheraoui
- Evidence- based Public Health, Centre for International Health Protection, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| |
Collapse
|
18
|
Bottomley C, Otiende M, Uyoga S, Gallagher K, Kagucia EW, Etyang AO, Mugo D, Gitonga J, Karanja H, Nyagwange J, Adetifa IMO, Agweyu A, Nokes DJ, Warimwe GM, Scott JAG. Quantifying previous SARS-CoV-2 infection through mixture modelling of antibody levels. Nat Commun 2021; 12:6196. [PMID: 34702829 PMCID: PMC8548402 DOI: 10.1038/s41467-021-26452-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/17/2021] [Indexed: 11/09/2022] Open
Abstract
As countries decide on vaccination strategies and how to ease movement restrictions, estimating the proportion of the population previously infected with SARS-CoV-2 is important for predicting the future burden of COVID-19. This proportion is usually estimated from serosurvey data in two steps: first the proportion above a threshold antibody level is calculated, then the crude estimate is adjusted using external estimates of sensitivity and specificity. A drawback of this approach is that the PCR-confirmed cases used to estimate the sensitivity of the threshold may not be representative of cases in the wider population-e.g., they may be more recently infected and more severely symptomatic. Mixture modelling offers an alternative approach that does not require external data from PCR-confirmed cases. Here we illustrate the bias in the standard threshold-based approach by comparing both approaches using data from several Kenyan serosurveys. We show that the mixture model analysis produces estimates of previous infection that are often substantially higher than the standard threshold analysis.
Collapse
Affiliation(s)
- C Bottomley
- International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK.
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
| | - M Otiende
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - S Uyoga
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - K Gallagher
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - E W Kagucia
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - A O Etyang
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - D Mugo
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - J Gitonga
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - H Karanja
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - J Nyagwange
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - I M O Adetifa
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - A Agweyu
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Oxford University, Oxford, UK
| | - D J Nokes
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- School of Life Sciences, University of Warwick, Coventry, UK
| | - G M Warimwe
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Oxford University, Oxford, UK
| | - J A G Scott
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Oxford University, Oxford, UK
| |
Collapse
|
19
|
Uyoga S, Adetifa IMO, Otiende M, Yegon C, Agweyu A, Warimwe GM, Scott JAG. Prevalence of SARS-CoV-2 Antibodies From a National Serosurveillance of Kenyan Blood Donors, January-March 2021. JAMA 2021; 326:1436-1438. [PMID: 34473191 PMCID: PMC8414357 DOI: 10.1001/jama.2021.15265] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This study examines the prevalence of SARS-CoV-2 antibodies among blood donors aged 16 to 64 years in Kenya from January to March 2021.
Collapse
Affiliation(s)
- Sophie Uyoga
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Mark Otiende
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Christine Yegon
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | | | | | | |
Collapse
|
20
|
Munywoki PK, Nasimiyu C, Alando MD, Otieno N, Ombok C, Njoroge R, Kikwai G, Odhiambo, D, Osita MP, Ouma A, Odour C, Juma B, Ochieng CA, Mutisya I, Ngere I, Dawa J, Osoro E, Njenga MK, Bigogo G, Munyua P, Lo TQ, Hunsperger E, Herman-Roloff A. Seroprevalence and risk factors of SARS-CoV-2 infection in an urban informal settlement in Nairobi, Kenya, December 2020. F1000Res 2021; 10:853. [PMID: 35528961 PMCID: PMC9065925 DOI: 10.12688/f1000research.72914.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction: Urban informal settlements may be disproportionately affected by the COVID-19 pandemic due to overcrowding and other socioeconomic challenges that make adoption and implementation of public health mitigation measures difficult. We conducted a seroprevalence survey in the Kibera informal settlement, Nairobi, Kenya, to determine the extent of SARS-CoV-2 infection. Methods: Members of randomly selected households from an existing population-based infectious disease surveillance (PBIDS) provided blood specimens between 27th November and 5th December 2020. The specimens were tested for antibodies to the SARS-CoV-2 spike protein. Seroprevalence estimates were weighted by age and sex distribution of the PBIDS population and accounted for household clustering. Multivariable logistic regression was used to identify risk factors for individual seropositivity. Results: Consent was obtained from 523 individuals in 175 households, yielding 511 serum specimens that were tested. The overall weighted seroprevalence was 43.3% (95% CI, 37.4 – 49.5%) and did not vary by sex. Of the sampled households, 122(69.7%) had at least one seropositive individual. The individual seroprevalence increased by age from 7.6% (95% CI, 2.4 – 21.3%) among children (<5 years), 32.7% (95% CI, 22.9 – 44.4%) among children 5 – 9 years, 41.8% (95% CI, 33.0 – 51.1%) for those 10-19 years, and 54.9%(46.2 – 63.3%) for adults (≥20 years). Relative to those from medium-sized households (3 and 4 individuals), participants from large (≥5 persons) households had significantly increased odds of being seropositive, aOR, 1.98(95% CI, 1.17 – 1.58), while those from small-sized households (≤2 individuals) had increased odds but not statistically significant, aOR, 2.31 (95% CI, 0.93 – 5.74). Conclusion: In densely populated urban settings, close to half of the individuals had an infection to SARS-CoV-2 after eight months of the COVID-19 pandemic in Kenya. This highlights the importance to prioritize mitigation measures, including COVID-19 vaccine distribution, in the crowded, low socioeconomic settings.
Collapse
|
21
|
Kagucia EW, Gitonga JN, Kalu C, Ochomo E, Ochieng B, Kuya N, Karani A, Nyagwange J, Karia B, Mugo D, Karanja HK, Tuju J, Mutiso A, Maroko H, Okubi L, Maitha E, Ajuck H, Mukabi D, Moracha W, Bulimu D, Andanje N, Aman R, Mwangangi M, Amoth P, Kasera K, Ng’ang’a W, Nyaguara A, Voller S, Otiende M, Bottomley C, Agoti CN, Ochola-Oyier LI, Adetifa IMO, Etyang AO, Gallagher KE, Uyoga S, Barasa E, Bejon P, Tsofa B, Agweyu A, Warimwe GM, Scott JAG. Anti-Severe Acute Respiratory Syndrome Coronavirus 2 Immunoglobulin G Antibody Seroprevalence Among Truck Drivers and Assistants in Kenya. Open Forum Infect Dis 2021; 8:ofab314. [PMID: 34660838 PMCID: PMC8519263 DOI: 10.1093/ofid/ofab314] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/09/2021] [Indexed: 11/14/2022] Open
Abstract
In October 2020, anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G seroprevalence among truck drivers and their assistants (TDA) in Kenya was 42.3%, higher than among healthcare workers and blood donors. Truck drivers and their assistants transport essential supplies during the coronavirus disease 2019 pandemic, placing them at increased risk of being infected and of transmitting SARS-CoV-2 over a wide geographical area.
Collapse
Affiliation(s)
| | | | | | - Eric Ochomo
- KEMRI Centre for Global Health Research (CGHR),
Kisumu, Kenya
| | - Benard Ochieng
- KEMRI Centre for Global Health Research (CGHR),
Kisumu, Kenya
| | - Nickline Kuya
- KEMRI Centre for Global Health Research (CGHR),
Kisumu, Kenya
| | - Angela Karani
- KEMRI-Wellcome Trust Research Programme,
Kilifi, Kenya
| | | | | | - Daisy Mugo
- KEMRI-Wellcome Trust Research Programme,
Kilifi, Kenya
| | | | - James Tuju
- KEMRI-Wellcome Trust Research Programme,
Kilifi, Kenya
| | - Agnes Mutiso
- KEMRI-Wellcome Trust Research Programme,
Kilifi, Kenya
| | - Hosea Maroko
- KEMRI Centre for Infectious and Parasitic Diseases Control
Research, Busia, Kenya
| | - Lucy Okubi
- KEMRI Centre for Infectious and Parasitic Diseases Control
Research, Busia, Kenya
| | | | | | | | | | | | | | - Rashid Aman
- Ministry of Health, Government of Kenya,
Nairobi, Kenya
| | | | - Patrick Amoth
- Ministry of Health, Government of Kenya,
Nairobi, Kenya
| | | | - Wangari Ng’ang’a
- Presidential Policy and Strategy Unit, The Presidency, Government of
Kenya, Nairobi, Kenya
| | - Amek Nyaguara
- KEMRI-Wellcome Trust Research Programme,
Kilifi, Kenya
| | - Shirine Voller
- KEMRI-Wellcome Trust Research Programme,
Kilifi, Kenya
- Department of Infectious Disease Epidemiology, London School of Hygiene
and Tropical Medicine, London, United
Kingdom
| | - Mark Otiende
- KEMRI-Wellcome Trust Research Programme,
Kilifi, Kenya
| | - Christian Bottomley
- Department of Infectious Disease Epidemiology, London School of Hygiene
and Tropical Medicine, London, United
Kingdom
| | | | | | - Ifedayo M O Adetifa
- KEMRI-Wellcome Trust Research Programme,
Kilifi, Kenya
- Department of Infectious Disease Epidemiology, London School of Hygiene
and Tropical Medicine, London, United
Kingdom
| | | | - Katherine E Gallagher
- KEMRI-Wellcome Trust Research Programme,
Kilifi, Kenya
- Department of Infectious Disease Epidemiology, London School of Hygiene
and Tropical Medicine, London, United
Kingdom
| | - Sophie Uyoga
- KEMRI-Wellcome Trust Research Programme,
Kilifi, Kenya
| | - Edwine Barasa
- KEMRI-Wellcome Trust Research Programme,
Kilifi, Kenya
| | - Philip Bejon
- KEMRI-Wellcome Trust Research Programme,
Kilifi, Kenya
- Nuffield Department of Medicine, Oxford University,
Oxford, United
Kingdom
| | | | | | - George M Warimwe
- KEMRI-Wellcome Trust Research Programme,
Kilifi, Kenya
- Nuffield Department of Medicine, Oxford University,
Oxford, United
Kingdom
| | - J Anthony G Scott
- KEMRI-Wellcome Trust Research Programme,
Kilifi, Kenya
- Department of Infectious Disease Epidemiology, London School of Hygiene
and Tropical Medicine, London, United
Kingdom
- Nuffield Department of Medicine, Oxford University,
Oxford, United
Kingdom
| | | |
Collapse
|
22
|
Adetifa IMO, Uyoga S, Gitonga JN, Mugo D, Otiende M, Nyagwange J, Karanja HK, Tuju J, Wanjiku P, Aman R, Mwangangi M, Amoth P, Kasera K, Ng'ang'a W, Rombo C, Yegon C, Kithi K, Odhiambo E, Rotich T, Orgut I, Kihara S, Bottomley C, Kagucia EW, Gallagher KE, Etyang A, Voller S, Lambe T, Wright D, Barasa E, Tsofa B, Bejon P, Ochola-Oyier LI, Agweyu A, Scott JAG, Warimwe GM. Temporal trends of SARS-CoV-2 seroprevalence during the first wave of the COVID-19 epidemic in Kenya. Nat Commun 2021; 12:3966. [PMID: 34172732 PMCID: PMC8233334 DOI: 10.1038/s41467-021-24062-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/25/2021] [Indexed: 12/17/2022] Open
Abstract
Observed SARS-CoV-2 infections and deaths are low in tropical Africa raising questions about the extent of transmission. We measured SARS-CoV-2 IgG by ELISA in 9,922 blood donors across Kenya and adjusted for sampling bias and test performance. By 1st September 2020, 577 COVID-19 deaths were observed nationwide and seroprevalence was 9.1% (95%CI 7.6-10.8%). Seroprevalence in Nairobi was 22.7% (18.0-27.7%). Although most people remained susceptible, SARS-CoV-2 had spread widely in Kenya with apparently low associated mortality.
Collapse
Affiliation(s)
- Ifedayo M O Adetifa
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom.
| | - Sophie Uyoga
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
| | | | - Daisy Mugo
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Mark Otiende
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | | | - James Tuju
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Rashid Aman
- Ministry of Health, Government of Kenya, Nairobi, Kenya
| | | | - Patrick Amoth
- Ministry of Health, Government of Kenya, Nairobi, Kenya
| | | | - Wangari Ng'ang'a
- Presidential Policy & Strategy Unit, The Presidency, Government of Kenya, Nairobi, Kenya
| | - Charles Rombo
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Christine Yegon
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Khamisi Kithi
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Elizabeth Odhiambo
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Thomas Rotich
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Irene Orgut
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Sammy Kihara
- Kenya National Blood Transfusion Services, Ministry of Health, Nairobi, Kenya
| | - Christian Bottomley
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom
| | | | - Katherine E Gallagher
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom
| | | | - Shirine Voller
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom
| | - Teresa Lambe
- Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | - Daniel Wright
- Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | - Edwine Barasa
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Philip Bejon
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | | | | | - J Anthony G Scott
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom
- Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | - George M Warimwe
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| |
Collapse
|