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Hookham L, Cantrell L, Cose S, Freyne B, Gadama L, Imede E, Kawaza K, Lissauer S, Musoke P, Nankabirwa V, Sekikubo M, Sommerfelt H, Voysey M, Le Doare K. Seroepidemiology of SARS-CoV-2 in a cohort of pregnant women and their infants in Uganda and Malawi. PLoS One 2024; 19:e0290913. [PMID: 38427691 PMCID: PMC10906847 DOI: 10.1371/journal.pone.0290913] [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: 08/16/2023] [Accepted: 11/24/2023] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Data on SARS-CoV-2 infection in pregnancy and infancy has accumulated throughout the course of the pandemic, though evidence regarding asymptomatic SARS-CoV-2 infection and adverse birth outcomes are scarce. Limited information is available from countries in sub-Saharan Africa (SSA). The pregnant woman and infant COVID in Africa study (PeriCOVID Africa) is a South-South-North partnership involving hospitals and health centres in five countries: Malawi, Uganda, Mozambique, The Gambia, and Kenya. The study leveraged data from three ongoing prospective cohort studies: Preparing for Group B Streptococcal Vaccines (GBS PREPARE), SARS-CoV-2 infection and COVID-19 in women and their infants in Kampala and Mukono (COMAC) and Pregnancy Care Integrating Translational Science Everywhere (PRECISE). In this paper we describe the seroepidemiology of SARS-CoV-2 infection in pregnant women enrolled in sites in Uganda and Malawi, and the impact of SARS-CoV-2 infection on pregnancy and infant outcomes. OUTCOME Seroprevalence of SARS-CoV-2 antibodies in maternal blood, reported as the proportion of seropositive women by study site and wave of COVID-19 within each country. METHODS The PeriCOVID study was a prospective mother-infant cohort study that recruited pregnant women at any gestation antenatally or on the day of delivery. Maternal and cord blood samples were tested for SARS-CoV-2 antibodies using Wantai and Euroimmune ELISA. In periCOVID Uganda and Malawi nose and throat swabs for SARS-Cov-2 RT-PCR were obtained. RESULTS In total, 1379 women were enrolled, giving birth to 1387 infants. Overall, 63% of pregnant women had a SARS-CoV-2 positive serology. Over subsequent waves (delta and omicron), in the absence of vaccination, seropositivity rose from 20% to over 80%. The placental transfer GMR was 1.7, indicating active placental transfer of anti-spike IgG. There was no association between SARS-CoV-2 antibody positivity and adverse pregnancy or infancy outcomes.
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Affiliation(s)
- Lauren Hookham
- Institute for Infection and Immunity, St George’s, University of London, London, United Kingdom
| | - Liberty Cantrell
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Stephen Cose
- London School of Hygiene & Tropical Medicine, London, United Kingdom
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Bridget Freyne
- Malawi Liverpool Wellcome Trust, Blantyre, Malawi
- Institute of Infection, Veterinary and Ecological Science, University of Liverpool, Liverpool, United Kingdom
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Luis Gadama
- Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Esther Imede
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | | | - Samantha Lissauer
- Malawi Liverpool Wellcome Trust, Blantyre, Malawi
- Institute of Infection, Veterinary and Ecological Science, University of Liverpool, Liverpool, United Kingdom
| | - Phillipa Musoke
- Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda
| | - Victoria Nankabirwa
- Department of Epidemiology & Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
| | - Musa Sekikubo
- Department of Obstetrics & Gynaecology Makerere University, Kampala, Uganda
| | - Halvor Sommerfelt
- Centre for Intervention Science in Maternal and Child Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Institute of Public Health, Bergen, Norway
| | - Merryn Voysey
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Kirsty Le Doare
- Institute for Infection and Immunity, St George’s, University of London, London, United Kingdom
- Makerere University, John’s Hopkins University, Kampala, Uganda
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Vermeulen M, Mhlanga L, Sykes W, Cable R, Coleman C, Pietersen N, Swanevelder R, Glatt TN, Bingham J, van den Berg K, Grebe E, Welte A. The evolution and interpretation of seroprevalence of SARS-CoV-2 antibodies among South African blood donors from the Beta to Omicron variant-driven waves. Vox Sang 2024; 119:242-251. [PMID: 38156504 DOI: 10.1111/vox.13571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND AND OBJECTIVES Confirmed COVID-19 diagnoses underestimate the total number of infections. Blood donors can provide representative seroprevalence estimates, which can be leveraged into reasonable estimates of total infection counts and infection fatality rate (IFR). MATERIALS AND METHODS Blood donors who donated after each of three epidemic waves (Beta, Delta and first Omicron waves) were tested for anti-SARS-CoV-2 nucleocapsid antibodies using the Roche Elecsys anti-SARS-CoV-2 total immunoglobulin assay. Roche Elecsys anti-spike antibody testing was done for the post-Omicron sampling. Prevalence of antibodies was estimated by age, sex, race and province and compared to official case reporting. Province and age group-specific IFRs were estimated using external excess mortality estimates. RESULTS The nationally weighted anti-nucleocapsid seroprevalence estimates after the Beta, Delta and Omicron waves were 47% (46.2%-48.6%), 71% (68.8%-73.5%) and 87% (85.5%-88.4%), respectively. There was no variation by age and sex, but there were statistically and epidemiologically significant differences by province (except at the latest time point) and race. There was a 13-fold higher seroprevalence than confirmed case counts at the first time point. Age-dependent IFR roughly doubled for every 10 years of age increase over 6 decades from 0.014% in children to 6.793% in octogenarians. CONCLUSION Discrepancies were found between seroprevalence and confirmed case counts. High seroprevalence rates found among Black African donors can be ascribed to historical inequities. Our IFR estimates were useful in refining previous large disagreements about the severity of the epidemic in South Africa. Blood donor-based serosurveys provided a valuable and efficient way to provide near real-time monitoring of the ongoing SARS-CoV-2 outbreak.
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Affiliation(s)
- Marion Vermeulen
- South African National Blood Service, Johannesburg, South Africa
- University of the Free State, Bloemfontein, South Africa
| | - Laurette Mhlanga
- DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
- Northwestern University, Chicago, Illinois, USA
| | - Wendy Sykes
- South African National Blood Service, Johannesburg, South Africa
| | | | - Charl Coleman
- South African National Blood Service, Johannesburg, South Africa
| | | | | | - Tanya Nadia Glatt
- South African National Blood Service, Johannesburg, South Africa
- University of Johannesburg, Johannesburg, South Africa
| | - Jeremy Bingham
- DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
| | - Karin van den Berg
- South African National Blood Service, Johannesburg, South Africa
- University of the Free State, Bloemfontein, South Africa
- University of Cape Town, Rondebosch, South Africa
| | - Eduard Grebe
- DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
- Vitalant Research Institute, San Francisco, California, USA
- University of California San Francisco, San Francisco, California, USA
| | - Alex Welte
- DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
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Samsunder N, Devnarain N, Sivro A, Kharsany ABM. The Performance of Diagnostic Tests for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the South African Population: A Scoping Review. Trop Med Infect Dis 2023; 8:514. [PMID: 38133446 PMCID: PMC10748306 DOI: 10.3390/tropicalmed8120514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023] Open
Abstract
To determine the performance and reliability of diagnostic tests for the identification of SARS-CoV-2 infection in South Africa, we conducted a scoping review to identify published studies undertaken in the English language from March 2020 to August 2022 that evaluated the performance of antigen- and antibody-based diagnostic tests for SARS-CoV-2 in South Africa. We identified 17 relevant peer-reviewed articles; six reported on SARS-CoV-2 gene and/or antigen detection whilst 11 reported on antibody detection. Of the SARS-CoV-2 gene and/or antigen-based tests, sensitivity ranged from 40% to 100%, whilst for the antibody-based tests, sensitivity ranged from 13% to 100%. All tests evaluated were highly dependent on the stage of infection and the timing of sample collection. This scoping review demonstrated that no single SARS-CoV-2 gene and/or antigen- or antibody-based assay was sufficiently sensitive and specific simultaneously. The sensitivity of the tests was highly dependent on the timing of sample collection with respect to SARS-CoV-2 infection. In the case of SARS-CoV-2 gene and/or antigen detection, the earlier the collection of samples, the greater the sensitivity, while antibody detection tests showed better sensitivity using samples from later stages of infection.
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Affiliation(s)
- Natasha Samsunder
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban 4013, South Africa; (N.S.); (N.D.); (A.S.)
| | - Nikita Devnarain
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban 4013, South Africa; (N.S.); (N.D.); (A.S.)
- School of Health Science, University of KwaZulu-Natal, Durban 4013, South Africa
| | - Aida Sivro
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban 4013, South Africa; (N.S.); (N.D.); (A.S.)
- Department of Medical Microbiology, University of KwaZulu-Natal, Durban 4013, South Africa
- JC Wilt Infectious Disease Research Centre, National Microbiology laboratory, Public Health Agency of Canada, Winnipeg, MB R3E 3L5, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Ayesha B. M. Kharsany
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban 4013, South Africa; (N.S.); (N.D.); (A.S.)
- Department of Medical Microbiology, University of KwaZulu-Natal, Durban 4013, South Africa
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Bingham J, Tempia S, Moultrie H, Viboud C, Jassat W, Cohen C, Pulliam JR. Estimating the time-varying reproduction number for COVID-19 in South Africa during the first four waves using multiple measures of incidence for public and private sectors across four waves. PLoS One 2023; 18:e0287026. [PMID: 37738280 PMCID: PMC10516415 DOI: 10.1371/journal.pone.0287026] [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: 09/02/2022] [Accepted: 05/30/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVES The aim of this study was to quantify transmission trends in South Africa during the first four waves of the COVID-19 pandemic using estimates of the time-varying reproduction number (R) and to compare the robustness of R estimates based on three different data sources, and using data from public and private sector service providers. METHODS R was estimated from March 2020 through April 2022, nationally and by province, based on time series of rt-PCR-confirmed cases, hospitalisations, and hospital-associated deaths, using a method that models daily incidence as a weighted sum of past incidence, as implemented in the R package EpiEstim. R was also estimated separately using public and private sector data. RESULTS Nationally, the maximum case-based R following the introduction of lockdown measures was 1.55 (CI: 1.43-1.66), 1.56 (CI: 1.47-1.64), 1.46 (CI: 1.38-1.53) and 3.33 (CI: 2.84-3.97) during the first (Wuhan-Hu), second (Beta), third (Delta), and fourth (Omicron) waves, respectively. Estimates based on the three data sources (cases, hospitalisations, deaths) were generally similar during the first three waves, but higher during the fourth wave for case-based estimates. Public and private sector R estimates were generally similar except during the initial lockdowns and in case-based estimates during the fourth wave. CONCLUSION Agreement between R estimates using different data sources during the first three waves suggests that data from any of these sources could be used in the early stages of a future pandemic. The high R estimates for Omicron relative to earlier waves are interesting given a high level of exposure pre-Omicron. The agreement between public and private sector R estimates highlights that clients of the public and private sectors did not experience two separate epidemics, except perhaps to a limited extent during the strictest lockdowns in the first wave.
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Affiliation(s)
- Jeremy Bingham
- South African DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
| | - Stefano Tempia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Harry Moultrie
- Division of the National Health Laboratory Service, Centre for Tuberculosis, National Institute for Communicable Diseases, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Cecile Viboud
- Fogarty International Center, NIH, Bethesda, MD, United States of America
| | - Waasila Jassat
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
- Right to Care, Pretoria, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Juliet R.C. Pulliam
- South African DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
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Chanda SL, Tembo E, Sinyange N, Kayeyi N, Musonda K, Chewe O, Kasonde M, Kapona O, Ngomah A, Hamukale A, Zulu PM, Kapina M. Characteristics of cases and deaths arising from SARS-CoV-2 infection in Zambia: March 2020 to April 2021. Pan Afr Med J 2023; 45:155. [PMID: 37869234 PMCID: PMC10589408 DOI: 10.11604/pamj.2023.45.155.32018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 03/09/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction since March 2020, Zambia has been experiencing a SARS-CoV-2 epidemic. Little data has been reported on cases and deaths arising from COVID-19 in Africa. We described the demographic characteristics of these cases and deaths in Zambia. Methods we analyzed data on all persons testing positive for SARS-CoV-2 from 18th March 2020 to 25th April 2021 in Zambia. COVID-19 cases were identified through port-of-entry surveillance, contact-tracing, health-care-worker testing, health-facility-based and community-based screening and community-death screening. All diagnoses were confirmed using real-time-polymerase-chain-reaction and rapid-antigen-test-kits of nasopharyngeal specimens. We analyzed age, sex, and date-of-reporting according to whether the cases or deaths occurred during the first wave (1st July to 15th September 2020) or the second wave (15th December 2020 to 10th April 2021). We computed Mann-Whitney-U-test to compare medians of continuous variables and chi-square tests to compare differences between proportions using R. Results a total 1,246 (1.36%) deaths were recorded among 91,378 confirmed cases during March 2020-April 2021 in Zambia. Persons who died were older than those who did not (median age 50 years versus 32.0 years, p< 0.001). Although only 4.7% of cases were among persons aged >60 years, most deaths (31.6%) occurred in this age group (p<0.001). More deaths (83.5%) occurred in the community than in health facilities (p<0.001). Conclusion during the SARS-CoV-2 epidemic in Zambia, most deaths occurred in the community, indicating potential gaps in public health messaging about COVID-19. Improving health-seeking behaviors for COVID-19 through public messaging campaigns and engaging key community stakeholders in Zambia might reduce avoidable mortality. As the group most impacted by COVID-19 mortality, older persons might need enhanced outreach and linkage to care.
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Affiliation(s)
- Stephen Longa Chanda
- Field Epidemiology Training Program (FETP), Zambia National Public Health Institute, Lusaka, Zambia
- Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia
| | - Emmanuel Tembo
- Field Epidemiology Training Program (FETP), Zambia National Public Health Institute, Lusaka, Zambia
- Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia
| | - Nyambe Sinyange
- Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia
| | - Nkomba Kayeyi
- Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia
| | - Kunda Musonda
- Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia
| | - Orbie Chewe
- Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia
| | - Mpanga Kasonde
- Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia
| | - Otridah Kapona
- Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia
| | - Albertina Ngomah
- Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia
| | - Amos Hamukale
- Field Epidemiology Training Program (FETP), Zambia National Public Health Institute, Lusaka, Zambia
- Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia
| | - Paul Msanzya Zulu
- Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia
| | - Muzala Kapina
- Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia
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Mabuka T, Naidoo N, Ncube N, Yiga T, Ross M, Kurehwa K, Nare Nyathi M, Silaji A, Ndemera T, Lemeke T, Taiwo R, Macharia W, Sithole M. The Impact of SARS-CoV-2 Lineages (Variants) and COVID-19 Vaccination on the COVID-19 Epidemic in South Africa: Regression Study. JMIRX MED 2023; 4:e34598. [PMID: 37463043 PMCID: PMC10337479 DOI: 10.2196/34598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 04/12/2022] [Accepted: 02/13/2023] [Indexed: 07/20/2023]
Abstract
Background Emerging SARS-CoV-2 variants have been attributed to the occurrence of secondary, tertiary, quaternary, and quinary COVID-19 epidemic waves threatening vaccine efforts owing to their immune invasiveness. Since the importation of SARS-CoV-2 in South Africa, with the first reported COVID-19 case on March 5, 2020, South Africa has observed 5 consecutive COVID-19 epidemic waves. The evolution of SARS-CoV-2 has played a major role in the resurgence of COVID-19 epidemic waves in South Africa and across the globe. Objective We aimed to conduct descriptive and inferential statistical analysis on South African COVID-19 epidemiological data to investigate the impact of SARS-CoV-2 lineages and COVID-19 vaccinations in South African COVID-19 epidemiology. Methods The general methodology involved the collation and stratification, covariance, regression analysis, normalization, and comparative inferential statistical analysis through null hypothesis testing (paired 2-tailed t tests) of South African COVID-19 epidemiological data. Results The mean daily positive COVID-19 tests in South Africa's first, second, third, fourth, and fifth COVID-19 epidemic wave periods were 11.5% (SD 8.58%), 11.5% (SD 8.45%), 13.3% (SD 9.72%), 13.1% (SD 9.91%), and 14.3% (SD 8.49%), respectively. The COVID-19 transmission rate in the first and second COVID-19 epidemic waves in South Africa was similar, while the COVID-19 transmission rate was higher in the third, fourth, and fifth COVID-19 epidemic waves than in the aforementioned waves. Most COVID-19 hospitalized cases in South Africa were in the general ward (60%-79.1%). Patients with COVID-19 on oxygen were the second-largest admission status (11.2%-16.8%), followed by patients with COVID-19 in the intensive care unit (8.07%-16.7%). Most patients hospitalized owing to COVID-19 in South Africa's first, second, third, and fourth COVID-19 epidemic waves were aged between 40 and 49 years (16.8%-20.4%) and 50 and 59 years (19.8%-25.3%). Patients admitted to the hospital owing to COVID-19 in the age groups of 0 to 19 years were relatively low (1.98%-4.59%). In general, COVID-19 hospital admissions in South Africa for the age groups between 0 and 29 years increased after each consecutive COVID-19 epidemic wave, while for age groups between 30 and 79 years, hospital admissions decreased. Most COVID-19 hospitalization deaths in South Africa in the first, second, third, fourth, and fifth COVID-19 epidemic waves were in the ages of 50 to 59 years (15.8%-24.8%), 60 to 69 years (15.9%-29.5%), and 70 to 79 years (16.6%-20.7%). Conclusions The relaxation of COVID-19 nonpharmaceutical intervention health policies in South Africa and the evolution of SARS-CoV-2 were associated with increased COVID-19 transmission and severity in the South African population. COVID-19 vaccination in South Africa was strongly associated with a decrease in COVID-19 hospitalization and severity in South Africa.
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Affiliation(s)
- Thabo Mabuka
- The Afrikan Research Initiative Motloung South Africa
| | | | - Nesisa Ncube
- The Afrikan Research Initiative Motloung South Africa
| | - Thabo Yiga
- The Afrikan Research Initiative Motloung South Africa
| | - Michael Ross
- The Afrikan Research Initiative Motloung South Africa
| | | | | | - Andrea Silaji
- The Afrikan Research Initiative Motloung South Africa
| | | | | | - Ridwan Taiwo
- The Afrikan Research Initiative Motloung South Africa
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Bloch EM, Kyeyune D, White JL, Ddungu H, Ashokkumar S, Habtehyimer F, Baker O, Kasirye R, Patel EU, Grabowski MK, Musisi E, Moses K, Hume HA, Lubega I, Shrestha R, Motevalli M, Fernandez RE, Reynolds SJ, Redd AD, Wambongo Musana H, Dhabangi A, Ouma J, Eroju P, de Lange T, Fowler MG, Musoke P, Stramer SL, Whitby D, Zimmerman PA, McCullough J, Sachithanandham J, Pekosz A, Goodrich R, Quinn TC, Ness PM, Laeyendecker O, Tobian AAR. SARS-CoV-2 seroprevalence among blood donors in Uganda: 2019-2022. Transfusion 2023; 63:1354-1365. [PMID: 37255467 PMCID: PMC10525030 DOI: 10.1111/trf.17449] [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: 03/29/2023] [Revised: 05/16/2023] [Accepted: 05/16/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND The true burden of COVID-19 in low- and middle-income countries remains poorly characterized, especially in Africa. Even prior to the availability of SARS-CoV-2 vaccines, countries in Africa had lower numbers of reported COVID-19 related hospitalizations and deaths than other regions globally. METHODS Ugandan blood donors were evaluated between October 2019 and April 2022 for IgG antibodies to SARS-CoV-2 nucleocapsid (N), spike (S), and five variants of the S protein using multiplexed electrochemiluminescence immunoassays (MesoScale Diagnostics, Rockville, MD). Seropositivity for N and S was assigned using manufacturer-provided cutoffs and trends in seroprevalence were estimated by quarter. Statistically significant associations between N and S antibody seropositivity and donor characteristics in November-December 2021 were assessed by chi-square tests. RESULTS A total of 5393 blood unit samples from donors were evaluated. N and S seropositivity increased throughout the pandemic to 82.6% in January-April 2022. Among seropositive individuals, N and S antibody levels increased ≥9-fold over the study period. In November-December 2021, seropositivity to N and S antibody was higher among repeat donors (61.3%) compared with new donors (55.1%; p = .043) and among donors from Kampala (capital city of Uganda) compared with rural regions (p = .007). Seropositivity to S antibody was significantly lower among HIV-seropositive individuals (58.8% vs. 84.9%; p = .009). CONCLUSIONS Despite previously reported low numbers of COVID-19 cases and related deaths in Uganda, high SARS-CoV-2 seroprevalence and increasing antibody levels among blood donors indicated that the country experienced high levels of infection over the course of the pandemic.
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Affiliation(s)
- Evan M Bloch
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Jodie L White
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Swetha Ashokkumar
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Feben Habtehyimer
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Owen Baker
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Eshan U Patel
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - M Kate Grabowski
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ezra Musisi
- Uganda Blood Transfusion Services, Kampala, Uganda
| | - Khan Moses
- Uganda Blood Transfusion Services, Kampala, Uganda
| | - Heather A Hume
- Department of Pediatrics, University of Montreal, Montréal, Quebec, Canada
| | | | - Ruchee Shrestha
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mahnaz Motevalli
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Reinaldo E Fernandez
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Steven J Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Andrew D Redd
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Aggrey Dhabangi
- Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Joseph Ouma
- MUJHU Research Collaboration, Kampala, Uganda
| | | | - Telsa de Lange
- National Institute of Allergy and Infectious Diseases Office of Cyber Infrastructure and Computational Biology, Bethesda, Maryland, USA
| | - Mary Glenn Fowler
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Susan L Stramer
- Scientific Affairs, American Red Cross, Gaithersburg, Maryland, USA
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Peter A Zimmerman
- The Center for Global Health & Diseases, Pathology Department, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jeffrey McCullough
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
| | - Jaiprasath Sachithanandham
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Andrew Pekosz
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Raymond Goodrich
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - Thomas C Quinn
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Paul M Ness
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Aaron A R Tobian
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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Bakr S, Ezzat EM, Salem KM, Masoud M, Abdelaziz HEM. Seroprevalence of SARS-CoV-2 immunoglobulin G antibody during COVID-19 pandemic in Fayoum District, Egypt: a community-based pilot survey. Pan Afr Med J 2023; 45:22. [PMID: 37521757 PMCID: PMC10386537 DOI: 10.11604/pamj.2023.45.22.36513] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 04/30/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction controlling the worldwide pandemic, coronavirus disease (COVID-19), could be impossible due to the hesitancy about the available vaccines and the difficulty to implement strict restrictions. Little information is available about herd immunity in the highly vulnerable region of North East Africa, Egypt. The objective of this study was to assess the seroprevalence of SARS-CoV-2 during the pandemic in one of the highly vulnerable populations in Egypt, the Fayoum district of Fayoum Governorate. Additionally, to assess the predictive value of symptoms and other associated risk factors towards a positive COVID-19 test. Methods in this cross-sectional community-based pilot study, immunoglobulin G (IgG) antibodies that are specific for the SARS-CoV-2 spike (S1-RBD) protein were tested during the period from February 2021 to July 2021. Results out of 155 participants, 60.6% were SARS-CoV-2 seropositive. Out of symptomatic and asymptomatic individuals, 76.5% and 56.2% were seropositive, respectively. Surprisingly, only one individual had received the COVID-19 vaccine. Previous history of COVID-19; such as symptoms and gender are statistically significant predictors of high seroconversion independent of age, comorbidities, and level of education. Conclusion this study which disclosed unexpectedly high SARS-CoV-2 seroconversion among the Egyptians, might provide a clear insight into COVID-19 transmission patterns and state of immunity. Further study with a larger sample size on a large scale is required to represent the whole local population.
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Affiliation(s)
- Salwa Bakr
- Department of Clinical Pathology/Hematology and Transfusion Medicine, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Eman Mahmoud Ezzat
- Department of Internal Medicine, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Karem Mohamed Salem
- Department of Internal Medicine, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Mohamed Masoud
- Department of Public Health and Community Medicine, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Hossam Eldin Mahmoud Abdelaziz
- Department of Clinical Pathology/Hematology and Transfusion Medicine, Faculty of Medicine, Fayoum University, Fayoum, Egypt
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9
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Metzger C, Leroy T, Bochnakian A, Jeulin H, Gegout-Petit A, Legrand K, Schvoerer E, Guillemin F. Seroprevalence and SARS-CoV-2 invasion in general populations: A scoping review over the first year of the pandemic. PLoS One 2023; 18:e0269104. [PMID: 37075077 PMCID: PMC10118383 DOI: 10.1371/journal.pone.0269104] [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: 10/25/2021] [Accepted: 05/13/2022] [Indexed: 04/20/2023] Open
Abstract
Since the beginning of the COVID-19 pandemic, counting infected people has underestimated asymptomatic cases. This literature scoping review assessed the seroprevalence progression in general populations worldwide over the first year of the pandemic. Seroprevalence studies were searched in PubMed, Web of Science and medRxiv databases up to early April 2021. Inclusion criteria were a general population of all ages or blood donors as a proxy. All articles were screened for the title and abstract by two readers, and data were extracted from selected articles. Discrepancies were resolved with a third reader. From 139 articles (including 6 reviews), the seroprevalence estimated in 41 countries ranged from 0 to 69%, with a heterogenous increase over time and continents, unevenly distributed among countries (differences up to 69%) and sometimes among regions within a country (up to 10%). The seroprevalence of asymptomatic cases ranged from 0% to 31.5%. Seropositivity risk factors included low income, low education, low smoking frequency, deprived area residency, high number of children, densely populated centres, and presence of a case in a household. This review of seroprevalence studies over the first year of the pandemic documented the progression of this virus across the world in time and space and the risk factors that influenced its spread.
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Affiliation(s)
- Clémentine Metzger
- CHRU -Nancy, INSERM, Université de Lorraine, CIC Epidémiologie clinique,
F-54000, Nancy, France
| | - Taylor Leroy
- CHRU -Nancy, INSERM, Université de Lorraine, CIC Epidémiologie clinique,
F-54000, Nancy, France
| | - Agathe Bochnakian
- CHRU -Nancy, INSERM, Université de Lorraine, CIC Epidémiologie clinique,
F-54000, Nancy, France
| | - Hélène Jeulin
- Université de Lorraine, CNRS, LCPME, F‐54000, Nancy,
France
- Laboratoire de Virologie, CHRU de Nancy Brabois, F‐54500, Nancy,
France
| | | | - Karine Legrand
- CHRU -Nancy, INSERM, Université de Lorraine, CIC Epidémiologie clinique,
F-54000, Nancy, France
| | - Evelyne Schvoerer
- Université de Lorraine, CNRS, LCPME, F‐54000, Nancy,
France
- Laboratoire de Virologie, CHRU de Nancy Brabois, F‐54500, Nancy,
France
| | - Francis Guillemin
- CHRU -Nancy, INSERM, Université de Lorraine, CIC Epidémiologie clinique,
F-54000, Nancy, France
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10
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Jeebhay MF, Naidoo RN, Naidoo S, Adams S, Zungu M, Kgalomono S, Naicker N, Kistnasamy B. Strengthening Social Compact and Innovative Health Sector Collaborations in Addressing COVID-19 in South African Workplaces. New Solut 2023; 32:288-303. [PMID: 36650981 PMCID: PMC9852971 DOI: 10.1177/10482911221150237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Workplaces are nodes for Severe Acute Respiratory Syndrome Coronavirus 2 transmission and require strategies to protect workers' health. This article reports on the South African national coronavirus disease 2019 (COVID-19) strategy that sought to ensure workers' health, protect the economic activity, safeguard livelihoods and support health services. Data from the Occupational Health Surveillance System, Surveillance System of Sentinel Hospital Sites, and government databases (public sector health worker and Compensation Fund data) was supplemented by peer-reviewed articles and grey literature. A multipronged, multi-stakeholder response to occupational health and safety (OHS) policy development, risk management, health surveillance, information, and training was adopted, underpinned by scientific input, through collaboration between government, organized labour, employer bodies, academia, and community partners. This resulted in government-promulgated legislation addressing OHS, sectoral guidelines, and work-related COVID-19 worker's compensation. The OHS Workstream of the National Department of Health provided leadership and technical support for COVID-specific workplace guidelines and practices, surveillance, information, and training, as well as a workplace-based vaccination strategy.
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Affiliation(s)
- Mohamed F. Jeebhay
- Occupational Medicine Division, School of Public Health, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Rajen N. Naidoo
- Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa,Rajen N. Naidoo, Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Room 321, George Campbell Building, Durban, 4041, South Africa.
| | - Saloshni Naidoo
- Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Shahieda Adams
- Occupational Medicine Division, School of Public Health, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Muzimkhulu Zungu
- National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, Gauteng, South Africa,School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Spo Kgalomono
- National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, Gauteng, South Africa
| | - Nisha Naicker
- National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, Gauteng, South Africa,Department of Environmental Health, University of Johannesburg, Johannesburg, Gauteng, South Africa
| | - Barry Kistnasamy
- Medical Bureau for Occupational Diseases, National Department of Health, Pretoria, South Africa
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11
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Hussey H, Vreede H, Davies MA, Heekes A, Kalk E, Hardie D, van Zyl G, Naidoo M, Morden E, Bam JL, Zinyakatira N, Centner CM, Maritz J, Opie J, Chapanduka Z, Mahomed H, Smith M, Cois A, Pienaar D, Redd AD, Preiser W, Wilkinson R, Chetty K, Boulle A, Hsiao NY. Epidemiology and outcomes of SARS-CoV-2 infection associated with anti-nucleocapsid seropositivity in Cape Town, South Africa. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.12.01.22282927. [PMID: 36523408 PMCID: PMC9753787 DOI: 10.1101/2022.12.01.22282927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Background In low- and middle-income countries where SARS-CoV-2 testing is limited, seroprevalence studies can characterise the scale and determinants of the pandemic, as well as elucidate protection conferred by prior exposure. Methods We conducted repeated cross-sectional serosurveys (July 2020 - November 2021) using residual plasma from routine convenient blood samples from patients with non-COVID-19 conditions from Cape Town, South Africa. SARS-CoV-2 anti-nucleocapsid antibodies and linked clinical information were used to investigate: (1) seroprevalence over time and risk factors associated with seropositivity, (2) ecological comparison of seroprevalence between subdistricts, (3) case ascertainment rates, and (4) the relative protection against COVID-19 associated with seropositivity and vaccination statuses, to estimate variant disease severity. Findings Among the subset sampled, seroprevalence of SARS-CoV-2 in Cape Town increased from 39.2% in July 2020 to 67.8% in November 2021. Poorer communities had both higher seroprevalence and COVID-19 mortality. Only 10% of seropositive individuals had a recorded positive SARS-CoV-2 test. Antibody positivity before the start of the Omicron BA.1 wave (28 November 2021) was strongly protective for severe disease (adjusted odds ratio [aOR] 0.15; 95%CI 0.05-0.46), with additional benefit in those who were also vaccinated (aOR 0.07, 95%CI 0.01-0.35). Interpretation The high population seroprevalence in Cape Town was attained at the cost of substantial COVID-19 mortality. At the individual level, seropositivity was highly protective against subsequent infections and severe COVID-19. Funding Wellcome Trust, National Health Laboratory Service, the Division of Intramural Research, NIAID, NIH (ADR) and Western Cape Government Health.
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Affiliation(s)
- Hannah Hussey
- Health Intelligence, Western Cape Government: Health, South Africa
- Metro Health Services, Western Cape Government: Health
- School of Public Health, University of Cape Town, South Africa
| | - Helena Vreede
- Division of Chemical Pathology, University of Cape Town, South Africa
- National Health Laboratory Service, South Africa
| | - Mary-Ann Davies
- Health Intelligence, Western Cape Government: Health, South Africa
- School of Public Health, University of Cape Town, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa
| | - Alexa Heekes
- Health Intelligence, Western Cape Government: Health, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa
| | - Emma Kalk
- School of Public Health, University of Cape Town, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa
| | - Diana Hardie
- National Health Laboratory Service, South Africa
- Division of Medical Virology, University of Cape Town, South Africa
| | - Gert van Zyl
- National Health Laboratory Service, South Africa
- Division of Medical Virology, Stellenbosch University, South Africa
| | - Michelle Naidoo
- National Health Laboratory Service, South Africa
- Division of Medical Virology, University of Cape Town, South Africa
- Division of Medical Virology, Stellenbosch University, South Africa
| | - Erna Morden
- Health Intelligence, Western Cape Government: Health, South Africa
- School of Public Health, University of Cape Town, South Africa
| | - Jamy-Lee Bam
- Health Intelligence, Western Cape Government: Health, South Africa
| | - Nesbert Zinyakatira
- Health Intelligence, Western Cape Government: Health, South Africa
- School of Public Health, University of Cape Town, South Africa
| | | | - Jean Maritz
- Division of Medical Virology, Stellenbosch University, South Africa
- PathCare Reference Laboratory, Cape Town, South Africa
| | - Jessica Opie
- National Health Laboratory Service, South Africa
- Division of Haematology, University of Cape Town, South Africa
| | - Zivanai Chapanduka
- National Health Laboratory Service, South Africa
- Division of Haematology, Stellenbosch University, South Africa
| | - Hassan Mahomed
- Metro Health Services, Western Cape Government: Health
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University
| | - Mariette Smith
- Health Intelligence, Western Cape Government: Health, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa
| | - Annibale Cois
- School of Public Health, University of Cape Town, South Africa
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University
| | - David Pienaar
- Rural Health Services, Western Cape Government: Health
| | - Andrew D Redd
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Wolfgang Preiser
- National Health Laboratory Service, South Africa
- Division of Medical Virology, Stellenbosch University, South Africa
| | - Robert Wilkinson
- Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa
- The Francis Crick Institute, Midland Road, London, NW1 1AT, UK
- Department of Infectious Diseases, Imperial College London, W12 0NN, UK
| | - Kamy Chetty
- National Health Laboratory Service, South Africa
| | - Andrew Boulle
- Health Intelligence, Western Cape Government: Health, South Africa
- School of Public Health, University of Cape Town, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa
| | - Nei-Yuan Hsiao
- National Health Laboratory Service, South Africa
- Division of Medical Virology, University of Cape Town, South Africa
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12
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Area-level inequalities in Covid-19 outcomes in Brazil in 2020 and 2021: An analysis of 1,894,165 severe Covid-19 cases. Prev Med 2022; 164:107298. [PMID: 36220401 PMCID: PMC9547655 DOI: 10.1016/j.ypmed.2022.107298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/03/2022] [Accepted: 10/06/2022] [Indexed: 11/23/2022]
Abstract
The study aims to analyze inequalities in Covid-19 outcomes in Brazil in 2020/2021 according to the per capita Gross Domestic Product (pcGDP) of municipalities. All cases of Severe Acute Respiratory Syndrome (SARS) who were hospitalized or died, regardless of hospitalization, registered in Brazil in 2020 and 2021 were analyzed (n = 2,902,742), including those with a confirmed diagnosis of Covid-19 (n = 1,894,165). We calculated lethality due to Covid-19, the performance of diagnostic tests among patients with SARS, and the hospital care received by those with Covid-19 according to the pcGDP of the patients' municipalities of residence. Data were analyzed for each epidemiological week and the risk of each outcome was estimated using Poisson regression. Municipalities in the lowest pcGDP decile had (i) 30% (95%CI 28%-32%) higher lethality from Covid-19, (ii) three times higher proportion of patients with SARS without the collection of biological material for the diagnosis of Covid-19, (iii) 16% (95%CI 15%-16%) higher proportion of SARS patients testing in a period longer than two days from the onset of symptoms, (iv) 140% (95%CI 134%-145%) higher absence of CT scan use. There is deep socioeconomic inequality among Brazilian municipalities regarding the occurrence of Covid-19 negative outcomes.
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13
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Albani VVL, Albani RAS, Bobko N, Massad E, Zubelli JP. On the role of financial support programs in mitigating the SARS-CoV-2 spread in Brazil. BMC Public Health 2022; 22:1781. [PMID: 36127657 PMCID: PMC9485798 DOI: 10.1186/s12889-022-14155-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 09/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND During 2020, there were no effective treatments or vaccines against SARS-CoV-2. The most common disease contention measures were social distance (social isolation), the use of face masks and lockdowns. In the beginning, numerous countries have succeeded to control and reduce COVID-19 infections at a high economic cost. Thus, to alleviate such side effects, many countries have implemented socioeconomic programs to fund individuals that lost their jobs and to help endangered businesses to survive. METHODS We assess the role of a socioeconomic program, so-called "Auxilio Emergencial" (AE), during 2020 as a measure to mitigate the Coronavirus Disease 2019 (COVID-19) outbreak in Brazil. For each Brazilian State, we estimate the time-dependent reproduction number from daily reports of COVID-19 infections and deaths using a Susceptible-Exposed-Infected-Recovered-like (SEIR-like) model. Then, we analyse the correlations between the reproduction number, the amount of individuals receiving governmental aid, and the index of social isolation based on mobile phone information. RESULTS We observed significant positive correlation values between the average values by the AE and median values of an index accounting for individual mobility. We also observed significantly negative correlation values between the reproduction number and this index on individual mobility. Using the simulations of a susceptible-exposed-infected-removed-like model, if the AE was not operational during the first wave of COVID-19 infections, the accumulated number of infections and deaths could be 6.5 (90% CI: 1.3-21) and 7.9 (90% CI: 1.5-23) times higher, respectively, in comparison with the actual implementation of AE. CONCLUSIONS Our results suggest that the AE implemented in Brazil had a significant influence on social isolation by allowing those in need to stay at home, which would reduce the expected numbers of infections and deaths.
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Affiliation(s)
- Vinicius V L Albani
- Department of Mathematics, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Roseane A S Albani
- Instituto Politécnico do Rio de Janeiro, Rio de Janeiro State University, Nova Friburgo, Brazil
| | - Nara Bobko
- Federal University of Technology - Paraná, Curitiba, Brazil
| | - Eduardo Massad
- School of Medicine, University of São Paulo and LIM01-HCFMUSP, São Paulo, Brazil.,School of Applied Mathematics, Fundação Getúlio Vargas, Rio de Janeiro, Brazil
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14
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Wolter N, Tempia S, von Gottberg A, Bhiman JN, Walaza S, Kleynhans J, Moyes J, Buys A, McMorrow ML, Aitken S, Magni S, Yun J, Fellows T, Maakamedi T, Weiner R, Cawood C, Martinson N, Lebina L, Jassat W, Brauer M, Cohen C. Seroprevalence of Severe Acute Respiratory Syndrome Coronavirus 2 After the Second Wave in South Africa in Human Immunodeficiency Virus-Infected and Uninfected Persons: A Cross-Sectional Household Survey. Clin Infect Dis 2022; 75:e57-e68. [PMID: 35271693 PMCID: PMC9047164 DOI: 10.1093/cid/ciac198] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Seroprevalence studies are important for quantifying the burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in resource-constrained countries. METHODS We conducted a cross-sectional household survey spanning the second pandemic wave (November 2020 to April 2021) in 3 communities. Blood was collected for SARS-CoV-2 antibody (2 enzyme-linked immunosorbent assays targeting spike and nucleocapsid) and human immunodeficiency virus (HIV) testing. An individual was considered seropositive if testing positive on ≥1 assay. Factors associated with infection, and the age-standardized infection case detection rate, infection hospitalization rate, and infection fatality rate were calculated. RESULTS Overall, 7959 participants were enrolled, with a median age of 34 years and an HIV prevalence of 22.7%. SARS-CoV-2 seroprevalence was 45.2% (95% confidence interval 43.7%-46.7%) and increased from 26.9% among individuals enrolled in December 2020 to 47.1% among those enrolled in April 2021. On multivariable analysis, seropositivity was associated with age, sex, race, being overweight/obese, having respiratory symptoms, and low socioeconomic status. Persons living with HIV with high viral load were less likely to be seropositive than HIV-uninfected individuals. The site-specific infection case detection rate, infection hospitalization rate, and infection fatality rate ranged across sites from 4.4% to 8.2%, 1.2% to 2.5%, and 0.3% to 0.6%, respectively. CONCLUSIONS South Africa has experienced a large burden of SARS-CoV-2 infections, with <10% of infections diagnosed. Lower seroprevalence among persons living with HIV who are not virally suppressed, likely as a result of inadequate antibody production, highlights the need to prioritize this group for intervention.
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Affiliation(s)
- Nicole Wolter
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Stefano Tempia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GeorgiaUSA
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jinal N Bhiman
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sibongile Walaza
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jackie Kleynhans
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jocelyn Moyes
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Amelia Buys
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Meredith L McMorrow
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GeorgiaUSA
| | - Sue Aitken
- Genesis Analytics, Johannesburg, South Africa
| | - Sarah Magni
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Genesis Analytics, Johannesburg, South Africa
| | - Jessica Yun
- Genesis Analytics, Johannesburg, South Africa
| | | | | | - Renay Weiner
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Neil Martinson
- Perinatal HIV Research Unit, MRC Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, South Africa
- DST/NRF Centre of Excellence for Biomedical Tuberculosis Research, University of the Witwatersrand, Johannesburg, South Africa
- Johns Hopkins University Center for TB Research, Baltimore, Maryland, USA
| | - Limakatso Lebina
- Perinatal HIV Research Unit, MRC Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, South Africa
| | - Waasila Jassat
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africaand
| | - Marieke Brauer
- Immunology Department, National Reference Laboratory, Ampath Pathology, Pretoria, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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15
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Bingham J, Tempia S, Moultrie H, Viboud C, Jassat W, Cohen C, Pulliam JRC. Estimating the time-varying reproduction number for COVID-19 in South Africa during the first four waves using multiple measures of incidence for public and private sectors across four waves. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.07.22.22277932. [PMID: 35982666 PMCID: PMC9387150 DOI: 10.1101/2022.07.22.22277932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objectives We aimed to quantify transmission trends in South Africa during the first four waves of the COVID-19 pandemic using estimates of the time-varying reproduction number (R) and to compare the robustness of R estimates based on three different data sources and using data from public and private sector service providers. Methods We estimated R from March 2020 through April 2022, nationally and by province, based on time series of rt-PCR-confirmed cases, hospitalizations, and hospital-associated deaths, using a method which models daily incidence as a weighted sum of past incidence. We also estimated R separately using public and private sector data. Results Nationally, the maximum case-based R following the introduction of lockdown measures was 1.55 (CI: 1.43-1.66), 1.56 (CI: 1.47-1.64), 1.46 (CI: 1.38-1.53) and 3.33 (CI: 2.84-3.97) during the first (Wuhan-Hu), second (Beta), third (Delta), and fourth (Omicron) waves respectively. Estimates based on the three data sources (cases, hospitalisations, deaths) were generally similar during the first three waves but case-based estimates were higher during the fourth wave. Public and private sector R estimates were generally similar except during the initial lockdowns and in case-based estimates during the fourth wave. Discussion Agreement between R estimates using different data sources during the first three waves suggests that data from any of these sources could be used in the early stages of a future pandemic. High R estimates for Omicron relative to earlier waves is interesting given a high level of exposure pre-Omicron. The agreement between public and private sector R estimates highlights the fact that clients of the public and private sectors did not experience two separate epidemics, except perhaps to a limited extent during the strictest lockdowns in the first wave.
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Affiliation(s)
- Jeremy Bingham
- South African DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
| | - Stefano Tempia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Harry Moultrie
- Centre for Tuberculosis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Cecile Viboud
- Fogarty International Center, NIH, Bethesda, MD, USA
| | - Waasila Jassat
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
- Right to Care, Pretoria, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Juliet R C Pulliam
- South African DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
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Arnaldo P, Mabunda N, Young PW, Tran T, Sitoe N, Chelene I, Nhanombe A, Isamael N, Júnior A, Cubula B, Inlamea OF, Gudo E, Jani IV. Prevalence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibodies in the Mozambican Population: A Cross-Sectional Serologic Study in 3 Cities, July-August 2020. Clin Infect Dis 2022; 75:S285-S293. [PMID: 35748663 PMCID: PMC9278262 DOI: 10.1093/cid/ciac516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The extent of population exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was uncertain in many African countries during the onset of the pandemic. METHODS We conducted a cross-sectional study and randomly selected and surveyed general population and occupational groups from 6 July to 24 August 2020, in 3 cities in Mozambique. Anti-SARS-CoV-2-specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies were measured using a point-of-care rapid test. The prevalence was weighted for population (by age, sex, and city) and adjusted for test sensitivity and specificity. RESULTS A total of 21 183 participants, including 11 143 from the general population and 10 040 from occupational groups, were included across all 3 cities. General population seropositivity (IgM or IgG) prevalence was 3.0% (95% confidence interval [CI], 1.0%-6.6%) in Pemba, 2.1% (95% CI, 1.2%-3.3%) in Maputo City, and 0.9% (95% CI, .1%-1.9%) in Quelimane. The prevalence in occupational groups ranged from 2.8% (95% CI, 1.3%-5.2%) to 5.9% (95% CI, 4.3%-8.0%) in Pemba, 0.3% (95% CI, .0%-2.2%) to 4.0% (95% CI, 2.6%-5.7%) in Maputo City, and 0.0% (95% CI, .0%-.7%) to 6.6% (95% CI, 3.8%-10.5%) in Quelimane, and showed variations between the groups tested. CONCLUSIONS In the first representative COVID-19 serosurveys in Mozambique, in mid-2020, weighted and assay-adjusted seroprevalence in 3 provincial capitals of anti-SARS-CoV-2 ranged from 0.9% to 3.0%, whereas adjusted prevalence in occupational groups ranged from 0.0% to 6.6% with variation between groups. Exposure to SARS-CoV-2 was extensive during the first pandemic wave, and transmission may have been more intense among occupational groups. These data have been of utmost importance to inform public health intervention to control and respond to the pandemic in Mozambique.
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Affiliation(s)
- Paulo Arnaldo
- Corresponding author contact information Paulo Arnaldo INSTITUTO NACIONAL DE SAÚDE (INS) EN1, Bairro da Vila - Parcela n°3943 Distrito de Marracuene Província de Maputo-Moçambique E-mail:
| | - Nédio Mabunda
- Departamento de Regulação e Promoção da Investigação em Saúde, Instituto Nacional de Saúde, Maputo, Mozambique
| | - Peter Wesley Young
- Division of Global HIV & Tuberculosis, U.S. Centers for Disease Control and Prevention (CDC), Maputo, Mozambique
| | - Tiffany Tran
- Division of Global HIV & Tuberculosis, U.S. Centers for Disease Control and Prevention (CDC), Maputo, Mozambique
| | - Nádia Sitoe
- Departamento de Plataformas Tecnológicas, Instituto Nacional de Saúde, Maputo, Mozambique
| | - Imelda Chelene
- Departamento de Plataformas Tecnológicas, Instituto Nacional de Saúde, Maputo, Mozambique
| | | | - Nália Isamael
- Departamento de Plataformas Tecnológicas, Instituto Nacional de Saúde, Maputo, Mozambique
| | - António Júnior
- Departamento de Gestão e Coordenação da Investigação em Saúde, Instituto Nacional de Saúde, Maputo, Mozambique
| | - Basílio Cubula
- Departamento de Métodos, Instituto Nacional de Estatística, Maputo, Mozambique
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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.
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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.)
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18
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Lambarey H, Blumenthal MJ, Chetram A, Joyimbana W, Jennings L, Tincho MB, Burgers WA, Orrell C, Schäfer G. SARS-CoV-2 Infection Is Associated with Uncontrolled HIV Viral Load in Non-Hospitalized HIV-Infected Patients from Gugulethu, South Africa. Viruses 2022; 14:v14061222. [PMID: 35746693 PMCID: PMC9229655 DOI: 10.3390/v14061222] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 12/04/2022] Open
Abstract
In South Africa, high exposure to SARS-CoV-2 occurs primarily in densely populated, low-income communities, which are additionally burdened by highly prevalent Human Immunodeficiency Virus (HIV). With the aim to assess SARS-CoV-2 seroprevalence and its association with HIV-related clinical parameters in non-hospitalized patients likely to be highly exposed to SARS-CoV-2, this observational cross-sectional study was conducted at the Gugulethu Community Health Centre Antiretroviral clinic between October 2020 and June 2021, after the first COVID-19 wave in South Africa and during the second and beginning of the third wave. A total of 150 adult (median age 39 years [range 20−65 years]) HIV-infected patients (69% female; 31% male) were recruited. 95.3% of the cohort was on antiretroviral therapy (ART), had a median CD4 count of 220 cells/µL (range 17−604 cells/µL) and a median HIV viral load (VL) of 49 copies/mL (range 1−1,050,867 copies/mL). Furthermore, 106 patients (70.7%) were SARS-CoV-2 seropositive, and 0% were vaccinated. When stratified for HIV VL, patients with uncontrolled HIV viremia (HIV VL > 1000 copies/mL) had significantly higher odds of SARS-CoV-2 seropositivity than patients with HIV VL < 1000 copies/mL, after adjusting for age, sex and ART status (p = 0.035, adjusted OR 2.961 [95% CI: 1.078−8.133]). Although the cause−effect relationship could not be determined due to the cross-sectional study design, these results point towards a higher risk of SARS-CoV-2 susceptibility among viremic HIV patients, or impaired HIV viral control due to previous co-infection with SARS-CoV-2.
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Affiliation(s)
- Humaira Lambarey
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town 7925, South Africa; (H.L.); (M.J.B.); (A.C.)
- Faculty of Health Sciences, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town 7925, South Africa; (M.B.T.); (W.A.B.); (C.O.)
- Department of Integrative Biomedical Sciences, Division of Medical Biochemistry, University of Cape Town, Cape Town 7925, South Africa
| | - Melissa J. Blumenthal
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town 7925, South Africa; (H.L.); (M.J.B.); (A.C.)
- Faculty of Health Sciences, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town 7925, South Africa; (M.B.T.); (W.A.B.); (C.O.)
- Department of Integrative Biomedical Sciences, Division of Medical Biochemistry, University of Cape Town, Cape Town 7925, South Africa
| | - Abeen Chetram
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town 7925, South Africa; (H.L.); (M.J.B.); (A.C.)
| | - Wendy Joyimbana
- Desmond Tutu Health Foundation, Cape Town 7925, South Africa; (W.J.); (L.J.)
| | - Lauren Jennings
- Desmond Tutu Health Foundation, Cape Town 7925, South Africa; (W.J.); (L.J.)
| | - Marius B. Tincho
- Faculty of Health Sciences, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town 7925, South Africa; (M.B.T.); (W.A.B.); (C.O.)
- Department of Pathology, Division of Medical Virology, University of Cape Town, Cape Town 7925, South Africa
| | - Wendy A. Burgers
- Faculty of Health Sciences, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town 7925, South Africa; (M.B.T.); (W.A.B.); (C.O.)
- Department of Pathology, Division of Medical Virology, University of Cape Town, Cape Town 7925, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Cape Town 7925, South Africa
| | - Catherine Orrell
- Faculty of Health Sciences, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town 7925, South Africa; (M.B.T.); (W.A.B.); (C.O.)
- Desmond Tutu Health Foundation, Cape Town 7925, South Africa; (W.J.); (L.J.)
| | - Georgia Schäfer
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town 7925, South Africa; (H.L.); (M.J.B.); (A.C.)
- Faculty of Health Sciences, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town 7925, South Africa; (M.B.T.); (W.A.B.); (C.O.)
- Department of Integrative Biomedical Sciences, Division of Medical Biochemistry, University of Cape Town, Cape Town 7925, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Cape Town 7925, South Africa
- Correspondence: ; Tel.: +27-21-404-7688
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19
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Shanaube K, Schaap A, Klinkenberg E, Floyd S, Bwalya J, Cheeba M, de Haas P, Kosloff B, Ruperez M, Hayes R, Ayles H. SARS-CoV-2 seroprevalence and associated risk factors in periurban Zambia: a population-based study. Int J Infect Dis 2022; 118:256-263. [PMID: 35306205 PMCID: PMC8925090 DOI: 10.1016/j.ijid.2022.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND We nested a seroprevalence survey within the TREATS (Tuberculosis Reduction through Expanded Antiretroviral Treatment and Screening) project. We aimed to measure the seroprevalence of SARS-CoV-2 infection and investigate associated risk factors in one community (population ∼27,000) with high prevalence of TB/HIV in Zambia. METHODS The study design was cross-sectional. A random sample of 3592 individuals aged ≥15 years enrolled in the TREATS TB-prevalence survey were selected for antibody testing. Randomly selected blocks of residence were visited between October 2020 and March 2021. Antibodies against SARS-CoV-2 were detected using Abbott- ARCHITECT SARS-CoV-2 IgG assay. RESULTS A total of 3035/3526 (86.1%) individuals had a blood sample taken. Antibody testing results were available for 2917/3035 (96.1%) participants. Overall, 401/2977 (13.5%) individuals tested positive for IgG antibodies. Seroprevalence was similar by sex (12.7% men vs 14.0% women) and was lowest in the youngest age group 15-19 years (9.7%) and similar in ages 20 years and older (∼15%). We found no evidence of an association between seroprevalence and HIV-status or TB. There was strong evidence (p <0.001) of variation by time of enrollment, with prevalence varying from 2.8% (95% CI 0.8-4.9) among those recruited in December 2020 to 33.7% (95% CI 27.7-39.7) among those recruited in mid-February 2021. CONCLUSION Seroprevalence was 13.5% but there was substantial variation over time, with a sharp increase to approximately 35% toward the end of the second epidemic wave.
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Affiliation(s)
| | - A Schaap
- Zambart, Lusaka, Zambia; London School of Hygiene and Tropical Medicine
| | | | - S Floyd
- London School of Hygiene and Tropical Medicine
| | | | | | - P de Haas
- KNCV Tuberculosis Foundation, Netherlands
| | - B Kosloff
- Zambart, Lusaka, Zambia; London School of Hygiene and Tropical Medicine
| | - M Ruperez
- London School of Hygiene and Tropical Medicine
| | - R Hayes
- London School of Hygiene and Tropical Medicine
| | - H Ayles
- Zambart, Lusaka, Zambia; London School of Hygiene and Tropical Medicine
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20
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Satter SM, Bhuiyan TR, Abdullah Z, Akhtar M, Akter A, Shafique SMZ, Alam MR, Chowdhury KIA, Nazneen A, Rimi NA, Alamgir ASM, Rahman M, Khan FI, Shirin T, Flora MS, Banu S, Rahman M, Rahman M, Qadri F. Transmission of SARS-CoV-2 in the Population Living in High- and Low-Density Gradient Areas in Dhaka, Bangladesh. Trop Med Infect Dis 2022; 7:tropicalmed7040053. [PMID: 35448828 PMCID: PMC9030026 DOI: 10.3390/tropicalmed7040053] [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: 02/14/2022] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 12/10/2022] Open
Abstract
Community transmission of SARS-CoV-2 in densely populated countries has been a topic of concern from the beginning of the pandemic. Evidence of community transmission of SARS-CoV-2 according to population density gradient and socio-economic status (SES) is limited. In June−September 2020, we conducted a descriptive longitudinal study to determine the community transmission of SARS-CoV-2 in high- and low-density areas in Dhaka city. The Secondary Attack Rate (SAR) was 10% in high-density areas compared to 20% in low-density areas. People with high SES had a significantly higher level of SARS-CoV-2-specific Immunoglobulin G (IgG) antibodies on study days 1 (p = 0.01) and 28 (p = 0.03) compared to those with low SES in high-density areas. In contrast, the levels of seropositivity of SARS-CoV-2-specific Immunoglobulin M (IgM) were comparable (p > 0.05) in people with high and low SES on both study days 1 and 28 in both high- and low-density areas. Due to the similar household size, no differences in the seropositivity rates depending on the population gradient were observed. However, people with high SES showed higher seroconversion rates compared to people with low SES. As no difference was observed based on population density, the SES might play a role in SARS-CoV-2 transmission, an issue that calls for further in-depth studies to better understand the community transmission of SARS-CoV-2.
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Affiliation(s)
- Syed Moinuddin Satter
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka 1212, Bangladesh; (T.R.B.); (Z.A.); (M.A.); (A.A.); (S.M.Z.S.); (M.R.A.); (K.I.A.C.); (A.N.); (N.A.R.); (S.B.); (M.R.); (F.Q.)
- Correspondence: ; Tel.: +88-0179-066-5868
| | - Taufiqur Rahman Bhuiyan
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka 1212, Bangladesh; (T.R.B.); (Z.A.); (M.A.); (A.A.); (S.M.Z.S.); (M.R.A.); (K.I.A.C.); (A.N.); (N.A.R.); (S.B.); (M.R.); (F.Q.)
| | - Zarin Abdullah
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka 1212, Bangladesh; (T.R.B.); (Z.A.); (M.A.); (A.A.); (S.M.Z.S.); (M.R.A.); (K.I.A.C.); (A.N.); (N.A.R.); (S.B.); (M.R.); (F.Q.)
| | - Marjahan Akhtar
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka 1212, Bangladesh; (T.R.B.); (Z.A.); (M.A.); (A.A.); (S.M.Z.S.); (M.R.A.); (K.I.A.C.); (A.N.); (N.A.R.); (S.B.); (M.R.); (F.Q.)
| | - Aklima Akter
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka 1212, Bangladesh; (T.R.B.); (Z.A.); (M.A.); (A.A.); (S.M.Z.S.); (M.R.A.); (K.I.A.C.); (A.N.); (N.A.R.); (S.B.); (M.R.); (F.Q.)
| | - S. M. Zafor Shafique
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka 1212, Bangladesh; (T.R.B.); (Z.A.); (M.A.); (A.A.); (S.M.Z.S.); (M.R.A.); (K.I.A.C.); (A.N.); (N.A.R.); (S.B.); (M.R.); (F.Q.)
| | - Muhammad Rashedul Alam
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka 1212, Bangladesh; (T.R.B.); (Z.A.); (M.A.); (A.A.); (S.M.Z.S.); (M.R.A.); (K.I.A.C.); (A.N.); (N.A.R.); (S.B.); (M.R.); (F.Q.)
| | - Kamal Ibne Amin Chowdhury
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka 1212, Bangladesh; (T.R.B.); (Z.A.); (M.A.); (A.A.); (S.M.Z.S.); (M.R.A.); (K.I.A.C.); (A.N.); (N.A.R.); (S.B.); (M.R.); (F.Q.)
| | - Arifa Nazneen
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka 1212, Bangladesh; (T.R.B.); (Z.A.); (M.A.); (A.A.); (S.M.Z.S.); (M.R.A.); (K.I.A.C.); (A.N.); (N.A.R.); (S.B.); (M.R.); (F.Q.)
| | - Nadia Ali Rimi
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka 1212, Bangladesh; (T.R.B.); (Z.A.); (M.A.); (A.A.); (S.M.Z.S.); (M.R.A.); (K.I.A.C.); (A.N.); (N.A.R.); (S.B.); (M.R.); (F.Q.)
| | - A. S. M. Alamgir
- Institute of Epidemiology, Disease Control & Research, 44 Mohakhali, Dhaka 1212, Bangladesh; (A.S.M.A.); (M.R.); (F.I.K.); (T.S.)
| | - Mahbubur Rahman
- Institute of Epidemiology, Disease Control & Research, 44 Mohakhali, Dhaka 1212, Bangladesh; (A.S.M.A.); (M.R.); (F.I.K.); (T.S.)
| | - Farzana Islam Khan
- Institute of Epidemiology, Disease Control & Research, 44 Mohakhali, Dhaka 1212, Bangladesh; (A.S.M.A.); (M.R.); (F.I.K.); (T.S.)
| | - Tahmina Shirin
- Institute of Epidemiology, Disease Control & Research, 44 Mohakhali, Dhaka 1212, Bangladesh; (A.S.M.A.); (M.R.); (F.I.K.); (T.S.)
| | | | - Sayera Banu
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka 1212, Bangladesh; (T.R.B.); (Z.A.); (M.A.); (A.A.); (S.M.Z.S.); (M.R.A.); (K.I.A.C.); (A.N.); (N.A.R.); (S.B.); (M.R.); (F.Q.)
| | - Mustafizur Rahman
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka 1212, Bangladesh; (T.R.B.); (Z.A.); (M.A.); (A.A.); (S.M.Z.S.); (M.R.A.); (K.I.A.C.); (A.N.); (N.A.R.); (S.B.); (M.R.); (F.Q.)
| | - Mahmudur Rahman
- Global Health Development, EMPHNET, 69 Mohakhali, Dhaka 1212, Bangladesh;
| | - Firdausi Qadri
- Programme for Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka 1212, Bangladesh; (T.R.B.); (Z.A.); (M.A.); (A.A.); (S.M.Z.S.); (M.R.A.); (K.I.A.C.); (A.N.); (N.A.R.); (S.B.); (M.R.); (F.Q.)
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21
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Bekker LG, Garrett N, Goga A, Fairall L, Reddy T, Yende-Zuma N, Kassanjee R, Collie S, Sanne I, Boulle A, Seocharan I, Engelbrecht I, Davies MA, Champion J, Chen T, Bennett S, Mametja S, Semenya M, Moultrie H, de Oliveira T, Lessells RJ, Cohen C, Jassat W, Groome M, Von Gottberg A, Le Roux E, Khuto K, Barouch D, Mahomed H, Wolmarans M, Rousseau P, Bradshaw D, Mulder M, Opie J, Louw V, Jacobson B, Rowji P, Peter JG, Takalani A, Odhiambo J, Mayat F, Takuva S, Corey L, Gray GE. Effectiveness of the Ad26.COV2.S vaccine in health-care workers in South Africa (the Sisonke study): results from a single-arm, open-label, phase 3B, implementation study. Lancet 2022; 399:1141-1153. [PMID: 35305740 PMCID: PMC8930006 DOI: 10.1016/s0140-6736(22)00007-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/18/2021] [Accepted: 12/13/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND We aimed to assess the effectiveness of a single dose of the Ad26.COV2.S vaccine (Johnson & Johnson) in health-care workers in South Africa during two waves of the South African COVID-19 epidemic. METHODS In the single-arm, open-label, phase 3B implementation Sisonke study, health-care workers aged 18 years and older were invited for vaccination at one of 122 vaccination sites nationally. Participants received a single dose of 5 × 1010 viral particles of the Ad26.COV2.S vaccine. Vaccinated participants were linked with their person-level data from one of two national medical insurance schemes (scheme A and scheme B) and matched for COVID-19 risk with an unvaccinated member of the general population. The primary outcome was vaccine effectiveness against severe COVID-19, defined as COVID-19-related admission to hospital, hospitalisation requiring critical or intensive care, or death, in health-care workers compared with the general population, ascertained 28 days or more after vaccination or matching, up to data cutoff. This study is registered with the South African National Clinical Trial Registry, DOH-27-022021-6844, ClinicalTrials.gov, NCT04838795, and the Pan African Clinical Trials Registry, PACTR202102855526180, and is closed to accrual. FINDINGS Between Feb 17 and May 17, 2021, 477 102 health-care workers were enrolled and vaccinated, of whom 357 401 (74·9%) were female and 119 701 (25·1%) were male, with a median age of 42·0 years (33·0-51·0). 215 813 vaccinated individuals were matched with 215 813 unvaccinated individuals. As of data cutoff (July 17, 2021), vaccine effectiveness derived from the total matched cohort was 83% (95% CI 75-89) to prevent COVID-19-related deaths, 75% (69-82) to prevent COVID-19-related hospital admissions requiring critical or intensive care, and 67% (62-71) to prevent COVID-19-related hospitalisations. The vaccine effectiveness for all three outcomes were consistent across scheme A and scheme B. The vaccine effectiveness was maintained in older health-care workers and those with comorbidities including HIV infection. During the course of the study, the beta (B.1.351) and then the delta (B.1.617.2) SARS-CoV-2 variants of concerns were dominant, and vaccine effectiveness remained consistent (for scheme A plus B vaccine effectiveness against COVID-19-related hospital admission during beta wave was 62% [95% CI 42-76] and during delta wave was 67% [62-71], and vaccine effectiveness against COVID-19-related death during beta wave was 86% [57-100] and during delta wave was 82% [74-89]). INTERPRETATION The single-dose Ad26.COV2.S vaccine shows effectiveness against severe COVID-19 disease and COVID-19-related death after vaccination, and against both beta and delta variants, providing real-world evidence for its use globally. FUNDING National Treasury of South Africa, the National Department of Health, Solidarity Response Fund NPC, The Michael & Susan Dell Foundation, The Elma Vaccines and Immunization Foundation, and the Bill & Melinda Gates Foundation.
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Affiliation(s)
- Linda-Gail Bekker
- The Desmond Tutu HIV Centre, Cape Town, South Africa; University of Cape Town, Cape Town, South Africa
| | - Nigel Garrett
- Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | - Ameena Goga
- HIV Prevention Research Unit, Cape Town, South Africa; Department of Paediatrics and Child Health, University of Pretoria, Pretoria, South Africa
| | - Lara Fairall
- The Desmond Tutu HIV Centre, Cape Town, South Africa; King's Global Health Institute, King's College London, London, UK
| | - Tarylee Reddy
- Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa
| | - Nonhlanhla Yende-Zuma
- Nelson R Mandela School of Medicine, Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa
| | - Reshma Kassanjee
- Centre of Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, Cape Town, South Africa
| | | | - Ian Sanne
- Clinical HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Witwatersrand, South Africa; Right to Care, Houghton South Africa
| | - Andrew Boulle
- Centre of Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, Cape Town, South Africa; Western Cape Government Health, Cape Town, South Africa; Wellcome Centre for Infectious Diseases Research in Africa, Cape Town, South Africa
| | - Ishen Seocharan
- Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa
| | | | - Mary-Ann Davies
- Centre of Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, Cape Town, South Africa; Western Cape Government: Health Centre for Infectious Disease Epidemiology and Research, Cape Town, South Africa
| | | | | | | | | | | | - Harry Moultrie
- Centre for Tuberculosis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Tulio de Oliveira
- KwaZulu-Natal Research Innovation, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Richard John Lessells
- KwaZulu-Natal Research Innovation, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Cheryl Cohen
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Witwatersrand, South Africa; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Waasila Jassat
- National Institute for Communicable Diseases, Sandringham, South Africa
| | - Michelle Groome
- School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Witwatersrand, South Africa; Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Anne Von Gottberg
- Department of Pathology, Cape Town, South Africa; School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Witwatersrand, South Africa; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
| | - Engelbert Le Roux
- Hutchinson Center Research Institute of South Africa (HCRISA), Chris Hani Baragwanath Academic Hospital, Soweto, South Africa
| | - Kentse Khuto
- Hutchinson Center Research Institute of South Africa (HCRISA), Chris Hani Baragwanath Academic Hospital, Soweto, South Africa
| | - Dan Barouch
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Hassan Mahomed
- Metro Health Services, Western Cape Government Health, Cape Town, South Africa; Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | | | - Debbie Bradshaw
- South African Medical Research Council, Tygerberg, South Africa
| | - Michelle Mulder
- South Africa Medical Research Council, Cape Town, South Africa
| | - Jessica Opie
- University of Cape Town, Cape Town, South Africa; National Health Laboratory Service, Cape Town, South Africa
| | - Vernon Louw
- Division of Clinical Haematology, Department of Medicine, Cape Town, South Africa; Groote Schuur Hospital, Cape Town, South Africa
| | - Barry Jacobson
- Faculty of Health Sciences, and Allergy and Immunology Unit, Cape Town, South Africa
| | - Pradeep Rowji
- Neurology Association of South Africa, The Southern African Society of Thrombosis and Haemostasis, Johannesburg, South Africa
| | - Jonny G Peter
- Division of Allergy and Clinical Immunology, Cape Town, South Africa
| | - Azwi Takalani
- Hutchinson Center Research Institute of South Africa (HCRISA), Chris Hani Baragwanath Academic Hospital, Soweto, South Africa
| | - Jackline Odhiambo
- Hutchinson Center Research Institute of South Africa (HCRISA), Chris Hani Baragwanath Academic Hospital, Soweto, South Africa
| | - Fatima Mayat
- Perinatal HIV Research Unit (PHRU), Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Witwatersrand, South Africa
| | - Simbarashe Takuva
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Lawrence Corey
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Glenda E Gray
- South Africa Medical Research Council, Cape Town, South Africa.
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22
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Ochola L, Ogongo P, Mungai S, Gitaka J, Suliman S. Performance Evaluation of Lateral Flow Assays for Coronavirus Disease-19 Serology. Clin Lab Med 2022; 42:31-56. [PMID: 35153047 PMCID: PMC8563367 DOI: 10.1016/j.cll.2021.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The coronavirus disease of 2019 (COVID-19) pandemic, caused by infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has undoubtedly resulted in significant morbidities, mortalities, and economic disruptions across the globe. Affordable and scalable tools to monitor the transmission dynamics of the SARS-CoV-2 virus and the longevity of induced antibodies will be paramount to monitor and control the pandemic as multiple waves continue to rage in many countries. Serologic assays detect humoral responses to the virus, to determine seroprevalence in target populations, or induction of antibodies at the individual level following either natural infection or vaccination. With multiple vaccines rolling out globally, serologic assays to detect anti-SARS-CoV-2 antibodies will be important tools to monitor the development of herd immunity. To address this need, serologic lateral flow assays (LFAs), which can be easily implemented for both population surveillance and home use, will be vital to monitor the evolution of the pandemic and inform containment measures. Such assays are particularly important for monitoring the transmission dynamics and durability of immunity generated by natural infections and vaccination, particularly in resource-limited settings. In this review, we discuss considerations for evaluating the accuracy of these LFAs, their suitability for different use cases, and implementation opportunities.
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Affiliation(s)
- Lucy Ochola
- Department of Tropical and Infectious Diseases, Institute of Primate Research, National Museums of Kenya, PO Box 24481, Nairobi 00502, Kenya
| | - Paul Ogongo
- Department of Tropical and Infectious Diseases, Institute of Primate Research, National Museums of Kenya, PO Box 24481, Nairobi 00502, Kenya; Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Samuel Mungai
- Directorate of Research and Innovation, Mount Kenya University, PO Box 342-01000, Thika, Kenya
| | - Jesse Gitaka
- Directorate of Research and Innovation, Mount Kenya University, PO Box 342-01000, Thika, Kenya
| | - Sara Suliman
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA; Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA 02115, USA.
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23
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Basto-Abreu A, Carnalla M, Torres-Ibarra L, Romero-Martínez M, Martínez-Barnetche J, López-Martínez I, Aparicio-Antonio R, Shamah-Levy T, Alpuche-Aranda C, Rivera JA, Barrientos-Gutierrez T. Nationally representative SARS-CoV-2 antibody prevalence estimates after the first epidemic wave in Mexico. Nat Commun 2022; 13:589. [PMID: 35105873 PMCID: PMC8807586 DOI: 10.1038/s41467-022-28232-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 01/05/2022] [Indexed: 11/30/2022] Open
Abstract
Seroprevalence surveys provide estimates of the extent of SARS-CoV-2 infections in the population, regardless of disease severity and test availability. In Mexico in 2020, COVID-19 cases reached a maximum in July and December. We aimed to estimate the national and regional seroprevalence of SARS-CoV-2 antibodies across demographic and socioeconomic groups in Mexico after the first wave, from August to November 2020. We used nationally representative survey data including 9,640 blood samples. Seroprevalence was estimated by socioeconomic and demographic characteristics, adjusting by the sensitivity and specificity of the immunoassay test. The national seroprevalence of SARS-CoV-2 antibodies was 24.9% (95%CI 22.2, 26.7), being lower for adults 60 years and older. We found higher seroprevalence among urban and metropolitan areas, low socioeconomic status, low education and workers. Among seropositive people, 67.3% were asymptomatic. Social distancing, lockdown measures and vaccination programs need to consider that vulnerable groups are more exposed to the virus and unable to comply with lockdown measures. SARS-CoV-2 seroprevalence surveys provide estimates of the extent of prior infection in a population. In this nationally representative survey from Mexico, the authors estimate seroprevalence after the first epidemic wave at ~25%, with variation by region, age, socioeconomic status, and education level.
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Affiliation(s)
- Ana Basto-Abreu
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Martha Carnalla
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Leticia Torres-Ibarra
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Martín Romero-Martínez
- Center for Research in Evaluation and Surveys, National Institute of Public Health, Cuernavaca, Mexico
| | - Jesús Martínez-Barnetche
- Center for Research on Infectious Diseases, National Institute of Public Health, Cuernavaca, Mexico
| | | | | | - Teresa Shamah-Levy
- Center for Research in Evaluation and Surveys, National Institute of Public Health, Cuernavaca, Mexico
| | - Celia Alpuche-Aranda
- Center for Research on Infectious Diseases, National Institute of Public Health, Cuernavaca, Mexico
| | - Juan A Rivera
- National Institute of Public Health, Cuernavaca, Mexico
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24
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Basto-Abreu A, Carnalla M, Torres-Ibarra L, Romero-Martínez M, Martínez-Barnetche J, López-Martínez I, Aparicio-Antonio R, Shamah-Levy T, Alpuche-Aranda C, Rivera JA, Barrientos-Gutierrez T. Nationally representative SARS-CoV-2 antibody prevalence estimates after the first epidemic wave in Mexico. Nat Commun 2022. [PMID: 35105873 DOI: 10.1038/s41467-022-28232-9.pmid:35105873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
Seroprevalence surveys provide estimates of the extent of SARS-CoV-2 infections in the population, regardless of disease severity and test availability. In Mexico in 2020, COVID-19 cases reached a maximum in July and December. We aimed to estimate the national and regional seroprevalence of SARS-CoV-2 antibodies across demographic and socioeconomic groups in Mexico after the first wave, from August to November 2020. We used nationally representative survey data including 9,640 blood samples. Seroprevalence was estimated by socioeconomic and demographic characteristics, adjusting by the sensitivity and specificity of the immunoassay test. The national seroprevalence of SARS-CoV-2 antibodies was 24.9% (95%CI 22.2, 26.7), being lower for adults 60 years and older. We found higher seroprevalence among urban and metropolitan areas, low socioeconomic status, low education and workers. Among seropositive people, 67.3% were asymptomatic. Social distancing, lockdown measures and vaccination programs need to consider that vulnerable groups are more exposed to the virus and unable to comply with lockdown measures.
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Affiliation(s)
- Ana Basto-Abreu
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Martha Carnalla
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Leticia Torres-Ibarra
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Martín Romero-Martínez
- Center for Research in Evaluation and Surveys, National Institute of Public Health, Cuernavaca, Mexico
| | - Jesús Martínez-Barnetche
- Center for Research on Infectious Diseases, National Institute of Public Health, Cuernavaca, Mexico
| | | | | | - Teresa Shamah-Levy
- Center for Research in Evaluation and Surveys, National Institute of Public Health, Cuernavaca, Mexico
| | - Celia Alpuche-Aranda
- Center for Research on Infectious Diseases, National Institute of Public Health, Cuernavaca, Mexico
| | - Juan A Rivera
- National Institute of Public Health, Cuernavaca, Mexico
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25
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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.
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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
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26
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Musa SS, Wang X, Zhao S, Li S, Hussaini N, Wang W, He D. The Heterogeneous Severity of COVID-19 in African Countries: A Modeling Approach. Bull Math Biol 2022; 84:32. [PMID: 35067773 PMCID: PMC8784278 DOI: 10.1007/s11538-022-00992-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 01/01/2022] [Indexed: 02/06/2023]
Abstract
The COVID-19 pandemic has had a considerable impact on global health and economics. The impact in African countries has not been investigated thoroughly via fitting epidemic models to the reported COVID-19 deaths. We downloaded the data for the 12 most-affected countries with the highest cumulative COVID-19 deaths to estimate the time-varying basic reproductive number (\documentclass[12pt]{minimal}
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\begin{document}$${R}_{0}(t)$$\end{document}R0(t)) and infection attack rate. We develop a simple epidemic model and fitted it to reported COVID-19 deaths in 12 African countries using iterated filtering and allowing a flexible transmission rate. We observe high heterogeneity in the case-fatality rate across the countries, which may be due to different reporting or testing efforts. South Africa, Tunisia, and Libya were most affected, exhibiting a relatively higher \documentclass[12pt]{minimal}
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\begin{document}$${R}_{0}(t)$$\end{document}R0(t) and infection attack rate. Thus, to effectively control the spread of COVID-19 epidemics in Africa, there is a need to consider other mitigation strategies (such as improvements in socioeconomic well-being, healthcare systems, the water supply, and awareness campaigns).
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27
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Musa SS, Wang X, Zhao S, Li S, Hussaini N, Wang W, He D. The Heterogeneous Severity of COVID-19 in African Countries: A Modeling Approach. Bull Math Biol 2022. [PMID: 35067773 DOI: 10.21203/rs.3.rs-316589/v1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The COVID-19 pandemic has had a considerable impact on global health and economics. The impact in African countries has not been investigated thoroughly via fitting epidemic models to the reported COVID-19 deaths. We downloaded the data for the 12 most-affected countries with the highest cumulative COVID-19 deaths to estimate the time-varying basic reproductive number ([Formula: see text]) and infection attack rate. We develop a simple epidemic model and fitted it to reported COVID-19 deaths in 12 African countries using iterated filtering and allowing a flexible transmission rate. We observe high heterogeneity in the case-fatality rate across the countries, which may be due to different reporting or testing efforts. South Africa, Tunisia, and Libya were most affected, exhibiting a relatively higher [Formula: see text] and infection attack rate. Thus, to effectively control the spread of COVID-19 epidemics in Africa, there is a need to consider other mitigation strategies (such as improvements in socioeconomic well-being, healthcare systems, the water supply, and awareness campaigns).
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Affiliation(s)
- Salihu Sabiu Musa
- Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, China
- Department of Mathematics, Kano University of Science and Technology, Wudil, Nigeria
| | - Xueying Wang
- Department of Mathematics and Statistics, Washington State University, Pullman, WA, USA
| | - Shi Zhao
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
- Shenzhen Research Institute of Chinese University of Hong Kong, Shenzhen, China
| | - Shudong Li
- Cyberspace Institute of Advanced Technology, Guangzhou University, Guangzhou, 510006, China
| | - Nafiu Hussaini
- Department of Mathematical Sciences, Bayero University Kano, Kano, Nigeria
| | - Weiming Wang
- School of Mathematics and Statistics, Huaiyin Normal University, Huaian, 223300, China
| | - Daihai He
- Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, China.
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28
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Das AK, Chandra K, Dudeja M, Aalam MK. Asymptomatic SARS-COV-2 carriage and sero-positivity in high risk contacts of COVID-19 cases'. Indian J Med Microbiol 2021; 40:279-284. [PMID: 34980489 PMCID: PMC8719123 DOI: 10.1016/j.ijmmb.2021.12.012] [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: 08/10/2021] [Revised: 12/01/2021] [Accepted: 12/20/2021] [Indexed: 11/23/2022]
Abstract
Purpose Identifying asymptomatic SARS-COV-2 carriage is one of the crucial factors in controlling the COVID 19 pandemic. The relationship between the asymptomatic viral carriage and the rate of seroconversion needs better understanding. The present study was conducted to identify the asymptomatic COVID-19 infection and seropositivity in high-risk contacts in the southern district of Delhi, India. Methods Following the screening of 6961 subjects, a total of 407 asymptomatic high-risk subjects were selected. Demographic data, socioeconomic status, and history of COVID-19 related symptoms in the last 4 months were recorded. Blood samples and Nasopharyngeal/oropharyngeal swabs were collected for the detection of SARS-COV-2 RNA and anti-SARS-COV-2 antibodies. Results 55 asymptomatic high-risk subjects (13.5%) tested positive for SARS-COV-2 infection and among them, 70.9% remained asymptomatic throughout their course of infection. The seropositivity among the subjects was 28.9% (n = 118) and was found significantly higher among lower-middle socioeconomic strata (p = 0.01). The antibody levels were significantly higher (p = 0.033) in individuals with a previous history of COVID-19 like symptoms as compared to the subjects, who had no such history. Asymptomatic healthcare workers showed a significantly increased rate of SARS-COV-2 infection (p = 0.004) and seropositivity (p = 0.005) as compared to the non-healthcare workers. Subjects, who were exposed to infection at their workplace (non-hospital setting) had the least RT-PCR positivity rate (p = 0.03). Conclusions A large proportion of SARS-COV-2 infection remains completely asymptomatic. The rate of asymptomatic carriage and seropositivity is significantly higher in healthcare workers as compared to the general population. The level of SARS-COV-2 antibodies is directly related to the appearance of symptoms. These observations may contribute to redefining COVID 19 screening, infection control, and professional health practice strategies.
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Affiliation(s)
- Ayan Kumar Das
- Department of Microbiology, HIMSR & HAHC Hospital, New Delhi, 110062, India.
| | - Kailash Chandra
- Department of Biochemistry, HIMSR & HAHC Hospital, New Delhi, 110062, India.
| | - Mridu Dudeja
- Department of Microbiology, HIMSR & HAHC Hospital, New Delhi, 110062, India.
| | - Mohd Khursheed Aalam
- Department of Community Medicine, HIMSR & HAHC Hospital, New Delhi, 110062, India.
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29
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McClarty L, Lazarus L, Pavlova D, Reza-Paul S, Balakireva O, Kimani J, Tarasova T, Lorway R, Becker ML, McKinnon LR. Socioeconomic Burdens of the COVID-19 Pandemic on LMIC Populations with Increased HIV Vulnerabilities. Curr HIV/AIDS Rep 2021; 19:76-85. [PMID: 34822064 PMCID: PMC8614077 DOI: 10.1007/s11904-021-00591-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 11/25/2022]
Abstract
Purpose of Review To review the impact of the COVID-19 pandemic and its public health response on key populations at risk of HIV infection, with a focus on sex workers. Recent Findings Since last year several groups have documented how the COVID-19 pandemic has impacted the livelihoods and health of sex workers. We focus on case studies from Kenya, Ukraine, and India and place these in the broader global context of sex worker communities, drawing on common themes that span geographies. Summary COVID-19-associated lockdowns have significantly disrupted sex work, leading to economic and health challenges for sex workers, ranging from HIV-related services to mental health and exposure to violence. Several adaptations have been undertaken by sex workers and frontline workers, including migration, a move to mobile services, and struggling to find economic supports. Strengthening community-based responses for future pandemics and other shocks is critical to safeguard the health of marginalized populations.
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Affiliation(s)
- Leigh McClarty
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Lisa Lazarus
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Daria Pavlova
- Ukrainian Institute for Social Research After Oleksandr Yaremenko, Kyiv, Ukraine
| | - Sushena Reza-Paul
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Ashodaya Samithi, Mysuru, India
| | - Olga Balakireva
- Ukrainian Institute for Social Research After Oleksandr Yaremenko, Kyiv, Ukraine
- Institute for Economics and Forecasting, Ukrainian National Academy of Sciences, Kyiv, Ukraine
| | - Joshua Kimani
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 504-745 Bannatyne Ave, Winnipeg, MB, R3E 0J9, Canada
- Institute of Tropical and Infectious Diseases (UNITID), University of Nairobi, University of Nairobi, Nairobi, Kenya
| | - Tetiana Tarasova
- Ukrainian Institute for Social Research After Oleksandr Yaremenko, Kyiv, Ukraine
| | - Robert Lorway
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Marissa L Becker
- Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 504-745 Bannatyne Ave, Winnipeg, MB, R3E 0J9, Canada
| | - Lyle R McKinnon
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 504-745 Bannatyne Ave, Winnipeg, MB, R3E 0J9, Canada.
- Institute of Tropical and Infectious Diseases (UNITID), University of Nairobi, University of Nairobi, Nairobi, Kenya.
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa.
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30
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Maltezou HC, Krumbholz B, Mavrouli M, Tseroni M, Gamaletsou MN, Botsa E, Anastassopoulou C, Gikas A, Fournarakou E, Kavieri M, Koureli A, Mandilara D, Marinopoulou A, Theodorikakou A, Tsiahris P, Zarzali A, Pournaras S, Lourida A, Elefsiniotis I, Vrioni G, Sipsas NV, Tsakris A. A study of the evolution of the third COVID-19 pandemic wave in the Athens metropolitan area, Greece, through two cross-sectional seroepidemiological surveys: March, June 2021. J Med Virol 2021; 94:1465-1472. [PMID: 34812522 PMCID: PMC9011894 DOI: 10.1002/jmv.27465] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/11/2021] [Accepted: 11/19/2021] [Indexed: 12/22/2022]
Abstract
We studied the third coronavirus disease 2019 (COVID‐19) pandemic wave in Athens metropolitan area (3 738 901 inhabitants) through two seroepidemiological surveys. Persons presenting in 12 healthcare facilities across Athens in March and June 2021 were studied (764 and 901, respectively). Immunoglobulin G antibodies against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) spike protein were measured by a chemiluminescent microparticle immunoassay. In March the seroprevalence rate was 11.6%, meaning that 435 208 residents of Athens had evidence of immunity. The respective values in June were 55.7% and 2 082 568 residents. The highest seroprevalence rates attributed to SARS‐CoV‐2 infection were recorded in persons <18 years (16.3% in March and 31.6% in June), while immunity was mainly vaccine‐induced in persons 18–64 years and >65 years. Infection‐attributed immunity also increased in older‐age groups. Wide ranges in seroprevalence rates were noted across areas in March and June. The highest seroprevalence rates were recorded in Piraeus (47.2%) and West Attica (37.5%). However, the highest increase (>5 times) occurred in Piraeus and the South Section of Athens, which are among the most densely populated areas in Athens. In both study periods, history of COVID‐19 or febrile episode, and having a cohabitant with COVID‐19 were associated with increased risk for seropositivity among unvaccinated persons (p values <0.001 for all). Residing in Piraeus, the South Section or West Attica was associated with increased risk for seropositivity in June (p values <0.001). Wide heterogeneity in seroprevalence rates was found across areas in Athens, which is mainly attributed to population density. The impact of population mobility and socioeconomic status should be explored.
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Affiliation(s)
- Helena C Maltezou
- Directorate of Research, Studies, and Documentation, National Public Health Organization, Athens, Greece
| | | | - Maria Mavrouli
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Tseroni
- Directorate of Epidemiological Surveillance of Infectious Diseases, National Public Health Organization, Athens, Greece
| | - Maria N Gamaletsou
- Department of Pathophysiology, Medical School, National and Kapodistrian University of Athens, and General Hospital of Athens Laiko, Athens, Greece
| | - Evanthia Botsa
- First Department of Pediatrics, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Cleo Anastassopoulou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | | | | | - Dionysia Mandilara
- Academic Department of Internal Medicine, General Oncology Hospital of Kifisia "Agioi Anargyroi", National and Kapodistrian University of Athens, Athens, Greece
| | | | | | | | | | - Spyridon Pournaras
- Laboratory of Clinical Microbiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasia Lourida
- Infection Control Committee, Aghia Sophia Children's Hospital, Athens, Greece
| | - Ioannis Elefsiniotis
- Academic Department of Internal Medicine, General Oncology Hospital of Kifisia "Agioi Anargyroi", National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Vrioni
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos V Sipsas
- Department of Pathophysiology, Medical School, National and Kapodistrian University of Athens, and General Hospital of Athens Laiko, Athens, Greece
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Sebastião CS, Galangue M, Gaston C, Van-Dunen R, Quivinja J, Lunbungululo E, Alfredo D, Sozinho A, Teixeira A, Manico E, Machado D, Mateus A, David Z, Paixão J, Neto Z, de Vasconcelos JN, Morais J. Seroprevalence of anti-SARS-CoV-2 antibodies and risk factors among healthy blood donors in Luanda, Angola. BMC Infect Dis 2021; 21:1131. [PMID: 34727874 PMCID: PMC8562364 DOI: 10.1186/s12879-021-06814-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 10/25/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND SARS-CoV-2 emerged in China and spread throughout the world due to its rapid transmission. The exposure rate in the healthy population is unknown, mainly in resource-limited countries. Herein, we estimated the seroprevalence of anti-SARS-CoV-2 antibodies and risk factors among blood donors in Luanda, the capital city of Angola. METHODS This was a retrospective study conducted with 343 blood donors. Chi-square and logistic regression were calculated to predict the independent variable for SARS-CoV-2 infection and deemed significant when p < 0.05. RESULTS Seroprevalence of anti-SARS-CoV-2 was 4.7%. Positivity rates varied to age groups (3.5-14.3%), gender (0-5%), area of residence (3.1-.6%), educational level (5.1-10.2%), occupation (4.4-7.7%), and the blood donor category (2.0-5.1%). Past and recent infections were detected in 3.2% and 1.5%, respectively. Blood donors under the age of 20 years (OR: 4.58, p = 0.241) and from non-urbanized areas (OR: 1.86, p = 0.293) presented a high risk related to infection. The infection was higher in blood group A and lower in blood group O. The risk of SARS-CoV-2 infection has increased from January 2020 (OR: 0.03, p = 0.001) to August 2020 (OR: 0.57, p = 0.426). CONCLUSIONS We provide an estimate of the exposure of healthy blood donors in Luanda. Also, we detected anti-SARS-CoV-2 in January 2020, indicating that the SARS-CoV-2 could have been imported during the first month of 2020. Further studies should be performed to assess the exposure rate in different groups from Angola.
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Affiliation(s)
- Cruz S Sebastião
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
- Centro de Investigação em Saúde de Angola (CISA), Caxito, Angola
- Instituto Superior de Ciências da Saúde (ISCISA), Universidade Agostinho Neto (UAN), Luanda, Angola
| | - Manuela Galangue
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Celestina Gaston
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Rui Van-Dunen
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Joltim Quivinja
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | | | | | - Alberto Sozinho
- Instituto Nacional de Sangue, Ministry of Health, Luanda, Angola
| | | | - Eunice Manico
- Instituto Nacional de Sangue, Ministry of Health, Luanda, Angola
| | - Deodete Machado
- Instituto Nacional de Sangue, Ministry of Health, Luanda, Angola
| | - António Mateus
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Zinga David
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Joana Paixão
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Zoraima Neto
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
| | - Jocelyne Neto de Vasconcelos
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola
- Centro de Investigação em Saúde de Angola (CISA), Caxito, Angola
| | - Joana Morais
- Instituto Nacional de Investigação em Saúde (INIS), Luanda, Angola.
- Faculdade de Medicina, Universidade Agostinho Neto (UAN), Luanda, Angola.
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Sharma N, Sharma P, Basu S, Bakshi R, Gupta E, Agarwal R, Dushyant K, Mundeja N, Marak Z, Singh S, Singh G, Rustagi R. Second Wave of the COVID-19 Pandemic in Delhi, India: High Seroprevalence Not a Deterrent? Cureus 2021; 13:e19000. [PMID: 34853742 PMCID: PMC8609204 DOI: 10.7759/cureus.19000] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2021] [Indexed: 12/13/2022] Open
Abstract
Background We report the findings of a large follow-up, community-based, cross-sectional serosurvey and correlate it with the coronavirus disease (COVID-19) test-positivity rate and the caseload observed between the peaks of the first and the second wave of the COVID-19 pandemic in Delhi, India. Methodology Individuals aged five and above were recruited from 274 wards of the state (population approximately 19.6 million) from January 11 to January 22, 2021. A total of 100 participants each were included from all wards for a net sample size of approximately 28,000. A multistage sampling technique was employed to select participants for the household serosurvey. Anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin (IgG) antibodies were detected by using the VITROS® (Ortho Clinical Diagnostics, Raritan, NJ, USA) assay (90% sensitivity, 100% specificity). Results Antibody positivity was observed in 14,298 (50.76%) of 28,169 samples. The age, sex, and district population-weighted seroprevalence of the SARS-CoV-2 IgG was 50.52% (95% confidence interval [CI] = 49.94-51.10), and after adjustment for assay characteristics, it was 56.13% (95% CI = 55.49-56.77). On adjusted analysis, participants aged ≥50 years, of female gender, housewives, having ever lived in containment zones, urban slum dwellers, and diabetes or hypertensive patients had significantly higher odds of SARS-CoV-2 antibody positivity. The peak infection rate and the test-positivity rate since October 2020 were initially observed in mid-November 2020, with a subsequent steep declining trend, followed by a period of persistently low case burden lasting until the first week of March 2021. This was followed by a steady increase followed by an exponential surge in infections from April 2021 onward culminating in the second wave of the pandemic. Conclusions The presence of infection-induced immunity from SARS-CoV-2 even in more than one in two people can be ineffective in protecting the population. Despite such high seroprevalence, population susceptibility to COVID-19 can be accentuated by variants of concern having the ability for rapid transmission and depletion of antibody levels with the threat of recurrent infections, signifying the need for mass vaccination.
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Affiliation(s)
- Nandini Sharma
- Community Medicine, Maulana Azad Medical College, New Delhi, IND
| | - Pragya Sharma
- Community Medicine, Maulana Azad Medical College, New Delhi, IND
| | - Saurav Basu
- Community Medicine, Maulana Azad Medical College, New Delhi, IND
| | - Ritika Bakshi
- Community Medicine, Maulana Azad Medical College, New Delhi, IND
| | - Ekta Gupta
- Department of Virology, Institute of Liver and Biliary Sciences, New Delhi, IND
| | - Reshu Agarwal
- Department of Virology, Institute of Liver and Biliary Sciences, New Delhi, IND
| | - Kumar Dushyant
- Community Medicine, Maulana Azad Medical College, New Delhi, IND
| | - Nutan Mundeja
- Director General Health Services, Directorate General of Health Services, Government of National Capital Territory, Delhi, New Delhi, IND
| | - Zeasaly Marak
- Public Health, Directorate General of Health Services, Government of National Capital Territory, Delhi, New Delhi, IND
| | - Sanjay Singh
- State Surveillance Unit, Directorate General of Health Services, Government of National Capital Territory, Delhi, New Delhi, IND
| | - Gautam Singh
- State Surveillance Unit, Directorate General of Health Services, Government of National Capital Territory, Delhi, New Delhi, IND
| | - Ruchir Rustagi
- State Surveillance Unit, Directorate of Family Welfare, Government of National Capital Territory, Delhi, New Delhi, IND
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Yang W, Shaman J. Development of a model-inference system for estimating epidemiological characteristics of SARS-CoV-2 variants of concern. Nat Commun 2021; 12:5573. [PMID: 34552095 PMCID: PMC8458278 DOI: 10.1038/s41467-021-25913-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/08/2021] [Indexed: 11/09/2022] Open
Abstract
To support COVID-19 pandemic planning, we develop a model-inference system to estimate epidemiological properties of new SARS-CoV-2 variants of concern using case and mortality data while accounting for under-ascertainment, disease seasonality, non-pharmaceutical interventions, and mass-vaccination. Applying this system to study three variants of concern, we estimate that B.1.1.7 has a 46.6% (95% CI: 32.3-54.6%) transmissibility increase but nominal immune escape from protection induced by prior wild-type infection; B.1.351 has a 32.4% (95% CI: 14.6-48.0%) transmissibility increase and 61.3% (95% CI: 42.6-85.8%) immune escape; and P.1 has a 43.3% (95% CI: 30.3-65.3%) transmissibility increase and 52.5% (95% CI: 0-75.8%) immune escape. Model simulations indicate that B.1.351 and P.1 could outcompete B.1.1.7 and lead to increased infections. Our findings highlight the importance of preventing the spread of variants of concern, via continued preventive measures, prompt mass-vaccination, continued vaccine efficacy monitoring, and possible updating of vaccine formulations to ensure high efficacy.
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Affiliation(s)
- Wan Yang
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
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Ngere I, Dawa J, Hunsperger E, Otieno N, Masika M, Amoth P, Makayotto L, Nasimiyu C, Gunn BM, Nyawanda B, Oluga O, Ngunu C, Mirieri H, Gachohi J, Marwanga D, Munywoki PK, Odhiambo D, Alando MD, Breiman RF, Anzala O, Njenga MK, Bulterys M, Herman-Roloff A, Osoro E. High seroprevalence of SARS-CoV-2 but low infection fatality ratio eight months after introduction in Nairobi, Kenya. Int J Infect Dis 2021; 112:25-34. [PMID: 34481966 PMCID: PMC8411609 DOI: 10.1016/j.ijid.2021.08.062] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 08/12/2021] [Accepted: 08/26/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The lower than expected COVID-19 morbidity and mortality in Africa has been attributed to multiple factors, including weak surveillance. This study estimated the burden of SARS-CoV-2 infections eight months into the epidemic in Nairobi, Kenya. METHODS A population-based, cross-sectional survey was conducted using multi-stage random sampling to select households within Nairobi in November 2020. Sera from consenting household members were tested for antibodies to SARS-CoV-2. Seroprevalence was estimated after adjusting for population structure and test performance. Infection fatality ratios (IFRs) were calculated by comparing study estimates with reported cases and deaths. RESULTS Among 1,164 individuals, the adjusted seroprevalence was 34.7% (95% CI 31.8-37.6). Half of the enrolled households had at least one positive participant. Seropositivity increased in more densely populated areas (spearman's r=0.63; p=0.009). Individuals aged 20-59 years had at least two-fold higher seropositivity than those aged 0-9 years. The IFR was 40 per 100,000 infections, with individuals ≥60 years old having higher IFRs. CONCLUSION Over one-third of Nairobi residents had been exposed to SARS-CoV-2 by November 2020, indicating extensive transmission. However, the IFR was >10-fold lower than that reported in Europe and the USA, supporting the perceived lower morbidity and mortality in sub-Saharan Africa.
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Affiliation(s)
- Isaac Ngere
- Washington State University (WSU) Global Health Kenya, Nairobi, Kenya; Paul G. Allen School of Global Health, Washington State University (WSU), Pullman, USA
| | - Jeanette Dawa
- Washington State University (WSU) Global Health Kenya, Nairobi, Kenya; Paul G. Allen School of Global Health, Washington State University (WSU), Pullman, USA
| | - Elizabeth Hunsperger
- Center for Global Health, US Centers for Disease Control and Prevention (CDC)-Kenya, Nairobi, Kenya
| | - Nancy Otieno
- Center for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Moses Masika
- KAVI-Institute for Clinical Research, University of Nairobi, Nairobi, Kenya
| | | | - Lyndah Makayotto
- Department of Health, Nairobi Metropolitan Services, Nairobi, Kenya
| | - Carolyne Nasimiyu
- Washington State University (WSU) Global Health Kenya, Nairobi, Kenya; Paul G. Allen School of Global Health, Washington State University (WSU), Pullman, USA
| | - Bronwyn M Gunn
- Paul G. Allen School of Global Health, Washington State University (WSU), Pullman, USA
| | - Bryan Nyawanda
- Center for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Ouma Oluga
- Department of Health, Nairobi Metropolitan Services, Nairobi, Kenya
| | - Carolyne Ngunu
- Department of Health, Nairobi Metropolitan Services, Nairobi, Kenya
| | - Harriet Mirieri
- Washington State University (WSU) Global Health Kenya, Nairobi, Kenya; Paul G. Allen School of Global Health, Washington State University (WSU), Pullman, USA
| | - John Gachohi
- Washington State University (WSU) Global Health Kenya, Nairobi, Kenya; Paul G. Allen School of Global Health, Washington State University (WSU), Pullman, USA; School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Kiambu, Kenya
| | - Doris Marwanga
- Washington State University (WSU) Global Health Kenya, Nairobi, Kenya; Paul G. Allen School of Global Health, Washington State University (WSU), Pullman, USA
| | - Patrick K Munywoki
- Center for Global Health, US Centers for Disease Control and Prevention (CDC)-Kenya, Nairobi, Kenya
| | - Dennis Odhiambo
- Center for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Moshe D Alando
- Center for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | | | - Omu Anzala
- KAVI-Institute for Clinical Research, University of Nairobi, Nairobi, Kenya
| | - M Kariuki Njenga
- Washington State University (WSU) Global Health Kenya, Nairobi, Kenya; Paul G. Allen School of Global Health, Washington State University (WSU), Pullman, USA
| | - Marc Bulterys
- Center for Global Health, US Centers for Disease Control and Prevention (CDC)-Kenya, Nairobi, Kenya
| | - Amy Herman-Roloff
- Center for Global Health, US Centers for Disease Control and Prevention (CDC)-Kenya, Nairobi, Kenya
| | - Eric Osoro
- Washington State University (WSU) Global Health Kenya, Nairobi, Kenya; Paul G. Allen School of Global Health, Washington State University (WSU), Pullman, USA.
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Wamai RG, Hirsch JL, Van Damme W, Alnwick D, Bailey RC, Hodgins S, Alam U, Anyona M. What Could Explain the Lower COVID-19 Burden in Africa despite Considerable Circulation of the SARS-CoV-2 Virus? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8638. [PMID: 34444386 PMCID: PMC8391172 DOI: 10.3390/ijerph18168638] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/13/2021] [Accepted: 08/13/2021] [Indexed: 01/12/2023]
Abstract
The differential spread and impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing Coronavirus Disease 2019 (COVID-19), across regions is a major focus for researchers and policy makers. Africa has attracted tremendous attention, due to predictions of catastrophic impacts that have not yet materialized. Early in the pandemic, the seemingly low African case count was largely attributed to low testing and case reporting. However, there is reason to consider that many African countries attenuated the spread and impacts early on. Factors explaining low spread include early government community-wide actions, population distribution, social contacts, and ecology of human habitation. While recent data from seroprevalence studies posit more extensive circulation of the virus, continuing low COVID-19 burden may be explained by the demographic pyramid, prevalence of pre-existing conditions, trained immunity, genetics, and broader sociocultural dynamics. Though all these prongs contribute to the observed profile of COVID-19 in Africa, some provide stronger evidence than others. This review is important to expand what is known about the differential impacts of pandemics, enhancing scientific understanding and gearing appropriate public health responses. Furthermore, it highlights potential lessons to draw from Africa for global health on assumptions regarding deadly viral pandemics, given its long experience with infectious diseases.
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Affiliation(s)
- Richard G. Wamai
- Department of Cultures, Societies, and Global Studies, Northeastern University, 201 Renaissance Park, 360 Huntington Ave., Boston, MA 02115, USA;
| | - Jason L. Hirsch
- Department of Cultures, Societies, and Global Studies, Northeastern University, 201 Renaissance Park, 360 Huntington Ave., Boston, MA 02115, USA;
| | - Wim Van Damme
- Department of Public Health, Institute of Tropical Medicine, B-2000 Antwerp, Belgium;
| | - David Alnwick
- DUNDEX (Deployable U.N.-Experienced Development Experts), FX68 Belturbet, Ireland;
| | - Robert C. Bailey
- School of Public Health, University of Illinois at Chicago, Chicago, IL 60607, USA;
| | - Stephen Hodgins
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada;
| | - Uzma Alam
- Researcher Africa Institute for Health Policy Foundation, Nairobi 020, Kenya;
| | - Mamka Anyona
- T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA;
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Abatan B, Agboghoroma O, Akemoke F, Antonio M, Awokola B, Bittaye M, Bojang A, Bojang K, Brotherton H, Cerami C, Clarke E, D'Alessandro U, de Silva T, Drammeh M, Forrest K, Hofmann N, Jagne S, Jah H, Jarju S, Jaye A, Jobe M, Kampmann B, Manjang B, Martinez-Alvarez M, Mohammed N, Nadjm B, Ndiath MO, Nkereuwem E, Nwakanma D, Oko F, Okoh E, Okomo U, Olatunji Y, Oriero E, Prentice AM, Roberts C, Roca A, Sabally B, Sambou S, Samateh A, Secka O, Sesay AK, Singhateh Y, Susso B, Usuf E, Vilane A, Wariri O. Intense and Mild First Epidemic Wave of Coronavirus Disease, The Gambia. Emerg Infect Dis 2021; 27:2064-2072. [PMID: 34286683 PMCID: PMC8314844 DOI: 10.3201/eid2708.204954] [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] [Indexed: 11/19/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is evolving differently in Africa than in other regions. Africa has lower SARS-CoV-2 transmission rates and milder clinical manifestations. Detailed SARS-CoV-2 epidemiologic data are needed in Africa. We used publicly available data to calculate SARS-CoV-2 infections per 1,000 persons in The Gambia. We evaluated transmission rates among 1,366 employees of the Medical Research Council Unit The Gambia (MRCG), where systematic surveillance of symptomatic cases and contact tracing were implemented. By September 30, 2020, The Gambia had identified 3,579 SARS-CoV-2 cases, including 115 deaths; 67% of cases were identified in August. Among infections, MRCG staff accounted for 191 cases; all were asymptomatic or mild. The cumulative incidence rate among nonclinical MRCG staff was 124 infections/1,000 persons, which is >80-fold higher than estimates of diagnosed cases among the population. Systematic surveillance and seroepidemiologic surveys are needed to clarify the extent of SARS-CoV-2 transmission in Africa.
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Chisale MRO, Ramazanu S, Mwale SE, Kumwenda P, Chipeta M, Kaminga AC, Nkhata O, Nyambalo B, Chavura E, Mbakaya BC. Seroprevalence of anti-SARS-CoV-2 antibodies in Africa: A systematic review and meta-analysis. Rev Med Virol 2021; 32:e2271. [PMID: 34228851 PMCID: PMC8420234 DOI: 10.1002/rmv.2271] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 12/20/2022]
Abstract
We estimated the seroprevalence of anti‐severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) antibodies in residents of African countries and explored its associated factors. We searched PubMed, EMBASE, PsycINFO, AMED, CINAHL, DOAJ and Google Scholar databases for peer reviewed articles and pre‐prints that reported anti‐SARS‐CoV‐2 antibody seroprevalence of general or specific human populations resident in Africa. The eligible studies were evaluated using Joana Briggs Institute prevalence critical appraisal tool. Twenty‐three studies involving 27,735 individuals were included in our paper. The pooled seroprevalence of anti‐SARS‐CoV‐2 antibodies in Africa was 22% (95%CI: 14–31) with very high heterogeneity (I2 = 100%, p < 0.001). Seroprevalence was highest in studies conducted in Central Africa compared to Southern Africa, West Africa, North Africa and East Africa respectively. The number of days between the first reported coronavirus disease 2019 case in each country and when a seroprevalence study was conducted was a significant moderator of seroprevalence. Seropositivity was numerically influenced by gender and age of the participants with males and those aged below 50 years being most affected with SARS‐CoV‐2 infection. The highest pooled seroprevalence in Africa reported in this review should be interpreted cautiously due to high heterogeneity between studies. Continued seroprevalence surveillance is warranted to establish Africa's transition towards herd immunity.
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Affiliation(s)
| | - Sheena Ramazanu
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
| | - Saul Eric Mwale
- Biological Sciences Department, Mzuzu University, Mzuzu, Malawi
| | - Pizga Kumwenda
- Biomedical Sciences Department, Mzuzu University, Mzuzu, Malawi
| | - Mep Chipeta
- Nursing and Midwifery Department, Mzuzu University, Mzuzu, Malawi
| | | | - Obed Nkhata
- St John's Institute for Health, Mzuzu, Malawi
| | | | - Elton Chavura
- Department of Public Health, University of Livingstonia, Mzuzu, Malawi
| | - Balwani C Mbakaya
- Department of Public Health, University of Livingstonia, Mzuzu, Malawi
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Gégout Petit A, Jeulin H, Legrand K, Jay N, Bochnakian A, Vallois P, Schvoerer E, Guillemin F. Seroprevalence of SARS-CoV-2, Symptom Profiles and Sero-Neutralization in a Suburban Area, France. Viruses 2021; 13:v13061076. [PMID: 34200070 PMCID: PMC8230202 DOI: 10.3390/v13061076] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/29/2021] [Accepted: 06/01/2021] [Indexed: 01/28/2023] Open
Abstract
The World Health Organisation recommends monitoring the circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We investigated anti-SARS-CoV-2 total immunoglobulin (IgT) antibody seroprevalence and in vitro sero-neutralization in Nancy, France, in spring 2020. Individuals were randomly sampled from electoral lists and invited with household members over 5 years old to be tested for anti-SARS-CoV-2 (IgT, i.e., IgA/IgG/IgM) antibodies by ELISA (Bio-rad); the sero-neutralization activity was evaluated on Vero CCL-81 cells. Among 2006 individuals, the raw seroprevalence was 2.1% (95% confidence interval 1.5 to 2.9), was highest for 20- to 34-year-old participants (4.7% (2.3 to 8.4)), within than out of socially deprived area (2.5% vs. 1%, p = 0.02) and with than without intra-family infection (p < 10-6). Moreover, 25% of participants presented at least one COVID-19 symptom associated with SARS-CoV-2 positivity (p < 10-13), with highly discriminant anosmia or ageusia (odds ratio 27.8 [13.9 to 54.5]); 16.3% (6.8 to 30.7) of seropositive individuals were asymptomatic. Positive sero-neutralization was demonstrated in vitro for 31/43 seropositive subjects. Regarding the very low seroprevalence, a preventive effect of the lockdown in March 2020 can be assumed for the summer, but a second COVID-19 wave, as expected, could be subsequently observed in this poorly immunized population.
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Affiliation(s)
- Anne Gégout Petit
- IECL, Université de Lorraine, CNRS, Inria, F-54000 Nancy, France; (A.G.P.); (P.V.)
| | - Hélène Jeulin
- LCPME, Université de Lorraine, CNRS, F-54000 Nancy, France;
- Laboratoire de Virologie, CHRU de Nancy Brabois, F-54500 Vandoeuvre-lès-Nancy, France
- Correspondence: ; Tel.: +33-383-153-467
| | - Karine Legrand
- CIC Epidémiologie Clinique, CHRU-Nancy, Inserm, Université de Lorraine, F-54000 Nancy, France; (K.L.); (A.B.); (F.G.)
| | - Nicolas Jay
- LORIA, CHRU-Nancy, Université de Lorraine, CNRS, Inria, LORIA, F-54000 Nancy, France;
| | - Agathe Bochnakian
- CIC Epidémiologie Clinique, CHRU-Nancy, Inserm, Université de Lorraine, F-54000 Nancy, France; (K.L.); (A.B.); (F.G.)
| | - Pierre Vallois
- IECL, Université de Lorraine, CNRS, Inria, F-54000 Nancy, France; (A.G.P.); (P.V.)
| | - Evelyne Schvoerer
- LCPME, Université de Lorraine, CNRS, F-54000 Nancy, France;
- Laboratoire de Virologie, CHRU de Nancy Brabois, F-54500 Vandoeuvre-lès-Nancy, France
| | - Francis Guillemin
- CIC Epidémiologie Clinique, CHRU-Nancy, Inserm, Université de Lorraine, F-54000 Nancy, France; (K.L.); (A.B.); (F.G.)
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Hussey H, Zinyakatira N, Morden E, Ismail M, Paleker M, Bam JL, London L, Boulle A, Davies MA. Higher COVID-19 mortality in low-income communities in the City of Cape Town - a descriptive ecological study. Gates Open Res 2021; 5:90. [PMID: 34286217 PMCID: PMC8264385 DOI: 10.12688/gatesopenres.13288.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 11/21/2022] Open
Abstract
Background Cape Town, a South African city with high levels of economic inequality, has gone through two COVID-19 waves. There is evidence globally that low-income communities experience higher levels of morbidity and mortality during the pandemic. Methods Age-standardized COVID-19 mortality in the eight sub-districts of Cape Town was compared by economic indicators taken from the most recent Census (unemployment rate, monthly income). Results The overall Standardized Death Rate (SDR) for COVID-19 in Cape Town was 1 640 per million, but there was wide variation across the different sub-districts. A linear relationship was seen between sub-districts with high poverty and high COVID-19 SDRs. Conclusions Low-income communities in Cape Town experienced higher levels of COVID-19 mortality. As we continue to contend with COVID-19, these communities need to be prioritized for access to quality health care.
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Affiliation(s)
- Hannah Hussey
- Health Intelligence, Western Cape Government: Health, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Nesbert Zinyakatira
- Health Intelligence, Western Cape Government: Health, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Erna Morden
- Health Intelligence, Western Cape Government: Health, Cape Town, South Africa
| | - Muzzammil Ismail
- Health Intelligence, Western Cape Government: Health, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Masudah Paleker
- Health Intelligence, Western Cape Government: Health, Cape Town, South Africa
- Division of Health Systems and Public Health, Stellenbosch University, Cape Town, South Africa
| | - Jamy-Lee Bam
- Health Intelligence, Western Cape Government: Health, Cape Town, South Africa
| | - Leslie London
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Andrew Boulle
- Health Intelligence, Western Cape Government: Health, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Mary-Ann Davies
- Health Intelligence, Western Cape Government: Health, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Mulenga LB, Hines JZ, Fwoloshi S, Chirwa L, Siwingwa M, Yingst S, Wolkon A, Barradas DT, Favaloro J, Zulu JE, Banda D, Nikoi KI, Kampamba D, Banda N, Chilopa B, Hanunka B, Stevens TL, Shibemba A, Mwale C, Sivile S, Zyambo KD, Makupe A, Kapina M, Mweemba A, Sinyange N, Kapata N, Zulu PM, Chanda D, Mupeta F, Chilufya C, Mukonka V, Agolory S, Malama K. Prevalence of SARS-CoV-2 in six districts in Zambia in July, 2020: a cross-sectional cluster sample survey. Lancet Glob Health 2021; 9:e773-e781. [PMID: 33711262 PMCID: PMC8382844 DOI: 10.1016/s2214-109x(21)00053-x] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Between March and December, 2020, more than 20 000 laboratory-confirmed cases of SARS-CoV-2 infection were reported in Zambia. However, the number of SARS-CoV-2 infections is likely to be higher than the confirmed case counts because many infected people have mild or no symptoms, and limitations exist with regard to testing capacity and surveillance systems in Zambia. We aimed to estimate SARS-CoV-2 prevalence in six districts of Zambia in July, 2020, using a population-based household survey. METHODS Between July 4 and July 27, 2020, we did a cross-sectional cluster-sample survey of households in six districts of Zambia. Within each district, 16 standardised enumeration areas were randomly selected as primary sampling units using probability proportional to size. 20 households from each standardised enumeration area were selected using simple random sampling. All members of selected households were eligible to participate. Consenting participants completed a questionnaire and were tested for SARS-CoV-2 infection using real-time PCR (rtPCR) and anti-SARS-CoV-2 antibodies using ELISA. Prevalence estimates, adjusted for the survey design, were calculated for each diagnostic test separately, and combined. We applied the prevalence estimates to census population projections for each district to derive the estimated number of SARS-CoV-2 infections. FINDINGS Overall, 4258 people from 1866 households participated in the study. The median age of participants was 18·2 years (IQR 7·7-31·4) and 50·6% of participants were female. SARS-CoV-2 prevalence for the combined measure was 10·6% (95% CI 7·3-13·9). The rtPCR-positive prevalence was 7·6% (4·7-10·6) and ELISA-positive prevalence was 2·1% (1·1-3·1). An estimated 454 708 SARS-CoV-2 infections (95% CI 312 705-596 713) occurred in the six districts between March and July, 2020, compared with 4917 laboratory-confirmed cases reported in official statistics from the Zambia National Public Health Institute. INTERPRETATION The estimated number of SARS-CoV-2 infections was much higher than the number of reported cases in six districts in Zambia. The high rtPCR-positive SARS-CoV-2 prevalence was consistent with observed community transmission during the study period. The low ELISA-positive SARS-CoV-2 prevalence might be associated with mitigation measures instituted after initial cases were reported in March, 2020. Zambia should monitor patterns of SARS-CoV-2 prevalence and promote measures that can reduce transmission. FUNDING US Centers for Disease Control and Prevention.
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Affiliation(s)
- Lloyd B Mulenga
- Zambia Ministry of Health, Lusaka, Zambia; University Teaching Hospital, Lusaka, Zambia; Levy Mwanawasa Medical University, Lusaka, Zambia; Vanderbilt Medical University, Nashville, TN, USA; School of Medicine, University of Zambia, Lusaka, Zambia
| | - Jonas Z Hines
- Centers for Disease Control and Prevention, Lusaka, Zambia.
| | - Sombo Fwoloshi
- Zambia Ministry of Health, Lusaka, Zambia; University Teaching Hospital, Lusaka, Zambia; Levy Mwanawasa Medical University, Lusaka, Zambia; School of Medicine, University of Zambia, Lusaka, Zambia
| | | | | | - Samuel Yingst
- Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Adam Wolkon
- Centers for Disease Control and Prevention, Lusaka, Zambia
| | | | | | - James E Zulu
- Zambia Field Epidemiology Training Program, Lusaka, Zambia; Zambia National Public Health Institute, Lusaka, Zambia
| | - Dabwitso Banda
- Zambia Field Epidemiology Training Program, Lusaka, Zambia; Zambia National Public Health Institute, Lusaka, Zambia
| | | | | | | | | | - Brave Hanunka
- Centers for Disease Control and Prevention, Lusaka, Zambia
| | | | - Aaron Shibemba
- Zambia Ministry of Health, Lusaka, Zambia; University Teaching Hospital, Lusaka, Zambia; Levy Mwanawasa Medical University, Lusaka, Zambia; School of Medicine, University of Zambia, Lusaka, Zambia
| | - Consity Mwale
- Levy Mwanawasa Medical University, Lusaka, Zambia; School of Medicine, University of Zambia, Lusaka, Zambia; Lusaka Provincial Health Office, Lusaka, Zambia
| | - Suilanji Sivile
- Zambia Ministry of Health, Lusaka, Zambia; University Teaching Hospital, Lusaka, Zambia; Levy Mwanawasa Medical University, Lusaka, Zambia; School of Medicine, University of Zambia, Lusaka, Zambia
| | - Khozya D Zyambo
- Zambia Ministry of Health, Lusaka, Zambia; University Teaching Hospital, Lusaka, Zambia; Levy Mwanawasa Medical University, Lusaka, Zambia
| | - Alex Makupe
- Zambia Ministry of Health, Lusaka, Zambia; University Teaching Hospital, Lusaka, Zambia; Levy Mwanawasa Medical University, Lusaka, Zambia; School of Medicine, University of Zambia, Lusaka, Zambia
| | - Muzala Kapina
- Zambia National Public Health Institute, Lusaka, Zambia
| | - Aggrey Mweemba
- Zambia Ministry of Health, Lusaka, Zambia; University Teaching Hospital, Lusaka, Zambia; Levy Mwanawasa Medical University, Lusaka, Zambia; School of Medicine, University of Zambia, Lusaka, Zambia
| | - Nyambe Sinyange
- Zambia Field Epidemiology Training Program, Lusaka, Zambia; Zambia National Public Health Institute, Lusaka, Zambia
| | - Nathan Kapata
- Zambia National Public Health Institute, Lusaka, Zambia; Pan-African Network for Rapid Research, Response, Relief and Preparedness for Infectious Diseases Epidemics, Amsterdam, Netherlands
| | - Paul M Zulu
- Zambia National Public Health Institute, Lusaka, Zambia
| | - Duncan Chanda
- University Teaching Hospital, Lusaka, Zambia; School of Medicine, University of Zambia, Lusaka, Zambia
| | - Francis Mupeta
- University Teaching Hospital, Lusaka, Zambia; Levy Mwanawasa Medical University, Lusaka, Zambia; School of Medicine, University of Zambia, Lusaka, Zambia
| | | | | | - Simon Agolory
- Centers for Disease Control and Prevention, Lusaka, Zambia
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Hughes GD, Mbamalu ON, Okonji CO, Puoane TR. The Impact of Health Disparities on COVID-19 Outcomes: Early Findings from a High-Income Country and Two Middle-Income Countries. J Racial Ethn Health Disparities 2021; 9:376-383. [PMID: 33686624 PMCID: PMC7938881 DOI: 10.1007/s40615-021-00999-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/14/2021] [Indexed: 12/20/2022]
Abstract
The SARS-CoV-2 infection, which causes the coronavirus disease (COVID-19), has affected lives, with very adverse outcomes in specific populations in the United States of America (USA), a high-income country, and two middle-income countries, Brazil and South Africa. This paper aims to discuss the relationship of race/ethnicity with COVID-19-associated factors in the three countries. The information is based on data collected from infectious disease/epidemiological centers in the USA, Brazil, and South Africa. Adverse COVID-19 outcomes have been associated with the burden of exposure and disease, linked to socioeconomic determinants, among specific ethnicities in all three countries. The prevalence of comorbidities before and the likelihood of work-related exposure in the context of COVID-19 infection puts ethnic minorities in the USA and some ethnic majorities and minorities in Brazil and South Africa at greater risk. We envisage that this work will contribute to ongoing discussions related to addressing socioeconomic determinants of health, and the need for stakeholders in various sectors to work on addressing observed health disparities for overall improvement in health and healthcare given the current pandemic.
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Affiliation(s)
- Gail Denise Hughes
- Department of Medical Bioscience, Faculty of Natural Sciences, University of the Western Cape, Private Bag X17, Bellville, 7535, South Africa
| | - Oluchi Nneka Mbamalu
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa.
| | - Christabel Osaretin Okonji
- School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Private Bag X17, Bellville, 7535, South Africa
| | - Thandi Rose Puoane
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Private Bag X17, Bellville, 7535, South Africa
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