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Koudokpon H, Lègba B, Sintondji K, Kissira I, Kounou A, Guindo I, Koné KM, Abdou M, Koné A, Sambou C, Bankolé H, Yadouleton A, Dougnon V. Empowering public health: building advanced molecular surveillance in resource-limited settings through collaboration and capacity-building. FRONTIERS IN HEALTH SERVICES 2024; 4:1289394. [PMID: 38957804 PMCID: PMC11217560 DOI: 10.3389/frhs.2024.1289394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 05/31/2024] [Indexed: 07/04/2024]
Abstract
The rapid detection and continuous surveillance of infectious diseases are important components of an effective public health response. However, establishing advanced molecular surveillance systems, crucial for monitoring and mitigating pandemics, poses significant challenges in resource-limited developing countries. In a collaborative effort, research institutions from Benin joined forces with Mali's National Institute of Public Health to implement a state-of-the-art molecular surveillance system in Mali. This approach was characterized by collaboration, multidisciplinarity, and tutoring. Key activities included a comprehensive assessment of infrastructure and human resources through document reviews, interviews, and laboratory visits; the development and validation of Standard Operating Procedures (SOPs) for advanced molecular surveillance following an inclusive approach; capacity-building initiatives for 25 biologists in Mali on sequencing techniques; and international tutoring sessions for eight Malian professionals held in Benin. These collective efforts enabled Mali to establish an advanced molecular surveillance system aligned with the WHO's global strategy for genomic surveillance. This manuscript aims to share experiences, insights, and outcomes from this initiative, with the hope of contributing to the broader discussion on strengthening global health security through collaborative approaches and capacity-building efforts, particularly in developing countries.
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Affiliation(s)
- Hornel Koudokpon
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Research Laboratory in Applied Biology, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Cotonou, Benin
| | - Boris Lègba
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Research Laboratory in Applied Biology, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Cotonou, Benin
| | - Kevin Sintondji
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Research Laboratory in Applied Biology, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Cotonou, Benin
| | - Islamiath Kissira
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Research Laboratory in Applied Biology, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Cotonou, Benin
| | - Arielle Kounou
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Research Laboratory in Applied Biology, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Cotonou, Benin
| | - Ibrehima Guindo
- National Institute of Public Health, Laboratory and Biomedical Research Department, Bamako, Mali
| | - Kléma Marcel Koné
- National Institute of Public Health, Laboratory and Biomedical Research Department, Bamako, Mali
| | - Mahamadou Abdou
- National Institute of Public Health, Laboratory and Biomedical Research Department, Bamako, Mali
| | - Amadou Koné
- University Clinical Research Center, University of Sciences, Techniques and Technology, Bamako, Mali
| | - Claire Sambou
- Project Responses to the various Crises Caused by COVID-19 in Mali (RC3-Mali), Health Department, Expertise France, Bamako, Mali
| | - Honoré Bankolé
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Research Laboratory in Applied Biology, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Cotonou, Benin
| | - Anges Yadouleton
- Hemorrhagic and Viral Fevers Laboratory, Ministry of Health, Cotonou, Benin
| | - Victorien Dougnon
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Research Laboratory in Applied Biology, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Cotonou, Benin
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Aguilar R, Jiménez A, Santano R, Vidal M, Maiga-Ascofare O, Strauss R, Bonney J, Agbogbatey M, Goovaerts O, Boham EEA, Adu EA, Cuamba I, Ramírez-Morros A, Dutta S, Angov E, Zhan B, Izquierdo L, Santamaria P, Mayor A, Gascón J, Ruiz-Comellas A, Molinos-Albert LM, Amuasi JH, Awuah AAA, Adriaensen W, Dobaño C, Moncunill G. Malaria and other infections induce polyreactive antibodies that impact SARS-CoV-2 seropositivity estimations in endemic settings. J Med Virol 2024; 96:e29713. [PMID: 38874194 DOI: 10.1002/jmv.29713] [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: 02/06/2024] [Revised: 05/13/2024] [Accepted: 05/21/2024] [Indexed: 06/15/2024]
Abstract
Anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence is used to estimate the proportion of individuals within a population previously infected, to track viral transmission, and to monitor naturally and vaccine-induced immune protection. However, in sub-Saharan African settings, antibodies induced by higher exposure to pathogens may increase unspecific seroreactivity to SARS-CoV-2 antigens, resulting in false positive responses. To investigate the level and type of unspecific seroreactivitiy to SARS-CoV-2 in Africa, we measured immunoglobulin G (IgG), IgA, and IgM to a broad panel of antigens from different pathogens by Luminex in 602 plasma samples from African and European subjects differing in coronavirus disease 2019, malaria, and other exposures. Seroreactivity to SARS-CoV-2 antigens was higher in prepandemic African than in European samples and positively correlated with antibodies against human coronaviruses, helminths, protozoa, and especially Plasmodium falciparum. African subjects presented higher levels of autoantibodies, a surrogate of polyreactivity, which correlated with P. falciparum and SARS-CoV-2 antibodies. Finally, we found an improved sensitivity in the IgG assay in African samples when using urea as a chaotropic agent. In conclusion, our data suggest that polyreactive antibodies induced mostly by malaria are important mediators of the unspecific anti-SARS-CoV-2 responses, and that the use of dissociating agents in immunoassays could be useful for more accurate estimates of SARS-CoV-2 seroprevalence in African settings.
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Affiliation(s)
- Ruth Aguilar
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Alfons Jiménez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
| | - Rebeca Santano
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Oumou Maiga-Ascofare
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Ricardo Strauss
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Joseph Bonney
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Melvin Agbogbatey
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Odin Goovaerts
- Clinical Immunology Unit, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Eric E A Boham
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | - Evan A Adu
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | - Inocencia Cuamba
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Anna Ramírez-Morros
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
| | - Sheetij Dutta
- U.S. Military Malaria Vaccine Program, Walter Reed Army Institute of Research (WRAIR), Silver Spring, Maryland, USA
| | - Evelina Angov
- U.S. Military Malaria Vaccine Program, Walter Reed Army Institute of Research (WRAIR), Silver Spring, Maryland, USA
| | - Bin Zhan
- Baylor College of Medicine (BCM), Houston, Texas, USA
| | - Luis Izquierdo
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
| | - Pere Santamaria
- Institut d'Investigacions Biomèdiques August Pi Sunyer, Barcelona, Spain
- Department of Microbiology, Immunology and Infectious Diseases, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Alfredo Mayor
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
- CIBER de Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Department of Physiological Sciences, Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Joaquim Gascón
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
| | - Anna Ruiz-Comellas
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Sant Fruitós de Bages, Spain
- Grup de Promoció de la Salut en l'Àmbit Rural (ProSaARu), Institut Català de la Salut, Sant Fruitós de Bages, Spain
- Facultat de Medicina, Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Spain
- Centre d'Atenció Primària (CAP) Sant Joan de Vilatorrada, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain
| | | | - John H Amuasi
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- College of Health Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Anthony A-A Awuah
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- College of Health Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Wim Adriaensen
- Clinical Immunology Unit, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Carlota Dobaño
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
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Grayo S, Sagno H, Diassy O, Zogbelemou JB, Kondabo SJ, Houndekon M, Dellagi K, Vigan-Womas I, Rourou S, Hamouda WB, Benabdessalem C, Ahmed MB, Tordo N. Snapshot of Anti-SARS-CoV-2 IgG Antibodies in COVID-19 Recovered Patients in Guinea. J Clin Med 2024; 13:2965. [PMID: 38792506 PMCID: PMC11122401 DOI: 10.3390/jcm13102965] [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: 03/21/2024] [Revised: 05/10/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Because the regular vaccine campaign started in Guinea one year after the COVID-19 index case, the profile of naturally acquired immunity following primary SARS-CoV-2 infection needs to be deepened. Methods: Blood samples were collected once from 200 patients (90% of African extraction) who were recovered from COVID-19 for at least ~2.4 months (72 days), and their sera were tested for IgG antibodies to SARS-CoV-2 using an in-house ELISA assay against the Receptor Binding Domain (RBD) of the SARS-CoV-2 spike1 protein (RBD/S1-IH kit). Results: Results revealed that 73% of sera (146/200) were positive for IgG to SARS-CoV-2 with an Optical Density (OD) ranging from 0.13 to 1.19 and a median value of 0.56 (IC95: 0.51-0.61). The median OD value at 3 months (1.040) suddenly decreased thereafter and remained stable around OD 0.5 until 15 months post-infection. The OD median value was slightly higher in males compared to females (0.62 vs. 0.49), but the difference was not statistically significant (p-value: 0.073). In contrast, the OD median value was significantly higher among the 60-100 age group (0.87) compared to other groups, with a noteworthy odds ratio compared to the 0-20 age group (OR: 9.69, p-value: 0.044*). Results from the RBD/S1-IH ELISA kit demonstrated superior concordance with the whole spike1 protein ELISA commercial kit compared to a nucleoprotein ELISA commercial kit. Furthermore, anti-spike1 protein ELISAs (whole spike1 and RBD/S1) revealed higher seropositivity rates. Conclusions: These findings underscore the necessity for additional insights into naturally acquired immunity against COVID-19 and emphasize the relevance of specific ELISA kits for accurate seropositivity rates.
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Affiliation(s)
- Solène Grayo
- Institut Pasteur de Guinée, Conakry BP 4416, Guinea; (H.S.); (N.T.)
| | - Houlou Sagno
- Institut Pasteur de Guinée, Conakry BP 4416, Guinea; (H.S.); (N.T.)
| | - Oumar Diassy
- Agence Nationale de Sécurité Sanitaire, Conakry BP 797, Guinea;
| | | | | | - Marilyn Houndekon
- Centre Médico-Social de L’ambassade de France, Conakry BP 295, Guinea; (J.-B.Z.); (M.H.)
| | - Koussay Dellagi
- Direction Internationale, Institut Pasteur, 75724 Paris, France;
| | | | - Samia Rourou
- Institut Pasteur de Tunis, Tunis BP 74-1002, Tunisia; (S.R.); : (C.B.); (M.B.A.)
| | - Wafa Ben Hamouda
- Institut Pasteur de Tunis, Tunis BP 74-1002, Tunisia; (S.R.); : (C.B.); (M.B.A.)
| | | | - Melika Ben Ahmed
- Institut Pasteur de Tunis, Tunis BP 74-1002, Tunisia; (S.R.); : (C.B.); (M.B.A.)
| | - Noël Tordo
- Institut Pasteur de Guinée, Conakry BP 4416, Guinea; (H.S.); (N.T.)
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Heilmann E, Tembo T, Fwoloshi S, Kabamba B, Chilambe F, Kalenga K, Siwingwa M, Mulube C, Seffren V, Bolton-Moore C, Simwanza J, Yingst S, Yadav R, Rogier E, Auld AF, Agolory S, Kapina M, Gutman JR, Savory T, Kangale C, Mulenga LB, Sikazwe I, Hines JZ. Trends in SARS-CoV-2 seroprevalence among pregnant women attending first antenatal care visits in Zambia: A repeated cross-sectional survey, 2021-2022. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003073. [PMID: 38568905 PMCID: PMC10990173 DOI: 10.1371/journal.pgph.0003073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/11/2024] [Indexed: 04/05/2024]
Abstract
SARS-CoV-2 serosurveys help estimate the extent of transmission and guide the allocation of COVID-19 vaccines. We measured SARS-CoV-2 seroprevalence among women attending ANC clinics to assess exposure trends over time in Zambia. We conducted repeated cross-sectional SARS-CoV-2 seroprevalence surveys among pregnant women aged 15-49 years attending their first ANC visits in four districts of Zambia (two urban and two rural) during September 2021-September 2022. Serologic testing was done using a multiplex bead assay which detects IgG antibodies to the nucleocapsid protein and the spike protein receptor-binding domain (RBD). We calculated monthly SARS-CoV-2 seroprevalence by district. We also categorized seropositive results as infection alone, infection and vaccination, or vaccination alone based on anti-RBD and anti-nucleocapsid test results and self-reported COVID-19 vaccination status (vaccinated was having received ≥1 dose). Among 8,304 participants, 5,296 (63.8%) were cumulatively seropositive for SARS-CoV-2 antibodies from September 2021 through September 2022. SARS-CoV-2 seroprevalence primarily increased from September 2021 to September 2022 in three districts (Lusaka: 61.8-100.0%, Chongwe: 39.6-94.7%, Chipata: 56.5-95.0%), but in Chadiza, seroprevalence increased from 27.8% in September 2021 to 77.2% in April 2022 before gradually dropping to 56.6% in July 2022. Among 5,906 participants with a valid COVID-19 vaccination status, infection alone accounted for antibody responses in 77.7% (4,590) of participants. Most women attending ANC had evidence of prior SARS-CoV-2 infection and most SARS-CoV-2 seropositivity was infection-induced. Capturing COVID-19 vaccination status and using a multiplex bead assay with anti-nucleocapsid and anti-RBD targets facilitated distinguishing infection-induced versus vaccine-induced antibody responses during a period of increasing COVID-19 vaccine coverage in Zambia. Declining seroprevalence in Chadiza may indicate waning antibodies and a need for booster vaccines. ANC clinics have a potential role in ongoing SARS-CoV-2 serosurveillance and can continue to provide insights into SARS-CoV-2 antibody dynamics to inform near real-time public health responses.
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Affiliation(s)
- Elizabeth Heilmann
- Public Health Institute, Oakland, California, United States of America
- Division of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Tannia Tembo
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Sombo Fwoloshi
- Division of Infectious Diseases, Ministry of Health, Lusaka, Zambia
| | | | - Felix Chilambe
- Adult Centre of Excellence, University Teaching Hospital, Lusaka, Zambia
| | - Kalubi Kalenga
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Mpanji Siwingwa
- Adult Centre of Excellence, University Teaching Hospital, Lusaka, Zambia
| | | | - Victoria Seffren
- Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - John Simwanza
- Surveillance and Disease Intelligence, Zambia National Public Health Institute, Lusaka, Zambia
| | - Samuel Yingst
- Division of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Ruchi Yadav
- Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Andrew F. Auld
- Division of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Simon Agolory
- Division of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Muzala Kapina
- Surveillance and Disease Intelligence, Zambia National Public Health Institute, Lusaka, Zambia
| | - Julie R. Gutman
- Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Theodora Savory
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | | | - Lloyd B. Mulenga
- Division of Infectious Diseases, Ministry of Health, Lusaka, Zambia
| | - Izukanji Sikazwe
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Jonas Z. Hines
- Division of Global HIV and Tuberculosis, U.S. Centers for Disease Control and Prevention, Lusaka, Zambia
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Röltgen K, Boyd SD. Antibody and B Cell Responses to SARS-CoV-2 Infection and Vaccination: The End of the Beginning. ANNUAL REVIEW OF PATHOLOGY 2024; 19:69-97. [PMID: 37738512 DOI: 10.1146/annurev-pathmechdis-031521-042754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
As the COVID-19 pandemic has evolved during the past years, interactions between human immune systems, rapidly mutating and selected SARS-CoV-2 viral variants, and effective vaccines have complicated the landscape of individual immunological histories. Here, we review some key findings for antibody and B cell-mediated immunity, including responses to the highly mutated omicron variants; immunological imprinting and other impacts of successive viral antigenic variant exposures on antibody and B cell memory; responses in secondary lymphoid and mucosal tissues and non-neutralizing antibody-mediated immunity; responses in populations vulnerable to severe disease such as those with cancer, immunodeficiencies, and other comorbidities, as well as populations showing apparent resistance to severe disease such as many African populations; and evidence of antibody involvement in postacute sequelae of infection or long COVID. Despite the initial phase of the pandemic ending, human populations will continue to face challenges presented by this unpredictable virus.
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Affiliation(s)
- Katharina Röltgen
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Scott D Boyd
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA;
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, California, USA
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Houngbégnon P, Nouatin O, Yadouléton A, Hounkpatin B, Fievet N, Atindégla E, Dechavanne S, Guichet E, Ayouba A, Pelloquin R, Maman D, Thaurignac G, Peeters M, Aviansou A, Sourakafou S, Delaporte E, Massougbodji A, Cottrell G. Interest of seroprevalence surveys for the epidemiological surveillance of the SARS-CoV-2 pandemic in African populations: Insights from the ARIACOV project in Benin. Trop Med Int Health 2023. [PMID: 37243412 DOI: 10.1111/tmi.13895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Many SARS-CoV-2 seroprevalence surveys since the end of 2020 have disqualified the first misconception that Africa had been spared by the pandemic. Through the analysis of three SARS-CoV-2 seroprevalence surveys carried out in Benin as part of the ARIACOV project, we argue that the integration of epidemiological serosurveillance of the SARS-CoV-2 infection in the national surveillance packages would be of great use to refine the understanding of the COVID-19 pandemic in Africa. METHODS We carried out three repeated cross-sectional surveys in Benin: two in Cotonou, the economic capital in March and May 2021, and one in Natitingou, a semi-rural city in the north of the country in August 2021. Total and weighted-by-age-group seroprevalences were estimated and the risk factors for SARS-CoV-2 infection were assessed by multivariate logistic regression. RESULTS In Cotonou, a slight increase in overall age-standardised SARS-CoV-2 seroprevalence from 29.77% (95% CI: 23.12%-37.41%) at the first survey to 34.86% (95% CI: 31.57%-38.30%) at the second survey was observed. In Natitingou, the globally adjusted seroprevalence was 33.34% (95% CI: 27.75%-39.44%). A trend of high risk for SARS-CoV 2 seropositivity was observed in adults over 40 versus the young (less than 18 years old) during the first survey in Cotonou but no longer in the second survey. CONCLUSIONS Our results show that, however, rapid organisation of preventive measures aimed at breaking the chains of transmission, they were ultimately unable to prevent a wide spread of the virus in the population. Routine serological surveillance on strategic sentinel sites and/or populations could constitute a cost-effective compromise to better anticipate the onset of new waves and define public health strategies.
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Affiliation(s)
| | - Odilon Nouatin
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Benin
| | - Anges Yadouléton
- Laboratoire des Fièvres Hémorragiques Virales et des Arbovirus du Bénin, Ministère de la Santé, Cotonou, Benin
- Ecole Normale Supérieure de Natitingou, Université Nationale des Sciences Technologies, Ingénierie et Mathématiques, Abomey-Calavi, Benin
| | | | - Nadine Fievet
- Université de Paris Cité, Institut de Recherche pour le Développement, MERIT, Paris, France
| | - Eloïc Atindégla
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Benin
| | - Sébastien Dechavanne
- Université de Paris Cité, Institut de Recherche pour le Développement, MERIT, Paris, France
| | - Emilande Guichet
- Recherches Translationnelles sur le VIH et les Maladies Infectieuses, Institut de Recherche pour le Développement, University of Montpellier, Montpellier, France
- Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | - Ahidjo Ayouba
- Recherches Translationnelles sur le VIH et les Maladies Infectieuses, Institut de Recherche pour le Développement, University of Montpellier, Montpellier, France
- Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | - Raphaël Pelloquin
- Recherches Translationnelles sur le VIH et les Maladies Infectieuses, Institut de Recherche pour le Développement, University of Montpellier, Montpellier, France
- Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | | | - Guillaume Thaurignac
- Recherches Translationnelles sur le VIH et les Maladies Infectieuses, Institut de Recherche pour le Développement, University of Montpellier, Montpellier, France
- Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | - Martine Peeters
- Recherches Translationnelles sur le VIH et les Maladies Infectieuses, Institut de Recherche pour le Développement, University of Montpellier, Montpellier, France
- Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | | | | | - Eric Delaporte
- Recherches Translationnelles sur le VIH et les Maladies Infectieuses, Institut de Recherche pour le Développement, University of Montpellier, Montpellier, France
- Institut National de la Santé et de la Recherche Médicale, Montpellier, France
| | | | - Gilles Cottrell
- Université de Paris Cité, Institut de Recherche pour le Développement, MERIT, Paris, France
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7
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Dabitao D, Shaw-Saliba K, Konate DS, Highbarger HC, Lallemand P, Sanogo I, Rehman T, Wague M, Coulibaly N, Kone B, Baya B, Diakite SAS, Samake S, Akpa E, Tounkara M, Laverdure S, Doumbia S, Lane HC, Diakite M, Dewar RL. Clinical evaluation of commercial SARS-CoV-2 serological assays in a malaria endemic setting. J Immunol Methods 2023; 517:113488. [PMID: 37179012 PMCID: PMC10174340 DOI: 10.1016/j.jim.2023.113488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 05/15/2023]
Abstract
The levels of immune response to SARS-CoV-2 infection or vaccination are poorly understood in African populations and is complicated by cross-reactivity to endemic pathogens as well as differences in host responsiveness. To begin to determine the best approach to minimize false positive antibody levels to SARS-CoV-2 in an African population, we evaluated three commercial assays, namely Bio-Rad Platelia SARS-CoV-2 Total Antibody (Platelia), Quanterix Simoa Semi-Quantitative SARS-CoV-2 IgG Antibody Test (anti-Spike), and the GenScript cPass™ SARS-CoV-2 Neutralization Antibody Detection Kit (cPass) using samples collected in Mali in West Africa prior to the emergence of SARS-CoV-2. A total of one hundred samples were assayed. The samples were categorized in two groups based on the presence or absence of clinical malaria. Overall, thirteen out of one hundred (13/100) samples were false positives with the Bio-Rad Platelia assay and one of the same one hundred (1/100) was a false positive with the anti-Spike IgG Quanterix assay. None of the samples tested with the GenScript cPass assay were positive. False positives were more common in the clinical malaria group, 10/50 (20%) vs. the non-malaria group 3/50 (6%); p = 0.0374 using the Bio-Rad Platelia assay. Association between false positive results and parasitemia by Bio-Rad remained evident, after adjusting for age and sex in multivariate analyses. In summary, the impact of clinical malaria on assay performance appears to depend on the assay and/or antigen being used. A careful evaluation of any given assay in the local context is a prerequisite for reliable serological assessment of anti-SARS-CoV-2 humoral immunity.
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Affiliation(s)
- Djeneba Dabitao
- University Clinical Research Center (UCRC), Faculty of Pharmacy and Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques, and Technologies of Bamako (USTTB), West Africa, Mali.
| | - Kathryn Shaw-Saliba
- Collaborative Clinical Research Branch (CCRB), Division of Clinical Research (DCR), National Institute of Allergy and Infectious Diseases (NIAID), Bethesda, MD, USA
| | - Drissa S Konate
- University Clinical Research Center (UCRC), Faculty of Pharmacy and Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques, and Technologies of Bamako (USTTB), West Africa, Mali
| | - Helene C Highbarger
- Virus Isolation and Serology Laboratory, Frederick National Laboratory (FNL)
| | - Perrine Lallemand
- Virus Isolation and Serology Laboratory, Frederick National Laboratory (FNL)
| | - Ibrahim Sanogo
- University Clinical Research Center (UCRC), Faculty of Pharmacy and Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques, and Technologies of Bamako (USTTB), West Africa, Mali
| | - Tauseef Rehman
- Virus Isolation and Serology Laboratory, Frederick National Laboratory (FNL)
| | - Mamadou Wague
- University Clinical Research Center (UCRC), Faculty of Pharmacy and Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques, and Technologies of Bamako (USTTB), West Africa, Mali
| | - Nadie Coulibaly
- University Clinical Research Center (UCRC), Faculty of Pharmacy and Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques, and Technologies of Bamako (USTTB), West Africa, Mali
| | - Bourahima Kone
- University Clinical Research Center (UCRC), Faculty of Pharmacy and Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques, and Technologies of Bamako (USTTB), West Africa, Mali
| | - Bocar Baya
- University Clinical Research Center (UCRC), Faculty of Pharmacy and Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques, and Technologies of Bamako (USTTB), West Africa, Mali
| | - Seidina A S Diakite
- University Clinical Research Center (UCRC), Faculty of Pharmacy and Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques, and Technologies of Bamako (USTTB), West Africa, Mali
| | - Seydou Samake
- University Clinical Research Center (UCRC), Faculty of Pharmacy and Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques, and Technologies of Bamako (USTTB), West Africa, Mali
| | - Esther Akpa
- Collaborative Clinical Research Branch (CCRB), Division of Clinical Research (DCR), National Institute of Allergy and Infectious Diseases (NIAID), Bethesda, MD, USA
| | - Moctar Tounkara
- University Clinical Research Center (UCRC), Faculty of Pharmacy and Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques, and Technologies of Bamako (USTTB), West Africa, Mali
| | - Sylvain Laverdure
- Laboratory of Human Retrovirology and Immunoinformatics, Frederick National Laboratory (FNL)
| | - Seydou Doumbia
- University Clinical Research Center (UCRC), Faculty of Pharmacy and Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques, and Technologies of Bamako (USTTB), West Africa, Mali
| | - H Clifford Lane
- Collaborative Clinical Research Branch (CCRB), Division of Clinical Research (DCR), National Institute of Allergy and Infectious Diseases (NIAID), Bethesda, MD, USA
| | - Mahamadou Diakite
- University Clinical Research Center (UCRC), Faculty of Pharmacy and Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques, and Technologies of Bamako (USTTB), West Africa, Mali
| | - Robin L Dewar
- Virus Isolation and Serology Laboratory, Frederick National Laboratory (FNL)
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8
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Chong YP, Choy KW, Doerig C, Lim CX. SARS-CoV-2 Testing Strategies in the Diagnosis and Management of COVID-19 Patients in Low-Income Countries: A Scoping Review. Mol Diagn Ther 2023; 27:303-320. [PMID: 36705912 PMCID: PMC9880944 DOI: 10.1007/s40291-022-00637-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2022] [Indexed: 01/28/2023]
Abstract
The accuracy of diagnostic laboratory tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can impact downstream clinical procedures in managing and controlling the outbreak of coronavirus disease 2019 (COVID-19). To assess the effectiveness of laboratory tools for managing COVID-19 patients in low-income countries (LICs), we systematically searched the PubMed, Embase, Scopus and CINHAL databases for reports published between January 2020 and June 2022. We found that 22 of 1303 articles reported the performance of various SARS-CoV-2 detection tools across 10 LICs. These tools were (1) real-time reverse transcriptase polymerase chain reaction (RT-PCR); (2) reverse transcription loop-mediated isothermal amplification (RT-LAMP); (3) rapid diagnostic tests (RDTs); (4) enzyme-linked immunosorbent assay (ELISA); and (5) dot-blot immunoassay. The detection of COVID-19 is largely divided into two main streams-direct virus (antigen) detection and serology (immunoglobulin)-based detection. Point-of-care testing using antigen-based RDTs is preferred in LICs because of cost effectiveness and simplicity in the test procedures. The nucleic acid amplification technology (RT-PCR and RT-LAMP) has the highest diagnostic performance among the available tests, but it is not broadly used in this context due to costs and shortage of facilities/trained staff. The serology-based test method is affected by antibody interferences and varying amounts of SARS-CoV-2 immunoglobulins expressed at different stages of disease onset. We further discuss the effectiveness and shortcomings of each of these tools in the diagnosis and management of COVID-19. Using the LICs as the study model, our findings highlight ways to improve the quality and turnaround time of COVID-19 testing in resource-constrained settings, notably through local/international collaborative efforts to refine the molecular-based or immunoassay-based testing technologies.
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Affiliation(s)
- Yuh Ping Chong
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia.
| | - Kay Weng Choy
- Northern Pathology Victoria, Northern Health, Epping, VIC, 3076, Australia
| | - Christian Doerig
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia
| | - Chiao Xin Lim
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia.
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9
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Dutta D, Ghosh A, Dutta C, Sukla S, Biswas S. Cross-reactivity of SARS-CoV-2 with other pathogens, especially dengue virus: A historical perspective. J Med Virol 2023; 95:e28557. [PMID: 36755367 DOI: 10.1002/jmv.28557] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/20/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023]
Abstract
Dengue is a vector-borne viral disease caused by a Flavivirus whereas the COVID-19 pandemic was caused by a highly contagious virus, SARS-CoV-2 belonging to the family Coronaviridae. However, COVID-19 severity was observably less in dengue-endemic countries and vice versa especially during the active years of the pandemic (2019-2021). We observed that dengue virus (DENV) antibodies (Abs) could cross-react with SARS-CoV-2 spike antigen. This resulted in SARS-CoV-2 false positivity by rapid Ab test kits. DENV Abs binding to SARS-CoV-2 receptor-binding domain (and the reverse scenario), as revealed by docking studies further validated DENV and SARS-CoV-2 cross-reactivity. Finally, SARS-CoV-2 Abs were found to cross-neutralize DENV1 and DENV2 in virus neutralization test (VNT). Abs to other pathogens like Plasmodium were also cross-reactive but non-neutralizing for SARS-CoV-2. Here, we analyze the existing data on SARS-CoV-2 cross-reactivity with other pathogens, especially dengue to assess its impact on health (cross-protection?) and differential sero-diagnosis/surveillance.
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Affiliation(s)
- Debrupa Dutta
- National Institute of Pharmaceutical Education and Research, Kolkata, West Bengal, India
| | - Anisa Ghosh
- Infectious Diseases and Immunology Division, CSIR-Indian Institute of Chemical Biology, Kolkata, West Bengal, India
| | - Chiroshri Dutta
- Infectious Diseases and Immunology Division, CSIR-Indian Institute of Chemical Biology, Kolkata, West Bengal, India
| | - Soumi Sukla
- National Institute of Pharmaceutical Education and Research, Kolkata, West Bengal, India
| | - Subhajit Biswas
- Infectious Diseases and Immunology Division, CSIR-Indian Institute of Chemical Biology, Kolkata, West Bengal, India.,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
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10
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Iriemenam NC, Ige FA, Greby SM, Okunoye OO, Uwandu M, Aniedobe M, Nwaiwu SO, Mba N, Okoli M, William NE, Ehoche A, Mpamugo A, Mitchell A, Stafford KA, Thomas AN, Olaleye T, Akinmulero OO, Agala NP, Abubakar AG, Owens A, Gwyn SE, Rogier E, Udhayakumar V, Steinhardt LC, Martin DL, Okoye MI, Audu R. Comparison of one single-antigen assay and three multi-antigen SARS-CoV-2 IgG assays in Nigeria. JOURNAL OF CLINICAL VIROLOGY PLUS 2023; 3:100139. [PMID: 36683611 PMCID: PMC9837382 DOI: 10.1016/j.jcvp.2023.100139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/03/2022] [Accepted: 01/12/2023] [Indexed: 01/14/2023] Open
Abstract
Objectives Determining an accurate estimate of SARS-CoV-2 seroprevalence has been challenging in African countries where malaria and other pathogens are endemic. We compared the performance of one single-antigen assay and three multi-antigen SARS-CoV-2 IgG assays in a Nigerian population endemic for malaria. Methods De-identified plasma specimens from SARS-CoV-2 RT-PCR positive, dried blood spot (DBS) SARS-CoV-2 RT-PCR positive, and pre-pandemic negatives were used to evaluate the performance of the four SARS-CoV-2 assays (Tetracore, SARS2MBA, RightSign, xMAP). Results Results showed higher sensitivity with the multi-antigen (81% (Tetracore), 96% (SARS2MBA), 85% (xMAP)) versus the single-antigen (RightSign (64%)) SARS-CoV-2 assay. The overall specificities were 98% (Tetracore), 100% (SARS2MBA and RightSign), and 99% (xMAP). When stratified based on <15 days to ≥15 days post-RT-PCR confirmation, the sensitivities increased from 75% to 88.2% for Tetracore; from 93% to 100% for the SARS2MBA; from 58% to 73% for RightSign; and from 83% to 88% for xMAP. With DBS, there was no positive increase after 15-28 days for the three assays (Tetracore, SARS2MBA, and xMAP). Conclusion Multi-antigen assays performed well in Nigeria, even with samples with known malaria reactivity, and might provide more accurate measures of COVID-19 seroprevalence and vaccine efficacy.
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Affiliation(s)
- Nnaemeka C Iriemenam
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Fehintola A Ige
- Center for Human Virology and Genomics, Microbiology Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Stacie M Greby
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Olumide O Okunoye
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Mabel Uwandu
- Center for Human Virology and Genomics, Microbiology Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Maureen Aniedobe
- Center for Human Virology and Genomics, Microbiology Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Stephnie O Nwaiwu
- Center for Human Virology and Genomics, Microbiology Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Nwando Mba
- Nigeria Centre for Disease Control (NCDC), Gaduwa, FCT, Nigeria
| | - Mary Okoli
- Nigeria Centre for Disease Control (NCDC), Gaduwa, FCT, Nigeria
| | | | - Akipu Ehoche
- University of Maryland Center for International Health, Education, and Biosecurity (CIHEB), Maryland Global Initiatives Corporation (MGIC), FCT, Nigeria
| | - Augustine Mpamugo
- University of Maryland Center for International Health, Education, and Biosecurity (CIHEB), Maryland Global Initiatives Corporation (MGIC), FCT, Nigeria
| | - Andrew Mitchell
- Center for International Health, Education, and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, USA
| | - Kristen A Stafford
- Center for International Health, Education, and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, USA
| | - Andrew N Thomas
- International Research Center of Excellence, Institute of Human Virology, Abuja, Nigeria
| | - Temitope Olaleye
- International Research Center of Excellence, Institute of Human Virology, Abuja, Nigeria
| | - Oluwaseun O Akinmulero
- International Research Center of Excellence, Institute of Human Virology, Abuja, Nigeria
| | - Ndidi P Agala
- International Research Center of Excellence, Institute of Human Virology, Abuja, Nigeria
| | - Ado G Abubakar
- International Research Center of Excellence, Institute of Human Virology, Abuja, Nigeria
| | - Ajile Owens
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sarah E Gwyn
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Venkatachalam Udhayakumar
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laura C Steinhardt
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Diana L Martin
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - McPaul I Okoye
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Rosemary Audu
- Center for Human Virology and Genomics, Microbiology Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
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11
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Idowu AO, Omosun YO, Igietseme JU, Azenabor AA. The COVID-19 pandemic in sub-Saharan Africa: The significance of presumed immune sufficiency. Afr J Lab Med 2023; 12:1964. [PMID: 36756213 PMCID: PMC9900247 DOI: 10.4102/ajlm.v12i1.1964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 10/24/2022] [Indexed: 02/04/2023] Open
Abstract
A novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in China in 2019 and later ignited a global pandemic. Contrary to expectations, the effect of the pandemic was not as devastating to Africa and its young population compared to the rest of the world. To provide insight into the possible reasons for the presumed immune sufficiency to coronavirus disease 2019 (COVID-19) in Africa, this review critically examines literature published from 2020 onwards on the dynamics of COVID-19 infection and immunity and how other prevalent infectious diseases in Africa might have influenced the outcome of COVID-19. Studies characterising the immune response in patients with COVID-19 show that the correlates of protection in infected individuals are T-cell responses against the SARS-CoV-2 spike protein and neutralising titres of immunoglobin G and immunoglobin A antibodies. In some other studies, substantial pre-existing T-cell reactivity to SARS-CoV-2 was detected in many people from diverse geographical locations without a history of exposure. Certain studies also suggest that innate immune memory, which offers protection against reinfection with the same or another pathogen, might influence the severity of COVID-19. In addition, an initial analysis of epidemiological data showed that COVID‑19 cases were not severe in some countries that implemented universal Bacillus Calmette-Guerin (BCG) vaccination policies, thus supporting the potential of BCG vaccination to boost innate immunity. The high burden of infectious diseases and the extensive vaccination campaigns previously conducted in Africa could have induced specific and non-specific protective immunity to infectious pathogens in Africans.
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Affiliation(s)
- Abel O Idowu
- Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmacy, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Yusuf O Omosun
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, Georgia, United States
| | - Joseph U Igietseme
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, Georgia, United States
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States
| | - Anthony A Azenabor
- Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmacy, College of Medicine, University of Lagos, Lagos, Nigeria
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12
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Lapidus S, Liu F, Casanovas-Massana A, Dai Y, Huck JD, Lucas C, Klein J, Filler RB, Strine MS, Sy M, Deme AB, Badiane AS, Dieye B, Ndiaye IM, Diedhiou Y, Mbaye AM, Diagne CT, Vigan-Womas I, Mbengue A, Sadio BD, Diagne MM, Moore AJ, Mangou K, Diallo F, Sene SD, Pouye MN, Faye R, Diouf B, Nery N, Costa F, Reis MG, Muenker MC, Hodson DZ, Mbarga Y, Katz BZ, Andrews JR, Campbell M, Srivathsan A, Kamath K, Baum-Jones E, Faye O, Sall AA, Vélez JCQ, Cappello M, Wilson M, Ben-Mamoun C, Tedder R, McClure M, Cherepanov P, Somé FA, Dabiré RK, Moukoko CEE, Ouédraogo JB, Boum Y, Shon J, Ndiaye D, Wisnewski A, Parikh S, Iwasaki A, Wilen CB, Ko AI, Ring AM, Bei AK. Plasmodium infection is associated with cross-reactive antibodies to carbohydrate epitopes on the SARS-CoV-2 Spike protein. Sci Rep 2022; 12:22175. [PMID: 36550362 PMCID: PMC9778468 DOI: 10.1038/s41598-022-26709-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Sero-surveillance can monitor and project disease burden and risk. However, SARS-CoV-2 antibody test results can produce false positive results, limiting their efficacy as a sero-surveillance tool. False positive SARS-CoV-2 antibody results are associated with malaria exposure, and understanding this association is essential to interpret sero-surveillance results from malaria-endemic countries. Here, pre-pandemic samples from eight malaria endemic and non-endemic countries and four continents were tested by ELISA to measure SARS-CoV-2 Spike S1 subunit reactivity. Individuals with acute malaria infection generated substantial SARS-CoV-2 reactivity. Cross-reactivity was not associated with reactivity to other human coronaviruses or other SARS-CoV-2 proteins, as measured by peptide and protein arrays. ELISAs with deglycosylated and desialated Spike S1 subunits revealed that cross-reactive antibodies target sialic acid on N-linked glycans of the Spike protein. The functional activity of cross-reactive antibodies measured by neutralization assays showed that cross-reactive antibodies did not neutralize SARS-CoV-2 in vitro. Since routine use of glycosylated or sialated assays could result in false positive SARS-CoV-2 antibody results in malaria endemic regions, which could overestimate exposure and population-level immunity, we explored methods to increase specificity by reducing cross-reactivity. Overestimating population-level exposure to SARS-CoV-2 could lead to underestimates of risk of continued COVID-19 transmission in sub-Saharan Africa.
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Affiliation(s)
- Sarah Lapidus
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Feimei Liu
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Arnau Casanovas-Massana
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Yile Dai
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - John D Huck
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Carolina Lucas
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Jon Klein
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Renata B Filler
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Madison S Strine
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Mouhamad Sy
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Awa B Deme
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Aida S Badiane
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Baba Dieye
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Ibrahima Mbaye Ndiaye
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Younous Diedhiou
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Amadou Moctar Mbaye
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Cheikh Tidiane Diagne
- DiaTROPIX Rapid Diagnostic Tests Facility, Institut Pasteur de Dakar, Dakar, Senegal
| | - Inés Vigan-Womas
- Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Alassane Mbengue
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Bacary D Sadio
- Pôle Virologie, Institut Pasteur de Dakar, Dakar, Senegal
| | | | - Adam J Moore
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Khadidiatou Mangou
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Fatoumata Diallo
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Seynabou D Sene
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Mariama N Pouye
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Rokhaya Faye
- Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Babacar Diouf
- Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Nivison Nery
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brazil
- Department of Internal Medicine, Yale Occupational and Environmental Medicine Program, Yale School of Medicine, New Haven, CT, USA
| | - Federico Costa
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil
| | - Mitermayer G Reis
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil
- Faculty of Medicine, Federal University of Bahia, Salvador, Brazil
| | - M Catherine Muenker
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Daniel Z Hodson
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | | | - Ben Z Katz
- Division of Infectious Diseases, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, USA
| | - Jason R Andrews
- Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Melissa Campbell
- Yale Center for Clinical Investigation, Yale School of Medicine, New Haven, CT, USA
| | - Ariktha Srivathsan
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | | | | | - Ousmane Faye
- Pôle Virologie, Institut Pasteur de Dakar, Dakar, Senegal
| | | | - Juan Carlos Quintero Vélez
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Grupo de Investigación Ciencias Veterinarias Centauro, University of Antioquia, Medellín, Colombia
- Grupo de Investigación Microbiología Básica y Aplicada, University of Antioquia, Medellín, Colombia
| | - Michael Cappello
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | - Michael Wilson
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Choukri Ben-Mamoun
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Richard Tedder
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
- South London Specialist Virology Centre, Kings College Hospital NHS Foundation Trust, London, UK
| | - Myra McClure
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Peter Cherepanov
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, NW1 1AT, UK
- Crick COVID19 Consortium, Francis Crick Institute, London, NW1 1AT, UK
| | - Fabrice A Somé
- Institut de Recherche en Sciences de La Santé (IRSS)/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Roch K Dabiré
- Institut de Recherche en Sciences de La Santé (IRSS)/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Carole Else Eboumbou Moukoko
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, 2701, BP, Cameroon
- Malaria Research Unit, Center Pasteur Cameroon, Yaoundé, Cameroon
| | - Jean Bosco Ouédraogo
- Institut de Recherche en Sciences de La Santé (IRSS)/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Yap Boum
- Médecins Sans Frontières, University of Yaoundé and Epicentre, Yaoundé, Cameroon
| | | | - Daouda Ndiaye
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal
| | - Adam Wisnewski
- Department of Internal Medicine, Yale Occupational and Environmental Medicine Program, Yale School of Medicine, New Haven, CT, USA
| | - Sunil Parikh
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Akiko Iwasaki
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
- Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - Craig B Wilen
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Albert I Ko
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil
| | - Aaron M Ring
- Department of Immunobiology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Amy K Bei
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA.
- Laboratory of Parasitology and Mycology, Aristide le Dantec Hospital, Cheikh Anta Diop University, Dakar, Senegal.
- G4-Malaria Experimental Genetic Approaches and Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal.
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13
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Baroncelli S, Galluzzo CM, Orlando S, Mphwere R, Kavalo T, Luhanga R, Amici R, Floridia M, Andreotti M, Scarcella P, Marazzi MC, Giuliano M. Dynamics of SARS-CoV-2 exposure in Malawian infants between February 2020 and May 2021. JOURNAL OF CLINICAL VIROLOGY PLUS 2022; 2:100110. [PMID: 36128323 PMCID: PMC9477783 DOI: 10.1016/j.jcvp.2022.100110] [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: 05/02/2022] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 11/21/2022] Open
Abstract
Background Very limited information is available on SARS-CoV-2 seroprevalence in infants in sub-Saharan countries. Objective In this study, we aimed to determine the rate and the temporal evolution of SARS CoV-2 seropositivity in breastfed Malawian infants. Study design Blood samples (n = 250) from 158 infants, born to HIV-negative women and women living with HIV, collected from February 2020 to May 2021, were first tested using an Anti-IgG/A/M SARS CoV 2 ELISA assay against trimeric spike protein, and then, if positive, confirmed using a second ELISA assay detecting IgG against Receptor Binding Domain. Results The confirmed prevalence of anti-SARS CoV-2 antibodies was 31.0% (95% CI: 23.7%-38.3%) with no significant difference between HIV-exposed and HIV-unexposed infants (29.3% and 37.1% respectively, P = 0.410). The presence of anti-SARS-CoV-2 IgG was not associated with maternal socioeconomic or demographic indices. Conclusions Our data underline the wide spread of the SARS-CoV-2 infection in the pediatric population in sub-Saharan Africa. Design of more specific serological tests for African samples and improvements in serosurveillance programs are needed for more rigorous monitoring of the dynamics of SARS-CoV-2 infection in Africa.
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Affiliation(s)
- Silvia Baroncelli
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Clementina Maria Galluzzo
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Stefano Orlando
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Robert Mphwere
- DREAM Program, Community of S. Egidio, P.O. Box 30355, Blantyre, Malawi
| | - Thom Kavalo
- DREAM Program, Community of S. Egidio, P.O. Box 30355, Blantyre, Malawi
| | - Richard Luhanga
- DREAM Program, Community of S. Egidio, P.O. Box 30355, Blantyre, Malawi
| | - Roberta Amici
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Marco Floridia
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Mauro Andreotti
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Paola Scarcella
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | | | - Marina Giuliano
- National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
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14
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Li Y, Merbah M, Wollen-Roberts S, Beckman B, Mdluli T, Swafford I, Mayer SV, King J, Corbitt C, Currier JR, Liu H, Esber A, Pinyakorn S, Parikh A, Francisco LV, Phanuphak N, Maswai J, Owuoth J, Kibuuka H, Iroezindu M, Bahemana E, Vasan S, Ake JA, Modjarrad K, Gromowski G, Paquin-Proulx D, Rolland M. Coronavirus Antibody Responses before COVID-19 Pandemic, Africa and Thailand. Emerg Infect Dis 2022; 28:2214-2225. [PMID: 36220131 PMCID: PMC9622245 DOI: 10.3201/eid2811.221041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Prior immune responses to coronaviruses might affect human SARS-CoV-2 response. We screened 2,565 serum and plasma samples collected from 2013 through early 2020, before the COVID-19 pandemic began, from 2,250 persons in 4 countries in Africa (Kenya, Nigeria, Tanzania, and Uganda) and in Thailand, including persons living with HIV-1. We detected IgG responses to SARS-CoV-2 spike (S) subunit 2 protein in 1.8% of participants. Profiling against 23 coronavirus antigens revealed that responses to S, subunit 2, or subunit 1 proteins were significantly more frequent than responses to the receptor-binding domain, S-Trimer, or nucleocapsid proteins (p<0.0001). We observed similar responses in persons with or without HIV-1. Among all coronavirus antigens tested, SARS-CoV-2, SARS-CoV-1, and Middle East respiratory syndrome coronavirus antibody responses were much higher in participants from Africa than in participants from Thailand (p<0.01). We noted less pronounced differences for endemic coronaviruses. Serosurveys could affect vaccine and monoclonal antibody distribution across global populations.
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15
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Dorkenoo AM, Gbeasor-Komlanvi FA, Gbada K, Zida-Compaore WIC, Teou D, Konu YR, Lack F, Sadio AJ, Tchankoni MK, Dagnra AC, Ekouevi DK. Prevalence of Malaria and Covid-19 in Febrile Patients in Lomé, Togo in 2020. Acta Parasitol 2022; 67:1335-1342. [PMID: 35834159 PMCID: PMC9281227 DOI: 10.1007/s11686-022-00586-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 06/15/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE The objective of this study was to estimate the prevalence of malaria and Covid-19 by PCR and serological tests in febrile patients in Lomé. METHODS A cross-sectional study was conducted from September 1 to October 31, 2020 in febrile patients ≥ 10 years in three health facilities in Lomé. Finger stick blood was collected to detect Plasmodium spp. using thin/thick smear and venous blood on EDTA tubes to test for malaria Histidin-Rich-Protein-2 antigen using rapid diagnostic tests (RDT) and SARS-CoV-2 antibodies specific immunoglobulin (Ig) M and G. Detection of SARS-CoV-2 in nasopharyngeal samples was performed by rRT-PCR using GeneXpert. RESULTS A total of 243 participants (61.7% of female) with median age 28 years (IQR 18-41) were included in the study. Prevalence of malaria was 25.1%, 95% CI [19.8-31.0] and 30.4%, 95% CI [24.7-36.7] for thin/thick smear and rapid malaria test, respectively. Eighteen patients (7.4%, 95% CI [4.4-11.5]) were positive for SARS-CoV-2 and forty-two (17.3%, 95% CI [12.8-22.6]) were positive for IgM and/or IgG against SARS-CoV-2. SARS-CoV-2 IgM seroprevalence was significantly higher in malaria RDT positive participants (33.8% vs. 10.1%, p < 0.001). CONCLUSION This study confirms a possible cross-reactivity between Covid-19 and malaria in case of single use of rapid tests, suggesting a possible past contamination. In case of clinical signs related to Covid-19 in malaria-endemic areas, PCR screening should be requested in order to identify and isolate patients.
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Affiliation(s)
- Ameyo Monique Dorkenoo
- Department of Parasitology, University of Lomé, Lomé, Togo.
- Direction of Laboratories, Ministry of Health, Public Hygiene, and Universal Health Coverage, Lomé, Togo.
| | | | - Komivi Gbada
- Department of Parasitology, University of Lomé, Lomé, Togo
| | | | - Diwaba Teou
- Direction of Laboratories, Ministry of Health, Public Hygiene, and Universal Health Coverage, Lomé, Togo
| | - Yao Rodion Konu
- Department of Public Health, University of Lomé, Lomé, Togo
- African Center for Research in Epidemiology and Public Health, Lomé, Togo
| | - Fiali Lack
- Direction of Laboratories, Ministry of Health, Public Hygiene, and Universal Health Coverage, Lomé, Togo
| | - Arnold Junior Sadio
- Department of Public Health, University of Lomé, Lomé, Togo
- African Center for Research in Epidemiology and Public Health, Lomé, Togo
| | | | - Anoumou Claver Dagnra
- National Mycobacteria Reference Laboratory, Ministry of Health, Public Hygiene, and Universal Health Coverage, Lomé, Togo
| | - Didier Koumavi Ekouevi
- Department of Public Health, University of Lomé, Lomé, Togo
- African Center for Research in Epidemiology and Public Health, Lomé, Togo
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16
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Ben Hamida A, Charles M, Murrill C, Henao O, Gallagher K. U.S. CDC support to international SARS-CoV-2 seroprevalence surveys, May 2020-February 2022. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000658. [PMID: 36157894 PMCID: PMC9490761 DOI: 10.1371/journal.pgph.0000658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/14/2022] [Indexed: 06/16/2023]
Abstract
SARS-CoV-2 seroprevalence surveys provide critical information to assess the burden of COVID-19, describe population immunity, and guide public health strategies. Early in the pandemic, most of these surveys were conducted within high-income countries, leaving significant knowledge gaps in low-and middle-income (LMI) countries. To address this gap, the U.S. Centers for Disease Control and Prevention (CDC) is supporting serosurveys internationally. We conducted a descriptive analysis of international serosurveys supported by CDC during May 12, 2020-February 28, 2022, using an internal tracker including data on the type of assistance provided, study design, population surveyed, laboratory testing performed, and status of implementation. Since the beginning of the pandemic, CDC has supported 72 serosurveys (77 serosurvey rounds) in 35 LMI countries by providing technical assistance (TA) on epidemiologic, statistical, and laboratory methods, financial assistance (FA), or both. Among these serosurvey rounds, the majority (61%) received both TA and FA from CDC, 30% received TA only, 3% received only FA, and 5% were part of informal reviews. Fifty-four percent of these serosurveys target the general population, 13% sample pregnant women, 7% sample healthcare workers, 7% sample other special populations (internally displaced persons, patients, students, and people living with HIV), and 18% assess multiple or other populations. These studies are in different stages of implementation, ranging from protocol development to dissemination of results. They are conducted under the leadership of local governments, who have ownership over the data, in collaboration with international partners. Thirty-four surveys rounds have completed data collection. CDC TA and FA of SARS-CoV-2 seroprevalence surveys will enhance the knowledge of the COVID-19 pandemic in almost three dozen LMI countries. Support for these surveys should account for current limitations with interpreting results, focusing efforts on prospective cohorts, identifying, and forecasting disease patterns over time, and helping understand antibody kinetics and correlates of protection.
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Affiliation(s)
- Amen Ben Hamida
- Division of Global Health Protection, U.S. CDC, Atlanta, GA, United States of America
- COVID-19 International Task Force, U.S. CDC, Atlanta, GA, United States of America
| | - Myrna Charles
- COVID-19 International Task Force, U.S. CDC, Atlanta, GA, United States of America
- Influenza Division, U.S CDC, Atlanta, GA, United States of America
| | - Christopher Murrill
- COVID-19 International Task Force, U.S. CDC, Atlanta, GA, United States of America
- Global Immunization Division, U.S. CDC, Atlanta, GA, United States of America
| | - Olga Henao
- Division of Global Health Protection, U.S. CDC, Atlanta, GA, United States of America
- COVID-19 International Task Force, U.S. CDC, Atlanta, GA, United States of America
| | - Kathleen Gallagher
- Division of Global Health Protection, U.S. CDC, Atlanta, GA, United States of America
- COVID-19 International Task Force, U.S. CDC, Atlanta, GA, United States of America
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17
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Pedersen J, Koumakpayi IH, Babuadze G, Baz M, Ndiaye O, Faye O, Diagne CT, Dia N, Naghibosadat M, McGeer A, Muberaka S, Moukandja IP, Ndidi S, Tauil CB, Lekana-Douki JB, Loucoubar C, Faye O, Sall A, Magalhães KG, Weis N, Kozak R, Kobinger GP, Fausther-Bovendo H. Cross-reactive immunity against SARS-CoV-2 N protein in Central and West Africa precedes the COVID-19 pandemic. Sci Rep 2022; 12:12962. [PMID: 35902675 PMCID: PMC9333058 DOI: 10.1038/s41598-022-17241-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 07/22/2022] [Indexed: 12/22/2022] Open
Abstract
Early predictions forecasted large numbers of severe acute respiratory syndrome coronavirus (SARS-CoV-2) cases and associated deaths in Africa. To date, Africa has been relatively spared. Various hypotheses were postulated to explain the lower than anticipated impact on public health in Africa. However, the contribution of pre-existing immunity is yet to be investigated. In this study, the presence of antibodies against SARS-CoV-2 spike (S) and nucleocapsid (N) proteins in pre-pandemic samples from Africa, Europe, South and North America was examined by ELISA. The protective efficacy of N specific antibodies isolated from Central African donors was tested by in vitro neutralization and in a mouse model of SARS-CoV-2 infection. Antibodies against SARS-CoV-2 S and N proteins were rare in all populations except in Gabon and Senegal where N specific antibodies were prevalent. However, these antibodies failed to neutralize the virus either in vitro or in vivo. Overall, this study indicates that cross-reactive immunity against SARS-CoV-2 N protein was present in Africa prior to the pandemic. However, this pre-existing humoral immunity does not impact viral fitness in rodents suggesting that other human immune defense mechanisms could be involved. In Africa, seroprevalence studies using the N protein are over-estimating SARS-CoV-2 circulation.
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Affiliation(s)
- Jannie Pedersen
- Département de Microbiologie-Infectiologie et Immunologie, Université Laval, Quebec City, Canada
| | | | - Giorgi Babuadze
- Biological Sciences Platform, University of Toronto, Sunnybrook Research Institute at Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Mariana Baz
- Département de Microbiologie-Infectiologie et Immunologie, Université Laval, Quebec City, Canada
| | | | - Oumar Faye
- Institut Pasteur de Dakar, Dakar, Senegal
| | | | - Ndongo Dia
- Institut Pasteur de Dakar, Dakar, Senegal
| | - Maedeh Naghibosadat
- Biological Sciences Platform, University of Toronto, Sunnybrook Research Institute at Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Allison McGeer
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.,Department of Microbiology, Sinai Health System/University Health Network, Toronto, Canada
| | - Samira Muberaka
- Biological Sciences Platform, University of Toronto, Sunnybrook Research Institute at Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.,Department of Laboratory Medicine and Molecular Diagnostics, Division of Microbiology, Sunnybrook Health Sciences Centre, Toronto, Canada
| | | | - Stella Ndidi
- Centre Hospitalier Universitaire de Libreville, Libreville, Gabon
| | - Carlos B Tauil
- Laboratory of Immunology and Inflammation, University of Brasilia, Brasilia, Brazil
| | - Jean-Bernard Lekana-Douki
- Unité d'Evolution Epidémiologie et Résistances Parasitaires, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon
| | | | | | | | - Kelly G Magalhães
- Laboratory of Immunology and Inflammation, University of Brasilia, Brasilia, Brazil
| | - Nina Weis
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Robert Kozak
- Biological Sciences Platform, University of Toronto, Sunnybrook Research Institute at Sunnybrook Health Sciences Centre, Toronto, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.,Department of Laboratory Medicine and Molecular Diagnostics, Division of Microbiology, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Gary P Kobinger
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, USA
| | - Hugues Fausther-Bovendo
- Département de Microbiologie-Infectiologie et Immunologie, Université Laval, Quebec City, Canada. .,Global Urgent and Advanced Research and Development, 911 Rue Principale, Unit 100, Batiscan, QC, G0X 1A0, Canada.
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18
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Serology as a Tool to Assess Infectious Disease Landscapes and Guide Public Health Policy. Pathogens 2022; 11:pathogens11070732. [PMID: 35889978 PMCID: PMC9323579 DOI: 10.3390/pathogens11070732] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/10/2022] [Accepted: 06/16/2022] [Indexed: 01/27/2023] Open
Abstract
Understanding the local burden and epidemiology of infectious diseases is crucial to guide public health policy and prioritize interventions. Typically, infectious disease surveillance relies on capturing clinical cases within a healthcare system, classifying cases by etiology and enumerating cases over a period of time. Disease burden is often then extrapolated to the general population. Serology (i.e., examining serum for the presence of pathogen-specific antibodies) has long been used to inform about individuals past exposure and immunity to specific pathogens. However, it has been underutilized as a tool to evaluate the infectious disease burden landscape at the population level and guide public health decisions. In this review, we outline how serology provides a powerful tool to complement case-based surveillance for determining disease burden and epidemiology of infectious diseases, highlighting its benefits and limitations. We describe the current serology-based technologies and illustrate their use with examples from both the pre- and post- COVID-19-pandemic context. In particular, we review the challenges to and opportunities in implementing serological surveillance in low- and middle-income countries (LMICs), which bear the brunt of the global infectious disease burden. Finally, we discuss the relevance of serology data for public health decision-making and describe scenarios in which this data could be used, either independently or in conjunction with case-based surveillance. We conclude that public health systems would greatly benefit from the inclusion of serology to supplement and strengthen existing case-based infectious disease surveillance strategies.
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19
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Shaw-Saliba K, Kosasih H, Lau CY. Editorial: COVID and Tropical Diseases – Intersection of Policy and Science. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.861715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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20
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Fcγ-Receptor-Based Enzyme-Linked Immunosorbent Assays for Sensitive, Specific, and Persistent Detection of Anti-SARS-CoV-2 Nucleocapsid Protein IgG Antibodies in Human Sera. J Clin Microbiol 2022; 60:e0007522. [PMID: 35574677 PMCID: PMC9199419 DOI: 10.1128/jcm.00075-22] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Sensitive and specific serological tests are mandatory for epidemiological studies evaluating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence as well as coronavirus disease 2019 (COVID-19) morbidity and mortality rates. The accuracy of results is challenged by antibody waning after convalescence and by cross-reactivity induced by previous infections with other pathogens. By employing a patented platform technology based on capturing antigen-antibody complexes with a solid-phase-bound Fcγ receptor (FcγR) and truncated nucleocapsid protein as the antigen, two SARS-CoV-2 IgG enzyme-linked immunosorbent assays (ELISAs), featuring different serum and antigen dilutions, were developed. Validation was performed using a serum panel comprising 213 longitudinal samples from 35 COVID-19 patients and a negative-control panel consisting of 790 pre-COVID-19 samples from different regions of the world. While both assays show similar diagnostic sensitivities in the early convalescent phase, ELISA 2 (featuring a higher serum concentration) enables SARS-CoV-2 IgG antibody detection for a significantly longer time postinfection (≥15 months). Correspondingly, analytical sensitivity referenced to indirect immunofluorescence testing (IIFT) is significantly higher for ELISA 2 in samples with a titer of ≤1:640; for high-titer samples, a prozone effect is observed for ELISA 2. The specificities of both ELISAs were excellent not only for pre-COVID-19 serum samples from Europe, Asia, and South America but also for several challenging African sample panels. The SARS-CoV-2 IgG FcγR ELISAs, methodically combining antigen-antibody binding in solution and isotype-specific detection of immune complexes, are valuable tools for seroprevalence studies requiring the (long-term) detection of anti-SARS-CoV-2 IgG antibodies in populations with a challenging immunological background and/or in which spike-protein-based vaccine programs have been rolled out.
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21
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Traoré A, Guindo MA, Konaté D, Traoré B, Diakité SA, Kanté S, Dembélé A, Cissé A, Incandela NC, Kodio M, Coulibaly YI, Faye O, Kajava AV, Pratesi F, Migliorini P, Papini AM, Pacini L, Rovero P, Errante F, Diakité M, Arevalo-Herrera M, Herrera S, Corradin G, Balam S. Seroreactivity of the Severe Acute Respiratory Syndrome Coronavirus 2 Recombinant S Protein, Receptor-Binding Domain, and Its Receptor-Binding Motif in COVID-19 Patients and Their Cross-Reactivity With Pre-COVID-19 Samples From Malaria-Endemic Areas. Front Immunol 2022; 13:856033. [PMID: 35585976 PMCID: PMC9109707 DOI: 10.3389/fimmu.2022.856033] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/28/2022] [Indexed: 12/23/2022] Open
Abstract
Despite the global interest and the unprecedented number of scientific studies triggered by the COVID-19 pandemic, few data are available from developing and low-income countries. In these regions, communities live under the threat of various transmissible diseases aside from COVID-19, including malaria. This study aims to determine the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroreactivity of antibodies from COVID-19 and pre-COVID-19 samples of individuals in Mali (West Africa). Blood samples from COVID-19 patients (n = 266) at Bamako Dermatology Hospital (HDB) and pre-COVID-19 donors (n = 283) from a previous malaria survey conducted in Dangassa village were tested by ELISA to assess IgG antibodies specific to the full-length spike (S) protein, the receptor-binding domain (RBD), and the receptor-binding motif (RBM436-507). Study participants were categorized by age, gender, treatment duration for COVID-19, and comorbidities. In addition, the cross-seroreactivity of samples from pre-COVID-19, malaria-positive patients against the three antigens was assessed. Recognition of the SARS-CoV-2 proteins by sera from COVID-19 patients was 80.5% for S, 71.1% for RBD, and 31.9% for RBM (p < 0.001). While antibody responses to S and RBD tended to be age-dependent, responses to RBM were not. Responses were not gender-dependent for any of the antigens. Higher antibody levels to S, RBD, and RBM at hospital entry were associated with shorter treatment durations, particularly for RBD (p < 0.01). In contrast, higher body weights negatively influenced the anti-S antibody response, and asthma and diabetes weakened the anti-RBM antibody responses. Although lower, a significant cross-reactive antibody response to S (21.9%), RBD (6.7%), and RBM (8.8%) was detected in the pre-COVID-19 and malaria samples. Cross-reactive antibody responses to RBM were mostly associated (p < 0.01) with the absence of current Plasmodium falciparum infection, warranting further study.
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Affiliation(s)
- Abdouramane Traoré
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Merepen A. Guindo
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Drissa Konaté
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Bourama Traoré
- Department of Ministry of Health and Social Development, Hopital de Dermatologie de Bamako (HDB), Bamako, Mali
| | - Seidina A. Diakité
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Salimata Kanté
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Assitan Dembélé
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Abdourhamane Cissé
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Nathan C. Incandela
- Center for Polymers and Organic Solids, Department of Chemistry and Biochemistry, University of California Santa Barbara, Santa Barbara, CA, United States
| | - Mamoudou Kodio
- Department of Ministry of Health and Social Development, Hopital de Dermatologie de Bamako (HDB), Bamako, Mali
| | - Yaya I. Coulibaly
- Department of Ministry of Health and Social Development, Hopital de Dermatologie de Bamako (HDB), Bamako, Mali
| | - Ousmane Faye
- Department of Ministry of Health and Social Development, Hopital de Dermatologie de Bamako (HDB), Bamako, Mali
| | - Andrey V. Kajava
- Montpellier Cell Biology Research Center (CRBM), University of Montpellier, CNRS, Montpellier, France
| | - Federico Pratesi
- Immuno-Allergology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Paola Migliorini
- Immuno-Allergology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Anna Maria Papini
- Interdepartmental Research Unit of Peptide and Protein Chemistry and Biology, Department of Chemistry “Ugo Schiff”, University of Florence, Florence, Italy
| | - Lorenzo Pacini
- Interdepartmental Research Unit of Peptide and Protein Chemistry and Biology, Department of Chemistry “Ugo Schiff”, University of Florence, Florence, Italy
| | - Paolo Rovero
- Interdepartmental Research Unit of Peptide and Protein Chemistry and Biology, Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmaceutical Sciences and Nutraceutics, University of Florence, Florence, Italy
| | - Fosca Errante
- Interdepartmental Research Unit of Peptide and Protein Chemistry and Biology, Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmaceutical Sciences and Nutraceutics, University of Florence, Florence, Italy
| | - Mahamadou Diakité
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Myriam Arevalo-Herrera
- Department of Immunology, Malaria Vaccine and Drug Development Center, Cali, Colombia
- Department of Immunology, Caucaseco Scientific Research Center, Cali, Colombia
| | - Socrates Herrera
- Department of Immunology, Malaria Vaccine and Drug Development Center, Cali, Colombia
- Department of Immunology, Caucaseco Scientific Research Center, Cali, Colombia
| | | | - Saidou Balam
- Immunogenetic Laboratory and Parasitology, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
- Department of Nephrology, University Hospital Regensburg, Regensburg, Germany
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22
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de Oliveira-Filho EF, de Carvalho OV, Carneiro IO, Fernandes FD, Vaz SN, Pedroso C, Gonzalez-Auza L, Urbieta VC, Kühne A, Mayoral R, Jo WK, Moreira-Soto A, Reusken CBEM, Drosten C, Brites C, Osterrieder K, Netto EM, Ristow LE, Maia RDC, Vogel FSF, de Almeida NR, Franke CR, Drexler JF. Frequent Infection of Cats With SARS-CoV-2 Irrespective of Pre-Existing Enzootic Coronavirus Immunity, Brazil 2020. Front Immunol 2022; 13:857322. [PMID: 35450070 PMCID: PMC9016337 DOI: 10.3389/fimmu.2022.857322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
Carnivores such as cats and minks are highly susceptible to SARS-CoV-2. Brazil is a global COVID-19 hot spot and several cases of human-to-cat transmission have been documented. We investigated the spread of SARS-CoV-2 by testing 547 domestic cats sampled between July-November 2020 from seven states in southern, southeastern, and northeastern Brazil. Moreover, we investigated whether immune responses elicited by enzootic coronaviruses affect SARS-CoV-2 infection in cats. We found infection with significantly higher neutralizing antibody titers against the Gamma variant of concern, endemic in Brazil during 2020, than against an early SARS-CoV-2 B.1 isolate (p<0.0001), validating the use of Gamma for further testing. The overall SARS-CoV-2 seroprevalence in Brazilian cats during late 2020 validated by plaque reduction neutralization test (PRNT90) was 7.3% (95% CI, 5.3-9.8). There was no significant difference in SARS-CoV-2 seroprevalence in cats between Brazilian states, suggesting homogeneous infection levels ranging from 4.6% (95% CI, 2.2-8.4) to 11.4% (95% CI, 6.7-17.4; p=0.4438). Seroprevalence of the prototypic cat coronavirus Feline coronavirus (FCoV) in a PRNT90 was high at 33.3% (95% CI, 24.9-42.5) and seroprevalence of Bovine coronavirus (BCoV) was low at 1.7% (95% CI, 0.2-5.9) in a PRNT90. Neutralizing antibody titers were significantly lower for FCoV than for SARS-CoV-2 (p=0.0001), consistent with relatively more recent infection of cats with SARS-CoV-2. Neither the magnitude of SARS-CoV-2 antibody titers (p=0.6390), nor SARS-CoV-2 infection status were affected by FCoV serostatus (p=0.8863). Our data suggest that pre-existing immunity against enzootic coronaviruses neither prevents, nor enhances SARS-CoV-2 infection in cats. High SARS-CoV-2 seroprevalence already during the first year of the pandemic substantiates frequent infection of domestic cats and raises concerns on potential SARS-CoV-2 mutations escaping human immunity upon spillback.
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Affiliation(s)
- Edmilson F de Oliveira-Filho
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Ianei O Carneiro
- School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | | | - Sara Nunes Vaz
- Disease Research Laboratory, University Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | - Célia Pedroso
- Disease Research Laboratory, University Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | - Lilian Gonzalez-Auza
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Victor Carvalho Urbieta
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Arne Kühne
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Rafaela Mayoral
- School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | - Wendy K Jo
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andrés Moreira-Soto
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Chantal B E M Reusken
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Christian Drosten
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Carlos Brites
- Disease Research Laboratory, University Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | | | - Eduardo Martins Netto
- Disease Research Laboratory, University Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | | | - Rita de Cassia Maia
- Veterinary Medicine Department, Federal Rural University of Pernambuco, Recife, Brazil
| | | | - Nadia Rossi de Almeida
- School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | - Carlos Roberto Franke
- School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | - Jan Felix Drexler
- Institute of Virology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,German Centre for Infection Research (DZIF), Associated Partner Site Charité, Berlin, Germany
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23
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Validation of xMAP SARS-CoV-2 Multi-Antigen IgG assay in Nigeria. PLoS One 2022; 17:e0266184. [PMID: 35363818 PMCID: PMC8974966 DOI: 10.1371/journal.pone.0266184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 03/15/2022] [Indexed: 11/19/2022] Open
Abstract
Objective There is a need for reliable serological assays to determine accurate estimates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence. Most single target antigen assays have shown some limitations in Africa. To assess the performance of a multi-antigen assay, we evaluated a commercially available SARS-CoV-2 Multi-Antigen IgG assay for human coronavirus disease 2019 (COVID-19) in Nigeria. Methods Validation of the xMAP SARS-CoV-2 Multi-Antigen IgG assay was carried out using well-characterized SARS-CoV-2 reverse transcription polymerase chain reactive positive (97) and pre-COVID-19 pandemic (86) plasma panels. Cross-reactivity was assessed using pre-COVID-19 pandemic plasma specimens (213) from the 2018 Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS). Results The overall sensitivity of the xMAP SARS-CoV-2 Multi-Antigen IgG assay was 75.3% [95% CI: 65.8%– 82.8%] and specificity was 99.0% [95% CI: 96.8%– 99.7%]. The sensitivity estimate increased to 83.3% [95% CI: 70.4%– 91.3%] for specimens >14 days post-confirmation of diagnosis. However, using the NAIIS pre-pandemic specimens, the false positivity rate was 1.4% (3/213). Conclusions Our results showed overall lower sensitivity and a comparable specificity with the manufacturer’s validation. There appears to be less cross-reactivity with NAIIS pre-pandemic COVID-19 specimens using the xMAP SARS-CoV-2 Multi-Antigen IgG assay. In-country SARS-CoV-2 serology assay validation can help guide the best choice of assays in Africa.
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24
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Gebrecherkos T, Kiros YK, Challa F, Abdella S, Gebreegzabher A, Leta D, Desta A, Hailu A, Tasew G, Abdulkader M, Tessema M, Tollera G, Kifle T, Arefaine ZG, Schallig HHDF, Adams ER, Urban BC, de Wit TFR, Wolday D. Longitudinal profile of antibody response to SARS-CoV-2 in patients with COVID-19 in a setting from Sub-Saharan Africa: A prospective longitudinal study. PLoS One 2022; 17:e0263627. [PMID: 35320286 PMCID: PMC8942258 DOI: 10.1371/journal.pone.0263627] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/24/2022] [Indexed: 12/14/2022] Open
Abstract
Background Serological testing for SARS-CoV-2 plays an important role for epidemiological studies, in aiding the diagnosis of COVID-19, and assess vaccine responses. Little is known on dynamics of SARS-CoV-2 serology in African settings. Here, we aimed to characterize the longitudinal antibody response profile to SARS-CoV-2 in Ethiopia. Methods In this prospective study, a total of 102 PCR-confirmed COVID-19 patients were enrolled. We obtained 802 plasma samples collected serially. SARS-CoV-2 antibodies were determined using four lateral flow immune-assays (LFIAs), and an electrochemiluminescent immunoassay. We determined longitudinal antibody response to SARS-CoV-2 as well as seroconversion dynamics. Results Serological positivity rate ranged between 12%-91%, depending on timing after symptom onset. There was no difference in positivity rate between severe and non-severe COVID-19 cases. The specificity ranged between 90%-97%. Agreement between different assays ranged between 84%-92%. The estimated positive predictive value (PPV) for IgM or IgG in a scenario with seroprevalence at 5% varies from 33% to 58%. Nonetheless, when the population seroprevalence increases to 25% and 50%, there is a corresponding increases in the estimated PPVs. The estimated negative-predictive value (NPV) in a low seroprevalence scenario (5%) is high (>99%). However, the estimated NPV in a high seroprevalence scenario (50%) for IgM or IgG is reduced significantly to 80% to 85%. Overall, 28/102 (27.5%) seroconverted by one or more assays tested, within a median time of 11 (IQR: 9–15) days post symptom onset. The median seroconversion time among symptomatic cases tended to be shorter when compared to asymptomatic patients [9 (IQR: 6–11) vs. 15 (IQR: 13–21) days; p = 0.002]. Overall, seroconversion reached 100% 5.5 weeks after the onset of symptoms. Notably, of the remaining 74 COVID-19 patients included in the cohort, 64 (62.8%) were positive for antibody at the time of enrollment, and 10 (9.8%) patients failed to mount a detectable antibody response by any of the assays tested during follow-up. Conclusions Longitudinal assessment of antibody response in African COVID-19 patients revealed heterogeneous responses. This underscores the need for a comprehensive evaluation of seroassays before implementation. Factors associated with failure to seroconvert needs further research.
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Affiliation(s)
| | | | - Feyissa Challa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Saro Abdella
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Dereje Leta
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | - Geremew Tasew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | | | | | | | - Henk HDF Schallig
- Department of Medical Microbiology, and Infection Prevention, Experimental Parasitology Unit, Amsterdam Institute for Infection and Immunity, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands
| | - Emily R. Adams
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Britta C. Urban
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Tobias F. Rinke de Wit
- Amsterdam Institute Global Health and Development, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Dawit Wolday
- Mekelle University College of Health Sciences, Mekelle, Ethiopia
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- * E-mail: ,
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25
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Sagara I, Woodford J, Kone M, Assadou MH, Katile A, Attaher O, Zeguime A, Doucoure M, Higbee E, Lane J, Mohan R, Doritchamou J, Zaidi I, Esposito D, Kwan J, Sadtler K, Dicko A, Duffy PE. Rapidly Increasing Severe Acute Respiratory Syndrome Coronavirus 2 Seroprevalence and Limited Clinical Disease in 3 Malian Communities: A Prospective Cohort Study. Clin Infect Dis 2022; 74:1030-1038. [PMID: 34185847 PMCID: PMC8394825 DOI: 10.1093/cid/ciab589] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The extent of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure and transmission in Mali and the surrounding region is not well understood. We aimed to estimate the cumulative incidence of SARS-CoV-2 in 3 communities and understand factors associated with infection. METHODS Between July 2020 and January 2021, we collected blood samples and demographic, social, medical, and self-reported symptoms information from residents aged 6 months and older over 2 study visits. SARS-CoV-2 antibodies were measured using a highly specific 2-antigen enzyme-linked immunosorbent assay optimized for use in Mali. We calculated cumulative adjusted seroprevalence for each community and evaluated factors associated with serostatus at each visit by univariate and multivariate analysis. RESULTS Overall, 94.8% (2533/2672) of participants completed both study visits. A total of 31.3% (837/2672) were aged <10 years, 27.6% (737/2672) were aged 10-17 years, and 41.1% (1098/2572) were aged ≥18 years. The cumulative SARS-CoV-2 exposure rate was 58.5% (95% confidence interval, 47.5-69.4). This varied between sites and was 73.4% in the urban community of Sotuba, 53.2% in the rural town of Bancoumana, and 37.1% in the rural village of Donéguébougou. Study site and increased age were associated with serostatus at both study visits. There was minimal difference in reported symptoms based on serostatus. CONCLUSIONS The true extent of SARS-CoV-2 exposure in Mali is greater than previously reported and may now approach hypothetical "herd immunity" in urban areas. The epidemiology of the pandemic in the region may be primarily subclinical and within background illness rates.
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Affiliation(s)
- Issaka Sagara
- Malaria Research and Training Center/University of Sciences, Techniques and Techniques of Bamako, Bamako, Mali
| | - John Woodford
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Maryland, Bethesda, USA
| | - Mamady Kone
- Malaria Research and Training Center/University of Sciences, Techniques and Techniques of Bamako, Bamako, Mali
| | - Mahamadoun Hamady Assadou
- Malaria Research and Training Center/University of Sciences, Techniques and Techniques of Bamako, Bamako, Mali
| | - Abdoulaye Katile
- Malaria Research and Training Center/University of Sciences, Techniques and Techniques of Bamako, Bamako, Mali
| | - Oumar Attaher
- Malaria Research and Training Center/University of Sciences, Techniques and Techniques of Bamako, Bamako, Mali
| | - Amatigue Zeguime
- Malaria Research and Training Center/University of Sciences, Techniques and Techniques of Bamako, Bamako, Mali
| | - M’Bouye Doucoure
- Malaria Research and Training Center/University of Sciences, Techniques and Techniques of Bamako, Bamako, Mali
| | - Emily Higbee
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Maryland, Bethesda, USA
| | - Jacquelyn Lane
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Maryland, Bethesda, USA
| | - Rathy Mohan
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Maryland, Bethesda, USA
| | - Justin Doritchamou
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Maryland, Bethesda, USA
| | - Irfan Zaidi
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Maryland, Bethesda, USA
| | - Dominic Esposito
- Frederick National Laboratory for Cancer Research, National Institutes of Health, Maryland, Frederick, USA
| | - Jennifer Kwan
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Maryland, Bethesda, USA
| | - Kaitlyn Sadtler
- National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Maryland, Bethesda, USA
| | - Alassane Dicko
- Malaria Research and Training Center/University of Sciences, Techniques and Techniques of Bamako, Bamako, Mali
| | - Patrick E Duffy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Maryland, Bethesda, USA
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26
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Audu RA, Stafford KA, Steinhardt L, Musa ZA, Iriemenam N, Ilori E, Blanco N, Mitchell A, Hamada Y, Moloney M, Iwara E, Abimiku A, Ige FA, William NE, Igumbor E, Ochu C, Omoare AA, Okunoye O, Greby SM, Rangaka MX, Copas A, Dalhatu I, Abubakar I, McCracken S, Alagi M, Mba N, Anthony A, Okoye M, Okoi C, Ezechi OC, Salako BL, Ihekweazu C. Seroprevalence of SARS-CoV-2 in four states of Nigeria in October 2020: A population-based household survey. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000363. [PMID: 36962359 PMCID: PMC10022353 DOI: 10.1371/journal.pgph.0000363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/31/2022] [Indexed: 04/25/2023]
Abstract
The observed epidemiology of SARS-CoV-2 in sub-Saharan Africa has varied greatly from that in Europe and the United States, with much lower reported incidence. Population-based studies are needed to estimate true cumulative incidence of SARS-CoV-2 to inform public health interventions. This study estimated SARS-CoV-2 seroprevalence in four selected states in Nigeria in October 2020. We implemented a two-stage cluster sample household survey in four Nigerian states (Enugu, Gombe, Lagos, and Nasarawa) to estimate age-stratified prevalence of SARS-CoV-2 antibodies. All individuals in sampled households were eligible for interview, blood draw, and nasal/oropharyngeal swab collection. We additionally tested participants for current/recent malaria infection. Seroprevalence estimates were calculated accounting for the complex survey design. Across all four states, 10,629 (96·5%) of 11,015 interviewed individuals provided blood samples. The seroprevalence of SARS-CoV-2 antibodies was 25·2% (95% CI 21·8-28·6) in Enugu State, 9·3% (95% CI 7·0-11·5) in Gombe State, 23·3% (95% CI 20·5-26·4) in Lagos State, and 18·0% (95% CI 14·4-21·6) in Nasarawa State. Prevalence of current/recent malaria infection ranged from 2·8% in Lagos to 45·8% in Gombe and was not significantly related to SARS-CoV-2 seroprevalence. The prevalence of active SARS-CoV-2 infection in the four states during the survey period was 0·2% (95% CI 0·1-0·4). Approximately eight months after the first reported COVID-19 case in Nigeria, seroprevalence indicated infection levels 194 times higher than the 24,198 officially reported COVID-19 cases across the four states; however, most of the population remained susceptible to COVID-19 in October 2020.
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Affiliation(s)
| | - Kristen A Stafford
- Center for International Health, Education and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Laura Steinhardt
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Zaidat A Musa
- Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Nnaemeka Iriemenam
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, United States Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Elsie Ilori
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Natalia Blanco
- Center for International Health, Education and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Andrew Mitchell
- Center for International Health, Education and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Yohhei Hamada
- Institute for Global Health, University College London, London, United Kingdom
| | - Mirna Moloney
- Center for International Health, Education and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Emem Iwara
- Center for International Health, Education and Biosecurity, University of Maryland, Baltimore, Abuja, Nigeria
| | - Alash'le Abimiku
- Center for International Health, Education and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | | | | | - Ehimario Igumbor
- Nigeria Centre for Disease Control, Abuja, Nigeria
- School of Public Health, University of Western Cape, Cape Town, South Africa
| | - Chinwe Ochu
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | - Olumide Okunoye
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, United States Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Stacie M Greby
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, United States Centers for Disease Control and Prevention, Abuja, Nigeria
| | | | - Andrew Copas
- Institute for Global Health, University College London, London, United Kingdom
| | - Ibrahim Dalhatu
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, United States Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Ibrahim Abubakar
- Institute for Global Health, University College London, London, United Kingdom
| | - Stephen McCracken
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Matthias Alagi
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, United States Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Nwando Mba
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | - McPaul Okoye
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, United States Centers for Disease Control and Prevention, Abuja, Nigeria
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27
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Yadouleton A, Sander AL, Adewumi P, de Oliveira Filho EF, Tchibozo C, Hounkanrin G, René KK, Ange D, Kohoun RK, Nari RC, Salifou S, Saizonou R, Kakai CG, Bedié SV, Al Onifade F, Nagel M, Aïssi MAJ, Akogbeto P, Drosten C, Wulf B, Moreira-Soto A, Djingarey MH, Hounkpatin B, Drexler JF. Emergence of SARS-CoV-2 Delta Variant, Benin, May-July 2021. Emerg Infect Dis 2022; 28:205-209. [PMID: 34807815 PMCID: PMC8714210 DOI: 10.3201/eid2801.211909] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 Delta variant epidemiology in Africa is unknown. We found Delta variant was introduced in Benin during April-May 2021 and became predominant within 2 months, after which a steep increase in reported coronavirus disease incidence occurred. Benin might require increased nonpharmaceutical interventions and vaccination coverage.
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Abstract
Latin America has been severely affected by the COVID-19 pandemic. The COVID-19 burden in rural settings in Latin America is unclear. We performed a cross-sectional, population-based, random-selection SARS-CoV-2 serologic study during March 2021 in the rural population of San Martin region, northern Peru. In total, 563 persons from 288 houses across 10 provinces were enrolled, reaching 0.2% of the total rural population of San Martin. Screening for SARS-CoV-2 IgG antibodies was done using a chemiluminescence immunoassay (CLIA), and reactive sera were confirmed using a SARS-CoV-2 surrogate virus neutralization test (sVNT). Validation of the testing algorithm using prepandemic sera from two regions of Peru showed false-positive results in the CLIA (23/84 sera; 27%) but not in the sVNT, highlighting the pitfalls of SARS-CoV-2 antibody testing in tropical regions and the high specificity of the two-step algorithm used in this study. An overall 59.0% seroprevalence (95% confidence interval [CI], 55 to 63%) corroborated intense SARS-CoV-2 spread in San Martin. Seroprevalence rates between the 10 provinces varied from 41.3 to 74.0% (95% CI, 30 to 84%). Higher seroprevalence was not associated with population size, population density, surface area, mean altitude, or poverty index in Spearman correlations. Seroprevalence and reported incidence diverged substantially between provinces, suggesting regional biases of COVID-19 surveillance data. Potentially, limited health care access due to environmental, economic, and cultural factors might lead to undetected infections in rural populations. Additionally, test avoidance to evade mandatory quarantine might affect rural regions more than urban regions. Serologic diagnostics should be pursued in resource-limited settings to inform country-level surveillance and vaccination strategies and to support control measures for COVID-19. IMPORTANCE Latin America is a global hot spot of the COVID-19 pandemic. Serologic studies in Latin America have been mostly performed in urban settings. Rural populations comprise 20% of the total Latin American population. Nevertheless, information on COVID-19 spread in rural settings is scarce. Using a representative population-based seroprevalence study, we detected a high seroprevalence in rural populations in San Martin, northern Peru, in 2021, reaching 41 to 74%. However, seroprevalence and reported incidence diverged substantially between regions, potentially due to limited health care access or test avoidance due to mandatory quarantine. Our results suggest that rural populations are highly affected by SARS-CoV-2 even though they are sociodemographically distinct from urban populations and that highly specific serological diagnostics should be performed in resource-limited settings to support public health strategies of COVID-19 control.
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29
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Woodford J, Sagara I, Dicko A, Zeguime A, Doucoure M, Kwan J, Zaidi I, Doritchamou J, Snow-Smith M, Alani N, Renn J, Kosik I, Holly J, Yewdell J, Esposito D, Sadtler K, Duffy P. Severe Acute Respiratory Syndrome Coronavirus 2 Seroassay Performance and Optimization in a Population With High Background Reactivity in Mali. J Infect Dis 2021; 224:2001-2009. [PMID: 34612499 PMCID: PMC8522418 DOI: 10.1093/infdis/jiab498] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/04/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND False positivity may hinder the utility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological tests in sub-Saharan Africa. METHODS From 312 Malian samples collected before 2020, we measured antibodies to the commonly tested SARS-CoV-2 antigens and 4 other betacoronaviruses by enzyme-linked immunosorbent assay (ELISA). In a subset of samples, we assessed antibodies to a panel of Plasmodium falciparum antigens by suspension bead array and functional antiviral activity by SARS-CoV-2 pseudovirus neutralization assay. We then evaluated the performance of an ELISA using SARS-CoV-2 spike protein and receptor-binding domain developed in the United States using Malian positive and negative control samples. To optimize test performance, we compared single- and 2-antigen approaches using existing assay cutoffs and population-specific cutoffs. RESULTS Background reactivity to SARS-CoV-2 antigens was common in prepandemic Malian samples. The SARS-CoV-2 reactivity varied between communities, increased with age, and correlated negligibly/weakly with other betacoronavirus and P falciparum antibodies. No prepandemic samples demonstrated functional activity. Regardless of the cutoffs applied, test specificity improved using a 2-antigen approach. Test performance was optimal using a 2-antigen assay with population-specific cutoffs (sensitivity, 73.9% [95% confidence interval {CI}, 51.6-89.8]; specificity, 99.4% [95% CI, 97.7-99.9]). CONCLUSIONS We have addressed the problem of SARS-CoV-2 seroassay performance in Africa by using a 2-antigen assay with cutoffs defined by performance in the target population.
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Affiliation(s)
- John Woodford
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Issaka Sagara
- Malaria Research and Training Center/University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Alassane Dicko
- Malaria Research and Training Center/University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Amatigue Zeguime
- Malaria Research and Training Center/University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - M’Bouye Doucoure
- Malaria Research and Training Center/University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Jennifer Kwan
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Irfan Zaidi
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Justin Doritchamou
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Maryonne Snow-Smith
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Nada Alani
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Jonathan Renn
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Ivan Kosik
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Jaroslav Holly
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Jonathan Yewdell
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Dominic Esposito
- Frederick National Laboratory for Cancer Research, National Institutes of Health, Frederick, Maryland, USA
| | - Kaitlyn Sadtler
- National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland, USA
| | - Patrick Duffy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
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30
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Woodford J, Sagara I, Dicko A, Zeguime A, Doucoure M, Kwan J, Zaidi I, Doritchamou J, Snow-Smith M, Alani N, Renn J, Kosik I, Holly J, Yewdell J, Esposito D, Sadtler K, Duffy P. Severe Acute Respiratory Syndrome Coronavirus 2 Seroassay Performance and Optimization in a Population With High Background Reactivity in Mali. J Infect Dis 2021. [PMID: 34612499 DOI: 10.1101/2021.03.08.21252784v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND False positivity may hinder the utility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological tests in sub-Saharan Africa. METHODS From 312 Malian samples collected before 2020, we measured antibodies to the commonly tested SARS-CoV-2 antigens and 4 other betacoronaviruses by enzyme-linked immunosorbent assay (ELISA). In a subset of samples, we assessed antibodies to a panel of Plasmodium falciparum antigens by suspension bead array and functional antiviral activity by SARS-CoV-2 pseudovirus neutralization assay. We then evaluated the performance of an ELISA using SARS-CoV-2 spike protein and receptor-binding domain developed in the United States using Malian positive and negative control samples. To optimize test performance, we compared single- and 2-antigen approaches using existing assay cutoffs and population-specific cutoffs. RESULTS Background reactivity to SARS-CoV-2 antigens was common in prepandemic Malian samples. The SARS-CoV-2 reactivity varied between communities, increased with age, and correlated negligibly/weakly with other betacoronavirus and P falciparum antibodies. No prepandemic samples demonstrated functional activity. Regardless of the cutoffs applied, test specificity improved using a 2-antigen approach. Test performance was optimal using a 2-antigen assay with population-specific cutoffs (sensitivity, 73.9% [95% confidence interval {CI}, 51.6-89.8]; specificity, 99.4% [95% CI, 97.7-99.9]). CONCLUSIONS We have addressed the problem of SARS-CoV-2 seroassay performance in Africa by using a 2-antigen assay with cutoffs defined by performance in the target population.
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Affiliation(s)
- John Woodford
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Issaka Sagara
- Malaria Research and Training Center/University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Alassane Dicko
- Malaria Research and Training Center/University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Amatigue Zeguime
- Malaria Research and Training Center/University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - M'Bouye Doucoure
- Malaria Research and Training Center/University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Jennifer Kwan
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Irfan Zaidi
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Justin Doritchamou
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Maryonne Snow-Smith
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Nada Alani
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Jonathan Renn
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Ivan Kosik
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Jaroslav Holly
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Jonathan Yewdell
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Dominic Esposito
- Frederick National Laboratory for Cancer Research, National Institutes of Health, Frederick, Maryland, USA
| | - Kaitlyn Sadtler
- National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, Maryland, USA
| | - Patrick Duffy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
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31
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Woodford J, Sagara I, Kwan J, Zaidi I, Dicko A, Duffy PE. Assessing and Minimizing the Effect of Malaria on SARS-CoV-2 Serodiagnostics. FRONTIERS IN TROPICAL DISEASES 2021. [DOI: 10.3389/fitd.2021.781586] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Malaria may affect the reliability of SARS-CoV-2 seroassay performance and limit understanding of SARS-CoV-2 epidemiology in malaria-endemic regions. We present our experience conducting SARS-CoV-2 serosurveillance in seasonal malaria-affected communities in Mali and discuss relevant literature regarding the effect of malaria on the performance of SARS-CoV-2 serodiagnostics, including approaches to minimize the effect of malaria-associated assay interference.
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32
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Yek C, Nam VS, Leang R, Parker DM, Heng S, Souv K, Sovannaroth S, Mayxay M, AbuBakar S, Sasmono RT, Tran ND, Le Nguyen HK, Lon C, Boonnak K, Huy R, Sovann L, Manning JE. The Pandemic Experience in Southeast Asia: Interface Between SARS-CoV-2, Malaria, and Dengue. FRONTIERS IN TROPICAL DISEASES 2021; 2:788590. [PMID: 35373190 PMCID: PMC8975143 DOI: 10.3389/fitd.2021.788590] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Southeast Asia (SEA) emerged relatively unscathed from the first year of the global SARS-CoV-2 pandemic, but as of July 2021 the region is experiencing a surge in case numbers primarily driven by Alpha (B.1.1.7) and subsequently the more transmissible Delta (B.1.617.2) variants. While initial disease burden was mitigated by swift government responses, favorable cultural and societal factors, the more recent rise in cases suggests an under-appreciation of prior prevalence and over-appreciation of possible cross-protective immunity from exposure to endemic viruses, and highlights the effects of vaccine rollout at varying tempos and of variable efficacy. This burgeoning crisis is further complicated by co-existence of malaria and dengue in the region, with implications of serological cross-reactivity on interpretation of SARS-CoV-2 assays and competing resource demands impacting efforts to contain both endemic and pandemic disease.
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Affiliation(s)
- Christina Yek
- Department of Critical Care Medicine, National Institutes of Health Clinical Center, Bethesda, MD, United States
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, United States
| | - Vu Sinh Nam
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Daniel M. Parker
- Department of Population Health and Disease Prevention, University of California, Irvine, Irvine, CA, United States
- Department of Epidemiology, University of California, Irvine, Irvine, CA, United States
| | - Seng Heng
- Ministry of Health, Phnom Penh, Cambodia
| | | | | | - Mayfong Mayxay
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
- Institute of Research and Education Development, University of Health Sciences, Vientiane, Laos
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Sazaly AbuBakar
- WHO Collaborating Center for Arbovirus Reference and Research (Dengue) and Tropical Infectious Diseases Research and Education Center, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Nhu Duong Tran
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Chanthap Lon
- International Center of Excellence in Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Phnom Penh, Cambodia
| | - Kobporn Boonnak
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Rekol Huy
- Ministry of Health, Phnom Penh, Cambodia
| | - Ly Sovann
- Ministry of Health, Phnom Penh, Cambodia
| | - Jessica E. Manning
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, United States
- International Center of Excellence in Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Phnom Penh, Cambodia
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Abstract
Validated assays are essential for reliable serosurveys; however, most SARS-CoV-2 immunoassays have been validated using specimens from China, Europe, or U.S. populations. We evaluated the performance of five commercial SARS-CoV-2 immunoassays to inform their use in serosurveys in Nigeria. Four semiquantitative enzyme-linked immunosorbent assays (ELISAs) (Euroimmun anti-SARS-CoV-2 nucleocapsid protein [NCP] immunoglobulin G [IgG], Euroimmun spike SARS-CoV-2 IgG, Mologic Omega COVID-19 IgG, Bio-Rad Platelia SARS-CoV-2 Total Ab) and one chemiluminescent microparticle immunoassay (Abbott Architect SARS-CoV-2 IgG) were evaluated. We estimated the analytical performance characteristics using plasma from 100 SARS-CoV-2 PCR-positive patients from varied time points post-PCR confirmation and 100 prepandemic samples (50 HIV positive and 50 hepatitis B positive). The Bio-Rad assay failed the manufacturer-specified validation steps. The Euroimmun NCP, Euroimmun spike, and Mologic assays had sensitivities of 73.7%, 74.4%, and 76.9%, respectively, on samples taken 15 to 58 days after PCR confirmation and specificities of 97%, 100%, and 83.8%, respectively. The Abbott assay had 71.3% sensitivity and 100% specificity on the same panel. Parallel or serial algorithms combining two tests did not substantially improve the sensitivity or specificity. Our results showed lower sensitivity and, for one immunoassay, lower specificity compared to the manufacturers’ results and other reported validations. Seroprevalence estimates using these assays might need to be interpreted with caution in Nigeria and similar settings. These findings highlight the importance of in-country validations of SARS-CoV-2 serological assays prior to use to ensure that accurate results are available for public health decision-making to control the COVID-19 pandemic in Africa. IMPORTANCE This study used positive and negative sample panels from Nigeria to test the performance of several commercially available SARS-CoV-2 serological assays. Using these prepandemic and SARS-CoV-2-positive samples, we found much lower levels of sensitivity in four commercially available assays than most assay manufacturer reports and independent evaluations. The use of these assays with suboptimal sensitivity and specificity in Nigeria or countries with population exposure to similar endemic pathogens could lead to a biased estimate of the seroprevalence, over- or underestimating the true disease prevalence, and limit efforts to stop the spread of SARS-CoV-2. It is important to conduct in-country validations of serological SARS-CoV-2 assays prior to their widespread use, especially in countries with limited representation in published assay validations.
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34
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Bottomley C, Otiende M, Uyoga S, Gallagher K, Kagucia EW, Etyang AO, Mugo D, Gitonga J, Karanja H, Nyagwange J, Adetifa IMO, Agweyu A, Nokes DJ, Warimwe GM, Scott JAG. Quantifying previous SARS-CoV-2 infection through mixture modelling of antibody levels. Nat Commun 2021; 12:6196. [PMID: 34702829 PMCID: PMC8548402 DOI: 10.1038/s41467-021-26452-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/17/2021] [Indexed: 11/09/2022] Open
Abstract
As countries decide on vaccination strategies and how to ease movement restrictions, estimating the proportion of the population previously infected with SARS-CoV-2 is important for predicting the future burden of COVID-19. This proportion is usually estimated from serosurvey data in two steps: first the proportion above a threshold antibody level is calculated, then the crude estimate is adjusted using external estimates of sensitivity and specificity. A drawback of this approach is that the PCR-confirmed cases used to estimate the sensitivity of the threshold may not be representative of cases in the wider population-e.g., they may be more recently infected and more severely symptomatic. Mixture modelling offers an alternative approach that does not require external data from PCR-confirmed cases. Here we illustrate the bias in the standard threshold-based approach by comparing both approaches using data from several Kenyan serosurveys. We show that the mixture model analysis produces estimates of previous infection that are often substantially higher than the standard threshold analysis.
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Affiliation(s)
- C Bottomley
- International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK.
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
| | - M Otiende
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - S Uyoga
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - K Gallagher
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - E W Kagucia
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - A O Etyang
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - D Mugo
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - J Gitonga
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - H Karanja
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - J Nyagwange
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - I M O Adetifa
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - A Agweyu
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Oxford University, Oxford, UK
| | - D J Nokes
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- School of Life Sciences, University of Warwick, Coventry, UK
| | - G M Warimwe
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Oxford University, Oxford, UK
| | - J A G Scott
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Oxford University, Oxford, UK
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35
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Specificity of SARS-CoV-2 antibody-detection assays against S and N protein among pre-COVID-19 sera from patients with protozoan and helminth parasitic infections. J Clin Microbiol 2021; 60:e0171721. [PMID: 34669455 PMCID: PMC8769729 DOI: 10.1128/jcm.01717-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We aimed to assess the specificity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody detection assays among people with tissue-borne parasitic infections. We tested three SARS-CoV-2 antibody-detection assays (cPass SARS-CoV-2 neutralization antibody detection kit [cPass], Abbott SARS-CoV-2 IgG assay [Abbott Architect], and Standard Q COVID-19 IgM/IgG combo rapid diagnostic test [SD RDT IgM/SD RDT IgG]) among 559 pre-COVID-19 seropositive sera for several parasitic infections. The specificity of assays was 95 to 98% overall. However, lower specificity was observed among sera from patients with protozoan infections of the reticuloendothelial system, such as human African trypanosomiasis (Abbott Architect; 88% [95% CI, 75 to 95]) and visceral leishmaniasis (SD RDT IgG; 80% [95% CI, 30 to 99]), and from patients with recent malaria in areas of Senegal where malaria is holoendemic (ranging from 91% for Abbott Architect and SD RDT IgM to 98 to 99% for cPass and SD RDT IgG). For specimens from patients with evidence of past or present helminth infection overall, test specificity estimates were all ≥96%. Sera collected from patients clinically suspected of parasitic infections that tested negative for these infections yielded a specificity of 98 to 100%. The majority (>85%) of false-positive results were positive by only one assay. The specificity of SARS-CoV-2 serological assays among sera from patients with tissue-borne parasitic infections was below the threshold required for decisions about individual patient care. Specificity is markedly increased by the use of confirmatory testing with a second assay. Finally, the SD RDT IgG proved similarly specific to laboratory-based assays and provides an option in low-resource settings when detection of anti-SARS-CoV-2 IgG is indicated.
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36
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Adams J, MacKenzie MJ, Amegah AK, Ezeh A, Gadanya MA, Omigbodun A, Sarki AM, Thistle P, Ziraba AK, Stranges S, Silverman M. The Conundrum of Low COVID-19 Mortality Burden in sub-Saharan Africa: Myth or Reality? GLOBAL HEALTH: SCIENCE AND PRACTICE 2021; 9:433-443. [PMID: 34593571 PMCID: PMC8514030 DOI: 10.9745/ghsp-d-21-00172] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/25/2021] [Indexed: 12/11/2022]
Abstract
The demographic age structure of sub-Saharan Africa contributes significantly to the low morbidity and mortality of COVID-19 compared to other regions in the world.
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Affiliation(s)
- Janica Adams
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Mary J MacKenzie
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Adeladza Kofi Amegah
- Public Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Alex Ezeh
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.,School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Muktar A Gadanya
- Bayero University, Kano, Kano State, Nigeria.,Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria
| | - Akinyinka Omigbodun
- University of Ibadan, Ibadan, Nigeria.,College of Medicine, University of Ibadan, Ibadan, Nigeria.,Pan African University Life & Earth Sciences Institute (PAULESI), Ibadan, Nigeria
| | - Ahmed M Sarki
- School of Nursing and Midwifery, Aga Khan University, Kampala, Uganda.,Family and Youth Health Initiative (FAYOHI), Jigawa State, Nigeria
| | - Paul Thistle
- Karanda Hospital, Mount Darwin, Zimbabwe.,The University of Zimbabwe, Harare, Zimbabwe.,University of Toronto, Toronto, Canada
| | | | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Family Medicine, Western University, London, Ontario, Canada.,The Africa Institute, Western University, London, Ontario, Canada.,Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Michael Silverman
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. .,Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,The Africa Institute, Western University, London, Ontario, Canada.,Division of Infectious Diseases, Western University, London, Ontario, Canada
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37
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Sander AL, Yadouleton A, de Oliveira Filho EF, Tchibozo C, Hounkanrin G, Badou Y, Adewumi P, René KK, Ange D, Sourakatou S, Sedjro E, Aïssi MAJ, Fidelia H, Djingarey MH, Nagel M, Jo WK, Moreira-Soto A, Drosten C, Landt O, Corman VM, Hounkpatin B, Drexler JF. Mutations Associated with SARS-CoV-2 Variants of Concern, Benin, Early 2021. Emerg Infect Dis 2021; 27:2889-2903. [PMID: 34463240 PMCID: PMC8544961 DOI: 10.3201/eid2711.211353] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Intense transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Africa might promote emergence of variants. We describe 10 SARS-CoV-2 lineages in Benin during early 2021 that harbored mutations associated with variants of concern. Benin-derived SARS-CoV-2 strains were more efficiently neutralized by antibodies derived from vaccinees than patients, warranting accelerated vaccination in Africa.
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38
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Fischer C, Jo WK, Haage V, Moreira-Soto A, de Oliveira Filho EF, Drexler JF. Challenges towards serologic diagnostics of emerging arboviruses. Clin Microbiol Infect 2021; 27:1221-1229. [DOI: 10.1016/j.cmi.2021.05.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/19/2021] [Accepted: 05/27/2021] [Indexed: 12/26/2022]
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39
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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: 36] [Impact Index Per Article: 12.0] [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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Shaweno T, Abdulhamid I, Bezabih L, Teshome D, Derese B, Tafesse H, Shaweno D. Seroprevalence of SARS-CoV-2 antibody among individuals aged above 15 years and residing in congregate settings in Dire Dawa city administration, Ethiopia. Trop Med Health 2021; 49:55. [PMID: 34246317 PMCID: PMC8271338 DOI: 10.1186/s41182-021-00347-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/28/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Determining the extent of seropositivity of SARS-CoV-2 antibody has the potential to guide prevention and control efforts. We aimed to determine the seroprevalence of SARS-CoV-2 antibody among individuals aged above15 years and residing in the congregate settings of Dire Dawa city administration, Ethiopia. METHOD We analyzed COVID-19 seroprevalence data on 684 individuals from a community based cross-sectional survey conducted among individuals aged above 15 years and residing in congregate settings in Dire Dawa from June 15 to July 30, 2020. Data were collected using interview and blood sample collection. Participants were asked about demographic characteristics, COVID-19 symptoms, and their practice of preventive measures. Seroprevalence was determined using SARS-CoV-2 IgG test. Bivariate and multivariate multilevel mixed effects logistic regression model was fitted and statistical significance was set at p value < 0.05. RESULT The estimated SARS-CoV-2 seroprevalence was 3.2% (95 % CI 2.0-4.8) in the study region with no differences by age and sex but considerable differences were observed by self-reported practice of COVID-19 preventive measures. The cluster effect is not significant (P = 0.396) which has suggested no evidence of heterogeneity in SARS-CoV-2 seroprevalence among the clusters. The odds of SARS-CoV-2 antibody seroprevalence were higher for individuals who were employed and work by moving from home to work area (AOR; 9.73 95% CI 2.51, 37.68), reported of not wearing facemasks when leaving home (AOR; 6.4 95% CI 2.30, 17.66) and did not practice physical distancing measures (AOR; 10 95% CI 3.01, 33.20) compared to their counterparts, respectively. Our estimated seroprevalence of SARS-CoV-2 among participants who reported not to have practiced social distancing measures was 12.8 (95% CI, 7.0, 19) and 1.5 (95% CI, 0.5, 2.5) among those who reported of practicing them. More than 80% of study participants reported of implementing infection prevention measures (face masks and physical distancing recommendations). CONCLUSION The detected SARS-CoV-2 seroprevalence among the study participants was low at the time of the survey indicating higher proportion of population yet to be infected. COVID-19 preventive measures were associated with reduced seroprevalence and should be promoted to avoid transmission to the uninfected majority.
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Affiliation(s)
- Tamrat Shaweno
- Department of Epidemiology, Faculty of Public Health, Jimma University Institute of Health, Jimma, Ethiopia
| | | | - Lemlem Bezabih
- Dire Dawa Administration Regional Health Bureau, Dire Dawa, Ethiopia
| | - Daniel Teshome
- Dire Dawa Administration Regional Health Bureau, Dire Dawa, Ethiopia
| | - Behailu Derese
- Dire Dawa Administration Regional Health Bureau, Dire Dawa, Ethiopia
| | | | - Debebe Shaweno
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Quashie PK, Mutungi JK, Dzabeng F, Oduro-Mensah D, Opurum PC, Tapela K, Udoakang AJ, Asante I, Paemka L, Kumi-Ansah F, Quaye O, Amoako E, Armah R, Kilba C, Boateng NA, Ofori M, Kyei GB, Bediako Y, Ndam N, Abugri J, Ansah P, Ampofo WK, Mutapi F, Awandare GA. Trends of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody prevalence in selected regions across Ghana. Wellcome Open Res 2021. [DOI: 10.12688/wellcomeopenres.16890.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: We set out to estimate the community-level exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Ghana. Methods: Phased seroprevalence studies of 2729 participants at selected locations across Ghana were conducted. Phase I (August 2020) sampled 1305 individuals at major markets/lorry stations, shopping malls, hospitals and research institutions involved in coronavirus disease 2019 (COVID-19) work. The study utilized a lateral flow rapid diagnostic test (RDT) which detected IgM and IgG antibodies against SARS-CoV-2 nucleocapsid protein. Results: During Phase I, 252/1305 (19%) tested positive for IgM or IgG or both. Exposure was significantly higher at markets/lorry stations (26.9%) compared to malls (9.4%), with 41–60-year group demonstrating highest seropositivity (27.2%). Exposure was higher in participants with no formal education (26.2%) than those with tertiary education (13.1%); and higher in informally employed workers (24.0%) than those in the formal sector (15.0%). Results from phases II and III, in October and December 2020 respectively, implied either reduced transmissions or loss of antibody expression in some participants. The Upper East region showed the lowest seropositivity (2%). Phase IV, in February 2021, showed doubled seropositivity in the upper income bracket (26.2%) since August 2020, reflective of Ghana’s second wave of symptomatic COVID-19 cases. This suggested that high transmission rates had overcome the initial socioeconomic stratification of exposure risk. Reflective of second wave hospitalisation trends, the 21-40 age group demonstrated modal seropositivity (24.9) in Phase IV whilst 40-60 years and 60+ previously demonstrated highest prevalence. Conclusions: Overall, the data indicates higher COVID-19 seroprevalence than officially acknowledged, likely implying a considerably lower-case fatality rate than the current national figure of 0.84%. The data also suggests that COVID-19 is predominantly asymptomatic COVID-19 in Ghana. The observed trends mimic clinical trends of infection and imply that the methodology used was appropriate.
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Vanroye F, den Bossche DV, Brosius I, Tack B, Esbroeck MV, Jacobs J. COVID-19 Antibody Detecting Rapid Diagnostic Tests Show High Cross-Reactivity When Challenged with Pre-Pandemic Malaria, Schistosomiasis and Dengue Samples. Diagnostics (Basel) 2021; 11:diagnostics11071163. [PMID: 34202195 PMCID: PMC8305106 DOI: 10.3390/diagnostics11071163] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/23/2021] [Accepted: 06/23/2021] [Indexed: 12/13/2022] Open
Abstract
COVID-19 Antibody Detecting Rapid Diagnostic Tests (COVID-19 Ab RDTs) are the preferred tool for SARS-CoV-2 seroprevalence studies, particularly in low- and middle-income countries. The present study challenged COVID-19 Ab RDTs with pre-pandemic samples of patients exposed to tropical pathogens. A retrospective study was performed on archived serum (n = 94) and EDTA whole blood (n = 126) samples obtained during 2010–2018 from 196 travelers with malaria (n = 170), schistosomiasis (n = 25) and dengue (n = 25). COVID-19 Ab RDTs were selected based on regulatory approval status, independent evaluation results and detecting antigens. Among 13 COVID-19 Ab RDT products, overall cross-reactivity was 18.5%; cross-reactivity for malaria, schistosomiasis and dengue was 20.3%, 18.1% and 7.5%, respectively. Cross-reactivity for current and recent malaria, malaria antibodies, Plasmodium species and parasite densities was similar. Cross-reactivity among the different RDT products ranged from 2.7% to 48.9% (median value 14.5%). IgM represented 67.9% of cross-reactive test lines. Cross-reactivity was not associated with detecting antigens, patient categories or disease (sub)groups, except for schistosomiasis (two products with ≥60% cross-reactivity). The high cross-reactivity for malaria, schistosomiasis and—to a lesser extent—dengue calls for risk mitigation when using COVID-19 Ab RDTs in co-endemic regions.
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Affiliation(s)
- Fien Vanroye
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
- Correspondence:
| | - Dorien Van den Bossche
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
| | - Isabel Brosius
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
| | - Bieke Tack
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
- Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
| | - Jan Jacobs
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; (D.V.d.B.); (I.B.); (B.T.); (M.V.E.); (J.J.)
- Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
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Differential Performance of CoronaCHEK SARS-CoV-2 Lateral Flow Antibody Assay by Geographic Origin of Samples. J Clin Microbiol 2021; 59:e0083721. [PMID: 33903166 DOI: 10.1128/jcm.00837-21] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
We assessed the performance of the CoronaCHEK lateral flow assay on samples from Uganda and Baltimore to determine the impact of geographic origin on assay performance. Plasma samples from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR-positive individuals (Uganda, 78 samples from 78 individuals, and Baltimore, 266 samples from 38 individuals) and from prepandemic individuals (Uganda, 1,077, and Baltimore, 532) were evaluated. Prevalence ratios (PR) were calculated to identify factors associated with a false-positive test. After the first positive PCR in Ugandan samples, the sensitivity was 45% (95% confidence interval [CI], 24,68) at 0 to 7 days, 79% (95% CI, 64 to 91) at 8 to 14 days, and 76% (95% CI, 50 to 93) at >15 days. In samples from Baltimore, sensitivity was 39% (95% CI, 30 to 49) at 0 to 7 days, 86% (95% CI, 79 to 92) at 8 to 14 days, and 100% (95% CI, 89 to 100) at 15 days after positive PCR. The specificity of 96.5% (95% CI, 97.5 to 95.2) in Ugandan samples was significantly lower than that in samples from Baltimore, 99.3% (95% CI, 98.1 to 99.8; P < 0.01). In Ugandan samples, individuals with a false-positive result were more likely to be male (PR, 2.04; 95% CI, 1.03,3.69) or individuals who had had a fever more than a month prior to sample acquisition (PR, 2.87; 95% CI, 1.12 to 7.35). Sensitivity of the CoronaCHEK was similar in samples from Uganda and Baltimore. The specificity was significantly lower in Ugandan samples than in Baltimore samples. False-positive results in Ugandan samples appear to correlate with a recent history of a febrile illness, potentially indicative of a cross-reactive immune response in individuals from East Africa.
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Cross-Reactivity of Two SARS-CoV-2 Serological Assays in a Setting Where Malaria Is Endemic. J Clin Microbiol 2021; 59:e0051421. [PMID: 33853839 DOI: 10.1128/jcm.00514-21] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Accurate SARS-CoV-2 serological assays are critical for COVID-19 serosurveillance. However, previous studies have indicated possible cross-reactivity of these assays, including in areas where malaria is endemic. We tested 213 well-characterized prepandemic samples from Nigeria using two SARS-CoV-2 serological assays, Abbott Architect IgG and Euroimmun NCP IgG assay, both targeting SARS-CoV-2 nucleocapsid protein. To assess antibody binding strength, an avidity assay was performed on these samples and on plasma from SARS-CoV-2 PCR-positive persons. Thirteen (6.1%) of 212 samples run on the Abbott assay and 38 (17.8%) of 213 run on the Euroimmun assay were positive. Anti-Plasmodium IgG levels were significantly higher among false positives for both Abbott and Euroimmun; no association was found with active Plasmodium falciparum infection. An avidity assay using various concentrations of urea wash in the Euroimmun assay reduced loosely bound IgG: of 37 positive/borderline prepandemic samples, 46%, 86%, 89%, and 97% became negative using 2 M, 4 M, 5 M, and 8 M urea washes, respectively. The wash slightly reduced avidity of antibodies from SARS-CoV-2 patients within 28 days of PCR confirmation; thereafter, avidity increased for all urea concentrations except 8 M. This validation found moderate to substantial cross-reactivity on two SARS-CoV-2 serological assays using samples from a setting where malaria is endemic. A simple urea wash appeared to alleviate issues of cross-reactivity.
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Wiens KE, Mawien PN, Rumunu J, Slater D, Jones FK, Moheed S, Caflisch A, Bior BK, Jacob IA, Lako RL, Guyo AG, Olu OO, Maleghemi S, Baguma A, Hassen JJ, Baya SK, Deng L, Lessler J, Demby MN, Sanchez V, Mills R, Fraser C, Charles RC, Harris JB, Azman AS, Wamala JF. Seroprevalence of Severe Acute Respiratory Syndrome Coronavirus 2 IgG in Juba, South Sudan, 2020 1. Emerg Infect Dis 2021; 27:1598-1606. [PMID: 34013872 PMCID: PMC8153877 DOI: 10.3201/eid2706.210568] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Relatively few coronavirus disease cases and deaths have been reported from sub-Saharan Africa, although the extent of its spread remains unclear. During August 10-September 11, 2020, we recruited 2,214 participants for a representative household-based cross-sectional serosurvey in Juba, South Sudan. We found 22.3% of participants had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor binding domain IgG titers above prepandemic levels. After accounting for waning antibody levels, age, and sex, we estimated that 38.3% (95% credible interval 31.8%-46.5%) of the population had been infected with SARS-CoV-2. At this rate, for each PCR-confirmed SARS-CoV-2 infection reported by the Ministry of Health, 103 (95% credible interval 86-126) infections would have been unreported, meaning SARS-CoV-2 has likely spread extensively within Juba. We also found differences in background reactivity in Juba compared with Boston, Massachusetts, USA, where the immunoassay was validated. Our findings underscore the need to validate serologic tests in sub-Saharan Africa populations.
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Affiliation(s)
- Kirsten E. Wiens
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Pinyi Nyimol Mawien
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - John Rumunu
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Damien Slater
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Forrest K. Jones
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Serina Moheed
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Andrea Caflisch
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Bior K. Bior
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Iboyi Amanya Jacob
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Richard Lino Lako
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Argata Guracha Guyo
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Olushayo Oluseun Olu
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Sylvester Maleghemi
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Andrew Baguma
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Juma John Hassen
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Sheila K. Baya
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Lul Deng
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Justin Lessler
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Maya N. Demby
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Vanessa Sanchez
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Rachel Mills
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
| | - Clare Fraser
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA (K.E. Wiens, F.K. Jones, J. Lessler, M.N. Demby, A.S. Azman)
- Republic of South Sudan Ministry of Health, Juba, South Sudan (P.N. Mawien, J. Rumunu, B.K. Bior, I.A. Jacob, R.L. Lako, L. Deng)
- Massachusetts General Hospital, Boston, Massachusetts, USA (D. Slater, S. Moheed, V. Sanchez, R. Mills, C. Fraser, R.C. Charles, J.B. Harris)
- International Organization for Migration, Juba (A. Caflisch)
- World Health Organization, Juba (A.G. Guyo, O.O. Olu, S. Maleghemi, A. Baguma, J.J. Hassen, S.K. Baya, J.F. Wamala)
- Kabale University School of Medicine, Kabale, Uganda (A. Baguma)
- Harvard Medical School, Boston (R.C. Charles, J.B. Harris)
- Médecins Sans Frontières, Geneva, Switzerland (A.S. Azman)
- Institute of Global Health, Geneva (A.S. Azman)
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46
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Lapidus S, Liu F, Casanovas-Massana A, Dai Y, Huck JD, Lucas C, Klein J, Filler RB, Strine MS, Sy M, Deme AB, Badiane AS, Dieye B, Ndiaye IM, Diedhiou Y, Mbaye AM, Diagne CT, Vigan-Womas I, Mbengue A, Sadio BD, Diagne MM, Moore AJ, Mangou K, Diallo F, Sene SD, Pouye MN, Faye R, Diouf B, Nery N, Costa F, Reis M, Muenker MC, Hodson DZ, Mbarga Y, Katz BZ, Andrews JR, Campbell M, Srivathsan A, Kamath K, Baum-Jones E, Faye O, Sall AA, Quintero Vélez JC, Cappello M, Wilson M, Ben-Mamoun C, Somé FA, Dabiré RK, Moukoko CEE, Ouédraogo JB, Boum Y, Shon J, Ndiaye D, Wisnewski A, Parikh S, Iwasaki A, Wilen CB, Ko AI, Ring AM, Bei AK. Plasmodium infection induces cross-reactive antibodies to carbohydrate epitopes on the SARS-CoV-2 Spike protein. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.05.10.21256855. [PMID: 34013301 PMCID: PMC8132281 DOI: 10.1101/2021.05.10.21256855] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Individuals with acute malaria infection generated high levels of antibodies that cross-react with the SARS-CoV-2 Spike protein. Cross-reactive antibodies specifically recognized the sialic acid moiety on N-linked glycans of the Spike protein and do not neutralize in vitro SARS-CoV-2. Sero-surveillance is critical for monitoring and projecting disease burden and risk during the pandemic; however, routine use of Spike protein-based assays may overestimate SARS-CoV-2 exposure and population-level immunity in malaria-endemic countries.
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Affiliation(s)
- Sarah Lapidus
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, CT, 06510, USA
| | - Feimei Liu
- Yale School of Medicine, Department of Immunobiology, New Haven, CT, 06510, USA
| | - Arnau Casanovas-Massana
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, CT, 06510, USA
| | - Yile Dai
- Yale School of Medicine, Department of Immunobiology, New Haven, CT, 06510, USA
| | - John D. Huck
- Yale School of Medicine, Department of Immunobiology, New Haven, CT, 06510, USA
| | - Carolina Lucas
- Yale School of Medicine, Department of Immunobiology, New Haven, CT, 06510, USA
| | - Jon Klein
- Yale School of Medicine, Department of Immunobiology, New Haven, CT, 06510, USA
| | - Renata B. Filler
- Yale School of Medicine, Department of Immunobiology, New Haven, CT, 06510, USA,Yale School of Medicine, Department of Laboratory Medicine, New Haven, CT, 06510, USA
| | - Madison S. Strine
- Yale School of Medicine, Department of Immunobiology, New Haven, CT, 06510, USA,Yale School of Medicine, Department of Laboratory Medicine, New Haven, CT, 06510, USA
| | - Mouhamad Sy
- Cheikh Anta Diop University, Aristide le Dantec Hospital, Laboratory of Parasitology and Mycology, Dakar, Senegal
| | - Awa B. Deme
- Cheikh Anta Diop University, Aristide le Dantec Hospital, Laboratory of Parasitology and Mycology, Dakar, Senegal
| | - Aida S. Badiane
- Cheikh Anta Diop University, Aristide le Dantec Hospital, Laboratory of Parasitology and Mycology, Dakar, Senegal
| | - Baba Dieye
- Cheikh Anta Diop University, Aristide le Dantec Hospital, Laboratory of Parasitology and Mycology, Dakar, Senegal
| | - Ibrahima Mbaye Ndiaye
- Cheikh Anta Diop University, Aristide le Dantec Hospital, Laboratory of Parasitology and Mycology, Dakar, Senegal
| | - Younous Diedhiou
- Cheikh Anta Diop University, Aristide le Dantec Hospital, Laboratory of Parasitology and Mycology, Dakar, Senegal
| | - Amadou Moctar Mbaye
- Cheikh Anta Diop University, Aristide le Dantec Hospital, Laboratory of Parasitology and Mycology, Dakar, Senegal
| | - Cheikh Tidiane Diagne
- DiaTROPIX Rapid Diagnostic Tests Facility, Institut Pasteur de Dakar, Dakar, Senegal
| | - Inés Vigan-Womas
- Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Alassane Mbengue
- G4 - Malaria Experimental Genetic Approaches & Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | | | | | - Adam J. Moore
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, CT, 06510, USA
| | - Khadidiatou Mangou
- G4 - Malaria Experimental Genetic Approaches & Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Fatoumata Diallo
- G4 - Malaria Experimental Genetic Approaches & Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Seynabou D. Sene
- G4 - Malaria Experimental Genetic Approaches & Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Mariama N. Pouye
- G4 - Malaria Experimental Genetic Approaches & Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Rokhaya Faye
- Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Babacar Diouf
- Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal
| | - Nivison Nery
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brazil,Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil
| | - Federico Costa
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, CT, 06510, USA,Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brazil,Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil
| | - Mitermayer Reis
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, CT, 06510, USA,Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brazil,Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil
| | - M. Catherine Muenker
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, CT, 06510, USA
| | - Daniel Z. Hodson
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, CT, 06510, USA
| | | | - Ben Z. Katz
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Division of Infectious Diseases, Ann & Robert H. Lurie Children’s Hospital of Chicago
| | - Jason R. Andrews
- Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Melissa Campbell
- Yale Center for Clinical Investigation, Yale School of Medicine, New Haven, Connecticut, USA
| | - Ariktha Srivathsan
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, CT, 06510, USA
| | | | | | - Ousmane Faye
- Pôle Virologie, Institut Pasteur de Dakar, Dakar, Senegal
| | | | - Juan Carlos Quintero Vélez
- Grupo de Investigación Ciencias Veterinarias Centauro, Universidad de Antioquia, Medellin, Colombia,Grupo de Investigación Ciencias Veterinarias Centauro, University of Antioquia, Medellín, Colombia,Grupo de Investigación Microbiología Básica y Aplicada, University of Antioquia, Medellín, Colombia
| | - Michael Cappello
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | - Michael Wilson
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Choukri Ben-Mamoun
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Fabrice A. Somé
- Institut de Recherche en Sciences de La Santé (IRSS)/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Roch K. Dabiré
- Institut de Recherche en Sciences de La Santé (IRSS)/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Carole Else Eboumbou Moukoko
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, BP 2701 Douala, Cameroon,Malaria Research Unit, Center Pasteur Cameroon, Yaoundé, Cameroon
| | - Jean Bosco Ouédraogo
- Institut de Recherche en Sciences de La Santé (IRSS)/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Yap Boum
- University of Yaoundé and Epicentre, Médecins Sans Frontières
| | | | - Daouda Ndiaye
- Cheikh Anta Diop University, Aristide le Dantec Hospital, Laboratory of Parasitology and Mycology, Dakar, Senegal
| | - Adam Wisnewski
- Yale Occupational and Environmental Medicine Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Sunil Parikh
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, CT, 06510, USA
| | - Akiko Iwasaki
- Yale School of Medicine, Department of Immunobiology, New Haven, CT, 06510, USA
| | - Craig B. Wilen
- Yale School of Medicine, Department of Immunobiology, New Haven, CT, 06510, USA
| | - Albert I. Ko
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, CT, 06510, USA,Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, Brazil
| | - Aaron M. Ring
- Yale School of Medicine, Department of Immunobiology, New Haven, CT, 06510, USA
| | - Amy K. Bei
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, CT, 06510, USA,Cheikh Anta Diop University, Aristide le Dantec Hospital, Laboratory of Parasitology and Mycology, Dakar, Senegal,G4 - Malaria Experimental Genetic Approaches & Vaccines, Pôle Immunophysiopathologie et Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal,
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47
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Sagara I, Woodford J, Kone M, Assadou MH, Katile A, Attaher O, Zeguime A, Doucoure M, Higbee E, Lane J, Doritchamou J, Zaidi I, Esposito D, Kwan J, Sadtler K, Dicko A, Duffy P. Rapidly increasing SARS-CoV-2 seroprevalence and limited clinical disease in three Malian communities: a prospective cohort study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.04.26.21256016. [PMID: 33948607 PMCID: PMC8095226 DOI: 10.1101/2021.04.26.21256016] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Background The extent of SARS-CoV-2 exposure and transmission in Mali and the surrounding region is not well understood, although infection has been confirmed in nearly 14,000 symptomatic individuals and their contacts since the first case in March 2020. We aimed to estimate the cumulative incidence of SARS-CoV-2 in three Malian communities, and understand factors associated with infection. Methods Between 27 July 2020 and 29 January 2021, we collected blood samples along with demographic, social, medical and self-reported symptoms information from residents aged 6 months and older in three study communities at two study visits. SARS-CoV-2 antibodies were measured using a highly specific two-antigen ELISA optimized for use in Mali. We calculated cumulative adjusted seroprevalence for each site and evaluated factors associated with serostatus at each visit by univariate and multivariate analysis. Findings Overall, 94.8% (2533/2672) of participants completed both study visits. A total of 50.3% (1343/2672) of participants were male, and 31.3% (837/2672) were aged <10 years, 27.6% (737/2672) were aged 10-17 years, and 41.1% (1098/2572) were aged ≥18 years. The cumulative SARS-CoV-2 exposure rate was 58.5% (95% CI: 47.5 to 69.4). This varied between sites and was 73.4% (95% CI: 59.2 to 87.5) in the urban community of Sotuba, 53.2% (95% CI: 42.8 to 63.6) in the rural town of Bancoumana, and 37.1% (95% CI: 29.6 to 44.5) in the rural village of Donéguébougou. This equates to an infection rate of approximately 1% of the population every three days in the study communities between visits. Increased age and study site were associated with serostatus at both study visits. There was minimal difference in reported symptoms based on serostatus. Interpretation The true extent of SARS-CoV-2 exposure in Mali is greater than previously reported and now approaches hypothetical herd immunity in urban areas. The epidemiology of the pandemic in the region may be primarily subclinical and within background illness rates. In this setting, ongoing surveillance and augmentation of diagnostics to characterize locally circulating variants will be critical to implement effective mitigation strategies like vaccines. Funding This project was funded by the Intramural Research Program of the National Institute of Allergy and Infectious Diseases, National Institute of Biomedical Imaging and Bioengineering, and National Cancer Institute.
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Affiliation(s)
- Issaka Sagara
- Malaria Research and Teaching Center, University of Sciences, Techniques, and Technology of Bamako, Mali
| | - John Woodford
- Laboratory of Malaria Immunology and Vaccinology, National Institutes of Health, USA
| | - Mamady Kone
- Malaria Research and Teaching Center, University of Sciences, Techniques, and Technology of Bamako, Mali
| | - Mahamadoun Hamady Assadou
- Malaria Research and Teaching Center, University of Sciences, Techniques, and Technology of Bamako, Mali
| | - Abdoulaye Katile
- Malaria Research and Teaching Center, University of Sciences, Techniques, and Technology of Bamako, Mali
| | - Oumar Attaher
- Malaria Research and Teaching Center, University of Sciences, Techniques, and Technology of Bamako, Mali
| | - Amatigue Zeguime
- Malaria Research and Teaching Center, University of Sciences, Techniques, and Technology of Bamako, Mali
| | - M'Bouye Doucoure
- Malaria Research and Teaching Center, University of Sciences, Techniques, and Technology of Bamako, Mali
| | - Emily Higbee
- Laboratory of Malaria Immunology and Vaccinology, National Institutes of Health, USA
| | - Jacquelyn Lane
- Laboratory of Malaria Immunology and Vaccinology, National Institutes of Health, USA
| | - Justin Doritchamou
- Malaria Research and Teaching Center, University of Sciences, Techniques, and Technology of Bamako, Mali
- Laboratory of Malaria Immunology and Vaccinology, National Institutes of Health, USA
- Frederic National Laboratory for Cancer Research, National Insitutes of Health, National Institutes of Health, USA
- Laboratory of Clinical Immunology and Microbiology, National Institutes of Health, USA
- National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, USA
| | - Irfan Zaidi
- Malaria Research and Teaching Center, University of Sciences, Techniques, and Technology of Bamako, Mali
- Laboratory of Malaria Immunology and Vaccinology, National Institutes of Health, USA
- Frederic National Laboratory for Cancer Research, National Insitutes of Health, National Institutes of Health, USA
- Laboratory of Clinical Immunology and Microbiology, National Institutes of Health, USA
- National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, USA
| | - Dominic Esposito
- Frederic National Laboratory for Cancer Research, National Insitutes of Health, National Institutes of Health, USA
| | - Jennifer Kwan
- Laboratory of Clinical Immunology and Microbiology, National Institutes of Health, USA
| | - Kaitlyn Sadtler
- National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, USA
| | - Alassane Dicko
- Malaria Research and Teaching Center, University of Sciences, Techniques, and Technology of Bamako, Mali
| | - Patrick Duffy
- Laboratory of Malaria Immunology and Vaccinology, National Institutes of Health, USA
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48
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Baker OR, Grabowski MK, Galiwango RM, Nalumansi A, Serwanga J, Clarke W, Hsieh YH, Rothman RE, Fernandez RE, Serwadda D, Kagaayi J, Lutalo T, Reynolds SJ, Kaleebu P, Quinn TC, Laeyendecker O. Differential Performance of CoronaCHEK SARS-CoV-2 Lateral Flow Antibody Assay by Geographic Origin of Samples. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.04.12.21255284. [PMID: 33880484 PMCID: PMC8057252 DOI: 10.1101/2021.04.12.21255284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background We assessed the performance of CoronaCHEK lateral flow assay on samples from Uganda and Baltimore to determine the impact of geographic origin on assay performance. Methods Serum samples from SARS-CoV-2 PCR+ individuals (Uganda: 78 samples from 78 individuals and Baltimore: 266 samples from 38 individuals) and from pre-pandemic individuals (Uganda 1077 and Baltimore 532) were evaluated. Prevalence ratios (PR) were calculated to identify factors associated with a false-positive test. Results After first positive PCR in Ugandan samples the sensitivity was: 45% (95% CI 24,68) at 0-7 days; 79% (95%CI 64,91) 8-14 days; and 76% (95%CI 50,93) >15 days. In samples from Baltimore, sensitivity was: 39% (95% CI 30, 49) 0-7 days; 86% (95% CI 79,92) 8-14 days; and 100% (95% CI 89,100) 15 days post positive PCR. The specificity of 96.5% (95% CI 97.5,95.2) in Ugandan samples was significantly lower than samples from Baltimore 99.3% (95% CI 98.1,99.8), p<0.01. In Ugandan samples, individuals with a false positive result were more likely to be male (PR 2.04, 95% CI 1.03,3.69) or individuals who had a fever more than a month prior to sample acquisition (PR 2.87, 95% CI 1.12,7.35). Conclusions Sensitivity of the CoronaCHEK was similar in samples from Uganda and Baltimore. The specificity was significantly lower in Ugandan samples than in Baltimore samples. False positive results in Ugandan samples appear to correlate with a recent history of a febrile illness, potentially indicative of a cross-reactive immune response in individuals from East Africa.
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Affiliation(s)
- Owen R. Baker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, USA
| | - M. Kate Grabowski
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Rakai Health Sciences Program, Kalisizo, Uganda
| | | | | | - Jennifer Serwanga
- Uganda Virus Research Institute, Entebbe, Uganda
- Medical Research Council, Uganda Virus Research Institute and London School of hygiene and Tropical Medicine Uganda Research Unit
| | - William Clarke
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yu-Hsiang Hsieh
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | - David Serwadda
- Rakai Health Sciences Program, Kalisizo, Uganda
- Makerere University School of Public Health, Kampala, Uganda
| | | | - Tom Lutalo
- Rakai Health Sciences Program, Kalisizo, Uganda
- Uganda Virus Research Institute, Entebbe, Uganda
| | - Steven J. Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Rakai Health Sciences Program, Kalisizo, Uganda
| | - Pontiano Kaleebu
- Uganda Virus Research Institute, Entebbe, Uganda
- Medical Research Council, Uganda Virus Research Institute and London School of hygiene and Tropical Medicine Uganda Research Unit
| | - Thomas C. Quinn
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Emmerich P, Murawski C, Ehmen C, von Possel R, Pekarek N, Oestereich L, Duraffour S, Pahlmann M, Struck N, Eibach D, Krumkamp R, Amuasi J, Maiga-Ascofaré O, Rakotozandrindrainy R, Asogun D, Ighodalo Y, Kann S, May J, Tannich E, Deschermeier C. Limited specificity of commercially available SARS-CoV-2 IgG ELISAs in serum samples of African origin. Trop Med Int Health 2021; 26:621-631. [PMID: 33666297 PMCID: PMC8014856 DOI: 10.1111/tmi.13569] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Specific serological tests are mandatory for reliable SARS-CoV-2 diagnostics and seroprevalence studies. Here, we assess the specificities of four commercially available SARS-CoV-2 IgG ELISAs in serum/plasma panels originating from Africa, South America, and Europe. METHODS 882 serum/plasma samples collected from symptom-free donors before the COVID-19 pandemic in three African countries (Ghana, Madagascar, Nigeria), Colombia, and Germany were analysed with three nucleocapsid-based ELISAs (Euroimmun Anti-SARS-CoV-2-NCP IgG, EDI™ Novel Coronavirus COVID-19 IgG, Mikrogen recomWell SARS-CoV-2 IgG), one spike/S1-based ELISA (Euroimmun Anti-SARS-CoV-2 IgG), and in-house common cold CoV ELISAs. RESULTS High specificity was confirmed for all SARS-CoV-2 IgG ELISAs for Madagascan (93.4-99.4%), Colombian (97.8-100.0%), and German (95.9-100.0%) samples. In contrast, specificity was much lower for the Ghanaian and Nigerian serum panels (Ghana: NCP-based assays 77.7-89.7%, spike/S1-based assay 94.3%; Nigeria: NCP-based assays 39.3-82.7%, spike/S1-based assay 90.7%). 15 of 600 African sera were concordantly classified as positive in both the NCP-based and the spike/S1-based Euroimmun ELISA, but did not inhibit spike/ACE2 binding in a surrogate virus neutralisation test. IgG antibodies elicited by previous infections with common cold CoVs were found in all sample panels, including those from Madagascar, Colombia, and Germany and thus do not inevitably hamper assay specificity. Nevertheless, high levels of IgG antibodies interacting with OC43 NCP were found in all 15 SARS-CoV-2 NCP/spike/S1 ELISA positive sera. CONCLUSIONS Depending on the chosen antigen and assay protocol, SARS-CoV-2 IgG ELISA specificity may be significantly reduced in certain populations probably due to interference of immune responses to endemic pathogens like other viruses or parasites.
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Affiliation(s)
- Petra Emmerich
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,Department of Tropical Medicine and Infectious Diseases, Center of Internal Medicine II, University of Rostock, Rostock, Germany
| | - Carolin Murawski
- Department for Infectious Disease Diagnostics, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Christa Ehmen
- Department for Infectious Disease Diagnostics, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Ronald von Possel
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Neele Pekarek
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Lisa Oestereich
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,German Center for Infection Research, Hamburg - Lübeck - Borstel - Riems, Germany
| | - Sophie Duraffour
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,German Center for Infection Research, Hamburg - Lübeck - Borstel - Riems, Germany
| | - Meike Pahlmann
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,German Center for Infection Research, Hamburg - Lübeck - Borstel - Riems, Germany
| | - Nicole Struck
- German Center for Infection Research, Hamburg - Lübeck - Borstel - Riems, Germany.,Department for Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Daniel Eibach
- German Center for Infection Research, Hamburg - Lübeck - Borstel - Riems, Germany.,Department for Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Ralf Krumkamp
- German Center for Infection Research, Hamburg - Lübeck - Borstel - Riems, Germany.,Department for Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - John Amuasi
- Global Health and Infectious Disease Research Group, Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | - Oumou Maiga-Ascofaré
- German Center for Infection Research, Hamburg - Lübeck - Borstel - Riems, Germany.,Infectious Disease Epidemiology Research Group, Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | | | - Danny Asogun
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | - Yemisi Ighodalo
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | - Simone Kann
- Medical Mission Institute, Würzburg, Germany
| | - Jürgen May
- Department for Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Egbert Tannich
- Department for Infectious Disease Diagnostics, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,National Reference Centre for Tropical Pathogens, Hamburg, Germany
| | - Christina Deschermeier
- Department for Infectious Disease Diagnostics, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
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50
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Sagara I, Woodford J, Dicko A, Zeguime A, Doucoure M, Kwan J, Zaidi I, Doritchamou J, Snow-Smith M, Alani N, Renn J, Kosik I, Holly J, Yewdell J, Esposito D, Sadtler K, Duffy P. SARS-CoV-2 seroassay optimization and performance in a population with high background reactivity in Mali. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.03.08.21252784. [PMID: 33758883 PMCID: PMC7987042 DOI: 10.1101/2021.03.08.21252784] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Serological tests are an indispensable tool to understand the epidemiology of the SARS-CoV-2 pandemic, particularly in areas where molecular diagnostics are limited. Poor assay performance may hinder the utility of these tests, including high rates of false-positivity previously reported in sub-Saharan Africa. From 312 Malian samples collected prior to 2020, we measured antibodies to the commonly tested SARS-CoV-2 antigens and four other betacoronaviruses by ELISA, and assessed functional cross-reactivity in a subset by SARS-CoV-2 pseudovirus neutralization assay. We then evaluated the performance of an ELISA developed in the US, using two-antigen SARS-CoV-2 spike protein and receptor-binding domain. To optimize test performance, we compared single and two-antigen approaches using existing assay cutoffs and population-specific cutoffs for Malian control samples (positive and negative). Background reactivity to SARS-CoV-2 antigens was common in pre-pandemic samples compared to US controls (43.4% (135/311) for spike protein, 22.8% (71/312) for RBD, and 33.9% (79/233) for nucleocapsid protein). SARS-CoV-2 reactivity correlated weakly with other betacoronavirus reactivity, varied between Malian communities, and increased with age. No pre-pandemic samples demonstrated functional activity. Regardless of the cutoffs applied, specificity improved using a two-antigen approach. Test performance was optimal using a two-antigen assay with population-specific cutoffs derived from ROC curve analysis [Sensitivity: 73.9% (51.6-89.8), Specificity: 99.4% (97.7-99.9)]. In the setting of high background reactivity, such as sub-Saharan Africa, SARS-CoV-2 serological assays need careful qualification is to characterize the epidemiology of disease, prevent unnecessary harm, and allocate resources for targeted control measures.
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