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Simons E, Nikolay B, Ouedraogo P, Pasquier E, Tiemeni C, Adjaho I, Badjo C, Chamman K, Diomandé M, Dosso M, Doumbia M, Izia YA, Kakompe H, Katsomya AM, Kij V, Akissi VK, Mambula C, Mbala-Kingebeni P, Muzinga J, Ngoy B, Penali L, Pini A, Porten K, Salou H, Sevede D, Luquero F, Gignoux E. Seroprevalence of SARS-CoV-2 antibodies and retrospective mortality in two African settings: Lubumbashi, Democratic Republic of the Congo and Abidjan, Côte d'Ivoire. PLOS Glob Public Health 2023; 3:e0001457. [PMID: 37289736 DOI: 10.1371/journal.pgph.0001457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/10/2023] [Indexed: 06/10/2023]
Abstract
Although seroprevalence studies have demonstrated the wide circulation of SARS-COV-2 in African countries, the impact on population health in these settings is still poorly understood. Using representative samples of the general population, we evaluated retrospective mortality and seroprevalence of anti-SARS-CoV-2 antibodies in Lubumbashi and Abidjan. The studies included retrospective mortality surveys and nested anti-SARS-CoV-2 antibody prevalence surveys. In Lubumbashi the study took place during April-May 2021 and in Abidjan the survey was implemented in two phases: July-August 2021 and October-November 2021. Crude mortality rates were stratified between pre-pandemic and pandemic periods and further investigated by age group and COVID waves. Anti-SARS-CoV-2 seroprevalence was quantified by rapid diagnostic testing (RDT) and laboratory-based testing (ELISA in Lubumbashi and ECLIA in Abidjan). In Lubumbashi, the crude mortality rate (CMR) increased from 0.08 deaths per 10 000 persons per day (pre-pandemic) to 0.20 deaths per 10 000 persons per day (pandemic period). Increases were particularly pronounced among <5 years old. In Abidjan, no overall increase was observed during the pandemic period (pre-pandemic: 0.05 deaths per 10 000 persons per day; pandemic: 0.07 deaths per 10 000 persons per day). However, an increase was observed during the third wave (0.11 deaths per 10 000 persons per day). The estimated seroprevalence in Lubumbashi was 15.7% (RDT) and 43.2% (laboratory-based). In Abidjan, the estimated seroprevalence was 17.4% (RDT) and 72.9% (laboratory-based) during the first phase of the survey and 38.8% (RDT) and 82.2% (laboratory-based) during the second phase of the survey. Although circulation of SARS-CoV-2 seems to have been extensive in both settings, the public health impact varied. The increases, particularly among the youngest age group, suggest indirect impacts of COVID and the pandemic on population health. The seroprevalence results confirmed substantial underdetection of cases through the national surveillance systems.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Hugues Kakompe
- Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | | | - Vicky Kij
- Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | | | | | | | - Jacques Muzinga
- Laboratoire National de Lubumbashi, Lubumbashi, Democratic Republic of the Congo
| | - Basile Ngoy
- Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Lou Penali
- Institut Pasteur Cote d'Ivoire, Abidjan, Cote d'Ivoire
| | | | | | | | - Daouda Sevede
- Institut Pasteur Cote d'Ivoire, Abidjan, Cote d'Ivoire
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Torreele E, Boum Y, Adjaho I, Alé FGB, Issoufou SH, Harczi G, Okonta C, Olliaro P. On the importance and challenges of global access to proven life-saving treatments for Ebolavirus - Authors' reply. Lancet Infect Dis 2023; 23:407-408. [PMID: 36963917 DOI: 10.1016/s1473-3099(23)00127-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 02/20/2023] [Indexed: 03/26/2023]
Affiliation(s)
- Els Torreele
- Médecins Sans Frontières West and Central Africa, Marcory, Abidjan, Cote d'Ivoire; Institute for Innovation and Public Purpose, University College London, London, UK.
| | - Yap Boum
- Epicentre, Yaoundé, Cameroon; Institut Pasteur Bangui, Bangui, Central African Republic; ISARIC Global Support Centre, International Severe Acute Respiratory and emerging Infection Consortium, Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Ismael Adjaho
- Médecins Sans Frontières West and Central Africa, Marcory, Abidjan, Cote d'Ivoire
| | - Franck Guy Biaou Alé
- Médecins Sans Frontières West and Central Africa, Marcory, Abidjan, Cote d'Ivoire
| | - Sal Ha Issoufou
- Médecins Sans Frontières West and Central Africa, Marcory, Abidjan, Cote d'Ivoire
| | - Geza Harczi
- Médecins Sans Frontières West and Central Africa, Marcory, Abidjan, Cote d'Ivoire
| | - Chibuzo Okonta
- Médecins Sans Frontières West and Central Africa, Marcory, Abidjan, Cote d'Ivoire
| | - Piero Olliaro
- Médecins Sans Frontières West and Central Africa, Marcory, Abidjan, Cote d'Ivoire
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Torreele E, Boum Y, Adjaho I, Alé FGB, Issoufou SH, Harczi G, Okonta C, Olliaro P. Breakthrough treatments for Ebola virus disease, but no access-what went wrong, and how can we do better? Lancet Infect Dis 2023:S1473-3099(22)00810-6. [PMID: 36682365 DOI: 10.1016/s1473-3099(22)00810-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/25/2022] [Accepted: 11/27/2022] [Indexed: 01/21/2023]
Abstract
Three years since proving effective for Ebola virus disease in a clinical trial, two breakthrough treatments are registered and stockpiled in the USA but still not registered and generally available in the countries most affected by this deadly infection of epidemic potential. Analysing the reasons for this, we see a fragmentation of the research and development value chain, with different stakeholders taking on different steps of the research and development process, without the public health-focused leadership needed to ensure the end goal of equitable access in countries where Ebola virus disease is prevalent. Current financial incentives for companies to overcome market failures and engage in epidemic-prone diseases are geared towards registration and stockpiling in the USA, without responsibility to provide access where and when needed. Ebola virus disease is the case in point, but not unique-a situation seen again for mpox and likely to occur again for other epidemics primarily affecting disempowered communities. Stronger leadership in African countries will help drive drug development efforts for diseases that primarily affect their communities, and ensure all partners align with and commit to an end-to-end approach to pharmaceutical development and manufacturing that puts equitable access when and where needed at its core.
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Affiliation(s)
- Els Torreele
- Médecins Sans Frontières West and Central Africa (MSF WaCA), Marcory, Abidjan, Côte d'Ivoire; Institute for Innovation and Public Purpose, University College London, London, UK.
| | - Yap Boum
- Epicentre, Yaoundé, Cameroon; Institut Pasteur Bangui, Bangui, Central African Republic
| | - Ismael Adjaho
- Médecins Sans Frontières West and Central Africa (MSF WaCA), Marcory, Abidjan, Côte d'Ivoire
| | - Franck Guy Biaou Alé
- Médecins Sans Frontières West and Central Africa (MSF WaCA), Marcory, Abidjan, Côte d'Ivoire
| | - Sal Ha Issoufou
- Médecins Sans Frontières West and Central Africa (MSF WaCA), Marcory, Abidjan, Côte d'Ivoire
| | - Geza Harczi
- Médecins Sans Frontières West and Central Africa (MSF WaCA), Marcory, Abidjan, Côte d'Ivoire
| | - Chibuzo Okonta
- Médecins Sans Frontières West and Central Africa (MSF WaCA), Marcory, Abidjan, Côte d'Ivoire
| | - Piero Olliaro
- International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) Global Support Centre, University of Oxford, Oxford, UK
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