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Seroepidemiology of Lassa virus in pregnant women in Southern Nigeria: A prospective hospital-based cohort study

BACKGROUND: There is limited epidemiological evidence on Lassa fever in pregnant women with acute gaps on prevalence, infection incidence, and risk factors. Such evidence would facilitate the design of therapeutic and vaccine trials and the design of control programs. Our study sought to address som...

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Autores principales: Kayem, Nzelle Delphine, Okogbenin, Sylvanus, Okoeguale, Joseph, Momoh, Mojeed, Njoku, Antonia, Eifediyi, Reuben, Enodiana, Xavier, Ngwu, Hilary, Irhiogbe, Wilfred, Ighodalo, Yemisi, Olokor, Thomas, Odigie, George, Castle, Lyndsey, Duraffour, Sophie, Oestereich, Lisa, Dahal, Prabin, Ariana, Proochista, Gunther, Stephan, Horby, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237645/
https://www.ncbi.nlm.nih.gov/pubmed/37216412
http://dx.doi.org/10.1371/journal.pntd.0011354
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author Kayem, Nzelle Delphine
Okogbenin, Sylvanus
Okoeguale, Joseph
Momoh, Mojeed
Njoku, Antonia
Eifediyi, Reuben
Enodiana, Xavier
Ngwu, Hilary
Irhiogbe, Wilfred
Ighodalo, Yemisi
Olokor, Thomas
Odigie, George
Castle, Lyndsey
Duraffour, Sophie
Oestereich, Lisa
Dahal, Prabin
Ariana, Proochista
Gunther, Stephan
Horby, Peter
author_facet Kayem, Nzelle Delphine
Okogbenin, Sylvanus
Okoeguale, Joseph
Momoh, Mojeed
Njoku, Antonia
Eifediyi, Reuben
Enodiana, Xavier
Ngwu, Hilary
Irhiogbe, Wilfred
Ighodalo, Yemisi
Olokor, Thomas
Odigie, George
Castle, Lyndsey
Duraffour, Sophie
Oestereich, Lisa
Dahal, Prabin
Ariana, Proochista
Gunther, Stephan
Horby, Peter
author_sort Kayem, Nzelle Delphine
collection PubMed
description BACKGROUND: There is limited epidemiological evidence on Lassa fever in pregnant women with acute gaps on prevalence, infection incidence, and risk factors. Such evidence would facilitate the design of therapeutic and vaccine trials and the design of control programs. Our study sought to address some of these gaps by estimating the seroprevalence and seroconversion risk of Lassa fever in pregnant women. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a prospective hospital-based cohort between February and December 2019 in Edo State, Southern Nigeria, enrolling pregnant women at antenatal clinic and following them up at delivery. Samples were evaluated for IgG antibodies against Lassa virus. The study demonstrates a seroprevalence of Lassa IgG antibodies of 49.6% and a seroconversion risk of 20.8%. Seropositivity was strongly correlated with rodent exposure around homes with an attributable risk proportion of 35%. Seroreversion was also seen with a seroreversion risk of 13.4%. CONCLUSIONS/SIGNIFICANCE: Our study suggests that 50% of pregnant women were at risk of Lassa infection and that 35.0% of infections might be preventable by avoiding rodent exposure and conditions which facilitate infestation and the risk of human-rodent contact. While the evidence on rodent exposure is subjective and further studies are needed to provide a better understanding of the avenues of human-rodent interaction; public health measures to decrease the risk of rodent infestation and the risk of spill over events may be beneficial. With an estimated seroconversion risk of 20.8%, our study suggests an appreciable risk of contracting Lassa fever during pregnancy and while most of these seroconversions may not be new infections, given the high risk of adverse outcomes in pregnancy, it supports the need for preventative and therapeutic options against Lassa fever in pregnancy. The occurrence of seroreversion in our study suggests that the prevalence obtained in this, and other cohorts may be an underestimate of the actual proportion of women of childbearing age who present at pregnancy with prior LASV exposure. Additionally, the occurrence of both seroconversion and seroreversion in this cohort suggests that these parameters would need to be considered for the development of Lassa vaccine efficacy, effectiveness, and utility models.
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spelling pubmed-102376452023-06-03 Seroepidemiology of Lassa virus in pregnant women in Southern Nigeria: A prospective hospital-based cohort study Kayem, Nzelle Delphine Okogbenin, Sylvanus Okoeguale, Joseph Momoh, Mojeed Njoku, Antonia Eifediyi, Reuben Enodiana, Xavier Ngwu, Hilary Irhiogbe, Wilfred Ighodalo, Yemisi Olokor, Thomas Odigie, George Castle, Lyndsey Duraffour, Sophie Oestereich, Lisa Dahal, Prabin Ariana, Proochista Gunther, Stephan Horby, Peter PLoS Negl Trop Dis Research Article BACKGROUND: There is limited epidemiological evidence on Lassa fever in pregnant women with acute gaps on prevalence, infection incidence, and risk factors. Such evidence would facilitate the design of therapeutic and vaccine trials and the design of control programs. Our study sought to address some of these gaps by estimating the seroprevalence and seroconversion risk of Lassa fever in pregnant women. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a prospective hospital-based cohort between February and December 2019 in Edo State, Southern Nigeria, enrolling pregnant women at antenatal clinic and following them up at delivery. Samples were evaluated for IgG antibodies against Lassa virus. The study demonstrates a seroprevalence of Lassa IgG antibodies of 49.6% and a seroconversion risk of 20.8%. Seropositivity was strongly correlated with rodent exposure around homes with an attributable risk proportion of 35%. Seroreversion was also seen with a seroreversion risk of 13.4%. CONCLUSIONS/SIGNIFICANCE: Our study suggests that 50% of pregnant women were at risk of Lassa infection and that 35.0% of infections might be preventable by avoiding rodent exposure and conditions which facilitate infestation and the risk of human-rodent contact. While the evidence on rodent exposure is subjective and further studies are needed to provide a better understanding of the avenues of human-rodent interaction; public health measures to decrease the risk of rodent infestation and the risk of spill over events may be beneficial. With an estimated seroconversion risk of 20.8%, our study suggests an appreciable risk of contracting Lassa fever during pregnancy and while most of these seroconversions may not be new infections, given the high risk of adverse outcomes in pregnancy, it supports the need for preventative and therapeutic options against Lassa fever in pregnancy. The occurrence of seroreversion in our study suggests that the prevalence obtained in this, and other cohorts may be an underestimate of the actual proportion of women of childbearing age who present at pregnancy with prior LASV exposure. Additionally, the occurrence of both seroconversion and seroreversion in this cohort suggests that these parameters would need to be considered for the development of Lassa vaccine efficacy, effectiveness, and utility models. Public Library of Science 2023-05-22 /pmc/articles/PMC10237645/ /pubmed/37216412 http://dx.doi.org/10.1371/journal.pntd.0011354 Text en © 2023 Kayem et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kayem, Nzelle Delphine
Okogbenin, Sylvanus
Okoeguale, Joseph
Momoh, Mojeed
Njoku, Antonia
Eifediyi, Reuben
Enodiana, Xavier
Ngwu, Hilary
Irhiogbe, Wilfred
Ighodalo, Yemisi
Olokor, Thomas
Odigie, George
Castle, Lyndsey
Duraffour, Sophie
Oestereich, Lisa
Dahal, Prabin
Ariana, Proochista
Gunther, Stephan
Horby, Peter
Seroepidemiology of Lassa virus in pregnant women in Southern Nigeria: A prospective hospital-based cohort study
title Seroepidemiology of Lassa virus in pregnant women in Southern Nigeria: A prospective hospital-based cohort study
title_full Seroepidemiology of Lassa virus in pregnant women in Southern Nigeria: A prospective hospital-based cohort study
title_fullStr Seroepidemiology of Lassa virus in pregnant women in Southern Nigeria: A prospective hospital-based cohort study
title_full_unstemmed Seroepidemiology of Lassa virus in pregnant women in Southern Nigeria: A prospective hospital-based cohort study
title_short Seroepidemiology of Lassa virus in pregnant women in Southern Nigeria: A prospective hospital-based cohort study
title_sort seroepidemiology of lassa virus in pregnant women in southern nigeria: a prospective hospital-based cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237645/
https://www.ncbi.nlm.nih.gov/pubmed/37216412
http://dx.doi.org/10.1371/journal.pntd.0011354
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