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Rapidly increasing SARS-CoV-2 seroprevalence and limited clinical disease in three Malian communities: a prospective cohort study
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 incidenc...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cold Spring Harbor Laboratory
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8095226/ https://www.ncbi.nlm.nih.gov/pubmed/33948607 http://dx.doi.org/10.1101/2021.04.26.21256016 |
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author | Sagara, Issaka Woodford, John Kone, Mamady Assadou, Mahamadoun Hamady Katile, Abdoulaye Attaher, Oumar Zeguime, Amatigue Doucoure, M’Bouye Higbee, Emily Lane, Jacquelyn Doritchamou, Justin Zaidi, Irfan Esposito, Dominic Kwan, Jennifer Sadtler, Kaitlyn Dicko, Alassane Duffy, Patrick |
author_facet | Sagara, Issaka Woodford, John Kone, Mamady Assadou, Mahamadoun Hamady Katile, Abdoulaye Attaher, Oumar Zeguime, Amatigue Doucoure, M’Bouye Higbee, Emily Lane, Jacquelyn Doritchamou, Justin Zaidi, Irfan Esposito, Dominic Kwan, Jennifer Sadtler, Kaitlyn Dicko, Alassane Duffy, Patrick |
author_sort | Sagara, Issaka |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8095226 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cold Spring Harbor Laboratory |
record_format | MEDLINE/PubMed |
spelling | pubmed-80952262021-05-05 Rapidly increasing SARS-CoV-2 seroprevalence and limited clinical disease in three Malian communities: a prospective cohort study Sagara, Issaka Woodford, John Kone, Mamady Assadou, Mahamadoun Hamady Katile, Abdoulaye Attaher, Oumar Zeguime, Amatigue Doucoure, M’Bouye Higbee, Emily Lane, Jacquelyn Doritchamou, Justin Zaidi, Irfan Esposito, Dominic Kwan, Jennifer Sadtler, Kaitlyn Dicko, Alassane Duffy, Patrick medRxiv Article 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. Cold Spring Harbor Laboratory 2021-04-29 /pmc/articles/PMC8095226/ /pubmed/33948607 http://dx.doi.org/10.1101/2021.04.26.21256016 Text en https://creativecommons.org/publicdomain/zero/1.0/This article is a US Government work. It is not subject to copyright under 17 USC 105 and is also made available for use under a CC0 license (https://creativecommons.org/publicdomain/zero/1.0/) . |
spellingShingle | Article Sagara, Issaka Woodford, John Kone, Mamady Assadou, Mahamadoun Hamady Katile, Abdoulaye Attaher, Oumar Zeguime, Amatigue Doucoure, M’Bouye Higbee, Emily Lane, Jacquelyn Doritchamou, Justin Zaidi, Irfan Esposito, Dominic Kwan, Jennifer Sadtler, Kaitlyn Dicko, Alassane Duffy, Patrick Rapidly increasing SARS-CoV-2 seroprevalence and limited clinical disease in three Malian communities: a prospective cohort study |
title | Rapidly increasing SARS-CoV-2 seroprevalence and limited clinical disease in three Malian communities: a prospective cohort study |
title_full | Rapidly increasing SARS-CoV-2 seroprevalence and limited clinical disease in three Malian communities: a prospective cohort study |
title_fullStr | Rapidly increasing SARS-CoV-2 seroprevalence and limited clinical disease in three Malian communities: a prospective cohort study |
title_full_unstemmed | Rapidly increasing SARS-CoV-2 seroprevalence and limited clinical disease in three Malian communities: a prospective cohort study |
title_short | Rapidly increasing SARS-CoV-2 seroprevalence and limited clinical disease in three Malian communities: a prospective cohort study |
title_sort | rapidly increasing sars-cov-2 seroprevalence and limited clinical disease in three malian communities: a prospective cohort study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8095226/ https://www.ncbi.nlm.nih.gov/pubmed/33948607 http://dx.doi.org/10.1101/2021.04.26.21256016 |
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