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BMC Infect Dis ; 21(1): 539, 2021 Jun 07.
Article in English | MEDLINE | ID: covidwho-1261266

ABSTRACT

BACKGROUND: In sub-Saharan Africa, acute respiratory infections (ARI), acute gastrointestinal infections (GI) and acute febrile disease of unknown cause (AFDUC) have a large disease burden, especially among children, while respective aetiologies often remain unresolved. The need for robust infectious disease surveillance to detect emerging pathogens along with common human pathogens has been highlighted by the ongoing novel coronavirus disease 2019 (COVID-19) pandemic. The African Network for Improved Diagnostics, Epidemiology and Management of Common Infectious Agents (ANDEMIA) is a sentinel surveillance study on the aetiology and clinical characteristics of ARI, GI and AFDUC in sub-Saharan Africa. METHODS: ANDEMIA includes 12 urban and rural health care facilities in four African countries (Côte d'Ivoire, Burkina Faso, Democratic Republic of the Congo and Republic of South Africa). It was piloted in 2018 in Côte d'Ivoire and the initial phase will run from 2019 to 2021. Case definitions for ARI, GI and AFDUC were established, as well as syndrome-specific sampling algorithms including the collection of blood, naso- and oropharyngeal swabs and stool. Samples are tested using comprehensive diagnostic protocols, ranging from classic bacteriology and antimicrobial resistance screening to multiplex real-time polymerase chain reaction (PCR) systems and High Throughput Sequencing. In March 2020, PCR testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and analysis of full genomic information was included in the study. Standardised questionnaires collect relevant clinical, demographic, socio-economic and behavioural data for epidemiologic analyses. Controls are enrolled over a 12-month period for a nested case-control study. Data will be assessed descriptively and aetiologies will be evaluated using a latent class analysis among cases. Among cases and controls, an integrated analytic approach using logistic regression and Bayesian estimation will be employed to improve the assessment of aetiology and associated risk factors. DISCUSSION: ANDEMIA aims to expand our understanding of ARI, GI and AFDUC aetiologies in sub-Saharan Africa using a comprehensive laboratory diagnostics strategy. It will foster early detection of emerging threats and continued monitoring of important common pathogens. The network collaboration will be strengthened and site diagnostic capacities will be reinforced to improve quality management and patient care.


Subject(s)
Communicable Diseases/diagnosis , Communicable Diseases/epidemiology , Mass Screening , Sentinel Surveillance , Bayes Theorem , Burkina Faso , Case-Control Studies , Cote d'Ivoire , Democratic Republic of the Congo , Fever/epidemiology , Fever/microbiology , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/microbiology , Humans , Real-Time Polymerase Chain Reaction , Respiratory Tract Infections/epidemiology , South Africa
2.
Clin Infect Dis ; 2021 Jun 05.
Article in English | MEDLINE | ID: covidwho-1258759

ABSTRACT

BACKGROUND: On October, 2020, after the first wave of COVID-19, only 8290 confirmed cases were reported in Kinshasa, Democratic Republic of the Congo, but the real prevalence remains unknown. To guide public health policies, we aimed to describe the prevalence of SARS-CoV-2 IgG antibodies in the general population in Kinshasa. METHODS: We conducted a cross-sectional, household-based serosurvey between October 22, 2020, and November 8, 2020. Participants were interviewed at home and tested for antibodies against SARS-CoV-2 spike and nucleocapsid proteins in a Luminex based assay. A positive serology was defined as a sample that reacted with both SARS-CoV-2 proteins (100% sensitivity, 99.7% specificity). The overall weighted, age-standardized prevalence was estimated and the infection-to-case ratio was calculated to determine the proportion of undiagnosed SARS-CoV-2 infections. RESULTS: A total of 1233 participants from 292 households were included (mean age, 32.4 years; 764 [61.2%] were women). The overall weighted, age-standardized SARS-CoV-2 seroprevalence was 16.6% (95% CI 14.0-19.5). The estimated infection-to-case ratio was 292:1. Prevalence was higher among participants ≥ 40 years than among those ˂18 years (21.2% vs 14.9%, respectively; p˂0.05). It was also higher in participants who reported hospitalization than among those who did not (29.8% vs 16.0%, respectively; p˂0.05). However, differences were not significant in the multivariate model (p=0.1). CONCLUSION: The prevalence of SARS-CoV-2 is much higher than the number of COVID-19 cases reported. These results justify the organization of a sequential series of serosurveys by public health authorities to adapt response measures to the dynamics of the pandemic.

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