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1.
PLoS Global Public Health ; 2(6), 2022.
Article in English | CAB Abstracts | ID: covidwho-2021480

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.

2.
Journal of Public Health in Africa ; 13:15, 2022.
Article in English | EMBASE | ID: covidwho-2006923

ABSTRACT

Introduction/ Background: There have been low reported cases per population of SARS-CoV-2 in sub-Saharan Africa. Populationbased studies are needed to estimate the true cumulative incidence of SARS-CoV-2 to inform public health interventions. This study estimated SARS-CoV- 2 seroprevalence in four states in Nigeria in October 2020, and two states in June 2021. Methods: We conducted a two-stage cluster sample household survey in Enugu, Gombe, Lagos, and Nasarawa September-October 2020 and Kano and Federal Capital Territory (FCT) in June 2021. Thirty-four enumeration areas (EAs) were randomly sampled per state (30 in Lagos), and 20 households randomly selected per EA. All household members were eligible. Oral and nasopharyngeal swabs were taken for molecular testing and blood collected for antibody testing. Samples were tested on the multi-antigen target Luminex xMAP assay. Results: A total of 3,546 households (>83% of households) and 14,835 individuals (>94% of individuals) participated. In October 2020, SARS-CoV-2 seroprevalence was 25.2% (95% CI:21.8-28.6) in Enugu, 9.3% (95% CI:7.0- 11.5) in Gombe, 23.3% (95% CI:20.5, 26.4) in Lagos, and 18.0% (95% CI:14.4-21.6) in Nasarawa. In June 2021, seroprevalence was 42.6% (95% CI:39.4-45.8) in Kano and 40.3% (95% CI:34.7-45.9) in FCT. By July 2021, <3% of the populations of Kano and FCT had received at least one vaccine dose. Among the 38.9% and 53.1% respectively who indicated they would not take the vaccine, safety concern was the main reason (84.9%, 83.7% respectively). Impact: Population based surveys are important tools to estimate the true seroprevalence of novel pathogens more accurately with predominantly asymptomatic presentation. These surveys provide seroprevalence provide estimates that are not subject to bias from unequal distribution or uptake of testing services during outbreaks for development of accurate public health mitigation measures. Conclusion: Sixteen months in, approximately 60% of the populations of FCT and Kano had no antibodies to SARS-CoV-2, indicating a significant proportion of the population remained vulnerable to infection. Rapid scale-up of vaccine distribution and efforts to encourage vaccine uptake are needed to prevent the emergence of SARS-CoV-2 variants of concern.

3.
BRITISH JOURNAL OF DERMATOLOGY ; 187:152-152, 2022.
Article in English | Web of Science | ID: covidwho-1935201
4.
Bergeri, I.; Whelan, M.; Ware, H.; Subissi, L.; Nardone, A.; Lewis, H. C.; Li, Z.; Ma, X.; Valenciano, M.; Cheng, B.; Ariqi, L. A.; Rashidian, A.; Okeibunor, J.; Azim, T.; Wijesinghe, P.; Le, L. V.; Vaughan, A.; Pebody, R.; Vicari, A.; Yan, T.; Yanes-Lane, M.; Cao, C.; Cheng, M. P.; Papenburg, J.; Buckeridge, D.; Bobrovitz, N.; Arora, R. K.; van Kerkhove, M. D.; Al-Shoteri, S.; Aly, E. A.; Audu, R. A.; Barakat, A.; Bin-Ghouth, A. S.; Birru, E.; Bokonjic, D.; Bolotin, S.; Boucher, E. L.; Catovic-Baralija, E.; Ceban, A.; Chauma-Mwale, A.; Chimeddorj, B.; Chung, P. S.; Clifton, D.; Dabakuyo-Yonli, T. S.; Deveaux, G. R.; Diop, B.; Dokubo, E. K.; Donnici, C.; Duarte, N.; Duarte, N. A.; Evans, T. G.; Fairlie, L.; Freidl, G. S.; Harris, T. G.; Herring, B. L.; Iamsirithaworn, S.; Ila, R.; Ilincic, N.; Ilori, E. A.; Inbanathan, F. Y.; Indenbaum, V.; Kaldor, J.; Kim, D.; Kolawole, O. M.; Kondwani, J. C.; Kuchuk, T.; Lalwani, P. J.; Laman, M.; Lavu, E.; Leite, J.; Liu, M.; Loeschnik, E.; Macartney, K.; Machalek, D. A.; Makiala-Mandanda, S.; Mallet, H. P.; Mapira, P.; Mawien, P. N.; Misra, P.; Musa, S.; Mutevedzi, P. C.; Najjar, O. A.; Nakphook, S.; Noel, K. C.; Nurmatov, Z.; Ome-Kaius, M.; Paudel, K. P.; Perlman-Arrow, S.; Qaddomi, S. E.; Quan, H.; Rady, A.; Rahim, H. P.; Rayyan, I. Y.; Rodriguez, A.; Sachathep, K.; Segal, M.; Selemon, A.; Shirin, T.; Stafford, K. A.; Steinhardt, L.; Tran, V.; Traore, I. T.; Wahyono, T. Y. M.; Williamson, T.; Wood, N.; Yansouni, C. P.; Zhang, C.; Lin, C. Z..
Embase;
Preprint in English | EMBASE | ID: ppcovidwho-326828

ABSTRACT

Background COVID-19 case data underestimates infection and immunity, especially in low- and middle-income countries (LMICs). We meta-analyzed standardized SARS-CoV-2 seroprevalence studies to estimate global seroprevalence. Objectives/Methods We conducted a systematic review and meta-analysis, searching MEDLINE, Embase, Web of Science, preprints, and grey literature for SARS-CoV-2 seroprevalence studies aligned with the WHO UNITY protocol published between 2020-01-01 and 2021-10-29. Eligible studies were extracted and critically appraised in duplicate. We meta-analyzed seroprevalence by country and month, pooling to estimate regional and global seroprevalence over time;compared seroprevalence from infection to confirmed cases to estimate under-ascertainment;meta-analyzed differences in seroprevalence between demographic subgroups;and identified national factors associated with seroprevalence using meta-regression. PROSPERO: CRD42020183634. Results We identified 396 full texts reporting 736 distinct seroprevalence studies (41% LMIC), including 355 low/moderate risk of bias studies with national/sub-national scope in further analysis. By April 2021, global SARS-CoV-2 seroprevalence was 26.1%, 95% CI [24.6-27.6%]. Seroprevalence rose steeply in the first half of 2021 due to infection in some regions (e.g., 18.2% to 45.9% in Africa) and vaccination and infection in others (e.g., 11.3% to 57.4% in the Americas high-income countries), but remained low in others (e.g., 0.3% to 1.6% in the Western Pacific). In 2021 Q1, median seroprevalence to case ratios were 1.9:1 in HICs and 61.9:1 in LMICs. Children 0-9 years and adults 60+ were at lower risk of seropositivity than adults 20-29. In a multivariate model using data pre-vaccination, more stringent public health and social measures were associated with lower seroprevalence. Conclusions Global seroprevalence has risen considerably over time and with regional variation, however much of the global population remains susceptible to SARS-CoV-2 infection. True infections far exceed reported COVID-19 cases. Standardized seroprevalence studies are essential to inform COVID-19 control measures, particularly in resource-limited regions.

5.
Journal of Clinical Oncology ; 39(15 SUPPL), 2021.
Article in English | EMBASE | ID: covidwho-1339289

ABSTRACT

Background: Genetic testing allows for enhanced prognostication and early intervention in patients with high risk of developing cancer. Genetic testing often reveals variants of uncertain significance (VUS), for which association with disease risk is unclear. The ambiguity of this finding creates a dilemma for patients and providers and has been associated with significant communication error and distress. In this retrospective observational study, we seek to characterize the indications, outcomes, and trends in patients undergoing genetic testing in a community hospital in Cambridge, MA. As our study spanned the beginning of the COVID-19 pandemic, we also assessed its impact on care accessibility. Methods: We included patients undergoing genetic testing at our hospital between December 2019 and October 2020 (n=371). Medical charts were abstracted to identify patient characteristics, family history, indication for genetic testing, genetic findings, and subsequent management. Results: Our population had a mean age of 48 years (SD=15), was predominantly female (88.1%), and had a high proportion of Ashkenazi Jewish descent (15.3%). The vast majority (351, 94.6%) had a family history of cancer, while 123 (33.2%) had a personal history of cancer, most commonly breast (n=89). The most common indications for genetic testing were Hereditary Breast and Ovarian Cancer (HBOC in 280, 75%), Lynch Syndrome (LS in 22, 5.9%), and Familial Adenomatous Polyposis (FAP in 7, 2%). Of patients who met HBOC, LS, or FAP criteria for genetic testing, pathogenic mutations were identified in 9.5% and VUS in 28.6%. Out of total 35 (9.4%) pathogenic mutations found in our entire study population, the most common were in BRCA (9, 25.7%), MUTYH (5, 14.2%), and Lynch genes (3, 8.6%). Out of 103 patients with VUS (27.8%), the most common sites were APC (14) and MSH3 (9). We found no significant trend in genetic counseling consultations over our 11 months study period despite the COVID-19 pandemic (R = 0.006). Conclusions: Among patients who met criteria for genetic cancer screening at a community hospital, 9.5% were found to have a pathogenic mutation while 28.6% were found to have VUS. These numbers are comparable to previously published estimates. Despite advances in our understanding of genetic colon and gynecological cancers, the majority of patients presenting for genetic cancer counseling continue to do so due to breast cancer concerns. Lastly, we noted high efficacy in our conversion of in-person genetics consultations to telemedicine during the COVID-19 pandemic, suggesting telemedicine is a robust format for genetic counselling. Mutations (N): BRCA1 (3), BRCA2 (6);MUTHY (5);MSH2 (2), MSH6 (1);ATM (2), and one each in PALB2, RAD50, RAD51C, RAD51D, Tp53, CDKN2A, APC, F2, SDHA, SDHB, VHL. FANCL, NTHL1.

6.
Epidemiol Infect ; 149: e80, 2021 03 25.
Article in English | MEDLINE | ID: covidwho-1211252

ABSTRACT

This study aimed to identify an appropriate simple mathematical model to fit the number of coronavirus disease 2019 (COVID-19) cases at the national level for the early portion of the pandemic, before significant public health interventions could be enacted. The total number of cases for the COVID-19 epidemic over time in 28 countries was analysed and fit to several simple rate models. The resulting model parameters were used to extrapolate projections for more recent data. While the Gompertz growth model (mean R2 = 0.998) best fit the current data, uncertainties in the eventual case limit introduced significant model errors. However, the quadratic rate model (mean R2 = 0.992) fit the current data best for 25 (89%) countries as determined by R2 values of the remaining models. Projection to the future using the simple quadratic model accurately forecast the number of future total number of cases 50% of the time up to 10 days in advance. Extrapolation to the future with the simple exponential model significantly overpredicted the total number of future cases. These results demonstrate that accurate future predictions of the case load in a given country can be made using this very simple model.


Subject(s)
COVID-19/diagnosis , Logistic Models , Models, Theoretical , COVID-19/epidemiology , Europe/epidemiology , Humans , Pandemics/prevention & control
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