Seroepidemiology and model-based prediction of SARS-CoV-2 in Ethiopia: longitudinal cohort study among front-line hospital workers and communities.
Seroepidemiology and model-based prediction of SARS-CoV-2 in Ethiopia: longitudinal cohort study among front-line hospital workers and communities.
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DOI：
10.1016/s2214-109x(21)00386-7
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发表时间：
2021-11
期刊：
影响因子：
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通讯作者：
Kroidl A
中科院分区：
文献类型：
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作者：
Gudina EK;Ali S;Girma E;Gize A;Tegene B;Hundie GB;Sime WT;Ambachew R;Gebreyohanns A;Bekele M;Bakuli A;Elsbernd K;Merkt S;Contento L;Hoelscher M;Hasenauer J;Wieser A;Kroidl A
自第一例报告病例以来已超过1年，由于监测不足，埃塞俄比亚的真正COVID-19负担仍然未知。我们的目的是调查SARS-CoV-2在埃塞俄比亚一线医院工作人员和社区中的血清流行病学。我们在两所三级教学医院进行了一项基于人群的纵向队列研究，研究对象包括Jimma和阿迪斯的医院工作人员、农村居民和城市社区。在这两家医院招募医院工作人员，并通过方便抽样招募社区参与者，包括城市大都市环境，城市和半城市环境以及农村社区。如果参与者年龄在18岁或以上，提供了书面知情同意书，并愿意通过静脉穿刺提供血液样本，则有资格参加。每个家庭只招募一名参与者。采用Elecsys抗SARS-CoV-2抗核衣壳试验连续三轮进行血清学检查，试验之间的平均间隔为6周，以获得队列内的血清阳性率和发病率估计值。在2020年8月5日至2021年4月10日期间，我们进行了三轮调查，共有1104名医院工作人员和1229名社区居民参与。在研究期间，医院工作人员中的SARS-CoV-2血清阳性率大幅上升：在阿迪斯，从2020年8月的10.9%（95%可信区间[CrI] 8.3 - 13.8）上升到2021年2月的53.7%（44.8 - 62.5），发病率为2223/10 万人周（95%CI 1785-2696）;积马镇从2020年11月的30.8%（95%CrI 26.9 - 34.8）上升至2021年2月的56.1%（51.1 - 61.1），发病率为3810/10 万人周（95%CI 3149-4540）。在城市社区中，2021年初观察到血清阳性率增加近40%，吉马镇的发病率为每10万人周1622例（1004-2429），阿迪斯的发病率为每10万人周4646例（2797-7255）。 农村社区的血清阳性率从2020年11月的18.0%（95%CrI 13.5 - 23.2）上升到2021年3月的31.0%（22.3 - 40.3）。在埃塞俄比亚，SARS-CoV-2在医院工作人员和城市社区中的传播非常活跃。我们可以推测，目前最大的SARS-CoV-2感染浪潮正在埃塞俄比亚农村地区发展，因此需要重点关注卫生保健负担和疾病预防。巴伐利亚州科学、研究和艺术部;德国教育和研究部;欧盟地平线2020方案;德国研究共同体;和社会基金会。
Over 1 year since the first reported case, the true COVID-19 burden in Ethiopia remains unknown due to insufficient surveillance. We aimed to investigate the seroepidemiology of SARS-CoV-2 among front-line hospital workers and communities in Ethiopia. We did a population-based, longitudinal cohort study at two tertiary teaching hospitals involving hospital workers, rural residents, and urban communities in Jimma and Addis Ababa. Hospital workers were recruited at both hospitals, and community participants were recruited by convenience sampling including urban metropolitan settings, urban and semi-urban settings, and rural communities. Participants were eligible if they were aged 18 years or older, had provided written informed consent, and were willing to provide blood samples by venepuncture. Only one participant per household was recruited. Serology was done with Elecsys anti-SARS-CoV-2 anti-nucleocapsid assay in three consecutive rounds, with a mean interval of 6 weeks between tests, to obtain seroprevalence and incidence estimates within the cohorts. Between Aug 5, 2020, and April 10, 2021, we did three survey rounds with a total of 1104 hospital workers and 1229 community residents participating. SARS-CoV-2 seroprevalence among hospital workers increased strongly during the study period: in Addis Ababa, it increased from 10·9% (95% credible interval [CrI] 8·3–13·8) in August, 2020, to 53·7% (44·8–62·5) in February, 2021, with an incidence rate of 2223 per 100 000 person-weeks (95% CI 1785–2696); in Jimma Town, it increased from 30·8% (95% CrI 26·9–34·8) in November, 2020, to 56·1% (51·1–61·1) in February, 2021, with an incidence rate of 3810 per 100 000 person-weeks (95% CI 3149–4540). Among urban communities, an almost 40% increase in seroprevalence was observed in early 2021, with incidence rates of 1622 per 100 000 person-weeks (1004–2429) in Jimma Town and 4646 per 100 000 person-weeks (2797–7255) in Addis Ababa. Seroprevalence in rural communities increased from 18·0% (95% CrI 13·5–23·2) in November, 2020, to 31·0% (22·3–40·3) in March, 2021. SARS-CoV-2 spread in Ethiopia has been highly dynamic among hospital worker and urban communities. We can speculate that the greatest wave of SARS-CoV-2 infections is currently evolving in rural Ethiopia, and thus requires focused attention regarding health-care burden and disease prevention. Bavarian State Ministry of Sciences, Research, and the Arts; Germany Ministry of Education and Research; EU Horizon 2020 programme; Deutsche Forschungsgemeinschaft; and Volkswagenstiftung.