RFA-GH-21-006, SICA Study: Seroepidemiological Insight into COVID-19 transmission in Africa

项目总结 新冠肺炎大流行给撒哈拉以南非洲地区的人们带来了截然不同的健康结果 与病例数量和死亡人数相对较高的其他国家相比。相对较低的 在刚果民主共和国和尼日利亚报告的病例和死亡人数，以及 在整个撒哈拉以南非洲，这可能反映了糟糕的医疗基础设施和有限的检测能力。 目前还不清楚SARS-CoV-2在城市和农村的传播水平如何影响COVID- 19严重程度以及随后两国检测地点对病例的确认。我们最重要的是 假设是以前接触过相关的冠状病毒和其他病原体，它们在 城市和农村社区，导致了显著的交叉保护免疫或先天免疫启动 人口增长，这使得这些国家的新冠肺炎负担减轻。我们将利用正在进行的 在刚果民主共和国和尼日利亚的城市和农村地点进行纵向队列研究，以支持以下特征：(I) SARS-CoV-2感染的发生率、危险因素和新冠肺炎严重程度，(Ii)目前的分布 呼吸道/非呼吸道病毒和非病毒病原体是否为非新冠肺炎急性肺炎的病因和严重程度 发热疾病，以及(Iii)接触同系病原体对新冠肺炎严重程度的作用。为此，我们 建议用血清流行病学描述SARS-CoV-2的发病率和流行率，并描述影响因素 与发病率和恢复率(AIM1)以及呼吸道和非呼吸道病毒或 寄生病原体即。新冠肺炎大流行期间的急性热病(AIM2)。我们的悠久历史 通过社区参与活动建立关系，并与公共卫生部以及 非洲疾病控制中心使我们能够以地方分辨率获得和传达准确的数据。我们 设想这一多国监测项目将提供亟需的对猪流感流行病学的洞察 刚果民主共和国和尼日利亚的SARS-CoV-2感染和新冠肺炎病，阐明发病率的差异 以及一系列城市和农村环境中的疾病结果，这反过来可以为公共卫生政策提供信息 并在国家和区域两级采取控制措施。

PROJECT SUMMARY The COVID-19 pandemic has resulted in vastly different health outcomes for populations in Sub-Saharan Africa as compared to other countries with comparatively higher case numbers and deaths. The comparatively low numbers of cases and deaths reported in the Democratic Republic of Congo (DRC) and Nigeria, as well as throughout sub-Saharan Africa, are likely reflective of poor healthcare infrastructure and limited testing capacity. It is also unclear how the level of transmission of SARS-CoV-2 in urban vs. rural settings may influence COVID- 19 severity and the subsequent identification of cases by testing sites in both countries. Our overarching hypothesis is that prior exposure to related coronaviruses and other pathogens, which partition differentially in urban vs. rural communities, have resulted in significant cross-protective immunity or innate immune priming in the population, which leads to a reduced COVID-19 burden in these countries. We will leverage ongoing longitudinal cohort studies in urban and rural sites in the DRC and Nigeria, to support the characterization of: (i) the incidence of and risk factors for SARS-CoV-2 infection and COVID-19 severity, (ii) the current distribution and severity of respiratory/non-respiratory viral and non-viral pathogens as a cause of non-COVID-19 acute febrile illness, and (iii) role that exposure to syndemic pathogens have on COVID-19 severity. To this end, we propose to describe the incidence and prevalence of SARS-CoV-2 using seroepidemiology and describe factors associated with incidence and recovery (AIM1) and the epidemiology of respiratory and non-respiratory viral or parasitic pathogens viz. acute febrile illness (AFI) during the COVID-19 pandemic (AIM2). Our long-standing relationships through community engagement activities, and direct ties to the Public Health ministries as well as the Africa Centres for Disease Control allow us to obtain and convey accurate data at local resolution. We envision that this multinational surveillance project will provide much needed insight into the epidemiology of SARS-CoV-2 infection and COVID-19 disease in the DRC and Nigeria, elucidating differences in the incidence and disease outcomes across a range of urban vs. rural settings, which in turn can inform public health policy and control measures at country and regional levels.