1School of Medicine, Universidad Espíritu Santo, Guayaquil, Ecuador.
2Community Center, The Atahualpa Project, Atahualpa, Ecuador.
Am J Trop Med Hyg. 2020 Sep;103(3):1207-1210. doi: 10.4269/ajtmh.20-0688.
The SARS-CoV-2 pandemic is now expanding into the developing world with devastating consequences. Departing from a population-based study in rural Ecuador where all adult individuals (aged 40 years or older) were tested for SARS-CoV-2 IgG and IgM antibodies, we expanded it to include a house-based case-control component assessing in-house clustering and other variables potentially associated with infection. We selected houses where exactly two study participants lived and were both seropositive (case-houses), and matched 1:1 to control-houses where both were seronegative. Younger household members had an antibody test performed. Infected household members were found in 33 (92%) case-houses and in only six (17%) control-houses. In 28/29 discordant house pairs, the case-house had seropositive household members and the control-house did not (odds ratio: 28; 95% CI: 4.6-1,144). Our data demonstrate strong in-house clustering of infection in community settings, stressing the importance of early case ascertainment and isolation for SARS-CoV-2 control.
SARS-CoV-2 大流行正在向发展中国家蔓延，带来了毁灭性的后果。本研究在厄瓜多尔农村进行了一项基于人群的研究，对所有 40 岁及以上的成年人进行了 SARS-CoV-2 IgG 和 IgM 抗体检测，在此基础上，我们进一步开展了一项以家庭为基础的病例对照研究，评估家庭内聚集和其他可能与感染相关的变量。我们选择了居住着两名血清学阳性（病例家庭）的研究参与者的家庭，并与居住着两名血清学阴性的对照家庭（对照家庭）进行了 1:1 匹配。对年轻的家庭成员进行了抗体检测。在 33 个（92%）病例家庭中发现了感染家庭成员，而在仅 6 个（17%）对照家庭中发现了感染家庭成员。在 28/29 对不一致的家庭对中，病例家庭有血清学阳性的家庭成员，而对照家庭没有（比值比：28；95%置信区间：4.6-1,144）。我们的数据表明，在社区环境中存在强烈的家庭内感染聚集现象，这强调了早期确定病例和隔离 SARS-CoV-2 以进行控制的重要性。
