乌干达早期的 SARS-CoV-2 感染病例：基于风险的检测方法的流行病学和经验教训-2020 年 3-4 月。
Early cases of SARS-CoV-2 infection in Uganda: epidemiology and lessons learned from risk-based testing approaches - March-April 2020.
机构信息
Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda.
Ministry of Health, Kampala, Uganda.
出版信息
Global Health. 2020 Nov 25;16(1):114. doi: 10.1186/s12992-020-00643-7.
BACKGROUND
On March 13, 2020, Uganda instituted COVID-19 symptom screening at its international airport, isolation and SARS-CoV-2 testing for symptomatic persons, and mandatory 14-day quarantine and testing of persons traveling through or from high-risk countries. On March 21, 2020, Uganda reported its first SARS-CoV-2 infection in a symptomatic traveler from Dubai. By April 12, 2020, 54 cases and 1257 contacts were identified. We describe the epidemiological, clinical, and transmission characteristics of these cases.
METHODS
A confirmed case was laboratory-confirmed SARS-CoV-2 infection during March 21-April 12, 2020 in a resident of or traveler to Uganda. We reviewed case-person files and interviewed case-persons at isolation centers. We identified infected contacts from contact tracing records.
RESULTS
Mean case-person age was 35 (±16) years; 34 (63%) were male. Forty-five (83%) had recently traveled internationally ('imported cases'), five (9.3%) were known contacts of travelers, and four (7.4%) were community cases. Of the 45 imported cases, only one (2.2%) was symptomatic at entry. Among all case-persons, 29 (54%) were symptomatic at testing and five (9.3%) were pre-symptomatic. Among the 34 (63%) case-persons who were ever symptomatic, all had mild disease: 16 (47%) had fever, 13 (38%) reported headache, and 10 (29%) reported cough. Fifteen (28%) case-persons had underlying conditions, including three persons with HIV. An average of 31 contacts (range, 4-130) were identified per case-person. Five (10%) case-persons, all symptomatic, infected one contact each.
CONCLUSION
The first 54 case-persons with SARS-CoV-2 infection in Uganda primarily comprised incoming air travelers with asymptomatic or mild disease. Disease would likely not have been detected in these persons without the targeted testing interventions implemented in Uganda. Transmission was low among symptomatic persons and nonexistent from asymptomatic persons. Routine, systematic screening of travelers and at-risk persons, and thorough contact tracing will be needed for Uganda to maintain epidemic control.
背景
2020 年 3 月 13 日，乌干达在国际机场对入境旅客实施 COVID-19 症状筛查，对出现症状者进行隔离和 SARS-CoV-2 检测，并对来自或途经高风险国家的旅客实施 14 天强制隔离和检测。2020 年 3 月 21 日，乌干达报告首例从迪拜入境的出现症状旅客感染 SARS-CoV-2。截至 2020 年 4 月 12 日，共发现 54 例确诊病例和 1257 名接触者。我们描述了这些病例的流行病学、临床和传播特征。
方法
确诊病例为 2020 年 3 月 21 日至 4 月 12 日期间居住在乌干达或来自乌干达的实验室确诊 SARS-CoV-2 感染病例。我们查阅了病例档案并在隔离中心对病例进行了访谈。我们从接触者追踪记录中确定了感染接触者。
结果
平均病例年龄为 35（±16）岁，34 例（63%）为男性。45 例（83%）为近期国际旅行者（“输入性病例”），5 例（9.3%）为旅行者的已知接触者，4 例（7.4%）为社区病例。45 例输入性病例中，仅有 1 例（2.2%）在入境时出现症状。所有病例中，29 例（54%）在检测时出现症状，5 例（9.3%）出现症状前。34 例（63%）出现症状的病例中，所有人均为轻症：16 例（47%）发热，13 例（38%）头痛，10 例（29%）咳嗽。15 例（28%）病例存在基础疾病，包括 3 例 HIV 感染者。每位病例平均有 31 名接触者（范围 4-130）。5 例（10%）有症状的病例，每人感染 1 名接触者。
结论
乌干达最初发现的 54 例 SARS-CoV-2 感染病例主要为无症状或轻症入境航空旅客。如果不实施乌干达所采取的有针对性的检测干预措施，这些人可能不会被发现感染。在出现症状的病例中，传播风险较低，而无症状病例中不存在传播。乌干达需要进行常规、系统的旅行者和高危人群筛查，并彻底追踪接触者，以维持疫情控制。
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