Tippett Barr Beth A, Herman-Roloff Amy, Mburu Margaret, Murnane Pamela M, Sang Norton, Bukusi Elizabeth, Oele Elizabeth, Odhiambo Albert, Lewis-Kulzer Jayne, Onyango Clayton O, Hunsperger Elizabeth, Odhiambo Francesca, Joseph Rachel H, Munyua Peninah, Othieno Kephas, Mulwa Edwin, Akelo Victor, Muok Erick, Bulterys Marc, Nzioka Charles, Cohen Craig R
U.S. Centers for Disease Control and Prevention, Kisumu, Kenya.
Nyanja Health Research Institute, Salima, Malawi.
PLOS Glob Public Health. 2022 Sep 8;2(9):e0000951. doi: 10.1371/journal.pgph.0000951. eCollection 2022.
We investigated the first 152 laboratory-confirmed SARS-CoV-2 cases (125 primary and 27 secondary) and their 248 close contacts in Kisumu County, Kenya. Conducted June 10-October 8, 2020, this study included interviews and sample collection at enrolment and 14-21 days later. Median age was 35 years (IQR 28-44); 69.0% reported COVID-19 related symptoms, most commonly cough (60.0%), headache (55.2%), fever (53.3%) and loss of taste or smell (43.8%). One in five were hospitalized, 34.4% >25 years of age had at least one comorbidity, and all deaths had comorbidities. Adults ≥25 years with a comorbidity were 3.15 (95% CI 1.37-7.26) times more likely to have been hospitalized or died than participants without a comorbidity. Infectious comorbidities included HIV, tuberculosis, and malaria, but no current cases of influenza, respiratory syncytial virus, dengue fever, leptospirosis or chikungunya were identified. Thirteen (10.4%) of the 125 primary infections transmitted COVID-19 to 27 close contacts, 158 (63.7%) of whom resided or worked within the same household. Thirty-one percent (4 of 13) of those who transmitted COVID-19 to secondary cases were health care workers; no known secondary transmissions occurred between health care workers. This rapid assessment early in the course of the COVID-19 pandemic identified some context-specific characteristics which conflicted with the national line-listing of cases, and which have been substantiated in the year since. These included over two-thirds of cases reporting the development of symptoms during the two weeks after diagnosis, compared to the 7% of cases reported nationally; over half of cases reporting headaches, and nearly half of all cases reporting loss of taste and smell, none of which were reported at the time by the World Health Organization to be common symptoms. This study highlights the importance of rapid in-depth assessments of outbreaks in understanding the local epidemiology and response measures required.
我们对肯尼亚基苏木县首批152例实验室确诊的新冠病毒病例（125例原发病例和27例继发病例）及其248名密切接触者进行了调查。该研究于2020年6月10日至10月8日开展，包括在登记时以及14至21天后进行访谈和样本采集。中位年龄为35岁（四分位间距28 - 44岁）；69.0%的人报告有新冠相关症状，最常见的是咳嗽（60.0%）、头痛（55.2%）、发热（53.3%）和味觉或嗅觉丧失（43.8%）。五分之一的人住院治疗，34.4%年龄大于25岁的人至少有一种合并症，且所有死亡病例均有合并症。有合并症的25岁及以上成年人住院或死亡的可能性是无合并症参与者的3.15倍（95%置信区间1.37 - 7.26）。感染性合并症包括艾滋病毒、结核病和疟疾，但未发现当前有流感、呼吸道合胞病毒、登革热、钩端螺旋体病或基孔肯雅热病例。125例原发感染中有13例（10.4%）将新冠病毒传播给了27名密切接触者，其中158名（63.7%）居住或工作在同一家庭。将新冠病毒传播给继发病例的人中有31%（13例中的4例）是医护人员；医护人员之间未发生已知的继发传播。在新冠疫情早期进行的这项快速评估确定了一些与国家病例清单不符的特定背景特征，并且在之后的一年里得到了证实。这些特征包括超过三分之二的病例报告在诊断后两周内出现症状，而全国报告的此类病例为7%；超过一半的病例报告有头痛症状，近一半的病例报告有味觉和嗅觉丧失，而世界卫生组织当时并未报告这些是常见症状。这项研究强调了对疫情进行快速深入评估对于了解当地流行病学和所需应对措施的重要性。
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