2021年3月和6月，在肯尼亚两个疫苗接种率低、人口结构不同的人群中，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的异质性传播和血清阳性率
Heterogenous transmission and seroprevalence of SARS-CoV-2 in two demographically diverse populations with low vaccination uptake in Kenya, March and June 2021.
作者信息
Munywoki Patrick K, Bigogo Godfrey, Nasimiyu Carolyne, Ouma Alice, Aol George, Oduor Clifford O, Rono Samuel, Auko Joshua, Agogo George O, Njoroge Ruth, Oketch Dismas, Odhiambo Dennis, Odeyo Victor W, Kikwai Gilbert, Onyango Clayton, Juma Bonventure, Hunsperger Elizabeth, Lidechi Shirley, Ochieng Caroline Apondi, Lo Terrence Q, Munyua Peninah, Herman-Roloff Amy
机构信息
Division for Global Health Protection, Global Health Center, U.S. Centers for Disease Control and Prevention (CDC)-Kenya, Nairobi, Kenya.
Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.
出版信息
Gates Open Res. 2023 Oct 9;7:101. doi: 10.12688/gatesopenres.14684.2. eCollection 2023.
BACKGROUND
SARS-CoV-2 has extensively spread in cities and rural communities, and studies are needed to quantify exposure in the population. We report seroprevalence of SARS-CoV-2 in two well-characterized populations in Kenya at two time points. These data inform the design and delivery of public health mitigation measures.
METHODS
Leveraging on existing population based infectious disease surveillance (PBIDS) in two demographically diverse settings, a rural site in western Kenya in Asembo, Siaya County, and an urban informal settlement in Kibera, Nairobi County, we set up a longitudinal cohort of randomly selected households with serial sampling of all consenting household members in March and June/July 2021. Both sites included 1,794 and 1,638 participants in the March and June/July 2021, respectively. Individual seroprevalence of SARS-CoV-2 antibodies was expressed as a percentage of the seropositive among the individuals tested, accounting for household clustering and weighted by the PBIDS age and sex distribution.
RESULTS
Overall weighted individual seroprevalence increased from 56.2% (95%CI: 52.1, 60.2%) in March 2021 to 63.9% (95%CI: 59.5, 68.0%) in June 2021 in Kibera. For Asembo, the seroprevalence almost doubled from 26.0% (95%CI: 22.4, 30.0%) in March 2021 to 48.7% (95%CI: 44.3, 53.2%) in July 2021. Seroprevalence was highly heterogeneous by age and geography in these populations-higher seroprevalence was observed in the urban informal settlement (compared to the rural setting), and children aged <10 years had the lowest seroprevalence in both sites. Only 1.2% and 1.6% of the study participants reported receipt of at least one dose of the COVID-19 vaccine by the second round of serosurvey-none by the first round.
CONCLUSIONS
In these two populations, SARS-CoV-2 seroprevalence increased in the first 16 months of the COVID-19 pandemic in Kenya. It is important to prioritize additional mitigation measures, such as vaccine distribution, in crowded and low socioeconomic settings.
背景
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）已在城市和农村社区广泛传播，需要开展研究以量化人群中的暴露情况。我们报告了肯尼亚两个特征明确的人群在两个时间点的SARS-CoV-2血清阳性率。这些数据为公共卫生缓解措施的设计和实施提供了依据。
方法
利用两个不同人口结构地区现有的基于人群的传染病监测（PBIDS），一个是肯尼亚西部锡亚亚县阿森博的农村地区，另一个是内罗毕县基贝拉的城市非正式定居点，我们建立了一个纵向队列，在2021年3月以及6月/7月对随机选择的家庭进行连续抽样，并征得所有家庭成员的同意。这两个地点在2021年3月和6月/7月分别有1794名和1638名参与者。SARS-CoV-2抗体的个体血清阳性率以检测个体中血清阳性者的百分比表示，考虑了家庭聚集情况，并根据PBIDS的年龄和性别分布进行加权。
结果
在基贝拉，总体加权个体血清阳性率从2021年3月的56.2%（95%置信区间：52.1，60.2%）增至2021年6月的63.9%（95%置信区间：59.5，68.0%）。在阿森博，血清阳性率几乎翻了一番，从2021年3月的26.0%（95%置信区间：22.4，30.0%）增至2021年7月的48.7%（95%置信区间：44.3，53.2%）。在这些人群中，血清阳性率在年龄和地理位置上差异很大——城市非正式定居点的血清阳性率更高（与农村地区相比），且两个地点<10岁的儿童血清阳性率最低。在第二轮血清学调查时，只有1.2%和1.6%的研究参与者报告至少接种了一剂新冠疫苗，第一轮时无人接种。
结论
在这两个人群中，肯尼亚新冠疫情的前16个月里SARS-CoV-2血清阳性率有所上升。在拥挤和社会经济水平较低的环境中，优先采取额外的缓解措施，如疫苗分发，非常重要。
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