Ingelbeen Brecht, Cumbane Victória, Mandlate Ferão, Barbé Barbara, Nhachungue Sheila Mercedes, Cavele Nilzio, Manhica Cremildo, Cubai Catildo, Nguenha Neusa Maimuna Carlos, Lacroix Audrey, Mariën Joachim, de Weggheleire Anja, van Kleef Esther, Selhorst Philippe, van der Sande Marianne A B, Peeters Martine, Widdowson Marc-Alain, Ismael Nalia, Macicame Ivalda
Instituut voor Tropische Geneeskunde, Antwerp, Belgium.
Julius Center for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands.
PLOS Glob Public Health. 2024 Aug 5;4(8):e0003550. doi: 10.1371/journal.pgph.0003550. eCollection 2024.
In sub-Saharan Africa, reported COVID-19 numbers have been lower than anticipated, even when considering populations' younger age. The extent to which risk factors, established in industrialised countries, impact the risk of infection and of disease in populations in sub-Saharan Africa, remains unclear. We estimated the incidence of mild and moderate COVID-19 in urban Mozambique and analysed factors associated with infection and disease in a population-based surveillance study. During December 2020-March 2022, 1,561 households (6,049 participants, median 21 years, 54.8% female, 7.3% disclosed HIV positive) of Polana Caniço, Maputo, Mozambique, were visited biweekly to report respiratory symptoms, anosmia, or ageusia, and self-administer a nasal swab for SARS-CoV-2 testing. Every three months, dried blood spots of a subset of participants (1,412) were collected for detection of antibodies against SARS-CoV-2 spike glycoprotein and nucleocapsid protein. Per 1000 person-years, 364.5 (95%CI 352.8-376.1) respiratory illness episodes were reported, of which 72.2 (95%CI 60.6-83.9) were COVID-19. SARS-CoV-2 seroprevalence rose from 4.8% (95%CI 1.1-8.6%) in December 2020 to 34.7% (95%CI 20.2-49.3%) in June 2021, when 3.0% were vaccinated. Increasing age, chronic lung disease, hypertension, and overweight increased risk of COVID-19. Older age increased the risk of SARS-CoV-2 seroconversion. We observed no association between socio-economic status, behaviour and COVID-19 or SARS-CoV-2 seroconversion. Active surveillance in an urban population confirmed frequent COVID-19 underreporting, yet indicated that the large majority of cases were mild and non-febrile. In contrast to reports from industrialised countries, social deprivation did not increase the risk of infection nor disease.
在撒哈拉以南非洲地区，报告的新冠病毒病（COVID-19）病例数低于预期，即便考虑到当地人口较为年轻这一因素。在工业化国家确定的风险因素对撒哈拉以南非洲地区人群感染风险和发病风险的影响程度仍不明确。我们在一项基于人群的监测研究中估计了莫桑比克城市地区轻度和中度COVID-19的发病率，并分析了与感染和疾病相关的因素。在2020年12月至2022年3月期间，每两周对莫桑比克马普托市波拉纳·卡尼索区的1561户家庭（6049名参与者，年龄中位数21岁，女性占54.8%，7.3%披露HIV检测呈阳性）进行走访，以报告呼吸道症状、嗅觉丧失或味觉丧失情况，并自行进行鼻拭子检测以筛查严重急性呼吸综合征冠状病毒2（SARS-CoV-2）。每三个月，采集一部分参与者（1412人）的干血斑，用于检测抗SARS-CoV-2刺突糖蛋白和核衣壳蛋白的抗体。每1000人年报告了364.5例（95%置信区间352.8 - 376.1）呼吸道疾病发作，其中72.2例（95%置信区间60.6 - 83.9）为COVID-19。SARS-CoV-2血清阳性率从2020年12月的4.8%（95%置信区间1.1 - 8.6%）升至2021年6月的34.7%（95%置信区间20.2 - 49.3%），当时3.0%的人接种了疫苗。年龄增长以及患有慢性肺病、高血压和超重会增加COVID-19风险。年龄较大增加了SARS-CoV-2血清转化的风险。我们未观察到社会经济地位、行为与COVID-19或SARS-CoV-2血清转化之间存在关联。对城市人群的主动监测证实了COVID-19报告存在频繁漏报情况，但表明绝大多数病例为轻症且无发热症状。与工业化国家的报告不同，社会贫困并未增加感染风险和发病风险。
