Thera Sekou Oumarou, Cissoko Mady, Landier Jordi, Doumbia Zoumana, Dolo Amagoron Mathias, Traore Siriman, Sangare Abdoul Karim, Berthe Ibrahima, Thera Ismaila, Berthe Hadiata, Sogodogo Elisabeth, Coulibaly Karyn, Guindo Abdoulaye, Balique Hubert, Sanogo Souleymane, Dara Charles, Roy Flore-Apolline, Sagara Issaka, Kouriba Bourema, Djimdé Abdoulaye A, Sagaon-Teyssier Luis, Vidal Laurent, Bendiane Marc-Karim, Gaudart Jean
Aix Marseille Univ, IRD, INSERM, SESSTIM, ISSPAM, Marseille, France.
Malaria Research and Training Center (MRTC), FMOS & FAPH, USTTB, Bamako, Mali.
PLOS Glob Public Health. 2025 Jul 21;5(7):e0004842. doi: 10.1371/journal.pgph.0004842. eCollection 2025.
In November 2023, three years after the onset of the pandemic, Mali officially recorded 33,160 confirmed COVID-19 cases and 743 related deaths. Tombouctou health district, following Bamako, the capital city, emerged as the second major hotspot with over 532 confirmed cases. However, these figures likely underestimate the true scale of the epidemic due to limited healthcare access and diagnostic capacity. This study aimed to describe the early trajectory of the epidemic, estimate seroprevalence, and identify factors associated with COVID-19 in the Tombouctou health district. A multi-level study was conducted in January 2021. First, the epidemic dynamics in Tombouctou were analyzed, estimating the basic reproduction number (R0) using daily case time series. Additionally, a cross-sectional survey was conducted, involving 419 households and 1102 participants, allowing for seroprevalence estimation by age and gender. A face-to-face questionnaire collected information on living conditions and knowledge, attitudes, behaviors and practices, regarding the epidemic. Factors associated with SARS-CoV-2 seropositivity were determined using generalized additive mixed models (GAMMs), adjusted to the variable under study and the level of analysis. We estimated an R0 of 2.08 [1.46-2.93]. The crude seroprevalence of SARS-CoV-2 was 33.5% (309/923, 95% CI: 30.4% to 36.6%). Living in a household where someone had been diagnosed with COVID-19 [Incidence Rate Ratio (IRR)=5.47; 95% CI (4.51 to 6.64)], traditionally wealth households [IRR = 2.02; 95% CI (1.23-3.33)], modernly wealth households [IRR = 1.33; 95% CI (1.02 - 1.72)], and older age (per year) [Adjusted Odds Ratio (AOR)=1.02 (1.00 to 1.03)] were significantly associated with seropositivity. Our analysis highlighted the active circulation of SARS-CoV-2 in Tombouctou, with higher seroprevalence observed among people from wealth households, as well as older age groups. The findings underscore the need for tailored and targeted approach focusing on specific households, demographics and settings.
2023年11月，在疫情爆发三年后，马里官方记录了33160例新冠肺炎确诊病例和743例相关死亡病例。继首都巴马科之后，通布图卫生区成为第二个主要热点地区，确诊病例超过532例。然而，由于医疗服务可及性和诊断能力有限，这些数字可能低估了疫情的实际规模。本研究旨在描述疫情的早期发展轨迹，估计血清阳性率，并确定通布图卫生区与新冠肺炎相关的因素。2021年1月进行了一项多层次研究。首先，分析了通布图的疫情动态，利用每日病例时间序列估计基本再生数（R0）。此外，还进行了一项横断面调查，涉及419户家庭和1102名参与者，以便按年龄和性别估计血清阳性率。通过面对面问卷调查收集了有关生活条件以及对疫情的知识、态度、行为和做法的信息。使用广义相加混合模型（GAMMs）确定与SARS-CoV-2血清阳性相关的因素，并根据所研究的变量和分析水平进行调整。我们估计R0为2.08[1.46 - 2.93]。SARS-CoV-2的粗血清阳性率为33.5%（309/923，95%CI：30.4%至36.6%）。生活在有成员被诊断为新冠肺炎的家庭中[发病率比（IRR）=5.47；95%CI（4.51至6.64）]、传统富裕家庭[IRR = 2.02；95%CI（1.23 - 3.33）]、现代富裕家庭[IRR = 1.33；95%CI（1.02 - 1.72）]以及年龄较大（每年）[调整后优势比（AOR）=1.02（1.00至1.03）]与血清阳性显著相关。我们的分析突出了SARS-CoV-2在通布图的活跃传播，在富裕家庭人群以及老年人群中观察到较高的血清阳性率。研究结果强调需要针对特定家庭、人口统计学特征和环境采取量身定制的针对性方法。
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