Longitudinal cohort study of SARS-CoV2 sero-conversion in a malaria-endemic community in Western Kenya

肯尼亚西部疟疾流行社区 SARS-CoV2 血清转化的纵向队列研究

• 批准号: 10539318
• 负责人: Wendy PrudhommeOMeara
• 金额: $ 20.22万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-12-10 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10539318
• 关键词: 2019-nCoV; Acceleration; Acute; Africa; African; Age; Appearance; Attenuated; Biological; Blood; Blood donor; COVID-19; COVID-19 impact; COVID-19 pandemic; Cessation of life; Clinical; Collection; Communities; Compensation; Contact Tracing; Country; Data; Detection; Developing Countries; Enrollment; Enzyme-Linked Immunosorbent Assay; Epidemic; Epidemiology; Falciparum Malaria; Fever; Funding; Future; Genotype; Household; Infection; Kenya; Longitudinal cohort; Longitudinal cohort study; Malaria; Measurable; Measures; Mediating; Morbidity - disease rate; Movement; Observational Study; Parasites; Parents; Participant; Persons; Phase; Plasmodium falciparum; Population; Positioning Attribute; Predisposition; Prevalence; Productivity; Questionnaires; Reporting; Risk; Risk Assessment; Risk Factors; Rural; SARS-CoV-2 antibody; SARS-CoV-2 spike protein; SARS-CoV-2 transmission; Sampling; Seroepidemiologic Studies; Seroprevalences; Severities; Shapes; Specimen; Statistical Models; Symptoms; Testing; Time; Travel; Visit; Work; chronic infection; clinical epidemiology; co-infection; cohort; community setting; community transmission; immunoregulation; insight; malaria infection; malaria transmission; member; mortality; multidisciplinary; national surveillance; neutralizing antibody; pandemic disease; pathogen; post-pandemic; pre-pandemic; recurrent infection; seroconversion; seropositive; transmission process

In many developing countries, the Covid-19 pandemic has had limited direct impact, including Kenya, which as of 5 March 2021, has recorded only 107,329 cases and 1,870 deaths owing to Covid19. Although this limited clinical impact is in part the result of strict travel and movement restrictions and under-reporting, these low numbers contrast with seroprevalences of 4-8% in Kenyan blood donors, suggesting that a large number of Covid19 cases in Kenya are subclinical. A further consideration in such settings is the potential for interactions between SARS-CoV2 and endemic pathogens such as Plasmodium falciparum, which in Western Kenya is transmitted perennially and intensely. These asymptomatic infections shape the risk of subsequent malaria and have differential impact on hosts. In this sero-epidemiologic study, our specific objective is to investigate the spread of SARS-CoV2 in a large, densely-sampled community cohort in rural Kenya. Our longitudinal cohort consists of Kenyan household members of all ages enrolled since January 2020 in an observational study of malaria transmission in the rural district of Webuye (parent study R01 AI146849, MPI: O’Meara/Taylor). From 550 people, we have collected blood from all participants during both i) monthly surveillance visits as well as ii) at febrile sick visits, and collection will be ongoing through 2023. The SARS-CoV2 antibody Prevalence and Acquisition in Rural Kenya (SPARK) study will be a sub-study of this parent cohort, in which we will test monthly specimens collected prior to and during the Covid19 pandemic using an ELISA detecting neutralizing antibodies to the SARS-CoV2 spike protein. Baseline sero-positivity will be measured in Jan 2020 specimens, and sero-conversion as the appearance of neutralizing antibodies in a previously-negative person. Monthly questionnaires will capture recent travel and illness not previously reported to the study team. We will then, using P. falciparum detection and genotype data from the parent study, estimate the impact of P. falciparum infection on the risk of SARS-CoV2 acquisition using longitudinal statistical modelling of the effect of cumulative malaria infections and of specific parasite genotypes on the risk of sero-conversion and the risk of acute illness during sero-conversion. Our multidisciplinary team will use samples and data from a large, separately-funded, densely-sampled longitudinal community cohort to describe the community spread and sero-epidemiology of SARS-CoV2 in a rural Kenyan setting and investigate its associated with P. falciparum malaria.

在许多发展中国家，COVID-19的大流行的直接影响有限，包括肯尼亚，这是 在2021年3月5日，由于Covid19，仅记录了107,329例和1,870例死亡。虽然这有限 临床影响部分是严格的旅行和运动限制和报告不足的结果，这些很低 数字与肯尼亚献血者的血清估计相反，这表明大量 肯尼亚的Covid19案件是亚临床的。在这种情况下的进一步考虑是进行互动的潜力 在肯尼亚西部的SARS-COV2和诸如恶性疟原虫等内粒病原体之间 诚实地传播。这些无症状的感染影响了随后的疟疾和 对宿主产生不同的影响。在这项血清流行学研究中，我们的具体目标是研究 SARS-COV2在肯尼亚农村地区的一个大型，不采样的社区人群中传播。我们的纵向队列 自2020年1月以来，肯尼亚的所有年龄段的家庭成员组成 Webuye粗糙区的疟疾传播（父母研究R01 AI146849，MPI：O’Meara/Taylor）。从 550人，我们在这两个参与者期间都收集了所有参与者的血液 在高温访问和收集时，将一直持续到2023年。SARS-COV2抗体患病率和 在肯尼亚农村的收购（Spark）研究将是该父子队的子研究，我们将在其中测试 使用ELISA检测到中和的ELISA在Covid19大流行之前和期间收集的月度标本 SARS-COV2尖峰蛋白的抗体。基线血清积极性将在2020年1月的标本中测量 血清转化是以前阴性的人中和抗体的出现。每月 问卷将捕获最近未向研究团队报告的最近的旅行和疾病。然后我们将 使用父母研究中的恶性疟原虫检测和基因型数据，估计恶性疟原虫的影响 使用纵向统计建模对SARS-COV2获取风险的感染 累积性疟疾感染和特定的寄生虫基因型关于血清转化风险和风险 血清转化过程中的急性疾病。我们的多学科团队将使用大型，大型的样本和数据 单独资助的，不采样的纵向社区人群来描述社区的传播和 SARS-COV2在粗糙的肯尼亚人环境中的血清 - 流行病学，并调查其与恶性疟原虫有关 疟疾。