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 大流行的直接影响有限，其中包括肯尼亚 截至 2021 年 3 月 5 日，仅记录了 107,329 例新冠肺炎病例和 1,870 例死亡病例，尽管这一数字有限。 临床影响部分是由于严格的旅行和行动限制以及报告不足造成的，这些低 这一数字与肯尼亚献血者 4-8% 的血清阳性率形成鲜明对比，这表明大量 肯尼亚的 Covid19 病例处于亚临床状态，在这种情况下需要进一步考虑的是相互作用的可能性。 SARS-CoV2 与地方性病原体（例如恶性疟原虫）之间的关系，恶性疟原虫在肯尼亚西部是 这些无症状感染常年且强烈地传播，从而导致了随后发生疟疾和疟疾的风险。 在这项血清流行病学研究中，我们的具体目标是调查 SARS-CoV2 在肯尼亚农村地区一个大型、密集采样的社区群体中的传播 我们的纵向队列。 由 2020 年 1 月以来参与一项观察性研究的肯尼亚各年龄段家庭成员组成 Webuye 农村地区的疟疾传播（母研究 R01 AI146849，MPI：O’Meara/Taylor）。 550 人，我们在 i) 每月监测访问以及 ii) 期间收集了所有参与者的血液 发热病人就诊时进行收集，收集工作将持续到 2023 年。 SARS-CoV2 抗体流行率和 肯尼亚农村地区的收购（SPARK）研究将是该家长队列的子研究，我们将在其中测试 在 Covid19 大流行之前和期间每月收集样本，使用 ELISA 检测中和 SARS-CoV2 刺突蛋白的抗体将在 2020 年 1 月的样本中进行基线血清阳性检测， 血清转化是先前呈阴性的人中出现中和抗体。 调查问卷将记录之前未向研究团队报告的近期旅行和疾病情况，然后我们将， 使用恶性疟原虫检测和母研究的基因型数据，估计恶性疟原虫的影响 使用纵向统计模型分析感染对 SARS-CoV2 感染风险的影响 累积疟疾感染和特定寄生虫基因型对血清转化风险和感染风险的影响 我们的多学科团队将使用来自大量的样本和数据。 单独资助的、密集采样的纵向社区队列来描述社区传播和 肯尼亚农村地区 SARS-CoV2 的血清流行病学并调查其与恶性疟原虫的相关性 疟疾。