Last data update: Jan 27, 2025. (Total: 48650 publications since 2009)
Records 1-30 (of 1029 Records) |
Query Trace: Martin M[original query] |
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Convenience sampling for pandemic surveillance of severe acute respiratory syndrome coronavirus 2 in children in Jackson, Mississippi
Inagaki K , Penny A , Gwyn S , Malloch L , Martin L , Hankins E , Ray C , Byers P , Harrison A , Handali S , Martin D , Hobbs CV . Pediatr Infect Dis J 2024 We assessed severe acute respiratory syndrome coronavirus 2 seroprevalence on residual blood samples for pediatric COVID-19 surveillance: 2263 samples were collected during routine outpatient visits (<18 years, April 2020-August 2021). Seroprevalence increased over time, coinciding with or preceding virus circulation in the community and with or preceding pediatric severe COVID-19 hospitalization peaks. Residual blood sample seroprevalence may be a useful surveillance tool in future outbreaks. |
Influenza vaccine effectiveness against medically attended outpatient illness, United States, 2023-24 season
Chung JR , Price AM , Zimmerman RK , Moehling Geffel K , House SL , Curley T , Wernli KJ , Phillips CH , Martin ET , Vaughn IA , Murugan V , Scotch M , Saade EA , Faryar KA , Gaglani M , Ramm JD , Williams OL , Walter EB , Kirby M , Keong LM , Kondor R , Ellington SR , Flannery B . Clin Infect Dis 2025 ![]() BACKGROUND: The 2023-24 U.S. influenza season was characterized by a predominance of A(H1N1)pdm09 virus circulation with co-circulation of A(H3N2) and B/Victoria viruses. We estimated vaccine effectiveness (VE) in the United States against mild-to-moderate medically attended influenza illness in the 2023-24 season. METHODS: We enrolled outpatients aged ≥8 months with acute respiratory illness in 7 states. Respiratory specimens were tested for influenza type/subtype by reverse-transcriptase polymerase chain reaction (RT-PCR). Influenza VE was estimated with a test-negative design comparing odds of testing positive for influenza among vaccinated versus unvaccinated participants. We estimated VE by virus sub-type/lineage and A(H1N1)pdm09 genetic subclades. RESULTS: Among 6,589 enrolled patients, 1,770 (27%) tested positive for influenza including 796 A(H1N1)pdm09, 563 B/Victoria, and 323 A(H3N2). Vaccine effectiveness against any influenza illness was 41% (95% Confidence Interval [CI]: 32 to 49): 28% (95% CI: 13 to 40) against influenza A(H1N1)pdm09, 68% (95% CI: 59 to 76) against B/Victoria, and 30% (95% CI: 9 to 47) against A(H3N2). Statistically significant protection against any influenza was found for all age groups except adults aged 50-64 years. Lack of protection in this age group was specific to influenza A-associated illness. We observed differences in VE by birth cohort and A(H1N1)pdm09 virus genetic subclade. CONCLUSIONS: Vaccination reduced outpatient medically attended influenza overall by 41% and provided protection overall against circulating influenza A and B viruses. Serologic studies would help inform differences observed by age groups. |
Effectiveness of mRNA COVID-19 vaccines and hybrid immunity in preventing SARS-CoV-2 infection and symptomatic COVID-19 among adults in the United States
Feldstein LR , Ruffin J , Wiegand RE , Borkowf CB , James-Gist J , Babu TM , Briggs-Hagen M , Chappell J , Chu HY , Englund JA , Kuntz JL , Lauring AS , Lo N , Carone M , Lockwood C , Martin ET , Midgley CM , Monto AS , Naleway AL , Ogilvie T , Saydah S , Schmidt MA , Schmitz JE , Smith N , Sohn I , Starita L , Talbot HK , Weil AA , Grijalva CG . J Infect Dis 2025 ![]() BACKGROUND: Understanding protection against SARS-CoV-2 infection by vaccine and hybrid immunity is important for informing public health strategies as new variants emerge. METHODS: We analyzed data from three cohort studies spanning September 1, 2022-July 31, 2023, to estimate COVID-19 vaccine effectiveness (VE) against SARS-CoV-2 infection and symptomatic COVID-19 among adults with and without prior infection in the United States. Participants collected weekly nasal swabs, irrespective of symptoms, annual blood draws, and completed periodic surveys, which included vaccination status and prior infection history. Swabs were tested molecularly for SARS-CoV-2. VE was estimated using Cox proportional hazards models for the hazard ratios of infections, adjusting for covariates. VE was calculated considering prior infection and recency of vaccination. RESULTS: Among 3,344 adults, adjusted VE of bivalent vaccine against infection was 37.2% (95% CI: 12.3-55.7%) within 7-59 days of vaccination and 21.1% (95% CI: -0.5-37.1%) within 60-179 days of vaccination compared to participants who were unvaccinated/received an original monovalent vaccine dose ≥180 days prior. Overall, adjusted VE of bivalent vaccine against infection, in conjunction with prior infection, was 62.2% (95% CI: 46.0-74.5%) within 7-179 days of vaccination and 39.4% (95% CI: 12.5-61.6%) ≥180 days compared to naïve participants who were unvaccinated/received a monovalent vaccine dose ≥180 days prior. CONCLUSIONS: Adults with both prior infection and recent vaccination had high protection against infection and symptomatic illness. Recent vaccination alone provided moderate protection. |
A framework for monitoring RSV prevention product effectiveness in the United States
Roper LE , Link-Gelles R , Surie D , DeCuir J , Zambrano LD , Prill MM , Havers FP , Jones JM , Melgar M , Hall AJ , Whitehead RD Jr , McMorrow ML , Ioannou GN , Hernandez-Romieu AC , Britton A , Novosad S , Martin A , Feldstein LR , Bajema KL , Kirking H , Moline H , Campbell AP , Aslan M , Hatfield K , Dawood F , Slayton R , Reddy S , Gomes D , Fleming-Dutra KE , Payne AB . Vaccine 2025 45 126633 During 2023, the Centers for Disease Control and Prevention (CDC) recommended the first respiratory syncytial virus (RSV) immunizations intended for widespread use in the United States to prevent severe RSV illness in infants and older adults. CDC, in collaboration with federal, public health, and academic partners, is conducting evaluations of real-world effectiveness of recommended RSV immunization products in the United States. Similar frameworks for evaluation are being applied to RSV vaccines and nirsevimab, a long-acting preventative monoclonal antibody, to estimate product effectiveness. The overall goal of CDC's RSV immunization effectiveness program is to generate timely and robust evidence through observational studies to inform immunization product policy decisions and other measures related to RSV prevention and control. CDC is evaluating effectiveness through high-quality, well-controlled observational studies leveraging a variety of platforms that provide robust data to inform policy decisions. |
SARS-CoV-2 serologic surveillance among people living with HIV in Nigeria, April 2022-January 2023
Chun HM , Osawe S , Adams-Dabban S , Favaloro J , Iriemenam NC , Dirlikov E , Martin D , Milligan K , Abutu A , Okunoye O , Okoli M , Akanbi O , Akinmulero O , Okonkwo R , Oyedele O , Greby S , Abimiku A , Okoye MIJ , Shiraishi RW . Int J Infect Dis 2024 151 107309 OBJECTIVES: Evidence indicates that people living with HIV (PLHIV) are more impacted by COVID-19. The burden of SARS-CoV-2 infection among PLHIV is unknown in Nigeria. METHODS: We conducted repeated cross-sectional SARS-CoV-2 serosurveys in 14 states and the Federal Capital Territory in Nigeria among PLHIV who had an HIV viral load (VL) test during April 2022 to January 2023. Evidence of SARS-CoV-2 immunoglobulin G (IgG) antibodies was assessed using a multiplex bead assay to measure IgG to spike (S), receptor binding domain (RBD), and nucleocapsid (N) proteins to identify potential infection and/or vaccination status. RESULTS: Between April 2022 and January 2023, 47,614 remnant VL samples were included and tested for SARS-CoV-2 antibodies. Seroprevalence of SARS-CoV-2 infection, defined as IgG antibodies to spike and RBD591 [S+] and nucleocapsid [N+], (S+N+), ranged between 21.1% (95% confidence intervals [CI]: 11.4-31.8) in Ekiti State in January 2023 to 71.4% (95% CI 71.9-81.9) in Gombe State in November 2022, with overall steady trends within and between states over time, across age and sex. CONCLUSION: High rates of SARS-CoV-2 antibody seroprevalence among PLHIV in Nigeria were observed. This underscores the need to understand the association between HIV and SARS-CoV-2 to inform strategies to reduce the threat posed by COVID-19. |
Establishment, implementation, initial outcomes, and lessons learned from recent HIV infection surveillance using a rapid test for recent infection among persons newly diagnosed with HIV in Thailand: Implementation study
Srithanaviboonchai K , Yingyong T , Tasaneeyapan T , Suparak S , Jantaramanee S , Roudreo B , Tanpradech S , Chuayen J , Kanphukiew A , Naiwatanakul T , Aungkulanon S , Martin M , Yang C , Parekh B , Northbrook SC . JMIR Public Health Surveill 2024 10 e65124 BACKGROUND: A recent infection testing algorithm (RITA) incorporating case surveillance (CS) with the rapid test for recent HIV infection (RTRI) was integrated into HIV testing services in Thailand as a small-scale pilot project in October 2020. OBJECTIVE: We aimed to describe the lessons learned and initial outcomes obtained after the establishment of the nationwide recent HIV infection surveillance project from April through August 2022. METHODS: We conducted desk reviews, developed a surveillance protocol and manual, selected sites, trained staff, implemented surveillance, and analyzed outcomes. Remnant blood specimens of consenting newly diagnosed individuals were tested using the Asanté HIV-1 Rapid Recency Assay. The duration of HIV infection was classified as RTRI-recent or RTRI-long-term. Individuals testing RTRI-recent with CD4 counts <200 cells/mm3 or those having opportunistic infections were classified as RITA-CS-long-term. Individuals testing RTRI-recent with CD4 counts >200 cells/mm3, no opportunistic infections, and not on antiretroviral treatment were classified as RITA-CS-recent. RESULTS: Two hundred and one hospitals in 14 high-burden HIV provinces participated in the surveillance. Of these, 69 reported ≥1 HIV diagnosis during the surveillance period. Of 1053 newly diagnosed cases, 64 (6.1%) were classified as RITA-CS-recent. On multivariate analysis, self-reporting as transgender women (adjusted odds ratio [AOR] 7.41, 95% CI 1.59-34.53) and men who have sex with men (AOR 2.59, 95% CI 1.02-6.56) compared to heterosexual men, and students compared to office workers or employers (AOR 3.76, 95% CI 1.25-11.35) were associated with RITA-CS-recent infection. The proper selection of surveillance sites, utilizing existing surveillance tools and systems, and conducting frequent follow-up and supervision visits were the most commonly cited lessons learned to inform the next surveillance phase. CONCLUSIONS: Recent HIV infection surveillance can provide an understanding of current epidemiologic trends to inform HIV prevention interventions to interrupt ongoing or recent HIV transmission. The key success factors of the HIV recent infection surveillance in Thailand include a thorough review of the existing HIV testing service delivery system, a streamlined workflow, strong laboratory and health services, and regular communication between sites and the Provincial Health Offices. |
Seroepidemiology of human leptospirosis in the Dominican Republic: A multistage cluster survey, 2021
Nilles EJ , Paulino CT , Galloway R , de St Aubin M , Mayfield HJ , Cadavid Restrepo A , Dumas D , Garnier S , Etienne MC , Duke W , Peña F , Iihoshi N , Abdalla G , Lopez B , de la Cruz L , Henríquez B , Durski K , Baldwin M , Loevinsohn G , Rees EM , Martin B , Sartorius B , Skewes-Ramm R , Gutiérrez EZ , Kucharski A , Lau CL . PLoS Negl Trop Dis 2024 18 (12) e0012463 Little is known about the epidemiology of leptospirosis in the Dominican Republic, the second most populous country in the Caribbean. We report on findings from a multi-stage household survey across two regions in the country that reveals a previously under-estimated burden of human Leptospira infection. Our findings, based on the reference-standard microscopic agglutination test, indicate a complex picture of serogroup diversity, spatial heterogeneity in infection and risk, and a marked discrepancy between reported cases and serologically estimated infections. Given an overall seroprevalence of 11.3% (95% CI: 10.8-13.0%) and a lower estimated force of infection (0.30% per year [0.27%-0.35%]) the number of infections may exceed national reported case data by 145-fold or more. Icterohaemorrhagiae, associated with severe Weil's disease, was the most commonly identified serogroup with a serogroup-specific prevalence of 4.4%. Consistent with other settings, risk factors including age, male sex, and rat exposure were associated with higher seroprevalence. Our study highlights the need for targeted public health interventions informed by serogroup-specific dynamics, detailed spatial analyses, knowledge of local animal reservoirs, and strengthened laboratory surveillance to effectively control this pathogen. |
Impact of late rainy season indoor residual spraying on holoendemic malaria transmission: a cohort study in northern Zambia
Martin AC , Chaponda M , Muleba M , Lupiya J , Gebhardt ME , Berube S , Shields T , Wesolowski A , Kobayashi T , Norris DE , Impoinvil DE , Chirwa B , Zulu R , Psychas P , Ippolito M , Moss WJ . J Infect Dis 2024 BACKGROUND: Indoor residual spraying (IRS) is a malaria control strategy implemented before the rainy season. Nchelenge District, Zambia is a holoendemic setting where IRS has been conducted since 2008 with little impact on malaria incidence or parasite prevalence. Pre-rainy season IRS may not reduce the post-rainy season peak abundance of the major vector, Anopheles funestus. METHODS: A controlled, pre-post, prospective cohort study assessed the impact of late-rainy season IRS on malaria prevalence, incidence, hazard, and vector abundance. Three hundred eighty-two individuals were enrolled across four household clusters, of which two were sprayed in April 2022 toward the end of the rainy season. Monthly household and individual surveys and indoor overnight vector collections were conducted through August 2022. Multivariate regression and time-to-event analyses estimated the impact of IRS on outcomes measured by rapid diagnostic tests, microscopy, and quantitative polymerase chain reaction. RESULTS: Seventy two percent of participants tested positive by rapid diagnostic test at least once and incidence by microscopy was 3.4 infections per person-year. Residing in a household in a sprayed area was associated with a 52% reduction in infection hazard (hazards ratio: 0.48, 95% confidence interval [0.29, 0.78]) but not with changes in incidence, prevalence, or vector abundance. The study-wide entomological inoculation rate was 34 infectious bites per person per year. CONCLUSION: Monthly tracking of incidence and prevalence did not demonstrate meaningful changes in holoendemic transmission intensity. However, hazard of infection, which provides greater power for detecting changes in transmission, demonstrated that late rainy season IRS reduced malaria risk. |
Protection from COVID-19 vaccination and prior SARS-CoV-2 infection among children aged 6 months - 4 years, United States, September 2022-April 2023
Feldstein LR , Ruffin J , Wiegand R , Grant L , Babu TM , Briggs-Hagen M , Burgess JL , Caban-Martinez AJ , Chu HY , Ellingson KD , Englund JA , Hegmann KT , Jeddy Z , Kuntz J , Lauring AS , Lutrick K , Martin ET , Mathenge C , Meece J , Midgley CM , Monto AS , Naleway AL , Newes-Adeyi G , Odame-Bamfo L , Olsho LE , Phillips AL , Rai RP , Saydah S , Smith N , Tyner H , Vaughan M , Weil AA , Yoon SK , Britton A , Gaglani M . J Pediatric Infect Dis Soc 2024 To understand how COVID-19 vaccines impact infection risk in children <5 years, we assessed risk of SARS-CoV-2 infection from Sept 2022-April 2023 in three cohort studies. There was no difference in risk by vaccination status. While vaccines reduce severe disease, they may not reduce SARS-CoV-2 infections in young children. |
Building competency to deal with environmental health challenges: experiences and a proposal
Leonardi GS , Zeka A , Ashworth M , Bouland C , Crabbe H , Duarte-Davidson R , Etzel RA , Giuashvili N , Gökdemir Ö , Hanke W , van den Hazel P , Jagals P , Khan EA , Martin-Olmedo P , Pett J , Ruadze E , Santamaria MG , Semenza JC , Sorensen C , Vardoulakis S , Yip F , Lauriola P . Front Public Health 2024 12 1373530 The global landscape of professional training in environmental health, encompassing ecological public health or environmental public health, lacks consistent global implementation for training programs for public health practitioners, clinical professionals, and individuals across various disciplines, as well as standardized curricula for undergraduates. This training gap is related to the overall lack of capacity in addressing the population impacts of the triple challenge of pollution, biodiversity loss, and climate change, impeding the worldwide transition to and development of ecological sustainability. This paper reviews existing approaches and their potential to address implementation challenges within the necessarily tight timescale. Spreading of best practice appears feasible even without substantial additional resources, through the reorientation of current practices via comprehensive multi-disciplinary training programs. By adopting international best practices of training in environmental health, the focus in training and education can shift from future decision-makers to enhancing the competencies of current professionals and their institutions. |
A new environmental public health practice to manage current and future global health challenges through education, training, and capacity building
Leonardi GS , Zeka A , Ashworth M , Bouland C , Crabbe H , Duarte-Davidson R , Etzel RA , Giuashvili N , Gökdemir Ö , Hanke W , van den Hazel P , Jagals P , Khan EA , Martin-Olmedo P , Pett J , Ruadze E , Santamaria MG , Semenza JC , Sorensen C , Vardoulakis S , Yip F , Lauriola P . Front Public Health 2024 12 1373490 Unsustainable globalisation of economic activities, lifestyles and social structures has contributed to environmental degradation, posing major threats to human health at the local and global levels. All these problems including climate change, pollution, and biodiversity loss represent challenges that are unlikely to be met with existing approaches, capabilities and tools. This article acknowledges the need for well-prepared practitioners from many walks of life to contribute to environmental public health (EPH) functions thus strengthening society's capacity and capability to respond effectively and in a timely manner to such complex situations and multiple challenges. It envisions a new EPH practice addressing questions on: Why do this? What needs to be addressed? Who will do it? How can it be implemented? This article focuses on the main challenging EPH issues worldwide and how they could be addressed using a conceptual framework for training. A companion article shows how they have been tackled in practice, providing ideas and experiences. |
Seroepidemiology of trachoma in a low prevalence region receiving annual mass azithromycin distribution in Maradi, Niger
Amza A , Kadri B , Nassirou B , Arzika A , Gebreegziabher E , Hu H , Zhong L , Chen C , Yu D , Abraham T , Liu Y , Wickens K , Doan T , Martin D , Arnold BF , Lietman TM , Oldenburg CE . PLoS Negl Trop Dis 2024 18 (12) e0012727 BACKGROUND: Trachoma programs use the indicator trachomatous inflammation--follicular (TF) to monitor indication for and response to treatment for trachoma at the district level. Alternative indicators, including serologic markers, are increasingly being evaluated for trachoma surveillance. We evaluated seroprevalence of IgG antibodies to the Pgp3 antigen in two districts in Maradi, Niger thought to have low TF prevalence. METHODS: Data were collected as part of the baseline assessment of the Azithromycin Reduction to Reach Elimination of Trachoma (ARRET) trial in September 2021. A random sample of 80 communities was selected from Mayahi and Guidan Roumdji districts, both of which had TF prevalence <20% at their most recent trachoma impact survey in 2018. A random sample of 50 children per community was sampled. We collected field grades, conjunctival swabs for processing PCR for ocular Chlamydia trachomatis, and dried blood spots for serologic assessment. RESULTS: Of 3,994 children sampled in 80 communities, 49% were female and median age was 4 years. Overall TF prevalence was 4.6% (95% CI 3.5 to 5.8%) and trachomatous inflammation-intense (TI) prevalence was 0.6% (95% 0.3 to 0.9%). The prevalence of ocular chlamydia was 0.03% (95% CI 0.08%). Seroprevalence for Pgp3 antibodies was 6.3% (95% CI 5.5 to 7.1%) in 1-9-year-olds and 3.7% (95% CI 2.9 to 4.4%) in 1-5-year-olds. TF and Pgp3 seroprevalence were better correlated in 1-5-year-olds (correlation coefficient 0.29) compared to 1-9-year-olds (correlation coefficient 0.09). CONCLUSIONS: In this low trachoma prevalence setting in Niger, seroprevalence of antibodies to Pgp3 were consistent with little ongoing transmission of C. trachomatis. |
Assessing COVID-19 pandemic impacts on the health of PWID using a novel data sharing model
Bradley H , Luisi N , Carter A , Pigott TD , Abramovitz D , Allen ST , Asher A , Austin C , Bartholomew TS , Baum M , Board A , Boodram B , Borquez A , Brookmeyer KA , Buchacz K , Burnett J , Cooper HLF , Crepaz N , Debeck K , Feinberg J , Fong C , Freeman E , Furukawa NW , Genberg B , Gorbach P , Hagan H , Hayashi K , Huriaux E , Hurley H , Keruly J , Kristensen K , Lai S , Martin NK , Mateu-Gelabert P , McClain GM Jr , Mehta S , Mok WY , Reynoso M , Strathdee S , Torigian N , Weng CA , Westergaard R , Young A , Jarlais DCD . Aids 2024 OBJECTIVE: Using an innovative data sharing model, we assessed the impacts of the COVID-19 pandemic on the health of people who inject drugs (PWID). DESIGN: The PWID Data Collaborative was established in 2021 to promote data sharing across PWID studies in North America. Contributing studies submitted aggregate data on 23 standardized indicators during four time periods: pre-pandemic (Mar 2019 - Feb 2020), early-pandemic (Mar 2020 - Feb 2021), mid-pandemic (Mar 2021 - Feb 2022), and late pandemic (Mar 2022 - Feb 2023). METHODS: We present study-specific and meta-analyzed estimates for the percentage of PWID who took medications for opioid use disorder, received substance use treatment, shared syringes or injection equipment, had a mental health condition, had been incarcerated, or had experienced houselessness. To examine change over time across indicators, we fit a random effects meta-regression model to prevalence estimates using time as a moderator. RESULTS: Thirteen studies contributed estimates to the Data Collaborative on these indicators, representing 6,213 PWID interviews. We observed minimal change across prevalence of the six indicators between the pre-pandemic (March 2019 - February 2020) and three subsequent time periods, overall or within individual studies. Considerable heterogeneity was observed across study- and time-specific estimates. CONCLUSIONS: Limited pandemic-related change observed in indicators of PWID health is likely a result of policy and supportive service-related changes and may also reflect resilience among service providers and PWID themselves. The Data Collaborative is an unprecedented data sharing model with potential to greatly improve the quality and timeliness of data on the health of PWID. |
Randomized immunogenicity trial comparing 2019-2020 recombinant and egg-based influenza vaccines among frequently vaccinated healthcare personnel in Israel
Fowlkes AL , Peretz A , Greenberg D , Hirsch A , Martin ET , Levine MZ , Edwards L , Radke S , Lauring AS , Ferdinands JM , Zhang C , Yoo YM , Dreiher J , Newes-Adeyi G , Azziz-Baumgartner E , Fry AM , Monto AS , Balicer R , Thompson MG , Katz MA . Int J Infect Dis 2024 149 107260 ![]() ![]() OBJECTIVES: Trivalent inactivated influenza vaccine effectiveness was low in a prospective cohort of healthcare personnel (HCP) in Israel from 2016 to 2019. We conducted a randomised immunogenicity trial of quadrivalent recombinant influenza vaccine (RIV4) and standard-dose inactivated influenza vaccine (IIV4) among frequently and infrequently vaccinated previous cohort participants. METHODS: From October 2019 to January 2020, we enrolled and randomly allocated HCP from two Israeli hospitals to receive IIV4 or RIV4. Hemagglutination inhibition (HAI) antibody titres against 2019-2020 vaccine reference influenza viruses were compared between vaccine groups using geometric mean titre (GMT) ratios from sera collected one-month post-vaccination and by frequency of vaccination in the past 5 years (>2 vs ≤2). RESULTS: Among 415 HCP, the GMT ratio comparing RIV4 to IIV4 was 2.0 (95% confidence interval [CI] 1.7-2.7) for A(H1N1)pdm09, 1.6 (95% CI: 1.3-1.9) for A(H3N2), 1.8 (95% CI: 1.4-2.2) for B(Yamagata), and 1.1 (95% CI: 0.9-1.4) for B(Victoria). Similarly, RIV4 elicited higher HAI titres than IIV4 against all 2019-2020 vaccine reference viruses except B(Victoria) among infrequently and frequently vaccinated HCP (lower bound of GMT ratio 95% CIs ≥1.0). CONCLUSION: RIV4 had improved immunogenicity for influenza vaccine strains among both infrequent and frequent vaccinees compared to standard-dose IIV4. CLINICAL TRIALS REGISTRATION: NCT04523324. |
Assessment and mitigation of bias in influenza and COVID-19 vaccine effectiveness analyses - IVY Network, September 1, 2022-March 30, 2023
Lewis NM , Harker EJ , Leis A , Zhu Y , Talbot HK , Grijalva CG , Halasa N , Chappell JD , Johnson CA , Rice TW , Casey JD , Lauring AS , Gaglani M , Ghamande S , Columbus C , Steingrub JS , Shapiro NI , Duggal A , Felzer J , Prekker ME , Peltan ID , Brown SM , Hager DN , Gong MN , Mohamed A , Exline MC , Khan A , Wilson JG , Mosier J , Qadir N , Chang SY , Ginde AA , Mohr NM , Mallow C , Harris ES , Johnson NJ , Srinivasan V , Gibbs KW , Kwon JH , Vaughn IA , Ramesh M , Safdar B , DeCuir J , Surie D , Dawood FS , Ellington S , Self WH , Martin ET . Vaccine 2024 43 126492 BACKGROUND: In test-negative studies of vaccine effectiveness (VE), including patients with co-circulating, vaccine-preventable, respiratory pathogens in the control group for the pathogen of interest can introduce a downward bias on VE estimates. METHODS: A multicenter sentinel surveillance network in the US prospectively enrolled adults hospitalized with acute respiratory illness from September 1, 2022-March 31, 2023. We evaluated bias in estimates of VE against influenza-associated and COVID-19-associated hospitalization based on: inclusion vs exclusion of patients with a co-circulating virus among VE controls; observance of VE against the co-circulating virus (rather than the virus of interest), unadjusted and adjusted for vaccination against the virus of interest; and observance of influenza or COVID-19 against a sham outcome of respiratory syncytial virus (RSV). RESULTS: Overall VE against influenza-associated hospitalizations was 6 percentage points lower when patients with COVID-19 were included in the control group, and overall VE against COVID-19-associated hospitalizations was 2 percentage points lower when patients with influenza were included in the control group. Analyses of VE against the co-circulating virus and against the sham outcome of RSV showed that downward bias was largely attributable the correlation of vaccination status across pathogens, but also potentially attributable to other sources of residual confounding in VE models. CONCLUSION: Excluding cases of confounding respiratory pathogens from the control group in VE analysis for a pathogen of interest can reduce downward bias. This real-world analysis demonstrates that such exclusion is a helpful bias mitigation strategy, especially for measuring influenza VE, which included a high proportion of COVID-19 cases among controls. |
Evaluation of test-negative design estimates of influenza vaccine effectiveness in the context of multiple, co-circulating, vaccine preventable respiratory viruses
Leis AM , Wagner A , Flannery B , Chung JR , Monto AS , Martin ET . Vaccine 2024 42 (26) 126493 Test-negative design (TND) studies are cornerstones of vaccine effectiveness (VE) monitoring for influenza. The introduction of SARS-CoV-2 and RSV vaccines complicate the analysis of this design, with control selection restriction based on other pathogen diagnosis proposed as a solution. We conducted a simulation study and secondary analysis of 2017-18 and 2018-19 TND estimates from a Southeast Michigan ambulatory population to evaluate RSV-status-based control restriction. Simulations suggest that with vaccine-preventable RSV, influenza VE could be moderately biased with RSV prevalence ≥25 % of controls. Real-world analysis showed 151 influenza-negative adults (10.4 %) had RSV detected from the enrollment nasal swab. There were minimal differences in results of adjusted models with or without RSV exclusion from control groups. Findings suggest that inclusion of RSV cases in the control group of TND studies for influenza VE, particularly where RSV is not vaccine preventable, does not currently pose a major concern for bias in VE estimates. |
Influenza A virus within-host evolution and positive selection in a densely sampled household cohort over three seasons
Bendall EE , Zhu Y , Fitzsimmons WJ , Rolfes M , Mellis A , Halasa N , Martin ET , Grijalva CG , Talbot HK , Lauring AS . Virus Evol 2024 10 (1) veae084 ![]() ![]() ![]() While influenza A virus (IAV) antigenic drift has been documented globally, in experimental animal infections, and in immunocompromised hosts, positive selection has generally not been detected in acute infections. This is likely due to challenges in distinguishing selected rare mutations from sequencing error, a reliance on cross-sectional sampling, and/or the lack of formal tests of selection for individual sites. Here, we sequenced IAV populations from 346 serial, daily nasal swabs from 143 individuals collected over three influenza seasons in a household cohort. Viruses were sequenced in duplicate, and intrahost single nucleotide variants (iSNVs) were identified at a 0.5% frequency threshold. Within-host populations exhibited low diversity, with >75% mutations present at <2% frequency. Children (0-5 years) had marginally higher within-host evolutionary rates than adolescents (6-18 years) and adults (>18 years, 4.4 × 10(-6) vs. 9.42 × 10(-7) and 3.45 × 10(-6), P < .001). Forty-five iSNVs had evidence of parallel evolution but were not over-represented in HA and NA. Several increased from minority to consensus level, with strong linkage among iSNVs across segments. A Wright-Fisher approximate Bayesian computational model identified positive selection at 23/256 loci (9%) in A(H3N2) specimens and 19/176 loci (11%) in A(H1N1)pdm09 specimens, and these were infrequently found in circulation. Overall, we found that within-host IAV populations were subject to genetic drift and purifying selection, with only subtle differences across seasons, subtypes, and age strata. Positive selection was rare and inconsistently detected. |
Discriminating north American swine influenza viruses with a portable, one-step, triplex real-time RT-PCR assay, and portable sequencing
Kirby MK , Shu B , Keller MW , Wilson MM , Rambo-Martin BL , Jang Y , Liddell J , Salinas Duron E , Nolting JM , Bowman AS , Davis CT , Wentworth DE , Barnes JR . Viruses 2024 16 (10) ![]() ![]() Swine harbors a genetically diverse population of swine influenza A viruses (IAV-S), with demonstrated potential to transmit to the human population, causing outbreaks and pandemics. Here, we describe the development of a one-step, triplex real-time reverse transcription-polymerase chain reaction (rRT-PCR) assay that detects and distinguishes the majority of the antigenically distinct influenza A virus hemagglutinin (HA) clades currently circulating in North American swine, including the IAV-S H1 1A.1 (α), 1A.2 (β), 1A.3 (γ), 1B.2.2 (δ1) and 1B.2.1 (δ2) clades, and the IAV-S H3 2010.1 clade. We performed an in-field test at an exhibition swine show using in-field viral concentration and RNA extraction methodologies and a portable real-time PCR instrument, and rapidly identified three distinct IAV-S clades circulating within the N.A. swine population. Portable sequencing is used to further confirm the results of the in-field test of the swine triplex assay. The IAV-S triplex rRT-PCR assay can be easily transported and used in-field to characterize circulating IAV-S clades in North America, allowing for surveillance and early detection of North American IAV-S with human outbreak and pandemic potential. |
Lyme disease prophylaxis by single-dose doxycycline in the United States, 2010-2020
Marx GE , Beck A , Corey C , Fuller CC , Haug N , Ko JS , Martin D , Hinckley AF . Open Forum Infect Dis 2024 11 (10) ofae593 Single-dose doxycycline after high-risk tick bites can prevent Lyme disease, which disproportionately affects children. We described single-dose doxycycline dispensings in an outpatient cohort in the United States. During 2010-2020, a total of 427 105 patients received ≥1 dispensing(s); most were aged ≥65 years. Lyme disease postexposure prophylaxis may be underprescribed for some groups, including children. |
Reemergence of Oropouche virus in the Americas and risk for spread in the United States and its territories, 2024
Guagliardo SAJ , Connelly CR , Lyons S , Martin SW , Sutter R , Hughes HR , Brault AC , Lambert AJ , Gould CV , Staples JE . Emerg Infect Dis 2024 30 (11) 2241-2249 Oropouche virus has recently caused outbreaks in South America and the Caribbean, expanding into areas to which the virus was previously not endemic. This geographic range expansion, in conjunction with the identification of vertical transmission and reports of deaths, has raised concerns about the broader threat this virus represents to the Americas. We review information on Oropouche virus, factors influencing its spread, transmission risk in the United States, and current status of public health response tools. On the basis of available data, the risk for sustained local transmission in the continental United States is considered low because of differences in vector ecology and in human-vector interactions when compared with Oropouche virus-endemic areas. However, more information is needed about the drivers for the current outbreak to clarify the risk for further expansion of this virus. Timely detection and control of this emerging pathogen should be prioritized to mitigate disease burden and stop its spread. |
Informing estimates of probability of Clostridioides difficile infection for testing and treatment: expert consensus from a modified-Delphi procedure
Baghdadi JD , Wessel M , Dubberke ER , Lydecker A , Claeys KC , Alonso C , Coffey KC , Durkin M , Gonzales-Luna AJ , Guh AY , Kwon JH , Martin E , Mehrotra P , Polage CR , Pulia MS , Rock C , Skinner AM , Vaughn VM , Vijayan T , Yarrington ME , Morgan DJ . Antimicrob Steward Healthc Epidemiol 2024 4 (1) e168 BACKGROUND: Clostridioides difficile infection (CDI) may be misdiagnosed if testing is performed in the absence of signs or symptoms of disease. This study sought to support appropriate testing by estimating the impact of signs, symptoms, and healthcare exposures on pre-test likelihood of CDI. METHODS: A panel of fifteen experts in infectious diseases participated in a modified UCLA/RAND Delphi study to estimate likelihood of CDI. Consensus, defined as agreement by >70% of panelists, was assessed via a REDCap survey. Items without consensus were discussed in a virtual meeting followed by a second survey. RESULTS: All fifteen panelists completed both surveys (100% response rate). In the initial survey, consensus was present on 6 of 15 (40%) items related to risk of CDI. After panel discussion and clarification of questions, consensus (>70% agreement) was reached on all remaining items in the second survey. Antibiotics were identified as the primary risk factor for CDI and grouped into three categories: high-risk (likelihood ratio [LR] 7, 93% agreement among panelists in first survey), low-risk (LR 3, 87% agreement in first survey), and minimal-risk (LR 1, 71% agreement in first survey). Other major factors included new or unexplained severe diarrhea (e.g., ≥ 10 liquid bowel movements per day; LR 5, 100% agreement in second survey) and severe immunosuppression (LR 5, 87% agreement in second survey). CONCLUSION: Infectious disease experts concurred on the importance of signs, symptoms, and healthcare exposures for diagnosing CDI. The resulting risk estimates can be used by clinicians to optimize CDI testing and treatment. |
Ongoing transmission of trachoma in low prevalence districts in Mozambique: results from four cross-sectional enhanced impact surveys, 2022
Sitoe HM , Oswald WE , Zita F , Fall M , Momade T , Adams MW , Flueckiger RM , McPherson S , Eyob S , Doan T , Lietman TM , Arnold BF , Wickens K , Gwyn S , Martin DL , Kasubi M , Boyd S , Bakhtiari A , Jimenez C , Solomon AW , Harding-Esch EM , Mwingira UJ , Ngondi JM . Sci Rep 2024 14 (1) 22842 Mozambique is making progress towards elimination of trachoma as a public health problem, but in some districts trachomatous inflammation-follicular (TF) prevalence remains above the 5% elimination threshold despite years of various interventions, including antibiotic mass drug administration. To characterize transmission in four districts, we incorporated testing of ocular infection and serology into routine trachoma impact surveys (TIS) in August 2022. We examined residents aged ≥ 1 year for trachoma and collected information on household water, sanitation, and hygiene. Among children aged 1-9 years, we tested conjunctival swabs for Chlamydia trachomatis nucleic acid and dried blood spots for C. trachomatis antibodies. We modeled age-dependent seroprevalence to estimate seroconversion rate (SCR). We examined 4841 children aged 1-9 years. TF prevalence ranged between 1.1 and 6.0% with three districts below the 5% threshold. PCR-confirmed infection prevalence ranged between 1.1 and 4.8%, and Pgp3 seroprevalence ranged between 8.8 and 24.3%. Pgp3 SCR was 1.9 per 100 children per year in the district with the lowest TF prevalence. Two other districts with TF < 5% had SCR of 5.0 and 4.7. The district with TF ≥ 5% had a SCR of 6.0. This enhanced TIS furthered understanding of transmission in these districts and provides information on additional indicators for monitoring trachoma programs. |
Completed genome segments of Maciel, Lechiguanas, and Laguna Negra orthohantaviruses
Shedroff E , Whitmer SLM , Mobley M , Morales-Betoulle M , Martin ML , Brignone J , Sen C , Nazar Y , Montgomery JM , Klena JD . Microbiol Resour Announc 2024 e0044124 ![]() ![]() New World orthohantaviruses are rodent-borne tri-segmented viruses that cause hantavirus cardiopulmonary syndrome in humans in the Americas. Molecular diagnostics for orthohantaviruses can be improved with more sequence data. Reported here are completed genomes for Lechiguanas, Maciel, and Laguna Negra viruses. |
Elevated body mass index is not significantly associated with reduced influenza vaccine effectiveness
King JP , Nguyen HQ , Kiniry EL , Phillips CH , Gaglani M , Martin ET , Geffel KM , Nowalk MP , Chung JR , Flannery B , Belongia EA . Sci Rep 2024 14 (1) 21466 Elevated body mass index (BMI) has been linked to severe influenza illness and impaired vaccine immunogenicity, but the relationship between BMI and clinical vaccine effectiveness (VE) is less well described. This secondary analysis of data from a test-negative study of outpatients with acute respiratory illness assessed BMI and VE against medically attended, PCR-confirmed influenza over seven seasons (2011-12 through 2017-18). Vaccination status was determined from electronic medical records (EMR) and self-report; BMI was estimated from EMR-documented height and weight categorized for adults as obesity (≥ 30 kg/m(2)), overweight (25-29 kg/m(2)), or normal and for children based on standardized z-scales. Current season VE by virus type/subtype was estimated separately for adults and children. Pooled VE for all seasons was calculated as 1-adjusted odds ratios from logistic regression with an interaction term for BMI and vaccination. Among 28,089 adults and 12,380 children, BMI category was not significantly associated with VE against outpatient influenza for any type/subtype. Adjusted VE against A/H3N2, A/H1N1pdm09, and B in adults ranged from 16-31, 46-54, and 44-57%, and in children from 29-34, 57-65, and 50-55%, respectively, across the BMI categories. Elevated BMI was not associated with reduced VE against laboratory confirmed, outpatient influenza illness. |
Can verbal autopsies be used on a national scale? Key findings and lessons from South Africa's national cause-of-death validation study
Maqungo M , Nannan N , Nojilana B , Nichols E , Morof D , Cheyip M , Rao C , Lombard C , Price J , Kahn K , Martin LJ , Bezuidenhout F , Laubscher R , Kabudula C , Glass T , Awotiwon O , Zinyakatira N , Funani N , Joubert J , Bradshaw D , Groenewald P . Glob Health Action 2024 17 (1) 2399413 BACKGROUND: Verbal autopsy (VA), though imperfect, serves as a vital tool to determine cause-of-death, particularly for out-of-facility deaths, but challenges persist in integrating VA into Civil Registration and Vital Statistics systems. OBJECTIVE: To describe the challenges and successes of collecting a national sample of verbal autopsy interviews in South Africa to obtain the cause of death profile in 2017/18. METHODS: We recruited next of kin from 27 randomly selected sub-districts (10.5%) across South Africa between September 2017 and April 2018. Trained fieldworkers conducted face-to-face interviews using the WHO2016 VA instrument, with physicians certifying underlying causes of death. Feasibility was evaluated based on response rates, participation, and data quality. RESULTS: Of the total 36,976 deaths registered, only 26% were identified during recruitment, with a 55% overall response rate for VA interviews. Physician-reviewed VA data were deemed of good quality for assigning underlying causes of death in 83% of cases. By comparing cause-specific mortality fractions, physician-reviewed VA identified 22.3% HIV/AIDS and InterVA-5 identified 18.5%, aligning with burden of disease estimates, while Statistics South Africa reported 4.9% HIV/AIDS. CONCLUSIONS: The study demonstrated the feasibility of using VA on a national scale, but immense challenges in identifying and recruiting next of kin highlight the importance of formalising VAs within the country's death notification system. | • Main findings: Next of kin of 9 730 decedents were approached at the time of registration of death and 55% consented to be approached later and agreed to do a VA interview by a trained field-worker; 83% of physician-reviewed VA data were considered high-quality for determining underlying causes and 22.3% of all the deaths were due to HIV/AIDS, much higher than the proportion reported in the national statistical office.• Added knowledge: Implementing the VA on a national scale was achievable but significant challenges in recruiting next of kin, emphasising a need to formalise VAs within the country’s death notification system.• Global health impact for policy and action: Accurate cause-of-death data are crucial for policymakers to make informed decisions about the country’s health system and could be supported by using VAs, particularly for the deaths that occur outside health facilities. | eng |
Perspectives on a peer-driven intervention to promote pre-exposure prophylaxis (PrEP) uptake among men who have sex with men in southern New England: a qualitative study
Tao J , Parent H , Karki I , Martin H , Marshall SA , Kapadia J , Nunn AS , Marshall BDL , Raymond HF , Mena L , Chan PA . BMC Health Serv Res 2024 24 (1) 1023 BACKGROUND: Pre-exposure prophylaxis (PrEP) is a highly effective pharmaceutical intervention that prevents HIV infection, but PrEP uptake across the US has been slow among men who have sex with men (MSM), especially among Black/African American (B/AA) and Hispanic /Latino (H/L) MSM. This study investigates the acceptability and essential components of a peer-driven intervention (PDI) for promoting PrEP uptake among MSM, with a specific focus on B/AA and H/L communities. METHODS: We conducted 28 semi-structured, qualitative interviews with MSM in southern New England to explore the components of a PDI, including attitudes, content, and effective communication methods. A purposive sampling strategy was used to recruit diverse participants who reflect the communities with the highest burden of HIV infection. RESULTS: Of 28 study participants, the median age was 28 years (interquartile range [IQR]: 25, 35). The sample comprised B/AA (39%, n = 11) and H/L (50%, n = 14) individuals. Notably, nearly half of the participants (46%) were current PrEP users. We found that many participants were in favor of using a PDI approach for promoting PrEP. Additionally, several participants showed interest in becoming peer educators themselves. They emphasized the need for strong communication skills to effectively teach others about PrEP. Moreover, participants noted that peer education should cover key topics like how PrEP works, how effective it is, and any possible side effects. CONCLUSIONS: Our study shows that effective PDIs, facilitated by well-trained peers knowledgeable about PrEP, could enhance PrEP uptake among MSM, addressing health disparities and potentially reducing HIV transmission in B/AA and H/L communities. |
Monovalent rotavirus vaccine effectiveness and long-term impact among children <5 years old in Antananarivo, Madagascar, 2010-2022
Raboba JL , Rahajamanana VL , Rakotojoelimaria HE , Masembe YV , Martin PR , Weldegebriel GG , Diallo AO , Burnett E , Tate JE , Parashar UD , Mwenda JM , Seheri M , Magagula N , Mphahlele J , Robinson AL . Vaccine 2024 42 (26) 126321 ![]() BACKGROUND: Monovalent rotavirus vaccine substantially reduced rotavirus disease burden after introduction (May 2014) in Madagascar. We examined the effectiveness and long-term impact on acute watery diarrhea and rotavirus-related hospitalizations among children <5 years old at two hospitals in Antananarivo, Madagascar (2010-2022). METHODS: We used a test-negative case-control design to estimate monovalent rotavirus vaccine effectiveness (VE) against laboratory-confirmed rotavirus hospitalizations among children age 6-23 months with documented vaccination status adjusted for year of symptom onset, rotavirus season, age group, nutritional status, and clinical severity. To evaluate the impact, we expanded to children age 0-59 months with acute watery diarrhea. First, we used admission logbook data to compare the proportion of all hospitalizations attributed to diarrhea in the pre-vaccine (January 2010-December 2013), transition period (January 2014-December 2014), and post-vaccine (January 2015-December 2022) periods. Second, we used active surveillance data (June 2013-May 2022) to describe rotavirus positivity and detected genotypes by vaccine introduction period and surveillance year (1 June-31 May). RESULT: Adjusted VE of at least one dose against hospitalization due to rotavirus diarrhea among children age 6-23 months was 61 % (95 % CI: -39 %-89 %). The annual median proportion of hospitalizations attributed to diarrhea declined from 28 % in the pre-vaccine to 10 % in the post-vaccine period. Rotavirus positivity among hospitalized children age 0-59 months with acute watery diarrhea was substantially higher during the pre-vaccine (59 %) than the post-vaccine (23 %) period. In the pre-vaccine period, G3P[8] (76 %) and G2P[4] (12 %) were the dominant genotypes detected. Although genotypes varied by surveillance year, G1P[8] and G2P[4] represented >50 % of the genotypes detected post-introduction. CONCLUSIONS: Rotavirus vaccine has been successfully implemented in Madagascar's routine childhood immunization program and had a large impact on rotavirus disease burden, supporting continued use of rotavirus vaccines in Madagascar. |
Seroprevalence and risk factors for toxoplasma gondii infection in women of reproductive age in Nigeria in 2018
Blackburn D , Mba N , Nwachukwu W , Zhou H , Hill A , Abbott A , Parameswaran N , Awala S , Greby S , Alagi M , Iriemenam NC , Okoye MI , Swaminathan M , Priest JW , Martin D , Straily A , Ihekweazu C . Am J Trop Med Hyg 2024 Congenital transmission of Toxoplasma gondii can occur when a woman becomes infected for the first time during or just before pregnancy. Toxoplasma gondii in the fetus can lead to miscarriage, stillbirth, ocular or neurological abnormalities at birth, or progressive visual, hearing, motor, and cognitive deficiencies. The national seroprevalence of T. gondii infection in Nigeria was previously unknown. The 2018 Nigeria HIV/AIDS Indicator and Impact Survey collected demographic, socioeconomic, and HIV-related data and stored blood specimens with consent for future analysis for other pathogens of public health importance. We evaluated toxoplasmosis seropositivity and risk factors in a sample of 44,269 women of reproductive age (WRA) between 15 and 44 years. The national T. gondii seroprevalence among WRA was 26.8% (95% CI: 25.8-27.7%). We found that WRA from all 36 states and the Federal Capital Territory had T. gondii exposure. Seroprevalence was higher in 25- to 44-year-olds than in 15- to 24-year-olds. A similar proportion of pregnant and nonpregnant women were seropositive. Increased odds of seropositivity were associated with unimproved toilet facilities and drinking water sources, being in a higher wealth quintile, and primary and secondary education compared with no education. Decreased odds of seropositivity were associated with living in an urban area and owning livestock. This study provides the first-ever national seroprevalence estimate for WRA in Nigeria. Although information on known risk factors for toxoplasmosis (e.g., consumption of undercooked meat, cat ownership) was not collected, future studies could further investigate potential risk factors to inform the development of effective toxoplasmosis prevention measures. |
Oropouche virus disease among U.S. travelers - United States, 2024
Morrison A , White JL , Hughes HR , Guagliardo SAJ , Velez JO , Fitzpatrick KA , Davis EH , Stanek D , Kopp E , Dumoulin P , Locksmith T , Heberlein L , Zimler R , Lassen J , Bestard C , Rico E , Mejia-Echeverri A , Edwards-Taylor KA , Holt D , Halphen D , Peters K , Adams C , Nichols AM , Ciota AT , Dupuis AP 2nd , Backenson PB , Lehman JA , Lyons S , Padda H , Connelly RC , Tong VT , Martin SW , Lambert AJ , Brault AC , Blackmore C , Staples JE , Gould CV . MMWR Morb Mortal Wkly Rep 2024 73 (35) 769-773 Beginning in late 2023, Oropouche virus was identified as the cause of large outbreaks in Amazon regions with known endemic transmission and in new areas in South America and the Caribbean. The virus is spread to humans by infected biting midges and some mosquito species. Although infection typically causes a self-limited febrile illness, reports of two deaths in patients with Oropouche virus infection and vertical transmission associated with adverse pregnancy outcomes have raised concerns about the threat of this virus to human health. In addition to approximately 8,000 locally acquired cases in the Americas, travel-associated Oropouche virus disease cases have recently been identified in European travelers returning from Cuba and Brazil. As of August 16, 2024, a total of 21 Oropouche virus disease cases were identified among U.S. travelers returning from Cuba. Most patients initially experienced fever, myalgia, and headache, often with other symptoms including arthralgia, diarrhea, nausea or vomiting, and rash. At least three patients had recurrent symptoms after the initial illness, a common characteristic of Oropouche virus disease. Clinicians and public health jurisdictions should be aware of the occurrence of Oropouche virus disease in U.S. travelers and request testing for suspected cases. Travelers should prevent insect bites when traveling, and pregnant persons should consider deferring travel to areas experiencing outbreaks of Oropouche virus disease. |
SARS-CoV-2 seroprevalence in people living with HIV in South Sudan
Chun HM , Lodiongo DK , Milligan K , Lesuk GJ , Patel D , Shiraishi RW , Martin D , Simon AK , Dirlikov E , Patel HK , Ellenberger D , Worku HA , Duong YT , Ekong RO , Katoro JS , Hussen SA , Lokore ML , Wani G , Bunga S . IJID Regions 2024 12 Objectives: The burden of SARS-CoV-2 infection in people living with HIV (PLHIV) in South Sudan is unknown. Methods: We conducted a cross-sectional seroprevalence survey of SARS-CoV-2 immunoglobulin (Ig) G antibodies and other diseases of public health importance (strongyloidiasis, toxoplasmosis) in PLHIV in South Sudan during April 1, 2020-April 30, 2022. We used a multiplex SARS-CoV-2 immunoassay to detect IgG antibodies targeting the SARS-CoV-2 spike, receptor binding domain, and nucelocapsid (N) proteins, and antigens for other pathogens (Strongyloides stercoralis and Toxoplasma gondii). Results: Among 3518 samples tested, seroprevalence of IgG antibodies to SARS-CoV-2 spike protein and receptor binding domain 591 and nucleocapsid ranged from 1.4% (95% confidence interval [CI]: 0.9-2.1%) in April-June 2020 to 53.3% (95% CI: 49.5-57.1%) in January-March 2022. The prevalence of S. stercoralis IgG ranged between 27.3% (95% CI: 23.4-31.5%) in October-December 2021 and 47.2% (95% CI: 37.8-56.8%) in July-September 2021, and, for T. gondii IgG, prevalence ranged from 15.5% (95% CI: 13.3-17.9%) in April-June 2020 to 36.2% (95% CI: 27.4-46.2%) July-September 2021. Conclusions: By early 2022, PLHIV in South Sudan had high rates of SARS-CoV-2 seropositivity. Surveillance of diseases of global health concern in PLHIV is crucial to estimate population-level exposure and inform public health responses. © 2024 The Authors |
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