SARS-CoV-2 seroprevalence, cumulative infections, and immunity to symptomatic infection - A multistage national household survey and modelling study, Dominican Republic, June-October 2021.

Autor:	Nilles EJ; Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Infectious Diseases and Epidemics Program, Harvard Humanitarian Initiative, Cambridge, MA, USA., Paulino CT; Ministry of Health and Social Assistance, Santo Domingo, Dominican Republic., de St Aubin M; Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA.; Infectious Diseases and Epidemics Program, Harvard Humanitarian Initiative, Cambridge, MA, USA., Restrepo AC; School of Public Health, University of Queensland, Brisbane, Australia., Mayfield H; School of Public Health, University of Queensland, Brisbane, Australia., Dumas D; Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA.; Infectious Diseases and Epidemics Program, Harvard Humanitarian Initiative, Cambridge, MA, USA., Finch E; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK., Garnier S; Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA.; Infectious Diseases and Epidemics Program, Harvard Humanitarian Initiative, Cambridge, MA, USA.; Harvard University, Cambridge, MA, USA., Etienne MC; Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA., Iselin L; University of Oxford, Oxford, UK., Duke W; Pedro Henríquez Ureña National University, Santo Domingo, Dominican Republic., Jarolim P; Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Oasan T; Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA., Yu J; Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA., Wan H; Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA., Peña F; Ministry of Health and Social Assistance, Santo Domingo, Dominican Republic., Iihoshi N; Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA., Abdalla G; Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA., Lopez B; Centers for Disease Control and Prevention, Central America Regional Office, Guatemala City, Guatemala., Cruz L; Ministry of Health and Social Assistance, Santo Domingo, Dominican Republic., Henríquez B; Ministry of Health and Social Assistance, Santo Domingo, Dominican Republic., Espinosa-Bode A; Centers for Disease Control and Prevention, Central America Regional Office, Guatemala City, Guatemala., Puello YC; Ministry of Health and Social Assistance, Santo Domingo, Dominican Republic., Durski K; Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA., Baldwin M; Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA.; Infectious Diseases and Epidemics Program, Harvard Humanitarian Initiative, Cambridge, MA, USA., Baez AA; Ministry of Health and Social Assistance, Santo Domingo, Dominican Republic.; Pedro Henríquez Ureña National University, Santo Domingo, Dominican Republic., Merchant RC; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Barouch DH; Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA., Skewes-Ramm R; Ministry of Health and Social Assistance, Santo Domingo, Dominican Republic., Gutiérrez EZ; Centers for Disease Control and Prevention, Central America Regional Office, Guatemala City, Guatemala., Kucharski A; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK., Lau CL; School of Public Health, University of Queensland, Brisbane, Australia.
Jazyk:	angličtina
Zdroj:	Lancet regional health. Americas [Lancet Reg Health Am] 2022 Dec; Vol. 16, pp. 100390. Date of Electronic Publication: 2022 Nov 08.
DOI:	10.1016/j.lana.2022.100390
Abstrakt:	Background: Population-level SARS-CoV-2 immunological protection is poorly understood but can guide vaccination and non-pharmaceutical intervention priorities. Our objective was to characterise cumulative infections and immunological protection in the Dominican Republic. Methods: Household members ≥5 years were enrolled in a three-stage national household cluster serosurvey in the Dominican Republic. We measured pan-immunoglobulin antibodies against the SARS-CoV-2 spike (anti-S) and nucleocapsid glycoproteins, and pseudovirus neutralising activity against the ancestral and B.1.617.2 (Delta) strains. Seroprevalence and cumulative prior infections were weighted and adjusted for assay performance and seroreversion. Binary classification machine learning methods and pseudovirus neutralising correlates of protection were used to estimate 50% and 80% protection against symptomatic infection. Findings: Between 30 Jun and 12 Oct 2021 we enrolled 6683 individuals from 3832 households. We estimate that 85.0% (CI 82.1-88.0) of the ≥5 years population had been immunologically exposed and 77.5% (CI 71.3-83) had been previously infected. Protective immunity sufficient to provide at least 50% protection against symptomatic SARS-CoV-2 infection was estimated in 78.1% (CI 74.3-82) and 66.3% (CI 62.8-70) of the population for the ancestral and Delta strains respectively. Younger (5-14 years, OR 0.47 [CI 0.36-0.61]) and older (≥75-years, 0.40 [CI 0.28-0.56]) age, working outdoors (0.53 [0.39-0.73]), smoking (0.66 [0.52-0.84]), urban setting (1.30 [1.14-1.49]), and three vs no vaccine doses (18.41 [10.69-35.04]) were associated with 50% protection against the ancestral strain. Interpretation: Cumulative infections substantially exceeded prior estimates and overall immunological exposure was high. After controlling for confounders, markedly lower immunological protection was observed to the ancestral and Delta strains across certain subgroups, findings that can guide public health interventions and may be generalisable to other settings and viral strains. Funding: This study was funded by the US CDC. Competing Interests: E.J.N. is the PI on a US CDC funded U01 award that funded the study, and C.L.L., A.K., D.D., M.d.S.A., A.C.R., H.M., S.G., M.C.E., W.D., N.I., G.A., B.H., K.D., M.B., E.F., and L.I. have received salaries, consultancy fees, or travel paid through this award. E.Z.G., B.L., and A.E.-B. are employees of the US CDC. B.H., C.T., L.C., F.P., and R.S.-R. are employees of the Ministry of Ministry of Health and Social Assistance, Dominican Republic, that was subcontracted with funds from the US CDC award. A.K. and E.F. are supported by the Welcome Trust, UK. D.B. had a patent for COVID-19 vaccine licensed to Janssen. We declare no other competing interests. (© 2022 The Author(s).)
Databáze:	MEDLINE
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