Symptom prevalence and secondary attack rate of SARS-CoV-2 in rural Kenyan households: A prospective cohort study.

Autor: Gallagher KE; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya.; Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK., Nyiro J; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya., Agoti CN; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya., Maitha E; Ministry of Health, Government of Kenya, Nairobi, Kenya., Nyagwange J; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya., Karani A; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya., Bottomley C; Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK., Murunga N; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya., Githinji G; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya., Mutunga M; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya., Ochola-Oyier LI; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya., Kombe I; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya., Nyaguara A; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya., Kagucia EW; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya., Warimwe G; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya.; Nuffield Department of Medicine, Oxford University, Oxford, UK., Agweyu A; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya.; Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK., Tsofa B; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya., Bejon P; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya.; Nuffield Department of Medicine, Oxford University, Oxford, UK., Scott JAG; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya.; Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.; Nuffield Department of Medicine, Oxford University, Oxford, UK., Nokes DJ; KEMRI-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya.; School of Life Sciences and the Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research (SBIDER), University of Warwick, Coventry, UK.
Jazyk: angličtina
Zdroj: Influenza and other respiratory viruses [Influenza Other Respir Viruses] 2023 Sep; Vol. 17 (9), pp. e13185.
DOI: 10.1111/irv.13185
Abstrakt: Background: We estimated the secondary attack rate of SARS-CoV-2 among household contacts of PCR-confirmed cases of COVID-19 in rural Kenya and analysed risk factors for transmission.
Methods: We enrolled incident PCR-confirmed cases and their household members. At baseline, a questionnaire, a blood sample, and naso-oropharyngeal swabs were collected. Household members were followed 4, 7, 10, 14, 21 and 28 days after the date of the first PCR-positive in the household; naso-oropharyngeal swabs were collected at each visit and used to define secondary cases. Blood samples were collected every 1-2 weeks. Symptoms were collected in a daily symptom diary. We used binomial regression to estimate secondary attack rates and survival analysis to analyse risk factors for transmission.
Results: A total of 119 households with at least one positive household member were enrolled between October 2020 and September 2022, comprising 503 household members; 226 remained in follow-up at day 14 (45%). A total of 43 secondary cases arose within 14 days of identification of the primary case, and 81 household members remained negative. The 7-day secondary attack rate was 4% (95% CI 1%-10%), the 14-day secondary attack rate was 28% (95% CI 17%-40%). Of 38 secondary cases with data, eight reported symptoms (21%, 95% CI 8%-34%). Antibody to SARS-CoV-2 spike protein at enrolment was not associated with risk of becoming a secondary case.
Conclusion: Households in our setting experienced a lower 7-day attack rate than a recent meta-analysis indicated as the global average (23%-43% depending on variant), and infection is mostly asymptomatic in our setting.
(© 2023 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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