埃斯瓦提尼人口中抗 SARS-CoV-2 抗体的流行率和水平以及第四波 COVID-19 流行病的严重程度

COVID Pub Date : 2024-02-20 DOI:10.3390/covid4030021
P. Mutevedzi, Vusie Lokotfwako, G. Kwatra, G. Maphalala, V. Baillie, L. Dlamini, Senzokuhle Dlamini, Fortune Mhlanga, Tenelisiwe Dlamini, Nhlanhla Nhlabatsi, Marta C. Nunes, Simon Zwane, S. Madhi
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引用次数: 0

摘要

背景:血清流行病学研究有助于量化过去的感染程度和估计人群的免疫程度,从而为未来的风险缓解策略提供依据。我们报告了在埃斯瓦提尼对严重急性呼吸系统综合征冠状病毒-2(SARS-CoV-2)免疫球蛋白 G(IgG)血清流行率进行的唯一一次全国性人群调查。调查方法调查于 2021 年 8 月 31 日至 9 月 30 日进行,此前发生了三波冠状病毒疾病(COVID-19),而第四波冠状病毒疾病则以令人担忧的 Omicron 变种为主。我们还报告了截至 2022 年 3 月的 COVID-19 第四波前后记录在案的 COVID-19 病例和住院人数的流行病学趋势。我们根据抗核头壳(N)或抗尖峰(S)抗原评估了免疫球蛋白 G(IgG)血清阳性率。结果显示在 4564 人中,58.5% 为女性,36.0% 年龄在 18-50 岁之间,863 人(18.9%)年龄大于 18 岁的成年人至少接种过一剂 COVID-19 疫苗。总体而言,有 2769 人(60.7%)血清反应呈阳性,但各分区域之间存在差异(53.7%;95% CI:49.2-58.1 至 68.6%;95% CI:64.5-72.4),其中曼齐尼地区的分区域血清反应呈阳性率最高。与未接种疫苗者(55.1%;95% CI:53.5-56.7)相比,接种疫苗者的血清阳性率更高(84.5%;95% CI:81.9-86.7)。在未接种疫苗的人群中,18-50 岁人群的血清阳性率最高(59.5%;95% CI:56.9-62.1)。血清阳性与女性、SARS-CoV-2 NAAT 阳性、接种过疫苗、不吸烟和有正式工作有关。据估计,截至 2021 年 9 月 15 日,埃斯瓦提尼共有 639,475 例 SARS-CoV-2 感染病例(95% CI;620,824-658,003),是当时记录的 25,048 例 COVID-19 病例的 25.5 倍。根据病例记录得出的全国病例致死率(CFR)为 4.8%,比根据死亡记录和血清流行率推断出的感染力得出的感染致死率(0.19;95% CI:0.18-0.19)高出 25 倍。在全国范围内以及在所有四个地区,我们报告了 COVID-19 病例与住院和死亡病例的脱钩情况,这种情况早在第三次波次中就已观察到,与前几次波次相比,这次波次以三角洲变异体为主。结论我们发现,在 2021 年 11 月中旬 Omicron 疫潮爆发之前,60.7% 的斯威士兰人至少感染过一次 SARS-CoV-2。尽管 COVID-19 疫苗的接种率不高,但感染后人群免疫力的演变很可能导致了感染与严重 COVID-19 在斯威士兰的脱钩。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prevalence and Levels of Anti-SARS-CoV-2 Antibodies in the Eswatini Population and Subsequent Severity of the Fourth COVID-19 Epidemic Wave
Background: Seroepidemiology studies are useful for quantifying the magnitude of past infections and estimating the extent of population-based immunity to inform risk mitigation strategies for the future. We report on the only national population-based survey of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) immunoglobulin G (IgG) seroprevalence in Eswatini. Methods: The survey was undertaken from 31 August to 30 September 2021, following three earlier waves of coronavirus disease (COVID-19), and preceded the onset of the fourth wave, which was dominated by the Omicron variant of concern. We also report on epidemiological trends of recorded COVID-19 cases and hospitalizations before and after the fourth COVID-19 wave through to March 2022. We evaluated the immunoglobulin G (IgG) seropositivity based on either anti-nucleocapsid (N) or anti-spike (S) antigens. Results: Of 4564 individuals, 58.5% were female, 36.0% were aged 18–50 years, and 863 (18.9%) of adults who were older than 18 years had received at least a single dose of COVID-19 vaccine. Overall, 2769 (60.7%) were seropositive with heterogeneity across sub-regions (53.7%; 95% CI:49.2–58.1 to 68.6%; 95% CI:64.5–72.4), with the highest rates occurring in sub-regions of the Manzini region. Seropositivity was higher in vaccinated individuals (84.5%; 95% CI: 81.9–86.7) compared to unvaccinated individuals (55.1%; 95% CI:53.5–56.7). Amongst unvaccinated individuals, seropositivity was highest in 18–50-year-olds (59.5%;95% CI: 56.9–62.1). Seropositivity was associated with female gender, previous positive SARS-CoV-2 NAAT status and being vaccinated, non-smoking, and being formally employed. We estimated as of 15 September 2021 that there had been 639,475 SARS-CoV-2 infections (95% CI; 620,824–658,003) in Eswatini, which was 25.5-fold greater than the 25,048 COVID-19 cases that had been recorded by then. The national case fatality rate (CFR) based on recorded cases was 4.8%, being 25-fold greater than the infection fatality rate (0.19; 95% CI: 0.18–0.19) based on recorded deaths and extrapolating the force of infection from seroprevalence. Nationally and across all four regions, we report the decoupling of COVID-19 cases from hospitalisations and deaths, observed as early as during the third wave, which was dominated by the Delta variant compared with earlier waves. Conclusions: We identified that 60.7% of people in Eswatini had been infected by SARS-CoV-2 at least once and before the onset of the Omicron wave in mid-November 2021. Despite a modest uptake of COVID-19 vaccines, the evolution of population immunity from infection has likely contributed to the decoupling of infection and severe COVID-19 in Eswatini.
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