34 results on '"Anne W. Rimoin"'
Search Results
2. Co-Circulating Monkeypox and Swinepox Viruses, Democratic Republic of the Congo, 2022
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Thierry Kalonji, Emile Malembi, Jean Paul Matela, Toutou Likafi, Eddy Kinganda-Lusamaki, Emmanuel Hasivirwe Vakaniaki, Nicole A. Hoff, Amuri Aziza, Francisca Muyembe, Joelle Kabamba, Tine Cooreman, Béatrice Nguete, Danae Witte, Ahidjo Ayouba, Nicolas Fernandez-Nuñez, Stijn Roge, Martine Peeters, Sydney Merritt, Steve Ahuka-Mundeke, Eric Delaporte, Elisabeth Pukuta, Joachim Mariën, Eugene Bangwen, Steven Lakin, Charles Lewis, Jeffrey B. Doty, Laurens Liesenborghs, Lisa E. Hensley, Andrea McCollum, Anne W. Rimoin, Jean Jacques Muyembe-Tamfum, Robert Shongo, Didine Kaba, and Placide Mbala-Kingebeni
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monkeypox virus ,mpox ,swinepox virus ,swinepox ,orthopoxvirus ,infectious diseases ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
In September 2022, deaths of pigs manifesting pox-like lesions caused by swinepox virus were reported in Tshuapa Province, Democratic Republic of the Congo. Two human mpox cases were found concurrently in the surrounding community. Specific diagnostics and robust sequencing are needed to characterize multiple poxviruses and prevent potential poxvirus transmission.
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- 2024
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3. Clade I–Associated Mpox Cases Associated with Sexual Contact, the Democratic Republic of the Congo
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Emile M. Kibungu, Emmanuel H. Vakaniaki, Eddy Kinganda-Lusamaki, Thierry Kalonji-Mukendi, Elisabeth Pukuta, Nicole A. Hoff, Isaac I. Bogoch, Muge Cevik, Gregg S. Gonsalves, Lisa E. Hensley, Nicola Low, Souradet Y. Shaw, Erin Schillberg, Mikayla Hunter, Lygie Lunyanga, Sylvie Linsuke, Joule Madinga, Martine Peeters, Jean-Claude Makangara Cigolo, Steve Ahuka-Mundeke, Jean-Jacques Muyembe, Anne W. Rimoin, Jason Kindrachuk, Placide Mbala-Kingebeni, and Robert S. Lushima
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mpox ,monkeypox virus ,MPXV ,viruses ,sexually transmitted infections ,the Democratic Republic of the Congo ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
We report a cluster of clade I monkeypox virus infections linked to sexual contact in the Democratic Republic of the Congo. Case investigations resulted in 5 reverse transcription PCR–confirmed infections; genome sequencing suggest they belonged to the same transmission chain. This finding demonstrates that mpox transmission through sexual contact extends beyond clade IIb.
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- 2024
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4. Use of High-Resolution Geospatial and Genomic Data to Characterize Recent Tuberculosis Transmission, Botswana
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Chelsea R. Baker, Ivan Barilar, Leonardo S. de Araujo, Anne W. Rimoin, Daniel M. Parker, Rosanna Boyd, James L. Tobias, Patrick K. Moonan, Eleanor S. Click, Alyssa Finlay, John E. Oeltmann, Vladimir N. Minin, Chawangwa Modongo, Nicola M. Zetola, Stefan Niemann, and Sanghyuk S. Shin
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tuberculosis and other mycobacteria ,bacteria ,respiratory infections ,whole-genome sequencing ,spatial analysis ,geographic heterogeneity ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
Combining genomic and geospatial data can be useful for understanding Mycobacterium tuberculosis transmission in high-burden tuberculosis (TB) settings. We performed whole-genome sequencing on M. tuberculosis DNA extracted from sputum cultures from a population-based TB study conducted in Gaborone, Botswana, during 2012–2016. We determined spatial distribution of cases on the basis of shared genotypes among isolates. We considered clusters of isolates with ≤5 single-nucleotide polymorphisms identified by whole-genome sequencing to indicate recent transmission and clusters of ≥10 persons to be outbreaks. We obtained both molecular and geospatial data for 946/1,449 (65%) participants with culture-confirmed TB; 62 persons belonged to 5 outbreaks of 10–19 persons each. We detected geospatial clustering in just 2 of those 5 outbreaks, suggesting heterogeneous spatial patterns. Our findings indicate that targeted interventions applied in smaller geographic areas of high-burden TB identified using integrated genomic and geospatial data might help interrupt TB transmission during outbreaks.
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- 2023
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5. Comparison of adverse pregnancy and birth outcomes using archival medical records before and during the first wave of the COVID-19 pandemic in Kinshasa, Democratic Republic of Congo: a facility-based, retrospective cohort study
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Patrick J. Arena, Camille Dzogang, Adva Gadoth, Dalau Mukadi Nkamba, Nicole A. Hoff, David Kampilu, Michael Beia, Hui-Lee Wong, Steven A. Anderson, Didine Kaba, and Anne W. Rimoin
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Adverse birth outcomes ,GAIA ,Democratic Republic of Congo ,Medical records ,COVID-19 ,Maternal immunization ,Gynecology and obstetrics ,RG1-991 - Abstract
Abstract Background Little research has been conducted on the impact of the coronavirus disease 2019 (COVID-19) pandemic on either birth outcomes or the ability of archival medical records to accurately capture these outcomes. Our study objective is thus to compare the prevalence of preterm birth, stillbirth, low birth weight (LBW), small for gestational age (SGA), congenital microcephaly, and neonatal bloodstream infection (NBSI) before and during the first wave of the COVID-19 pandemic in Kinshasa, Democratic Republic of Congo (DRC). Methods We conducted a facility-based retrospective cohort study in which identified cases of birth outcomes were tabulated at initial screening and subcategorized according to level of diagnostic certainty using Global Alignment of Immunization Safety Assessment in pregnancy (GAIA) definitions. Documentation of any birth complications, delivery type, and maternal vaccination history were also evaluated. The prevalence of each birth outcome was compared in the pre-COVID-19 (i.e., July 2019 to February 2020) and intra-COVID-19 (i.e., March to August 2020) periods via two-sample z-test for equality of proportions. Results In total, 14,300 birth records were abstracted. Adverse birth outcomes were identified among 22.0% and 14.3% of pregnancies in the pre-COVID-19 and intra-COVID-19 periods, respectively. For stillbirth, LBW, SGA, microcephaly, and NBSI, prevalence estimates were similar across study periods. However, the prevalence of preterm birth in the intra-COVID-19 period was significantly lower than that reported during the pre-COVID-19 period (8.6% vs. 11.5%, p
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- 2023
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6. Poliovirus-Neutralizing Antibody Seroprevalence and Vaccine Habits in a Vaccine-Derived Poliovirus Outbreak Region in the Democratic Republic of Congo in 2018: The Impact on the Global Eradication Initiative
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Megan Halbrook, Adva Gadoth, Patrick Mukadi, Nicole A. Hoff, Kamy Musene, Camille Dzogang, Cyrus Shannon Sinai, D’Andre Spencer, Guillaume Ngoie-Mwamba, Sylvia Tangney, Frank Salet, Michel Nyembwe, Michel Kambamba Nzaji, Merly Tambu, Placide Mbala, Trevon Fuller, Sue K. Gerber, Didine Kaba, Jean Jacques Muyembe-Tamfum, and Anne W. Rimoin
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poliovirus ,serosurvey ,Democratic Republic of the Congo ,vaccine coverage ,cVDPV ,SIAs ,Medicine - Abstract
Despite the successes in wild-type polio eradication, poor vaccine coverage in the DRC has led to the occurrence of circulating vaccine-derived poliovirus outbreaks. This cross-sectional population-based survey provides an update to previous poliovirus-neutralizing antibody seroprevalence studies in the DRC and quantifies risk factors for under-immunization and parental knowledge that guide vaccine decision making. Among the 964 children between 6 and 35 months in our survey, 43.8% (95% CI: 40.6–47.0%), 41.1% (38.0–44.2%), and 38.0% (34.9–41.0%) had protective neutralizing titers to polio types 1, 2, and 3, respectively. We found that 60.7% of parents reported knowing about polio, yet 25.6% reported knowing how it spreads. Our data supported the conclusion that polio outreach efforts were successfully connecting with communities—79.4% of participants had someone come to their home with information about polio, and 88.5% had heard of a polio vaccination campaign. Additionally, the odds of seroreactivity to only serotype 2 were far greater in health zones that had a history of supplementary immunization activities (SIAs) compared to health zones that did not. While SIAs may be reaching under-vaccinated communities as a whole, these results are a continuation of the downward trend of seroprevalence rates in this region.
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- 2024
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7. Vascular and Non-HLA autoantibody profiles in hospitalized patients with COVID-19
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Brian Lichtenstein, Ying Zheng, David Gjertson, Kathie G. Ferbas, Anne W. Rimoin, Otto O. Yang, Grace M. Aldrovandi, Joanna M. Schaenman, Elaine F. Reed, and Jennifer A. Fulcher
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COVID-19 ,autoantibody ,angiotensin II receptor type 1 (AT1R) ,Non-HLA antigens ,Anti-endothelial antibodies ,Immunologic diseases. Allergy ,RC581-607 - Abstract
IntroductionSevere COVID-19 illness is characterized by an overwhelming immune hyperactivation. Autoantibodies against vascular, tissue, and cytokine antigens have been detected across the spectrum of COVID-19. How these autoantibodies correlate with COVID-19 severity is not fully defined.MethodsWe performed an exploratory study to investigate the expression of vascular and non-HLA autoantibodies in 110 hospitalized patients with COVID-19 ranging from moderate to critically ill. Relationships between autoantibodies and COVID- 19 severity and clinical risk factors were examined using logistic regression analysis.ResultsThere were no absolute differences in levels of expression of autoantibodies against angiotensin II receptor type 1 (AT1R) or endothelial cell proteins between COVID-19 severity groups. AT1R autoantibody expression also did not differ by age, sex, or diabetes status. Using a multiplex panel of 60 non- HLA autoantigens we did identify seven autoantibodies that differed by COVID-19 severity including myosin (myosin; p=0.02), SHC-transforming protein 3 (shc3; p=0.07), peroxisome proliferator-activated receptor gamma coactivator 1-beta (perc; p=0.05), glial-cell derived neurotrophic factor (gdnf; p=0.07), enolase 1 (eno1; p=0.08), latrophilin-1 (lphn1; p=0.08), and collagen VI (coll6; p=0.05) with greater breadth and higher expression levels seen in less severe COVID-19.DiscussionOverall, we found that patients hospitalized with COVID-19 demonstrate evidence of auto-reactive antibodies targeting endothelial cells, angiotensin II receptors, and numerous structural proteins including collagens. Phenotypic severity did not correlate with specific autoantibodies. This exploratory study underscores the importance of better understanding of the role of autoimmunity in COVID-19 disease and sequelae.
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- 2023
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8. Persistent memory despite rapid contraction of circulating T Cell responses to SARS-CoV-2 mRNA vaccination
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Ellie Taus, Christian Hofmann, F. Javier Ibarrondo, Laura S. Gong, Mary Ann Hausner, Jennifer A. Fulcher, Paul Krogstad, Scott G. Kitchen, Kathie G. Ferbas, Nicole H. Tobin, Anne W. Rimoin, Grace M. Aldrovandi, and Otto O. Yang
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SARS-CoV-2 ,cellular immunity ,T cells ,elispot ,intracellular cytokine staining ,SARS-CoV-2 mRNA vaccines ,Immunologic diseases. Allergy ,RC581-607 - Abstract
IntroductionWhile antibodies raised by SARS-CoV-2 mRNA vaccines have had compromised efficacy to prevent breakthrough infections due to both limited durability and spike sequence variation, the vaccines have remained highly protective against severe illness. This protection is mediated through cellular immunity, particularly CD8+ T cells, and lasts at least a few months. Although several studies have documented rapidly waning levels of vaccine-elicited antibodies, the kinetics of T cell responses have not been well defined.MethodsInterferon (IFN)-γ enzyme-linked immunosorbent spot (ELISpot) assay and intracellular cytokine staining (ICS) were utilized to assess cellular immune responses (in isolated CD8+ T cells or whole peripheral blood mononuclear cells, PBMCs) to pooled peptides spanning spike. ELISA was performed to quantitate serum antibodies against the spike receptor binding domain (RBD). ResultsIn two persons receiving primary vaccination, tightly serially evaluated frequencies of anti-spike CD8+ T cells using ELISpot assays revealed strikingly short-lived responses, peaking after about 10 days and becoming undetectable by about 20 days after each dose. This pattern was also observed in cross-sectional analyses of persons after the first and second doses during primary vaccination with mRNA vaccines. In contrast, cross-sectional analysis of COVID-19-recovered persons using the same assay showed persisting responses in most persons through 45 days after symptom onset. Cross-sectional analysis using IFN-γ ICS of PBMCs from persons 13 to 235 days after mRNA vaccination also demonstrated undetectable CD8+ T cells against spike soon after vaccination, and extended the observation to include CD4+ T cells. However, ICS analyses of the same PBMCs after culturing with the mRNA-1273 vaccine in vitro showed CD4+ and CD8+ T cell responses that were readily detectable in most persons out to 235 days after vaccination.DiscussionOverall, we find that detection of spike-targeted responses from mRNA vaccines using typical IFN-γ assays is remarkably transient, which may be a function of the mRNA vaccine platform and an intrinsic property of the spike protein as an immune target. However, robust memory, as demonstrated by capacity for rapid expansion of T cells responding to spike, is maintained at least several months after vaccination. This is consistent with the clinical observation of vaccine protection from severe illness lasting months. The level of such memory responsiveness required for clinical protection remains to be defined.
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- 2023
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9. High-resolution population estimation using household survey data and building footprints
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Gianluca Boo, Edith Darin, Douglas R. Leasure, Claire A. Dooley, Heather R. Chamberlain, Attila N. Lázár, Kevin Tschirhart, Cyrus Sinai, Nicole A. Hoff, Trevon Fuller, Kamy Musene, Arly Batumbo, Anne W. Rimoin, and Andrew J. Tatem
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Science - Abstract
A lack of up-to-date population figures may hamper effective decision-making. Here, the authors develop a Bayesian model to estimate population data at high resolution in five provinces of the Democratic Republic of the Congo.
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- 2022
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10. Poliovirus immunity among adults in the Democratic Republic of the Congo: a cross-sectional serosurvey
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Vivian H. Alfonso, Arie Voorman, Nicole A. Hoff, William C. Weldon, Sue Gerber, Adva Gadoth, Megan Halbrook, Amelia Goldsmith, Patrick Mukadi, Reena H. Doshi, Guillaume Ngoie-Mwamba, Trevon L. Fuller, Emile Okitolonda-Wemakoy, Jean-Jacques Muyembe-Tamfum, and Anne W. Rimoin
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Poliovirus ,Polio ,Immunization ,Vaccine-preventable diseases ,Adult immunity ,Democratic Republic of the Congo ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Vaccination efforts to eradicate polio currently focus on children under 5 years of age, among whom most cases of poliomyelitis still occur. However, in the Democratic Republic of the Congo (DRC), an outbreak of wild poliovirus type 1 occurred in 2010–2011 in which 16% of cases occurred among adults; in a related outbreak in the neighboring Republic of Congo, 75% of cases occurred among the same adult age-group. Given that infected adults may transmit poliovirus, this study was designed to assess adult immunity against polioviruses. Methods We assessed poliovirus seroprevalence using dried blood spots from 5,526 adults aged 15–59 years from the 2013–2014 Demographic and Health Survey in the DRC. Results Among adults in the DRC, 74%, 72%, and 57% were seropositive for neutralizing antibodies for poliovirus types 1, 2, and 3, respectively. For all three serotypes, seroprevalence tended to be higher among older age groups, those living in households with more children, and among women. Conclusions Protection against poliovirus is generally low among adults in the DRC, particularly for type 3 poliovirus. The lack of acquired immunity in adults suggests a potentially limited poliovirus circulation over the lifetime of those surveyed (spanning 1954 through 2014) and transmission of vaccine-derived poliovirus in this age group while underscoring the risk of these outbreaks among adults in the DRC.
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- 2022
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11. Corrigendum to 'Examination of scenarios introducing rubella vaccine in the Democratic Republic of the Congo' [Vaccine: X 9 (2021) 100127]
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Alvan Cheng, Kurt Frey, Guillaume Ngoie Mwamba, Kevin A. McCarthy, Nicole A. Hoff, and Anne W. Rimoin
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Immunologic diseases. Allergy ,RC581-607 - Published
- 2022
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12. Hybrid Immunity Shifts the Fc-Effector Quality of SARS-CoV-2 mRNA Vaccine-Induced Immunity
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Kathryn A. Bowman, Daniel Stein, Sally Shin, Kathie G. Ferbas, Nicole H. Tobin, Colin Mann, Stephanie Fischinger, Erica Ollmann Saphire, Douglas Lauffenburger, Anne W. Rimoin, Grace Aldrovandi, and Galit Alter
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COVID-19 ,Fc-receptors ,hybrid immunity ,SARS-CoV-2 ,antibody function ,vaccines ,Microbiology ,QR1-502 - Abstract
ABSTRACT Despite the robust immunogenicity of SARS-CoV-2 mRNA vaccines, emerging data have revealed enhanced neutralizing antibody and T cell cross-reactivity among individuals that previously experienced COVID-19, pointing to a hybrid immune advantage with infection-associated immune priming. Beyond neutralizing antibodies and T cell immunity, mounting data point to a potential role for additional antibody effector functions, including opsinophagocytic activity, in the resolution of symptomatic COVID-19. Whether hybrid immunity modifies the Fc-effector profile of the mRNA vaccine-induced immune response remains incompletely understood. Thus, here we profiled the SARS-CoV-2 specific humoral immune response in a group of individuals with and without prior COVID-19. As expected, hybrid Spike-specific antibody titers were enhanced following the primary dose of the mRNA vaccine but were similar to those achieved by naive vaccinees after the second mRNA vaccine dose. Conversely, Spike-specific vaccine-induced Fc-receptor binding antibody levels were higher after the primary immunization in individuals with prior COVID-19 and remained higher following the second dose compared to those in naive individuals, suggestive of a selective improvement in the quality, rather than the quantity, of the hybrid humoral immune response. Thus, while the magnitude of antibody titers alone may suggest that any two antigen exposures—either hybrid immunity or two doses of vaccine alone—represent a comparable prime/boost immunologic education, we find that hybrid immunity offers a qualitatively improved antibody response able to better leverage Fc-effector functions against conserved regions of the virus. IMPORTANCE Recent data indicates improved immunity to SARS-CoV-2 in individuals who experience a combination of two mRNA vaccine doses and infection, “hybrid immunity,” compared to individuals who receive vaccination or experience infection alone. While previous infection accelerates the vaccine-induced immune response following the first dose of mRNA vaccination, subsequent doses demonstrate negligible increases in antibody titers or T cell immunity. Here, using systems serology, we observed a unique antibody profile induced by hybrid immunity, marked by the unique induction of robust Fc-recruiting antibodies directed at the conserved region of the viral Spike antigen, the S2-domain, induced at lower levels in individuals who only received mRNA vaccination. Thus, hybrid immunity clearly redirects vaccine-induced immunodominance, resulting in the induction of a robust functional humoral immune response to the most highly conserved region of the SARS-CoV-2 Spike antigen, which may be key to protection against existing and emerging variants of concern. Thus, next-generation vaccines able to mimic hybrid immunity and drive a balanced response to conserved regions of the Spike antigen may confer enhanced protection against disease.
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- 2022
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13. Dominant CD8+ T Cell Nucleocapsid Targeting in SARS-CoV-2 Infection and Broad Spike Targeting From Vaccination
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Ellie Taus, Christian Hofmann, Francisco Javier Ibarrondo, Mary Ann Hausner, Jennifer A. Fulcher, Paul Krogstad, Kathie G. Ferbas, Nicole H. Tobin, Anne W. Rimoin, Grace M. Aldrovandi, and Otto O. Yang
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SARS-CoV-2 ,cellular immunity ,CD8+ T cells ,COVID-19 vaccine ,COVID-19 ,Immunologic diseases. Allergy ,RC581-607 - Abstract
CD8+ T cells have key protective roles in many viral infections. While an overall Th1-biased cellular immune response against SARS-CoV-2 has been demonstrated, most reports of anti-SARS-CoV-2 cellular immunity have evaluated bulk T cells using pools of predicted epitopes, without clear delineation of the CD8+ subset and its magnitude and targeting. In recently infected persons (mean 29.8 days after COVID-19 symptom onset), we confirm a Th1 bias (and a novel IL-4-producing population of unclear significance) by flow cytometry, which does not correlate to antibody responses against the receptor binding domain. Evaluating isolated CD8+ T cells in more detail by IFN-γ ELISpot assays, responses against spike, nucleocapsid, matrix, and envelope proteins average 396, 901, 296, and 0 spot-forming cells (SFC) per million, targeting 1.4, 1.5, 0.59, and 0.0 epitope regions respectively. Nucleocapsid targeting is dominant in terms of magnitude, breadth, and density of targeting. The magnitude of responses drops rapidly post-infection; nucleocapsid targeting is most sustained, and vaccination selectively boosts spike targeting. In SARS-CoV-2-naïve persons, evaluation of the anti-spike CD8+ T cell response soon after vaccination (mean 11.3 days) yields anti-spike CD8+ T cell responses averaging 2,463 SFC/million against 4.2 epitope regions, and targeting mirrors that seen in infected persons. These findings provide greater clarity on CD8+ T cell anti-SARS-CoV-2 targeting, breadth, and persistence, suggesting that nucleocapsid inclusion in vaccines could broaden coverage and durability.
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- 2022
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14. Examination of scenarios introducing rubella vaccine in the Democratic Republic of the Congo
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Alvan Cheng, Kurt Frey, Guillaume Ngoie Mwamba, Kevin A. McCarthy, Nicole A. Hoff, and Anne W. Rimoin
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Rubella ,Congenital rubella syndrome ,Vaccine introduction ,Agent-based model ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Background: Rubella vaccine has yet to be introduced into the national immunization schedule of the Democratic Republic of the Congo (DRC); the current burden of congenital rubella syndrome (CRS) is unknown and likely to be high. An important consideration prior to introducing rubella containing vaccine (RCV) is the potential inverse relationship between RCV coverage and CRS incidence. Increasing RCV coverage will also increase in the average age of infection. Cumulative infections across all age groups will decrease, but the number of infections in age groups vulnerable to CRS may increase. Methods: Rubella transmission dynamics in the DRC were simulated using a stochastic agent-based model of transmission. Input parameter values for known properties, demographic variables, and interventions were fixed; infectivity was inferred from seropositivity profiles in survey data. Results: Our simulations of RCV introduction for the DRC demonstrate that an increase in CRS burden is unlikely. Continued endemic transmission is only plausible when routine immunization coverage is less than 40% and follow-up supplemental immunization activities have poor coverage for decades. Conclusion: Increased vaccination coverage tends to increase the annual variability of CRS burden. Simulations examining low vaccination coverage and high mean CRS burden are outbreak prone, with multiple years of reduced burden followed by acute outbreaks. These outcomes contrast simulations with no vaccination coverage and high mean CRS burden, which have more consistent burden from year to year.
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- 2021
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15. Engaging Same-Day Peer Ambassadors to Increase Coronavirus Disease 2019 Vaccination Among People Experiencing Unsheltered Homelessness in Los Angeles County: A Hybrid Feasibility-Evaluation Study
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Chelsea L Shover, Allison Rosen, José Mata, Brooke Robie, Julissa Alvarado, Ashley Frederes, Ruby Romero, Jacqueline Beltran, Anna Bratcher, Alicia H Chang, Kristen R Choi, Candelaria Garcia, Steven Shoptaw, Priyanka Guha, Lindsey Richard, Gunner Sixx, Angel Baez, Anthony Coleman, Sarah Harvell, Shirnae Jackson, Caroline Lee, Joanna Swan, Kenny Torres, Emily Uyeda Kantrim, Maya McKeever, Anh Nguyen, Adam Rice, Marisol Rosales, Jordan Spoliansky, Elizabeth Bromley, Heidi Behforouz, Lillian Gelberg, Pamina M Gorbach, Anne W Rimoin, and Emily H Thomas
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Adult ,Vaccines ,Homelessness & ID Supplement ,COVID-19 Vaccines ,Adolescent ,Prevention ,Vaccination ,Clinical Trials and Supportive Activities ,COVID-19 ,Homelessness ,Peer education ,Biological Sciences ,Los Angeles ,Medical and Health Sciences ,Microbiology ,Vaccine Related ,Good Health and Well Being ,Infectious Diseases ,Clinical Research ,Ill-Housed Persons ,Humans ,Feasibility Studies ,Immunology and Allergy ,Immunization - Abstract
Background This study aimed to evaluate the feasibility and acceptability of engaging unhoused peer ambassadors (PAs) in coronavirus disease 2019 (COVID-19) vaccination efforts to reach people experiencing unsheltered homelessness in Los Angeles County. Methods From August to December 2021, vaccinated PAs aged ≥18 years who could provide informed consent were recruited during vaccination events for same-day participation. Events were held at encampments, service providers (eg, housing agencies, food lines, and mobile showers), and roving locations around Los Angeles. PAs were asked to join outreach alongside community health workers and shared their experience getting vaccinated, receiving a $25 gift card for each hour they participated. Postevent surveys evaluated how many PAs enrolled and how long they participated. In October 2021, we added a preliminary effectiveness evaluation of how many additional vaccinations were attributable to PAs. Staff who enrolled the PAs estimated the number of additional people vaccinated because of talking with the PA. Results A total of 117 PAs were enrolled at 103 events, participating for an average of 2 hours. At events with the effectiveness evaluation, 197 additional people were vaccinated over 167 PA hours ($21.19 gift card cost per additional person vaccinated), accounting for >25% of all vaccines given at these events. Discussion Recruiting same-day unhoused PAs is a feasible, acceptable, and preliminarily effective technique to increase COVID-19 vaccination in unsheltered settings. The findings can inform delivery of other health services for people experiencing homelessness.
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- 2022
16. Hesitancy to receive the novel coronavirus vaccine and potential influences on vaccination among a cohort of healthcare workers in the Democratic Republic of the Congo
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Angelica L. Barrall, Nicole A. Hoff, Dalau Mukadi Nkamba, Kamy Musene, Nicholas Ida, Anna Bratcher, Camille Dzogang, Sylvia Tangney, Michael Beia, Michel Kabamba Nzaji, David Kampilu, Gloire Mbaka Onya, Christophe Luhata, Adva Gadoth, Elisabeth Mukamba Musenga, Placide Mbala, Didine Kaba, and Anne W. Rimoin
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and promotion of well-being ,COVID-19 Vaccines ,Health Personnel ,Medical and Health Sciences ,Vaccine Related ,Virology ,Humans ,Vaccine hesitancy ,Vaccines ,Agricultural and Veterinary Sciences ,General Veterinary ,General Immunology and Microbiology ,SARS-CoV-2 ,Prevention ,Vaccination ,Public Health, Environmental and Occupational Health ,COVID-19 ,Biological Sciences ,Prevention of disease and conditions ,Good Health and Well Being ,Infectious Diseases ,3.4 Vaccines ,Democratic Republic of the Congo ,Healthcare worker ,Molecular Medicine ,Immunization ,COVID-19 vaccine - Abstract
Hesitancy to receive the COVID-19 vaccine among healthcare workers (HCWs) in low-resource settings, such as the Democratic Republic of the Congo (DRC), is a major global health challenge. This study identifies changes in willingness to receive vaccination among 588 HCWs in the DRC and reported influences on COVID-19 vaccination intentions. Up to 25 repeated measures were collected from participants between August 2020 to August 2021. Among the overall cohort, between August 2020 and mid-March 2021, the proportion of HCWs in each period of data collection reporting COVID-19 vaccine hesitancy ranged from 8.6% (95% CI: 5.97, 11.24) to 24.3% (95% CI: 20.12, 28.55). By early April 2021, the proportion reporting hesitancy more than doubled (52.0%; 95% CI: 46.22, 57.83). While hesitancy in the cohort began to decline by late-June 2021, 22.6% (95% CI: 18.05, 27.18) respondents indicated hesitancy in late-August 2021 which remains greater than the proportion of hesitancy at any time prior to early-March 2021. Patterns in reported influences on COVID-19 vaccination were varied with the proportion reporting some influences (e.g., no serious side effects, country of vaccine production) remaining stable throughout the year and other factors (e.g., recommendation of Ministry of Health, ease of vaccination) falling in popularity among respondents. Agreement that the national vaccination schedule should be followed apart from the COVID-19 vaccine remained high among respondents throughout the study period. This study shows that, among a cohort of HCWs in the DRC who have likely been influenced by regional, national, and global factors, COVID-19 vaccine hesitancy has fluctuated during the pandemic and should not be treated as a static factor. Additional research to determine which factors most influence HCWs' willingness to receive the COVID-19 vaccine offers opportunities to reduce vaccine hesitancy among this important population through tailored public health messaging.
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- 2022
17. A Successful National and Multipartner Approach to Increase Immunization Coverage: The Democratic Republic of Congo Mashako Plan 2018-2020
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Paul Lame, Augustin Milabyo, Sylvia Tangney, Gloire O. Mbaka, Christophe Luhata, Jean-Bernard Le Gargasson, Christelle Mputu, Nicole A. Hoff, Sydney Merritt, Dalau M. Nkamba, Djariatou Sow Sall, John Samuel Otomba, Amine El Mourid, Paul Lusamba, Kamel Senouci, Emmanuel Bor, Anne W. Rimoin, Didine Kaba, Guillaume Mwamba, and Elisabeth Mukamba
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Pediatric ,Vaccines ,Vaccination Coverage ,Immunization Programs ,Health Policy ,Prevention ,Public Health, Environmental and Occupational Health ,Vaccine Related ,Infectious Diseases ,Good Health and Well Being ,Democratic Republic of the Congo ,Humans ,Immunization ,Child ,Infection ,Program Evaluation - Abstract
BackgroundThe immunization system in the Democratic Republic of the Congo faces many challenges, including persistent large-scale outbreaks of polio, measles, and yellow fever; a large number of unvaccinated children for all antigens; minimal and delayed funding; and poor use of immunization data at all levels. In response, the Expanded Programme on Immunization within the Ministry of Health (MOH) collaborated with global partners to develop a revitalization strategy for the routine immunization (RI) system called the Mashako Plan.Mashako plan design and developmentThe Mashako Plan aimed to increase full immunization coverage in children aged 12-23 months by 15 percentage points overall in 9 of 26 provinces within 18 months of implementation. In 2018, we conducted a diagnostic review and identified gaps in coordination, service delivery, vaccine availability, real-time monitoring, and evaluation as key areas for intervention to improve the RI system. Five interventions were then implemented in the 9 identified provinces.DiscussionAccording to the 2020 vaccine coverage survey, full immunization coverage increased to 56.4%, and Penta3/DTP3 increased to 71.1% across the Mashako Plan provinces; the initial objective of the plan was reached and additional improvements in key service delivery indicators had been achieved. Increases in immunization sessions held per month, national stock of pentavalent vaccine, and supervision visits conducted demonstrate that simple, measurable changes at all levels can quickly improve immunization systems. Despite short-term improvements in all indicators tracked, challenges remain in vaccine availability, regular funding of immunization activities, systematic provision of immunization services, and ensuring long-term sustainability.ConclusionsStrong commitment of MOH staff combined with partner involvement enabled the improvement of the entire system. A simple set of interventions and indicators focused the energy of managers on discrete actions to improve outcomes. Further exploration of the results is necessary to determine the long-term impact and generate all-level engagement for sustainable success in all provinces.
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- 2023
18. Assessing the feasibility of passive surveillance for maternal immunization safety utilizing archival medical records in Kinshasa, Democratic Republic of the Congo
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Adva Gadoth, Dalau Mukadi Nkamba, Patrick J. Arena, Nicole A. Hoff, Camille Dzogang, David Kampilu, Michael Beya, Hui-Lee Wong, Steven A. Anderson, Didine Kaba, and Anne W. Rimoin
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Tetanus ,General Veterinary ,General Immunology and Microbiology ,Vaccination ,Infant, Newborn ,Public Health, Environmental and Occupational Health ,Infant ,Stillbirth ,Medical Records ,Infectious Diseases ,Pregnancy ,Democratic Republic of the Congo ,Birth Weight ,Feasibility Studies ,Humans ,Premature Birth ,Molecular Medicine ,Female ,Immunization ,Retrospective Studies - Abstract
Since the establishment of the Global Alignment of Immunization Safety Assessment in pregnancy (GAIA) case definitions in 2015, there has been an urgent need for field validation of pharmacovigilance feasibility in low- and middle-income countries. In this study, we assess the availability and quality of archival medical records at ten randomly selected high-traffic maternity wards in Kinshasa province, Democratic Republic of Congo (DRC).A retrospective cohort of mother-child pairs was established from all recorded births taking place at study sites between July 1, 2019 to February 28, 2020 through digitization of medical records. Adverse birth outcomes and maternal vaccination status, where available and linkable, were defined according to GAIA. Basic demographic information on mothers and newborns was also tabulated; birth outcomes were assessed for both intra-site prevalence and a pooled prevalence.A total of 7,697 mother-newborn pair records were extracted, with 37% of infants screening positive as cases of adverse outcomes. Maternal vaccination information was linkable to 67% of those cases. In total, 51% of stillbirths, 98% of preterm births, 100% of low birthweight infants, 90% of small for gestational age infants, 100% of microcephalic infants, and 0% of neonatal bloodstream infections were classifiable according to GAIA standards following initial screening. Forty percent of case mothers had some indication of tetanus vaccination prior to delivery in their medical records, but only 26% of case mothers met some level of GAIA definition for maternal vaccination during the pregnancy of interest.Archival birth records from delivery centers can be feasibly utilized to screen for stillbirth and maternal tetanus vaccination, and to accurately classify preterm birth, low birthweight, small for gestational age, and congenital microcephaly. Assessment of other neonatal outcomes were limited by inconsistent postpartum infant follow-up and records keeping.
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- 2022
19. Correction: Human T-cell lymphotropic virus type 1 transmission dynamics in rural villages in the Democratic Republic of the Congo with high nonhuman primate exposure
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Megan Halbrook, Adva Gadoth, Anupama Shankar, HaoQiang Zheng, Ellsworth M. Campbell, Nicole A. Hoff, Jean-Jacques Muyembe, Emile Okitolonda Wemakoy, Anne W. Rimoin, and William M. Switzer
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Infectious Diseases ,Good Health and Well Being ,Tropical Medicine ,Public Health, Environmental and Occupational Health ,Biological Sciences ,Medical and Health Sciences - Abstract
[This corrects the article DOI: 10.1371/journal.pntd.0008923.].
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- 2023
20. Increasing Ebola transmission behaviors 6 months post-vaccination: Comparing vaccinated and unvaccinated populations near 2018 Mbandaka Ebola outbreak in the Democratic Republic of Congo
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Jean Paul Kompany, Kamy Musene, Steve Ahuka, Camille Dzogong, Guillaume Ngoie Mwamba, Nicole A. Hoff, Didine Kaba, J. Daniel Kelly, Anne W. Rimoin, Anna Bratcher, Megan Halbrook, Placide Mbala, Benoit Kebela-Ilunga, Jean Jacque Muyemebe-Tamfum, Merly Tambu, Patrick Mukadi, and Michel Kabamba
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Zaire ebolavirus ,Population ,medicine.disease_cause ,Article ,Disease Outbreaks ,law.invention ,law ,Post vaccination ,Humans ,Medicine ,education ,Post-outbreak behaviors ,Vaccination behaviors ,education.field_of_study ,General Veterinary ,General Immunology and Microbiology ,business.industry ,Vaccination ,Behavior change ,Democratic Republic of the Congo (DRC) ,Public Health, Environmental and Occupational Health ,Outbreak ,Post-vaccination behaviors ,Hemorrhagic Fever, Ebola ,Ebolavirus ,Infectious Diseases ,Transmission (mechanics) ,rVSV-EBOV ,Ebola ,Cohort ,Democratic Republic of the Congo ,Molecular Medicine ,business ,Demography - Abstract
Background In 2018, the Democratic Republic of the Congo (DRC) declared its 9th and 10th Zaire ebolavirus (EBOV) outbreaks, in the Equateur province (end: July 2018), and in the eastern provinces including North Kivu (end: June 2020). The DRC Ministry of Health deployed the rVSV-vectored glycoprotein (VSV-EBOV) vaccine in response during both outbreaks. Methods A cohort of vaccinated and unvaccinated individuals from the Equateur province were enrolled and followed prospectively for 6 months. Among participants included in this analysis, 505 were vaccinated and 1,418 were unvaccinated. Differences in transmission behaviors pre- and post- outbreak were identified, along with associations between behaviors and vaccination. Results There was an overall increase in the proportion of both unvaccinated and vaccinated individuals in Mbandaka who participated in risky activities post-outbreak. Travel outside of the province pre-outbreak was associated with vaccination. Post-outbreak, vaccinated individuals were less likely to participate in funeral traditions than unvaccinated individuals. Conclusion A net increase in activities considered high risk was observed in both groups despite significant efforts to inform the population of risky behaviors. The absence of a reduction in transmission behavior post-outbreak should be considered for improving future behavior change campaigns in order to prevent recurrent outbreaks.
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- 2021
21. Risk Factors for Ebola Exposure in Health Care Workers in Boende, Tshuapa Province, Democratic Republic of the Congo
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Anna Bratcher, Benoit Ilunga-Kebela, Adva Gadoth, Matthew S. Bramble, Vivian H. Alfonso, Cyrus Sinai, Jean-Jacques Muyembe-Tamfum, Anne W. Rimoin, Alexis Mwanza, Bradly P. Nicholson, Nicole A. Hoff, Rupal Shah, Matthias Mossoko, Patrick Mukadi, Daniel Mukadi, Reena H. Doshi, Emile Okitolonda-Wemakoy, Joseph Wasiswa, and Russell A. Williams
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Health Personnel ,030231 tropical medicine ,Population ,Disease ,medicine.disease_cause ,Logistic regression ,Asymptomatic ,Medical and Health Sciences ,Microbiology ,health care workers ,Disease Outbreaks ,Vaccine Related ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Clinical Research ,Environmental health ,Biodefense ,medicine ,Immunology and Allergy ,Humans ,030212 general & internal medicine ,education ,Subclinical infection ,education.field_of_study ,Ebola virus ,business.industry ,Transmission (medicine) ,Prevention ,Outbreak ,Hemorrhagic Fever, Ebola ,Biological Sciences ,Ebolavirus ,Emerging Infectious Diseases ,Infectious Diseases ,Good Health and Well Being ,Immunoglobulin G ,Ebola ,Democratic Republic of the Congo ,Hemorrhagic Fever ,medicine.symptom ,business ,Infection - Abstract
Background Health care workers (HCW) are more likely to be exposed to Ebola virus (EBOV) during an outbreak compared to people in the general population due to close physical contact with patients and potential exposure to infectious fluids. However, not all will fall ill. Despite evidence of subclinical and paucisymptomatic Ebola virus disease (EVD), prevalence and associated risk factors remain unknown. Methods We conducted a serosurvey among HCW in Boende, Tshuapa Province, Democratic Republic of Congo. Human anti-EBOV glycoprotein IgG titers were measured using a commercially available ELISA kit. We assessed associations between anti-EBOV IgG seroreactivity, defined as ≥2.5 units/mL, and risk factors using univariable and multivariable logistic regression. Sensitivity analyses explored a more conservative cutoff, >5 units/mL. Results Overall, 22.5% of HCWs were seroreactive for EBOV. In multivariable analyses, using any form of personal protective equipment when interacting with a confirmed, probable, or suspect EVD case was negatively associated with seroreactivity (adjusted odds ratio, 0.23; 95% confidence interval, .07–.73). Discussion Our results suggest high exposure to EBOV among HCWs and provide additional evidence for asymptomatic or minimally symptomatic EVD. Further studies should be conducted to determine the probability of onward transmission and if seroreactivity is associated with immunity.
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- 2022
22. Adherence to face mask use during the COVID-19 pandemic among women seeking antenatal care in Kinshasa, Democratic Republic of Congo: a facility-based cross-sectional study
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Dalau Mukadi Nkamba, Patrick J Arena, Adva Gadoth, Nicole A Hoff, Camille Dzogang, David Kampilu, Michael Beya, Hui-Lee Wong, Steven Anderson, Didine Kaba, and Anne W Rimoin
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Male ,maternal medicine ,Other Medical and Health Sciences ,Prevention ,public health ,Clinical Sciences ,Masks ,COVID-19 ,Prenatal Care ,General Medicine ,Reproductive health and childbirth ,Cross-Sectional Studies ,Good Health and Well Being ,Pregnancy ,Democratic Republic of the Congo ,Public Health and Health Services ,Humans ,Female ,Prospective Studies ,Pandemics - Abstract
ObjectivesTo describe face mask use among pregnant women seeking antenatal care (ANC) in Kinshasa, Democratic Republic of Congo and to identify factors associated with masking adherence in this population.DesignFacility-based cross-sectional study nested within a prospective cohort study.SettingRandom sample of 10 health facilities, including 5 primary health centers and 5 secondary facilities or hospitals.ParticipantsA total of 934 pregnant women aged 18 years or above with a gestational age of at least 32 weeks were consecutively surveyed from 17 August 2020 to 31 January 2021.Primary and secondary outcome measuresWe estimated the proportions of pregnant women wearing a face mask and masking correctly (ie, over the mouth and nose), and assessed their knowledge regarding the COVID-19 pandemic. Multivariable logistic regression was employed to identify factors associated with overall and correct face mask use.ResultsOverall, 309 (33.1%) women wore a mask during the interview after their antenatal appointments, but only 33 (10.7%) wore a mask correctly. The odds of masking and correct mask use were significantly higher among women who had their ANC visit in a facility that provided COVID-19 care. Additionally, women who experienced COVID-19-like symptoms in the past 6 months had higher odds of wearing a mask correctly compared with those reporting no recent symptoms. Although 908 (97.2%) women were aware of the COVID-19 pandemic, only 611 (67.3%) thought that COVID-19 was circulating locally in Kinshasa.ConclusionOverall and correct face mask adherence levels were low among pregnant women attending ANC in Kinshasa. Our study highlights the need for improving adherence to correct face mask use in order to help control the spread of COVID-19 within Kinshasa alongside other control measures, like vaccination.
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- 2022
23. High-resolution characterization of recent tuberculosis transmission in Botswana using geospatial and genomic data – the Kopanyo Study
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Chelsea R. Baker, Ivan Barilar, Leonardo S. de Araujo, Anne W. Rimoin, Daniel M. Parker, Rosanna Boyd, James L. Tobias, Patrick K. Moonan, Eleanor S. Click, Alyssa Finlay, John E. Oeltmann, Vladimir N. Minin, Chawangwa Modongo, Nicola M. Zetola, Stefan Niemann, and Sanghyuk S. Shin
- Abstract
IntroductionCombining genomic and geospatial data can be useful for understanding Mycobacterium tuberculosis (Mtb) transmission in high tuberculosis burden settings.MethodsWe performed whole genome sequencing (WGS) on Mtb DNA extracted from sputum cultures from a population-based tuberculosis study conducted in 2012–2016 in Gaborone, Botswana. We used kernel density estimation, spatial K-functions, and created spatial distributions of phylogenetic trees. WGS-based clusters of isolates ≤5 single nucleotide polymorphisms were considered recent transmission, and large WGS-based clusters (≥10 members) were considered outbreaks.ResultsWe analyzed data from 1449 participants with culture-confirmed TB. Among these, 946 (65%) participants had both molecular and geospatial data. A total of 62 belonged to five large outbreaks (10–19 participants each). Geospatial clustering was detected in two of the five large outbreaks, suggesting heterogeneous spatial patterns within the community.ConclusionsIntegration of genomic and geospatial data identified distinct patterns of tuberculosis transmission in a high-tuberculosis burden setting. Targeted interventions in these smaller geographies may interrupt on-going transmission.
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- 2022
24. Pan-ebolavirus serology study of healthcare workers in the Mbandaka Health Region, Democratic Republic of the Congo
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Kelly C. L. Shaffer, Sean Hui, Anna Bratcher, Liam B. King, Rachel Mutombe, Nathalie Kavira, Jean Paul Kompany, Merly Tambu, Kamy Musene, Patrick Mukadi, Placide Mbala, Adva Gadoth, Brandyn R. West, Benoit Kebela Ilunga, Didine Kaba, Jean Jacques Muyembe-Tanfum, Nicole A. Hoff, Anne W. Rimoin, Erica Ollmann Saphire, and Ainsworth, Stuart Robert
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Health Personnel ,Prevention ,Public Health, Environmental and Occupational Health ,Hemorrhagic Fever, Ebola ,Biological Sciences ,Antibodies, Viral ,Ebolavirus ,Medical and Health Sciences ,Antibodies ,Vaccine Related ,Infectious Diseases ,Emerging Infectious Diseases ,Good Health and Well Being ,Immunoglobulin G ,Biodefense ,Tropical Medicine ,Ebola ,Democratic Republic of the Congo ,Humans ,Hemorrhagic Fever ,Viral ,Infection ,Glycoproteins - Abstract
Although multiple antigenically distinct ebolavirus species can cause human disease, previous serosurveys focused on only Zaire ebolavirus (EBOV). Thus, the extent of reactivity or exposure to other ebolaviruses, and which sociodemographic factors are linked to this seroreactivity, are unclear. We conducted a serosurvey of 539 healthcare workers (HCW) in Mbandaka, Democratic Republic of the Congo, using ELISA-based analysis of serum IgG against EBOV, Sudan ebolavirus (SUDV) and Bundibugyo ebolavirus (BDBV) glycoproteins (GP). We compared seroreactivity to risk factors for viral exposure using univariate and multivariable logistic regression. Seroreactivity against different GPs ranged from 2.2–4.6%. Samples from six individuals reacted to all three species of ebolavirus and 27 samples showed a species-specific IgG response. We find that community health volunteers are more likely to be seroreactive against each antigen than nurses, and in general, that HCWs with indirect patient contact have higher anti-EBOV GP IgG levels than those with direct contact. Seroreactivity against ebolavirus GP may be associated with positions that offer less occupational training and access to PPE. Those individuals with broadly reactive responses may have had multiple ebolavirus exposures or developed cross-reactive antibodies. In contrast, those individuals with species-specific BDBV or SUDV GP seroreactivity may have been exposed to an ebolavirus not previously known to circulate in the region.
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- 2022
25. Immunogenicity of rVSVΔG-ZEBOV-GP Ebola vaccination in exposed and potentially exposed persons in the Democratic Republic of the Congo
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Nicole A. Hoff, Anna Bratcher, J. Daniel Kelly, Kamy Musene, Jean Paul Kompany, Michel Kabamba, Placide Mbala-Kingebeni, Bonnie Dighero-Kemp, Gregory Kocher, Elizabeth Elliott, Cavan Reilly, Megan Halbrook, Benoit Ilunga Kebela, Adva Gadoth, Guillaume Ngoie Mwamba, Merly Tambu, David R. McIlwain, Patrick Mukadi, Lisa E. Hensley, Steve Ahuka-Mundeke, George W. Rutherford, Jean Jacques Muyembe-Tamfum, and Anne W. Rimoin
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Adult ,Male ,and promotion of well-being ,Adolescent ,Ebola virus disease ,immunogenicity ,Antibodies, Viral ,Antibodies ,Disease Outbreaks ,Vaccine Related ,Young Adult ,Immunogenicity, Vaccine ,Viral Envelope Proteins ,Seroepidemiologic Studies ,Biodefense ,parasitic diseases ,rVSV Delta G-ZEBOV-GP ,80 and over ,Humans ,Viral ,Ebola Vaccines ,Child ,rVSVΔG-ZEBOV-GP ,Glycoproteins ,Aged ,Aged, 80 and over ,Multidisciplinary ,Ebola vaccine ,Prevention ,Vaccination ,Hemorrhagic Fever, Ebola ,Middle Aged ,Ebolavirus ,Prevention of disease and conditions ,Infectious Diseases ,Emerging Infectious Diseases ,Good Health and Well Being ,3.4 Vaccines ,Ebola ,Democratic Republic of the Congo ,Hemorrhagic Fever ,Female ,Immunization ,Vaccine - Abstract
Despite more than 300,000 rVSVΔG-ZEBOV-glycoprotein (GP) vaccine doses having been administered during Ebola virus disease (EVD) outbreaks in the Democratic Republic of the Congo (DRC) between 2018 and 2020, seroepidemiologic studies of vaccinated Congolese populations are lacking. This study examines the antibody response at 21 d and 6 mo postvaccination after single-dose rVSVΔG-ZEBOV-GP vaccination among EVD-exposed and potentially exposed populations in the DRC. We conducted a longitudinal cohort study of 608 rVSVΔG-ZEBOV-GP-vaccinated individuals during an EVD outbreak in North Kivu Province, DRC. Participants provided questionnaires and blood samples at three study visits (day 0, visit 1; day 21, visit 2; and month 6, visit 3). Anti-GP immunoglobulin G (IgG) antibody titers were measured in serum by the Filovirus Animal Nonclinical Group anti-Ebola virus GP IgG enzyme-linked immunosorbent assay. Antibody response was defined as an antibody titer that had increased fourfold from visit 1 to visit 2 and was above four times the lower limit of quantification at visit 2; antibody persistence was defined as a similar increase from visit 1 to visit 3. We then examined demographics for associations with follow-up antibody titers using generalized linear mixed models. A majority of the sample, 87.2%, had an antibody response at visit 2, and 95.6% demonstrated antibody persistence at visit 3. Being female and of young age was predictive of a higher antibody titer postvaccination. Antibody response and persistence after Ebola vaccination was robust in this cohort, confirming findings from outside of the DRC.
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- 2022
26. Dominant CD8
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Ellie, Taus, Christian, Hofmann, Francisco Javier, Ibarrondo, Mary Ann, Hausner, Jennifer A, Fulcher, Paul, Krogstad, Kathie G, Ferbas, Nicole H, Tobin, Anne W, Rimoin, Grace M, Aldrovandi, and Otto O, Yang
- Subjects
Enzyme-Linked Immunospot Assay ,COVID-19 Vaccines ,SARS-CoV-2 ,Vaccination ,COVID-19 ,CD8-Positive T-Lymphocytes ,Antibodies, Viral ,United States ,Spike Glycoprotein, Coronavirus ,Humans ,Molecular Targeted Therapy ,Nucleocapsid ,Peptides ,Broadly Neutralizing Antibodies ,Cells, Cultured - Abstract
CD8
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- 2021
27. Monkeypox and Global Health Inequities: A Tale as Old as Time…
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Monica Malta, Placide Mbala-Kingebeni, Anne W. Rimoin, and Steffanie A. Strathdee
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Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,Humans ,Health Inequities ,Monkeypox ,Disease Outbreaks - Abstract
Infectious disease outbreaks can quickly become global in what has increasingly become a closely interconnected world, influenced by what is considered to be an unprecedented era of technological, demographic, and climatic change [...]
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- 2022
28. Wildlife in Cameroon harbor diverse coronaviruses including many isolates closely related to human coronavirus 229E
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James A. Ayukekbong, Anne W. Rimoin, Nkom F Ntumvi, Nathan D. Wolfe, Matthew LeBreton, Christian Lange, Bradley S. Schneider, Corina Monagin, Damien O. Joly, Karen Saylors, Moctar M M Mouiche, David J McIver, Joseph Le Doux Diffo, Ubald Tamoufe, Sanjit Roy, Edward M. Rubin, Amethyst Gillis, Jean-Michel Takuo, Valantine Ngum Ndze, and Julius Nwobegahay
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Human coronavirus 229E ,biology ,Phylogenetic tree ,viruses ,Shrew ,Wildlife ,Intermediate host ,virus diseases ,Zoology ,biology.organism_classification ,Hipposideridae ,Virus ,biology.animal ,Civet - Abstract
Zoonotic spillover of animal viruses into human populations is a continuous and increasing public health risk. SARS-CoV-2 highlights the global impact emergence events can have. Considering the history and diversity of coronaviruses (CoVs), especially in bats, SARS-CoV-2 will likely not be the last to spillover from animals into human populations.We sampled and tested wildlife in the central African country Cameroon to determine which CoVs are circulating and how they relate to previously detected human and animal CoVs. We collected animal and ecological data at sampling locations and used family-level consensus PCR combined with amplicon sequencing for virus detection.Between 2003 and 2018, samples were collected from 6,580 animals of several different orders. CoV RNA was detected in 175 bats, a civet, and a shrew. The CoV RNAs detected in the bats represented 17 different genetic clusters, coinciding with alpha (n=8) and beta (n=9) CoVs. Sequences resembling human CoV-229E (HCoV-229E) were found in 40 Hipposideridae bats. Phylogenetic analyses place the human derived HCoV-229E isolates closest to those from camels in terms of the S and N genes, but closest to isolates from bats for the E, M, and RdRp genes. The CoV RNA positivity rate in bats varied significantly (pEight of the suspected CoV species of which we detected RNA appear to be entirely novel CoV species, which suggests that CoV diversity in African wildlife is still rather poorly understood. The detection of multiple different variants of HCoV-229E-like viruses supports the bat reservoir hypothesis for this virus, with the phylogenetic results casting some doubt on camels as an intermediate host. The findings also support the previously proposed influence of ecological factors on CoV circulation, indicating a high level of underlying complexity to the viral ecology. These results indicate the importance of investing in surveillance activities among wild animals to detect all potential threats as well as sentinel surveillance among exposed humans to determine emerging threats.
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- 2021
29. Examination of scenarios introducing rubella vaccine in the Democratic Republic of the Congo
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Guillaume Ngoie Mwamba, Kevin A. McCarthy, Anne W. Rimoin, Nicole A. Hoff, Kurt Frey, and Alvan Cheng
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and promotion of well-being ,Agent-based model ,Psychological intervention ,Rubella ,law.invention ,Vaccine Related ,Rubella vaccine ,Rare Diseases ,law ,Environmental health ,medicine ,Congenital rubella syndrome ,General Veterinary ,General Immunology and Microbiology ,business.industry ,Prevention ,Incidence (epidemiology) ,Public Health, Environmental and Occupational Health ,virus diseases ,Outbreak ,Vaccine introduction ,RC581-607 ,Prevention of disease and conditions ,medicine.disease ,Emerging Infectious Diseases ,Good Health and Well Being ,Infectious Diseases ,Transmission (mechanics) ,3.4 Vaccines ,Immunization ,Regular paper ,Molecular Medicine ,Immunologic diseases. Allergy ,Infection ,business ,medicine.drug - Abstract
Highlights • Serosurvey data suggest R0 values for rubella in the DRC on the range 3 to 8. • Supplementary immunization activities provide multi-decade reduction in burden. • Post-vaccine introduction, burden will likely be concentrated in outbreaks., Background Rubella vaccine has yet to be introduced into the national immunization schedule of the Democratic Republic of the Congo (DRC); the current burden of congenital rubella syndrome (CRS) is unknown and likely to be high. An important consideration prior to introducing rubella containing vaccine (RCV) is the potential inverse relationship between RCV coverage and CRS incidence. Increasing RCV coverage will also increase in the average age of infection. Cumulative infections across all age groups will decrease, but the number of infections in age groups vulnerable to CRS may increase. Methods Rubella transmission dynamics in the DRC were simulated using a stochastic agent-based model of transmission. Input parameter values for known properties, demographic variables, and interventions were fixed; infectivity was inferred from seropositivity profiles in survey data. Results Our simulations of RCV introduction for the DRC demonstrate that an increase in CRS burden is unlikely. Continued endemic transmission is only plausible when routine immunization coverage is less than 40% and follow-up supplemental immunization activities have poor coverage for decades. Conclusion Increased vaccination coverage tends to increase the annual variability of CRS burden. Simulations examining low vaccination coverage and high mean CRS burden are outbreak prone, with multiple years of reduced burden followed by acute outbreaks. These outcomes contrast simulations with no vaccination coverage and high mean CRS burden, which have more consistent burden from year to year.
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- 2021
30. Capability and feasibility of the Global Alignment of Immunisation Safety Assessment in pregnancy criteria for the assessment of pregnancy and birth outcomes in Kinshasa, Democratic Republic of the Congo: a prospective cohort study
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Steven Anderson, Dalau Mukadi Nkamba, Patrick J Arena, Adva Gadoth, Camille Dzogang, David Kampilu, Hui-Lee Wong, Didine Kaba, Anne W Rimoin, Nicole Hoff, Angelica L Barrall, and Michael Beia
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Public aspects of medicine ,RA1-1270 - Abstract
Introduction There is an urgent need to investigate the capabilities of active surveillance in strengthening the development of pharmacovigilance (PV) systems in low-resource settings. Here, we assess the capability and feasibility of prospectively collected data to document maternal immunisation and adverse birth outcomes across delivery centres in Kinshasa, Democratic Republic of the Congo (DRC) according to the Global Alignment of Immunisation Safety Assessment in pregnancy (GAIA) definitions.Methods We conducted a facility-based prospective cohort study that enrolled mothers via convenience sampling either during their antenatal care visit or following their delivery. Demographic and clinical information as well as postpartum details related to the index pregnancy were collected after delivery; all mothers were also contacted via telephone 30 days postdelivery to determine if certain outcomes occurred after health facility discharge. Adverse birth outcomes of interest and maternal tetanus immunisation were categorised according to the GAIA criteria, and the level and impact of loss to follow-up (LTFU) was also evaluated.Results The study population consisted of 2675 mothers. The proportion of adverse birth outcomes ranged from 1.6% (for neonatal death) to 15.8% (for small for gestational age). Evidence of maternal tetanus immunisation during the index pregnancy was found for 637 mothers of newborns with any adverse birth outcome. GAIA diagnostic certainty was high for low birth weight and preterm birth, but much lower for stillbirth and neonatal bloodstream infections. Additionally, LTFU was high: only 47.9% of all mothers were successfully followed up via phone call.Conclusion Our investigation highlighted some of the challenges associated with the utilisation of the GAIA criteria in (prospective) observational studies within health facilities in Kinshasa, DRC (eg, data quality, LTFU and selection bias). Nevertheless, active surveillance remains a promising tool for future PV activities in DRC and beyond.
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- 2023
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31. Adherence to face mask use during the COVID-19 pandemic among women seeking antenatal care in Kinshasa, Democratic Republic of Congo: a facility-based cross-sectional study
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Steven Anderson, Dalau Mukadi Nkamba, Patrick J Arena, Adva Gadoth, Nicole A Hoff, Camille Dzogang, David Kampilu, Michael Beya, Hui-Lee Wong, Didine Kaba, and Anne W Rimoin
- Subjects
Medicine - Abstract
Objectives To describe face mask use among pregnant women seeking antenatal care (ANC) in Kinshasa, Democratic Republic of Congo and to identify factors associated with masking adherence in this population.Design Facility-based cross-sectional study nested within a prospective cohort study.Setting Random sample of 10 health facilities, including 5 primary health centers and 5 secondary facilities or hospitals.Participants A total of 934 pregnant women aged 18 years or above with a gestational age of at least 32 weeks were consecutively surveyed from 17 August 2020 to 31 January 2021.Primary and secondary outcome measures We estimated the proportions of pregnant women wearing a face mask and masking correctly (ie, over the mouth and nose), and assessed their knowledge regarding the COVID-19 pandemic. Multivariable logistic regression was employed to identify factors associated with overall and correct face mask use.Results Overall, 309 (33.1%) women wore a mask during the interview after their antenatal appointments, but only 33 (10.7%) wore a mask correctly. The odds of masking and correct mask use were significantly higher among women who had their ANC visit in a facility that provided COVID-19 care. Additionally, women who experienced COVID-19-like symptoms in the past 6 months had higher odds of wearing a mask correctly compared with those reporting no recent symptoms. Although 908 (97.2%) women were aware of the COVID-19 pandemic, only 611 (67.3%) thought that COVID-19 was circulating locally in Kinshasa.Conclusion Overall and correct face mask adherence levels were low among pregnant women attending ANC in Kinshasa. Our study highlights the need for improving adherence to correct face mask use in order to help control the spread of COVID-19 within Kinshasa alongside other control measures, like vaccination.
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- 2022
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32. Correction: Zoonotic risk factors associated with seroprevalence of Ebola virus GP antibodies in the absence of diagnosed Ebola virus disease in the Democratic Republic of Congo.
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Anna Bratcher, Nicole A Hoff, Reena H Doshi, Adva Gadoth, Megan Halbrook, Patrick Mukadi, Kami Musene, Benoit Ilunga-Kebela, D'Andre Spencer, Matthew S Bramble, David McIlwain, J Daniel Kelly, Daniel Mukadi, Placide Mbala Kingebeni, Steve Ahuka, Emile Okitolonda-Wemakoy, Jean -Jacques Muyembe-Tamfum, and Anne W Rimoin
- Subjects
Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
[This corrects the article DOI: 10.1371/journal.pntd.0009566.].
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- 2022
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33. Pan-ebolavirus serology study of healthcare workers in the Mbandaka Health Region, Democratic Republic of the Congo.
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Kelly C L Shaffer, Sean Hui, Anna Bratcher, Liam B King, Rachel Mutombe, Nathalie Kavira, Jean Paul Kompany, Merly Tambu, Kamy Musene, Patrick Mukadi, Placide Mbala, Adva Gadoth, Brandyn R West, Benoit Kebela Ilunga, Didine Kaba, Jean Jacques Muyembe-Tanfum, Nicole A Hoff, Anne W Rimoin, and Erica Ollmann Saphire
- Subjects
Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
Although multiple antigenically distinct ebolavirus species can cause human disease, previous serosurveys focused on only Zaire ebolavirus (EBOV). Thus, the extent of reactivity or exposure to other ebolaviruses, and which sociodemographic factors are linked to this seroreactivity, are unclear. We conducted a serosurvey of 539 healthcare workers (HCW) in Mbandaka, Democratic Republic of the Congo, using ELISA-based analysis of serum IgG against EBOV, Sudan ebolavirus (SUDV) and Bundibugyo ebolavirus (BDBV) glycoproteins (GP). We compared seroreactivity to risk factors for viral exposure using univariate and multivariable logistic regression. Seroreactivity against different GPs ranged from 2.2-4.6%. Samples from six individuals reacted to all three species of ebolavirus and 27 samples showed a species-specific IgG response. We find that community health volunteers are more likely to be seroreactive against each antigen than nurses, and in general, that HCWs with indirect patient contact have higher anti-EBOV GP IgG levels than those with direct contact. Seroreactivity against ebolavirus GP may be associated with positions that offer less occupational training and access to PPE. Those individuals with broadly reactive responses may have had multiple ebolavirus exposures or developed cross-reactive antibodies. In contrast, those individuals with species-specific BDBV or SUDV GP seroreactivity may have been exposed to an ebolavirus not previously known to circulate in the region.
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- 2022
- Full Text
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34. Tetanus seroprotection among children in the Democratic Republic of the Congo, 2013-2014.
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Alvan Cheng, Angie Ghanem-Uzqueda, Nicole A Hoff, Hayley Ashbaugh, Reena H Doshi, Patrick Mukadi, Roger Budd, Stephen G Higgins, Christina Randall, Sue Gerber, Michel Kabamba, Guilluame Ngoie Mwamba, Emile Okitolonda-Wemakoy, Jean Jacques Muyembe-Tanfum, and Anne W Rimoin
- Subjects
Medicine ,Science - Abstract
BackgroundTetanus is a potentially fatal disease that is preventable through vaccination. While the Democratic Republic of the Congo (DRC) has continued to improve implementing routine vaccination activities throughout the country, they have struggled to maintain high childhood vaccine coverage. This study aims to examine the seroprevalence of tetanus in children 6 to 59 months to identify areas for intervention and improvement of vaccination coverage.MethodsIn collaboration with the 2013-2014 Demographic and Health Survey, we assessed the seroprevalence of tetanus antibodies among children in the DRC. Dried blood spot samples collected from children 6-59 months of age were processed using a prototype DYNEX Multiplier® chemiluminescent automated immunoassay instrument with a multiplex measles, mumps, rubella, varicella and tetanus assay. Multivariable logistic regression was used to determine factors associated with tetanus vaccination and seroprotection.ResultsOverall, 36.1% of children 6-59 months of age reported receiving at least 1 dose of tetanus vaccine while 28.7% reported receiving 3 doses; tetanus seroprotection was 40%. Increasing age in children was associated with decreased tetanus seroprotection, but increased number tetanus vaccinations received. Factors related to increased tetanus seroprotection included number of children in the household, wealth index of the family, urban residence compared to rural, level of maternal education, and province and geography.ConclusionsOur findings in this nationally representative sample indicate that serology biomarkers may help identify children who are not fully immunized to tetanus more accurately than reported vaccination. While children may be captured for routine immunization activities, as children age, decreasing seroprevalence may indicate additional need to bolster routine vaccination activities and documentation of vaccination in school aged children. Additionally, the study highlights gaps in rural residential areas and vaccination coverage based on maternal education, indicating that policies targeting maternal education and awareness could improve the coverage and seroprevalence of tetanus antibodies in the DRC.
- Published
- 2022
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