148 results on '"Anne W. Rimoin"'
Search Results
2. Co-Circulating Monkeypox and Swinepox Viruses, Democratic Republic of the Congo, 2022
- Author
-
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
- Subjects
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.
- Published
- 2024
- Full Text
- View/download PDF
3. Clade I–Associated Mpox Cases Associated with Sexual Contact, the Democratic Republic of the Congo
- Author
-
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
- Subjects
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.
- Published
- 2024
- Full Text
- View/download PDF
4. Use of High-Resolution Geospatial and Genomic Data to Characterize Recent Tuberculosis Transmission, Botswana
- Author
-
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
- Subjects
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.
- Published
- 2023
- Full Text
- View/download PDF
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
- Author
-
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
- Subjects
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
- Published
- 2023
- Full Text
- View/download PDF
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
- Author
-
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
- Subjects
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.
- Published
- 2024
- Full Text
- View/download PDF
7. Vascular and Non-HLA autoantibody profiles in hospitalized patients with COVID-19
- Author
-
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
- Subjects
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.
- Published
- 2023
- Full Text
- View/download PDF
8. Persistent memory despite rapid contraction of circulating T Cell responses to SARS-CoV-2 mRNA vaccination
- Author
-
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
- Subjects
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.
- Published
- 2023
- Full Text
- View/download PDF
9. High-resolution population estimation using household survey data and building footprints
- Author
-
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
- Subjects
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.
- Published
- 2022
- Full Text
- View/download PDF
10. Poliovirus immunity among adults in the Democratic Republic of the Congo: a cross-sectional serosurvey
- Author
-
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
- Subjects
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.
- Published
- 2022
- Full Text
- View/download PDF
11. Corrigendum to 'Examination of scenarios introducing rubella vaccine in the Democratic Republic of the Congo' [Vaccine: X 9 (2021) 100127]
- Author
-
Alvan Cheng, Kurt Frey, Guillaume Ngoie Mwamba, Kevin A. McCarthy, Nicole A. Hoff, and Anne W. Rimoin
- Subjects
Immunologic diseases. Allergy ,RC581-607 - Published
- 2022
- Full Text
- View/download PDF
12. Hybrid Immunity Shifts the Fc-Effector Quality of SARS-CoV-2 mRNA Vaccine-Induced Immunity
- Author
-
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
- Subjects
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.
- Published
- 2022
- Full Text
- View/download PDF
13. Dominant CD8+ T Cell Nucleocapsid Targeting in SARS-CoV-2 Infection and Broad Spike Targeting From Vaccination
- Author
-
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
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.
- Published
- 2022
- Full Text
- View/download PDF
14. Controlling emerging zoonoses at the animal-human interface
- Author
-
Riley O. Mummah, Nicole A. Hoff, Anne W. Rimoin, and James O. Lloyd-Smith
- Subjects
Subcritical zoonoses ,Stuttering zoonoses ,Epidemiological control ,Emerging infectious diseases ,Cross-species spillover transmission ,Human-to-human transmission ,Environmental sciences ,GE1-350 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background For many emerging or re-emerging pathogens, cases in humans arise from a mixture of introductions (via zoonotic spillover from animal reservoirs or geographic spillover from endemic regions) and secondary human-to-human transmission. Interventions aiming to reduce incidence of these infections can be focused on preventing spillover or reducing human-to-human transmission, or sometimes both at once, and typically are governed by resource constraints that require policymakers to make choices. Despite increasing emphasis on using mathematical models to inform disease control policies, little attention has been paid to guiding rational disease control at the animal-human interface. Methods We introduce a modeling framework to analyze the impacts of different disease control policies, focusing on pathogens exhibiting subcritical transmission among humans (i.e. pathogens that cannot establish sustained human-to-human transmission). We quantify the relative effectiveness of measures to reduce spillover (e.g. reducing contact with animal hosts), human-to-human transmission (e.g. case isolation), or both at once (e.g. vaccination), across a range of epidemiological contexts. Results We provide guidelines for choosing which mode of control to prioritize in different epidemiological scenarios and considering different levels of resource and relative costs. We contextualize our analysis with current zoonotic pathogens and other subcritical pathogens, such as post-elimination measles, and control policies that have been applied. Conclusions Our work provides a model-based, theoretical foundation to understand and guide policy for subcritical zoonoses, integrating across disciplinary and species boundaries in a manner consistent with One Health principles.
- Published
- 2020
- Full Text
- View/download PDF
15. Seroreactivity against Marburg or related filoviruses in West and Central Africa
- Author
-
Imke Steffen, Kai Lu, Nicole A. Hoff, Prime Mulembakani, Emile Okitolonda Wemakoy, Jean-Jacques Muyembe-Tamfum, Nicaise Ndembi, Catherine A. Brennan, John Hackett, William M. Switzer, Sentob Saragosti, Guy O. Mbensa, Syria Laperche, Anne W. Rimoin, and Graham Simmons
- Subjects
Filoviruses ,Marburgvirus ,hemorrhagic fever virus ,serology ,prevalence ,Cameroon ,Infectious and parasitic diseases ,RC109-216 ,Microbiology ,QR1-502 - Abstract
ABSTRACTA serological survey of 2,430 archived serum samples collected between 1997 and 2012 was conducted to retrospectively determine the prevalence of Marburg virus in five African countries. Serum samples were screened for neutralizing antibodies in a pseudotype micro-neutralization assay and confirmed by enzyme-linked immunosorbent assay (ELISA). Surprisingly, a seroprevalence for Marburg virus of 7.5 and 6.3% was found in Cameroon and Ghana, respectively, suggesting the circulation of filoviruses or related viruses outside of known endemic areas that remain undetected by current surveillance efforts. However, due to the lack of validated assays and appropriate positive controls, these results must be considered preliminary.
- Published
- 2020
- Full Text
- View/download PDF
16. Examination of scenarios introducing rubella vaccine in the Democratic Republic of the Congo
- Author
-
Alvan Cheng, Kurt Frey, Guillaume Ngoie Mwamba, Kevin A. McCarthy, Nicole A. Hoff, and Anne W. Rimoin
- Subjects
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.
- Published
- 2021
- Full Text
- View/download PDF
17. Serologic Prevalence of Ebola Virus in Equatorial Africa
- Author
-
Imke Steffen, Kai Lu, Lauren K. Yamamoto, Nicole A. Hoff, Prime Mulembakani, Emile O. Wemakoy, Jean-Jacques Muyembe-Tamfum, Nicaise Ndembi, Catherine A. Brennan, John Hackett, Susan L. Stramer, William M. Switzer, Sentob Saragosti, Guy O. Mbensa, Syria Laperche, Anne W. Rimoin, and Graham Simmons
- Subjects
Ebola virus ,viruses ,hemorrhagic fever virus ,folivirus ,serologic prevalence ,neutralization assay ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
We conducted a serologic survey of 2,430 serum samples collected during 1997–2012 for various studies to determine the prevalence of the hemorrhagic fever virus Ebola virus (EBOV) in equatorial Africa. We screened serum samples for neutralizing antibodies by using a pseudotype microneutralization assay and a newly developed luciferase immunoprecipitation system assay. Specimens seroreactive for EBOV were confirmed by using an ELISA. Our results suggest a serologic prevalence of 2%–3.5% in the Republic of the Congo and the Democratic Republic of the Congo, which have reported outbreaks of infection with EBOV. In addition we detected a seroprevalence of 1.3% in southern Cameroon, which indicated a low risk for exposure in this region.
- Published
- 2019
- Full Text
- View/download PDF
18. Humoral responses to SARS-CoV-2 mRNA vaccines: Role of past infection
- Author
-
Ashley N. Gray, Rachel Martin-Blais, Nicole H. Tobin, Yan Wang, Sarah L. Brooker, Fan Li, Adva Gadoth, Julie Elliott, Emmanuelle Faure-Kumar, Megan Halbrook, Christian Hofmann, Saman Kashani, Clayton Kazan, Otto O. Yang, Jennifer A. Fulcher, Kathie Grovit-Ferbas, Anne W. Rimoin, and Grace M. Aldrovandi
- Subjects
Medicine ,Science - Abstract
Two mRNA vaccines (BNT162b2 and mRNA-1273) against severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) are globally authorized as a two-dose regimen. Understanding the magnitude and duration of protective immune responses is vital to curbing the pandemic. We enrolled 461 high-risk health services workers at the University of California, Los Angeles (UCLA) and first responders in the Los Angeles County Fire Department (LACoFD) to assess the humoral responses in previously infected (PI) and infection naïve (NPI) individuals to mRNA-based vaccines (BNT162b2/Pfizer- BioNTech or mRNA-1273/Moderna). A chemiluminescent microparticle immunoassay was used to detect antibodies against SARS-CoV-2 Spike in vaccinees prior to (n = 21) and following each vaccine dose (n = 246 following dose 1 and n = 315 following dose 2), and at days 31–60 (n = 110) and 61–90 (n = 190) following completion of the 2-dose series. Both vaccines induced robust antibody responses in all immunocompetent individuals. Previously infected individuals achieved higher median peak titers (p = 0.002) and had a slower rate of decay (p = 0.047) than infection-naïve individuals. mRNA-1273 vaccinated infection-naïve individuals demonstrated modestly higher titers following each dose (p = 0.005 and p = 0.029, respectively) and slower rates of antibody decay (p = 0.003) than those who received BNT162b2. A subset of previously infected individuals (25%) required both doses in order to reach peak antibody titers. The biologic significance of the differences between previously infected individuals and between the mRNA-1273 and BNT162b2 vaccines remains uncertain, but may have important implications for booster strategies.
- Published
- 2021
19. Race, COVID-19 and deaths of despair
- Author
-
Patrick J. Arena, Monica Malta, Anne W. Rimoin, and Steffanie A. Strathdee
- Subjects
Medicine (General) ,R5-920 - Published
- 2020
- Full Text
- View/download PDF
20. The coronavirus 2019-nCoV epidemic: Is hindsight 20/20?
- Author
-
Monica Malta, Anne W. Rimoin, and Steffanie A. Strathdee
- Subjects
Medicine (General) ,R5-920 - Published
- 2020
- Full Text
- View/download PDF
21. Real-time predictions of the 2018–2019 Ebola virus disease outbreak in the Democratic Republic of the Congo using Hawkes point process models
- Author
-
J. Daniel Kelly, Junhyung Park, Ryan J. Harrigan, Nicole A. Hoff, Sarita D. Lee, Rae Wannier, Bernice Selo, Mathias Mossoko, Bathe Njoloko, Emile Okitolonda-Wemakoy, Placide Mbala-Kingebeni, George W. Rutherford, Thomas B. Smith, Steve Ahuka-Mundeke, Jean Jacques Muyembe-Tamfum, Anne W. Rimoin, and Frederic Paik Schoenberg
- Subjects
Infectious and parasitic diseases ,RC109-216 - Abstract
As of June 16, 2019, an Ebola virus disease (EVD) outbreak has led to 2136 reported cases in the northeastern region of the Democratic Republic of the Congo (DRC). As this outbreak continues to threaten the lives and livelihoods of people already suffering from civil strife and armed conflict, relatively simple mathematical models and their short-term predictions have the potential to inform Ebola response efforts in real time. We applied recently developed non-parametrically estimated Hawkes point processes to model the expected cumulative case count using daily case counts from May 3, 2018, to June 16, 2019, initially reported by the Ministry of Health of DRC and later confirmed in World Health Organization situation reports. We generated probabilistic estimates of the ongoing EVD outbreak in DRC extending both before and after June 16, 2019, and evaluated their accuracy by comparing forecasted vs. actual outbreak sizes, out-of-sample log-likelihood scores and the error per day in the median forecast. The median estimated outbreak sizes for the prospective thee-, six-, and nine-week projections made using data up to June 16, 2019, were, respectively, 2317 (95% PI: 2222, 2464); 2440 (95% PI: 2250, 2790); and 2544 (95% PI: 2273, 3205). The nine-week projection experienced some degradation with a daily error in the median forecast of 6.73 cases, while the six- and three-week projections were more reliable, with corresponding errors of 4.96 and 4.85 cases per day, respectively. Our findings suggest the Hawkes point process may serve as an easily-applied statistical model to predict EVD outbreak trajectories in near real-time to better inform decision-making and resource allocation during Ebola response efforts. Keywords: Ebola virus disease, Hawkes point process, Mathematical modeling, Democratic Republic of Congo, Compartmental models
- Published
- 2019
- Full Text
- View/download PDF
22. Estimating the impact of violent events on transmission in Ebola virus disease outbreak, Democratic Republic of the Congo, 2018–2019
- Author
-
S. Rae Wannier, Lee Worden, Nicole A. Hoff, Eduardo Amezcua, Bernice Selo, Cyrus Sinai, Mathias Mossoko, Bathe Njoloko, Emile Okitolonda-Wemakoy, Placide Mbala-Kingebeni, Steve Ahuka-Mundeke, Jean Jacques Muyembe-Tamfum, Eugene T. Richardson, George W. Rutherford, James H Jones, Thomas M. Lietman, Anne W. Rimoin, Travis C. Porco, and J. Daniel Kelly
- Subjects
Infectious and parasitic diseases ,RC109-216 - Abstract
Introduction: As of April 2019, the current Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) is occurring in a longstanding conflict zone and has become the second largest EVD outbreak in history. It is suspected that after violent events occur, EVD transmission will increase; however, empirical studies to understand the impact of violence on transmission are lacking. Here, we use spatial and temporal trends of EVD case counts to compare transmission rates between health zones that have versus have not experienced recent violent events during the outbreak. Methods: We collected daily EVD case counts from DRC Ministry of Health. A time-varying indicator of recent violence in each health zone was derived from events documented in the WHO situation reports. We used the Wallinga-Teunis technique to estimate the reproduction number R for each case by day per zone in the 2018–2019 outbreak. We fit an exponentially decaying curve to estimates of R overall and by health zone, for comparison to past outbreaks. Results: As of 16 April 2019, the mean overall R for the entire outbreak was 1.11. We found evidence of an increase in the estimated transmission rates in health zones with recently reported violent events versus those without (p = 0.008). The average R was estimated as between 0.61 and 0.86 in regions not affected by recent violent events, and between 1.01 and 1.07 in zones affected by violent events within the last 21 days, leading to an increase in R between 0.17 and 0.53. Within zones with recent violent events, the mean estimated quenching rate was lower than for all past outbreaks except the 2013–2016 West African outbreak. Conclusion: The difference in the estimated transmission rates between zones affected by recent violent events suggests that violent events are contributing to increased transmission and the ongoing nature of this outbreak. Keywords: Ebola virus disease, Outbreak, Mathematical modeling, Geospatial, Democratic Republic of Congo, Africa
- Published
- 2019
- Full Text
- View/download PDF
23. Field Test and Validation of the Multiplier Measles, Mumps, Rubella, and Varicella-Zoster Multiplexed Assay System in the Democratic Republic of the Congo by Using Dried Blood Spots
- Author
-
Stephen G. Higgins, Nicole A. Hoff, Adva Gadoth, Andrew Fusellier, Patrick Mukadi, Vivian Alfonso, Christina Randall, Hayley Ashbaugh, Melanie Poncheri, Reena H. Doshi, Sue Gerber, Roger Budd, Robert Wolfert, Russell Williams, Emile Okitolonda-Wemakoy, Jean-Jacque Muyembe-Tamfum, and Anne W. Rimoin
- Subjects
Democratic Republic of the Congo ,MMRV ,assay validation ,multiplex assay ,Microbiology ,QR1-502 - Abstract
ABSTRACT Here we describe baseline validation studies and field performance of a research-use-only chemiluminescent multiplex serology panel for measles, mumps, rubella, and varicella-zoster virus used with dried blood spots in support of the 2013–2014 Democratic Republic of the Congo Demographic and Health Survey. Characterization of the panel using U.S. FDA-cleared commercial kits shows good concordance for measles, mumps, rubella, and varicella-zoster with average sensitivity across assays of 94.9% and an average specificity of 91.4%. As expected, performance versus available standards validated for plaque-reduction assays does not provide a 1:1 correspondence with international units and yet demonstrates excellent linearity (average Hill’s slope = 1.02) and ∼4 logs of dynamic range. In addition, for the four assays, the multiplexed format allowed for inclusion of three positive and two negative controls for each sample. A prototype Dynex Multiplier chemiluminescent automated immunoassay instrument with a charge-coupled device camera provided a rugged and robust processing and data acquisition platform. Performance of a multiplex instrument for serological testing in a substantially resource-limited environment shows excellent reproducibility, minimal cross-reactivity, and a clear discrimination between specific assays and should be considered a viable option for future serosurveys. IMPORTANCE The critical evaluation of immunization programs is key to identifying areas of suboptimal vaccination coverage, monitoring activities, and aiding development of public health policy. For evaluation of vaccine effectiveness, direct antibody binding assay methods, including enzyme immunoassay, enzyme-linked fluorescence assays, and indirect immunofluorescence assay, are most commonly used for detection of IgG antibodies. However, despite their well-demonstrated, reliable performance, they can be labor-intensive and time-consuming and require separate assays for each individual marker. This necessitates increased sample volumes, processing time, and personnel, which may limit assessment to a few key targets in resource-limited settings, that is, low- and middle-income locations where funding for public health or general infrastructure that directly impacts public health is restricted, limiting access to equipment, infrastructure, and trained personnel. One solution is a multiplexed immunoassay, which allows for the detection of multiple analytes in a single reaction for increased efficiency and rapid surveillance of infectious diseases in limited-resource settings. Thus, the scope of the project precluded a full validation, and here we present abbreviated validation studies demonstrating adequate sensitivity, specificity, and reproducibility.
- Published
- 2019
- Full Text
- View/download PDF
24. Genomic Variability of Monkeypox Virus among Humans, Democratic Republic of the Congo
- Author
-
Jeffrey R. Kugelman, Sara C. Johnston, Prime M. Mulembakani, Neville Kisalu, Michael S. Lee, Galina Koroleva, Sarah E. McCarthy, Marie C. Gestole, Nathan D. Wolfe, Joseph N. Fair, Bradley S. Schneider, Linda L. Wright, John Huggins, Chris A. Whitehouse, Emile Okitolonda Wemakoy, Jean Jacques Muyembe-Tamfum, Lisa E. Hensley, Gustavo F. Palacios, and Anne W. Rimoin
- Subjects
Monkeypox virus ,genomic diversity ,emerging infectious disease ,genomic reduction ,gene loss ,Democratic Republic of the Congo ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
Monkeypox virus is a zoonotic virus endemic to Central Africa. Although active disease surveillance has assessed monkeypox disease prevalence and geographic range, information about virus diversity is lacking. We therefore assessed genome diversity of viruses in 60 samples obtained from humans with primary and secondary cases of infection from 2005 through 2007. We detected 4 distinct lineages and a deletion that resulted in gene loss in 10 (16.7%) samples and that seemed to correlate with human-to-human transmission (p = 0.0544). The data suggest a high frequency of spillover events from the pool of viruses in nonhuman animals, active selection through genomic destabilization and gene loss, and increased disease transmissibility and severity. The potential for accelerated adaptation to humans should be monitored through improved surveillance. Download MP3 Length: 1:11
- Published
- 2014
- Full Text
- View/download PDF
25. Exposure to Wild Primates among HIV-infected Persons
- Author
-
Matthew LeBreton, Otto Yang, Ubald Tamoufe, Eitel Mpoudi-Ngole, Judith N. Torimiro, Cyrille F. Djoko, Jean K. Carr, A. Tassy Prosser, Anne W. Rimoin, Deborah L. Birx, Donald S. Burke, and Nathan D. Wolfe
- Subjects
Africa ,Central ,acquired immunodeficiency syndrome ,HIV-1 ,immunocompromised host ,zoonoses ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
HIV-1 is an immunosuppressive pathogen. Our behavioral data for 191 HIV-1–infected rural Cameroonians show frequent exposure to nonhuman primates through activities such as hunting and butchering. Immunosuppression among persons exposed to body fluids of wild nonhuman primates could favor the process of adaptation and subsequent emergence of zoonotic pathogens.
- Published
- 2007
- Full Text
- View/download PDF
26. Epidemiology of Human Parvovirus 4 Infection in Sub-Saharan Africa
- Author
-
Colin P. Sharp, Marion Vermeulen, Yacouba K. Nébié, Cyrille F. Djoko, Matthew LeBreton, Ubald Tamoufe, Anne W. Rimoin, Patrick K. Kayembe, Jean K. Carr, Annabelle Servant-Delmas, Syria Laperche, G.L. Abby Harrison, Oliver G. Pybus, Eric Delwart, Nathan D. Wolfe, Andrew Saville, Jean-Jacques Lefrère, and Peter Simmonds
- Subjects
Viruses ,human parvovirus ,PARV4 ,parenteral transmission ,HIV/AIDS and other retroviruses ,hepatitis C virus ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
Human parvovirus 4 infections are primarily associated with parenteral exposure in western countries. By ELISA, we demonstrate frequent seropositivity for antibody to parvovirus 4 viral protein 2 among adult populations throughout sub-Saharan Africa (Burkina Faso, 37%; Cameroon, 25%; Democratic Republic of the Congo, 35%; South Africa, 20%), which implies existence of alternative transmission routes.
- Published
- 2010
- Full Text
- View/download PDF
27. Endemic Human Monkeypox, Democratic Republic of Congo, 2001–2004
- Author
-
Anne W. Rimoin, Neville Kisalu, Benoit Kebela-Ilunga, Thibaut Mukaba, Linda L. Wright, Pierre Formenty, Nathan D. Wolfe, Robert Loshima Shongo, Florimond Tshioko, Emile Okitolonda, Jean-Jacques Muyembe, Robert W. Ryder, and Hermann Meyer
- Subjects
Human monkeypox ,monkeypox virus ,chickenpox ,varicella-zoster virus ,VZV ,Democratic Republic of Congo ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
By analyzing vesicle fluids and crusted scabs from 136 persons with suspected monkeypox, we identified 51 cases of monkeypox by PCR, sequenced the hemagglutinin gene, and confirmed 94% of cases by virus culture. PCR demonstrated chickenpox in 61 patients. Coinfection with both viruses was found in 1 additional patient.
- Published
- 2007
- Full Text
- View/download PDF
28. 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.
- Author
-
Anna Bratcher, Nicole A Hoff, Reena H Doshi, Adva Gadoth, Megan Halbrook, Patrick Mukadi, Kamy Musene, Benoit Ilunga-Kebela, D'Andre Spencer, Matthew S Bramble, David McIlwan, 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
BackgroundEbola virus (EBOV) is a zoonotic filovirus spread through exposure to infected bodily fluids of a human or animal. Though EBOV is capable of causing severe disease, referred to as Ebola Virus Disease (EVD), individuals who have never been diagnosed with confirmed, probable or suspected EVD can have detectable EBOV antigen-specific antibodies in their blood. This study aims to identify risk factors associated with detectable antibody levels in the absence of an EVD diagnosis.MethodologyData was collected from September 2015 to August 2017 from 1,366 consenting individuals across four study sites in the DRC (Boende, Kabondo-Dianda, Kikwit, and Yambuku). Seroreactivity was determined to EBOV GP IgG using Zaire Ebola Virus Glycoprotein (EBOV GP antigen) ELISA kits (Alpha Diagnostic International, Inc.) in Kinshasa, DRC; any result above 4.7 units/mL was considered seroreactive. Among the respondents, 113 (8.3%) were considered seroreactive. Several zoonotic exposures were associated with EBOV seroreactivity after controlling for age, sex, healthcare worker status, location, and history of contact with an EVD case, namely: ever having contact with bats, ever having contact with rodents, and ever eating non-human primate meat. Contact with monkeys or non-human primates was not associated with seroreactivity.ConclusionsThis analysis suggests that some zoonotic exposures that have been linked to EVD outbreaks can also be associated with EBOV GP seroreactivity in the absence of diagnosed EVD. Future investigations should seek to clarify the relationships between zoonotic exposures, seroreactivity, asymptomatic infection, and EVD.
- Published
- 2021
- Full Text
- View/download PDF
29. 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
- Author
-
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
- Subjects
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.
- Published
- 2022
30. 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
- Author
-
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
- Subjects
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.
- Published
- 2022
31. A Successful National and Multipartner Approach to Increase Immunization Coverage: The Democratic Republic of Congo Mashako Plan 2018-2020
- Author
-
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
- Subjects
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.
- Published
- 2023
32. Assessing the feasibility of passive surveillance for maternal immunization safety utilizing archival medical records in Kinshasa, Democratic Republic of the Congo
- Author
-
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
- Subjects
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.
- Published
- 2022
33. 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
- Author
-
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
- Subjects
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.].
- Published
- 2023
34. Increasing Ebola transmission behaviors 6 months post-vaccination: Comparing vaccinated and unvaccinated populations near 2018 Mbandaka Ebola outbreak in the Democratic Republic of Congo
- Author
-
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
- Subjects
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.
- Published
- 2021
35. Risk Factors for Ebola Exposure in Health Care Workers in Boende, Tshuapa Province, Democratic Republic of the Congo
- Author
-
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
- Subjects
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.
- Published
- 2022
36. 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
- Author
-
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
- Subjects
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.
- Published
- 2022
37. Recommendations for Demonstrators, Law Enforcement Agencies, and Public Health Agencies for Reducing SARS-CoV-2 Transmission During Civil Protests
- Author
-
Catherine M. Waters, Kirsten Bibbins-Domingo, Thelma Hurd, Dorothy J. Wiley, Anne W. Rimoin, David Eisenman, George W. Rutherford, Brad H. Pollock, Carol Dawson-Rose, and Harvey Checkoway
- Subjects
medicine.medical_specialty ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Policy and Administration ,Civil Disorders ,Nursing ,Public administration ,disasters ,law.invention ,Law Enforcement ,Disease Transmission ,law ,Disease Transmission, Infectious ,medicine ,Humans ,Peace ,SARS-CoV-2 ,business.industry ,Public health ,Infectious ,Public Health, Environmental and Occupational Health ,Law enforcement ,COVID-19 ,Justice and Strong Institutions ,Transmission (mechanics) ,Communicable Disease Control ,Public Health and Health Services ,Commentary ,Public Health ,business - Published
- 2021
38. Pan-ebolavirus serology study of healthcare workers in the Mbandaka Health Region, Democratic Republic of the Congo
- Author
-
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
- Subjects
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.
- Published
- 2022
39. Immunogenicity of rVSVΔG-ZEBOV-GP Ebola vaccination in exposed and potentially exposed persons in the Democratic Republic of the Congo
- Author
-
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
- Subjects
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.
- Published
- 2022
40. Responding to the Challenge of the Dual COVID-19 and Ebola Epidemics in the Democratic Republic of Congo—Priorities for Achieving Control
- Author
-
Wolfgang Preiser, John O Otshudiema, Jean Jacques Muyembe Tamfum, Joel G. Breman, Justus Nsio, Oscar Kallay, Jean B. Nachega, Anne W. Rimoin, Susan Michaels-Strasser, Alimuddin Zumla, Steve Ahuka-Mundeke, Linda M. Mobula, and Placide Mbala-Kingebeni
- Subjects
Economic growth ,medicine.medical_specialty ,030231 tropical medicine ,Population ,Pneumonia, Viral ,medicine.disease_cause ,Perspective Piece ,03 medical and health sciences ,Betacoronavirus ,0302 clinical medicine ,Virology ,Political science ,Epidemiology ,medicine ,Humans ,education ,Health communication ,Pandemics ,education.field_of_study ,Ebola virus ,Community engagement ,SARS-CoV-2 ,Public health ,Outbreak ,COVID-19 ,Hemorrhagic Fever, Ebola ,Infectious Diseases ,Health Communication ,Democratic Republic of the Congo ,Parasitology ,Contact Tracing ,Coronavirus Infections ,Case Management ,Delivery of Health Care ,Contact tracing - Abstract
As of June 11, 2020, the Democratic Republic of the Congo (DRC) has reported 4,258 COVID-19 cases with 90 deaths. With other African countries, the DRC faces the challenge of striking a balance between easing public health lockdown measures to curtail the spread of SARS-CoV-2 and minimizing both economic hardships for large sectors of the population and negative impacts on health services for other infectious and noninfectious diseases. The DRC recently controlled its tenth Ebola virus disease (EVD) outbreak, but COVID-19 and a new EVD outbreak beginning on June 1, 2020 in the northwest Équateur Province have added an additional burden to health services. Although the epidemiology and transmission of EVD and COVID-19 differ, leveraging the public health infrastructures and experiences from coordinating the EVD response to guide the public health response to COVID-19 is critical. Building on the DRC’s 40 years of experience with 10 previous EVD outbreaks, we highlight the DRC’s multi-sectoral public health approach to COVID-19, which includes community-based screening, testing, contact-tracing, risk communication, community engagement, and case management. We also highlight remaining challenges and discuss the way forward for achieving control of both COVID-19 and EVD in the DRC.
- Published
- 2020
41. Prenatal chlamydial, gonococcal, and trichomonal screening in the Democratic Republic of Congo for case detection and management
- Author
-
Jeffrey D. Klausner, Nicole A. Hoff, Risa M Hoffman, Emile Okitolonda-Wemakoy, Kamy Musene, Gisèle Mvumbi, Anne W. Rimoin, Chelsea Shannon, and Adva Gadoth
- Subjects
Infectious Disease Transmission ,Chlamydia trachomatis ,Reproductive health and childbirth ,Azithromycin ,medicine.disease_cause ,Tinidazole ,Gonorrhea ,0302 clinical medicine ,Pregnancy ,Vertical ,Mass Screening ,Pharmacology (medical) ,030212 general & internal medicine ,Chlamydia ,Pregnancy Complications, Infectious ,Pediatric ,screening and diagnosis ,0303 health sciences ,Obstetrics ,Infectious ,Diagnostic test ,Prenatal Care ,Health Services ,Anti-Bacterial Agents ,Detection ,Treatment Outcome ,Infectious Diseases ,Medical Microbiology ,Public Health and Health Services ,Democratic Republic of the Congo ,Female ,Public Health ,Infection ,Trichomonas Vaginitis ,4.2 Evaluation of markers and technologies ,Urologic Diseases ,Adult ,medicine.medical_specialty ,Clinical Sciences ,Dermatology ,Article ,Vaccine Related ,03 medical and health sciences ,Clinical Research ,Biodefense ,Metronidazole ,Trichomonas vaginalis ,medicine ,Humans ,Conditions Affecting the Embryonic and Fetal Periods ,Case detection ,030306 microbiology ,business.industry ,screening ,Prevention ,Public Health, Environmental and Occupational Health ,Perinatal Period - Conditions Originating in Perinatal Period ,Chlamydia Infections ,Patient Acceptance of Health Care ,Infectious Disease Transmission, Vertical ,Neisseria gonorrhoeae ,Pregnancy Complications ,Good Health and Well Being ,Cross-Sectional Studies ,Africa ,Sexually Transmitted Infections ,Feasibility Studies ,trichomoniasis ,business - Abstract
Prenatal Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) infections are associated with adverse birth outcomes. As rapid diagnostic tests become available, it is important to evaluate prenatal sexually transmitted infection (STI) prevalence, as well as the acceptability and feasibility of prenatal screening programs. We recruited 371 pregnant women from four clinics in Kisantu Health Zone, Democratic Republic of Congo (DRC) from October 2016 to March 2017. Trained clinicians collected cervical swabs, and samples were tested by nucleic acid amplification for CT, NG, and TV using a GeneXpert® system. Those testing positive for an STI were treated and asked to return after 4–8 weeks for tests-of-cure. Screening for STIs was widely accepted (99%). STI prevalence at baseline was CT, 3.2%; NG, 1.5%; and TV, 14%; treatment completion was 97%. Symptoms were reported among 34% of STI-positive women at baseline, compared with 37% of STI-negative women. Upon first test-of-cure, 100% of returning women were cured of CT ( n = 10) and NG ( n = 5), but only 47% were cured of TV. This study demonstrates the feasibility of implementing diagnostic STI testing for case detection and treatment among expectant mothers in DRC, with implications for maternal and birth outcomes.
- Published
- 2020
42. Seroreactivity against Marburg or related filoviruses in West and Central Africa
- Author
-
Prime Mulembakani, Emile Okitolonda Wemakoy, Anne W. Rimoin, Jean-Jacques Muyembe-Tamfum, Sentob Saragosti, Nicole A. Hoff, Syria Laperche, Nicaise Ndembi, Kai Lu, John Hackett, Guy Olivier Mbensa, Graham Simmons, William M. Switzer, Catherine A. Brennan, and Imke Steffen
- Subjects
0301 basic medicine ,Letter ,Epidemiology ,serology ,Antibodies, Viral ,Ghana ,Serology ,Seroepidemiologic Studies ,Drug Discovery ,Medicine ,Marburg Virus Disease ,Viral ,Cameroon ,biology ,hemorrhagic fever virus ,General Medicine ,Hemorrhagic fever virus ,3. Good health ,Infectious Diseases ,Filoviruses ,Antibody ,Infection ,Biotechnology ,prevalence ,030106 microbiology ,Immunology ,Enzyme-Linked Immunosorbent Assay ,Microbiology ,Antibodies ,Vaccine Related ,Marburg virus ,03 medical and health sciences ,Biodefense ,Virology ,Filoviridae Infections ,Animals ,Humans ,Seroprevalence ,Retrospective Studies ,business.industry ,Prevention ,Central africa ,Filoviridae ,Serum samples ,Marburgvirus ,biology.organism_classification ,Good Health and Well Being ,030104 developmental biology ,biology.protein ,Parasitology ,business - Abstract
A serological survey of 2,430 archived serum samples collected between 1997 and 2012 was conducted to retrospectively determine the prevalence of Marburg virus in five African countries. Serum samples were screened for neutralizing antibodies in a pseudotype micro-neutralization assay and confirmed by enzyme-linked immunosorbent assay (ELISA). Surprisingly, a seroprevalence for Marburg virus of 7.5 and 6.3% was found in Cameroon and Ghana, respectively, suggesting the circulation of filoviruses or related viruses outside of known endemic areas that remain undetected by current surveillance efforts. However, due to the lack of validated assays and appropriate positive controls, these results must be considered preliminary.
- Published
- 2020
43. Measles antibody levels among vaccinated and unvaccinated children 6–59 months of age in the Democratic Republic of the Congo, 2013–2014
- Author
-
Jean Jacques Muyembe-Tamfum, Adva Gadoth, Sue Gerber, Roger Budd, Hayley R. Ashbaugh, Guillaume Ngoie Mwamba, Vivian H. Alfonso, Emile Okitolonda-Wemakoy, Nicole A. Hoff, Reena H. Doshi, Patrick Mukadi, James D. Cherry, Christina Randall, Anne W. Rimoin, and Stephen G. Higgins
- Subjects
Male ,Vaccination Coverage ,030231 tropical medicine ,Measles Vaccine ,Logistic regression ,Antibodies, Viral ,Measles ,Article ,Herd immunity ,03 medical and health sciences ,0302 clinical medicine ,Immunity ,Seroepidemiologic Studies ,Medicine ,Humans ,030212 general & internal medicine ,General Veterinary ,General Immunology and Microbiology ,Transmission (medicine) ,business.industry ,Immunization Programs ,Public Health, Environmental and Occupational Health ,Infant ,medicine.disease ,Vaccination ,Infectious Diseases ,Immunization ,Child, Preschool ,Immunoglobulin G ,Democratic Republic of the Congo ,Molecular Medicine ,Female ,Serostatus ,business ,Demography - Abstract
Background Measles is endemic in the Democratic Republic of the Congo (DRC), and 89–94% herd immunity is required to halt its transmission. Much of the World Health Organization African Region, including the DRC, has vaccination coverage below the 95% level required to eliminate measles, heightening concern of inadequate measles immunity. Methods We assessed 6706 children aged 6–59 months whose mothers were selected for interview in the 2013–2014 DRC Demographic and Health Survey. History of measles was obtained by maternal report, and classification of children who had measles was completed using maternal recall and measles immunoglobulin G serostatus obtained from a multiplex chemiluminescent automated immunoassay dried blood spot analysis. A logistic regression model was used to identify associations of covariates with measles and seroprotection, and vaccine effectiveness (VE) was calculated. Results Out of our sample, 64% of children were seroprotected. Measles vaccination was associated with protection against measles (OR: 0.15, 95% CI: 0.03, 0.81) when administered to children 12 months of age or older. Vaccination was predictive of seroprotection at all ages. VE was highest (88%) among children 12–24 months of age. Conclusion Our results demonstrated lower than expected seroprotection against measles among vaccinated children. Understanding the factors that affect host immunity to measles will aid in developing more efficient and effective immunization programs in DRC.
- Published
- 2020
44. Urogenital Schistosomiasis and Sexually Transmitted Coinfections among Pregnant Women in a Schistosome-Endemic Region of the Democratic Republic of Congo
- Author
-
Pamina M. Gorbach, Patrick Mukadi, Marjan Javanbakht, Emile Okitolonda-Wemakoy, Anne W. Rimoin, Hayley R. Ashbaugh, Kamy Musene, Reena H. Doshi, Jeffrey D. Klausner, Adva Gadoth, Gisèle Mvumbi, and Nicole A. Hoff
- Subjects
Endemic Diseases ,Cross-sectional study ,Reproductive health and childbirth ,medicine.disease_cause ,Medical and Health Sciences ,Schistosomiasis haematobia ,0302 clinical medicine ,Pregnancy ,2.2 Factors relating to the physical environment ,Pregnancy Complications, Infectious ,Aetiology ,Reproductive health ,Pediatric ,Schistosoma haematobium ,biology ,Coinfection ,Transmission (medicine) ,Obstetrics ,Infectious ,Articles ,Infectious Diseases ,Democratic Republic of the Congo ,Female ,Infection ,Adult ,Urologic Diseases ,medicine.medical_specialty ,030231 tropical medicine ,Sexually Transmitted Diseases ,Schistosomiasis ,Prenatal care ,Vaccine Related ,03 medical and health sciences ,Rare Diseases ,Clinical Research ,Tropical Medicine ,Virology ,medicine ,Humans ,Conditions Affecting the Embryonic and Fetal Periods ,business.industry ,Prevention ,Perinatal Period - Conditions Originating in Perinatal Period ,biology.organism_classification ,medicine.disease ,Female Urogenital Diseases ,Pregnancy Complications ,Vector-Borne Diseases ,Cross-Sectional Studies ,Good Health and Well Being ,Sexually Transmitted Infections ,Parasitology ,Trichomonas vaginalis ,Digestive Diseases ,business ,Chlamydia trachomatis - Abstract
Schistosomiasis afflicts an estimated 10 million pregnant women in Africa annually. With mounting evidence of adverse impacts to reproductive health resulting from urogenital schistosomiasis, including increased transmission of HIV, further research on prenatal disease epidemiology is warranted, with implications for maternal and fetal health. Between October 2016 and March 2017, we conducted a cross-sectional study examining the prevalence of urogenital schistosomiasis and its association with sexually transmitted infections (STIs) other than HIV among pregnant women visiting antenatal clinics in Kisantu health zone, Democratic Republic of Congo. An extensive sociodemographic and clinical survey was administered to consenting participants, with urine samples and vaginal swabs collected to deduce active schistosomiasis and STIs, respectively. In total, 17.4% of expectant mothers were infected with Schistosoma haematobium, 3.1% with Chlamydia trachomatis (CT), 1.4% with Neisseria gonorrhoeae (NG), and 14.6% with Trichomonas vaginalis (TV). Women infected with urogenital schistosomiasis were at significantly increased odds of harboring a CT, NG, or TV infection (adjusted odds ratio = 3.0, 95% CI: 1.5, 6.0), but reports of clinical symptoms were low, ranging from 17.2% of schistosomiasis to 30.8% of TV cases. Laboratory confirmation of schistosomiasis and STIs provided objective evidence of disease in a cohort with low symptomology where syndromic management may not suffice. Shedding light on local risk factors and associated coinfections of urogenital schistosomiasis can identify unique intervention opportunities for prenatal care in trematode-endemic regions and aid in reducing adverse pregnancy outcomes.
- Published
- 2019
45. Dominant CD8
- Author
-
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
- Published
- 2021
46. Monkeypox and Global Health Inequities: A Tale as Old as Time…
- Author
-
Monica Malta, Placide Mbala-Kingebeni, Anne W. Rimoin, and Steffanie A. Strathdee
- Subjects
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 [...]
- Published
- 2022
47. Wildlife in Cameroon harbor diverse coronaviruses including many isolates closely related to human coronavirus 229E
- Author
-
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
- Subjects
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.
- Published
- 2021
48. Tetanus seroprotection among children in the Democratic Republic of the Congo, 2013-2014
- Author
-
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, Anne W. Rimoin, and Borrow, Ray
- Subjects
Pediatric ,and promotion of well-being ,Multidisciplinary ,Tetanus ,General Science & Technology ,Prevention ,Vaccination ,Infant ,Prevention of disease and conditions ,Vaccine Related ,Emerging Infectious Diseases ,Infectious Diseases ,Good Health and Well Being ,3.4 Vaccines ,Seroepidemiologic Studies ,Democratic Republic of the Congo ,Tetanus Toxoid ,Humans ,Immunization ,Child ,Measles - Abstract
Background Tetanus 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. Methods In 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. Results Overall, 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. Conclusions Our 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
- 2021
49. Wildlife in Cameroon harbor diverse coronaviruses, including many closely related to human coronavirus 229E
- Author
-
Nkom F Ntumvi, Valantine Ngum Ndze, Amethyst Gillis, Joseph Le Doux Diffo, Ubald Tamoufe, Jean-Michel Takuo, Moctar M M Mouiche, Julius Nwobegahay, Matthew LeBreton, Anne W Rimoin, Bradley S Schneider, Corina Monagin, David J McIver, Sanjit Roy, James A Ayukekbong, Karen E Saylors, Damien O Joly, Nathan D Wolfe, Edward M Rubin, and Christian E Lange
- Subjects
viruses ,Virology ,virus diseases ,Microbiology - Abstract
Zoonotic spillover of animal viruses into human populations is a continuous and increasing public health risk. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) highlights the global impact of emergence. 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 envelope, membrane, and RNA-dependent RNA polymerase genes. The CoV RNA positivity rate in bats varied significantly (P
- Published
- 2021
50. Primary, Recall, and Decay Kinetics of SARS-CoV-2 Vaccine Antibody Responses
- Author
-
Mary Ann Hausner, Otto O. Yang, William Mu, Jonathan Fulcher, Ellie Taus, Scott G. Kitchen, David Goodman-Meza, F. Javier Ibarrondo, Paul Krogstad, Julie Elliott, Ayub Ali, Arumugam Balamurugan, Grace M. Aldrovandi, Kathie G Ferbas, Nicole H. Tobin, Anne W. Rimoin, and Christian Hofmann
- Subjects
and promotion of well-being ,General Physics and Astronomy ,02 engineering and technology ,Antibodies, Viral ,01 natural sciences ,Neutralization ,humoral immunity ,Medicine ,General Materials Science ,Viral ,Neutralizing ,anti-RBD antibodies ,Lung ,biology ,Vaccination ,General Engineering ,021001 nanoscience & nanotechnology ,Infectious Diseases ,3.4 Vaccines ,Pneumonia & Influenza ,Antibody ,0210 nano-technology ,Infection ,Biotechnology ,vaccine response durability ,COVID-19 Vaccines ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,010402 general chemistry ,Antibodies ,Vaccine Related ,Biodefense ,Humans ,Potency ,Nanoscience & Nanotechnology ,business.industry ,SARS-CoV-2 ,Prevention ,COVID-19 ,Viral Vaccines ,Pneumonia ,Prevention of disease and conditions ,Antibodies, Neutralizing ,0104 chemical sciences ,mRNA nanoparticle vaccine ,Good Health and Well Being ,Antibody response ,Emerging Infectious Diseases ,Antibody Formation ,Immunology ,Humoral immunity ,biology.protein ,Immunization ,business - Abstract
Studies of two SARS-CoV-2 mRNA vaccines suggested that they yield ∼95% protection from symptomatic infection at least short-term, but important clinical questions remain. It is unclear how vaccine-induced antibody levels quantitatively compare to the wide spectrum induced by natural SARS-CoV-2 infection. Vaccine response kinetics and magnitudes in persons with prior COVID-19 compared to virus-naı̈ve persons are not well-defined. The relative stability of vaccine-induced versus infection-induced antibody levels is unclear. We addressed these issues with longitudinal assessments of vaccinees with and without prior SARS-CoV-2 infection using quantitative enzyme-linked immunosorbent assay (ELISA) of anti-RBD antibodies. SARS-CoV-2-naı̈ve individuals achieved levels similar to mild natural infection after the first vaccination; a second dose generated levels approaching severe natural infection. In persons with prior COVID-19, one dose boosted levels to the high end of severe natural infection even in those who never had robust responses from infection, increasing no further after the second dose. Antiviral neutralizing assessments using a spike-pseudovirus assay revealed that virus-naı̈ve vaccinees did not develop physiologic neutralizing potency until the second dose, while previously infected persons exhibited maximal neutralization after one dose. Finally, antibodies from vaccination waned similarly to natural infection, resulting in an average of ∼90% loss within 90 days. In summary, our findings suggest that two doses are important for quantity and quality of humoral immunity in SARS-CoV-2-naı̈ve persons, while a single dose has maximal effects in those with past infection. Antibodies from vaccination wane with kinetics very similar to that seen after mild natural infection; booster vaccinations will likely be required.
- Published
- 2021
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.