How often did co-infections of SARS-CoV-2 and malaria occur in the first wave of the pandemic?

In a recent study posted on medrex sib*Preprint Server, Researchers Find Out Prevalence of Circulating Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Variants and Concurrent Coronavirus Disease 2019 (COVID-19) and Malaria in Burkina Faso, West Africa Determined the frequency of occurrence.

Background

SARS-CoV-2 infections in Africa have been reported to have a lower incidence, mostly asymptomatic, and lower associated mortality compared to developed countries. A high proportion of young people, socio-ecological variability (low population, warm climate, trained immune response to infectious diseases), and rapid enforcement of health measures such as lockdowns by governments contribute to the incidence may explain the decline in

Research shows that the COVID-19 pandemic has had a greater impact on some countries (such as Tunisia, Morocco and South Africa), demonstrating endemic spread of SARS-CoV-2. However, the findings may be due to low and disproportionate levels of diagnostic testing and monitoring measures.

Additionally, malaria is endemic in Africa, where cases increased during the first wave of COVID-19. This may be due to the disruption of malaria campaigns and diagnostic and testing capacity during the first pandemic wave.

About research

In the current population-based study, researchers evaluated the frequency of co-infections of COVID-19 and malaria in the West African country of Burkina Faso.

The study was conducted between 22 August and 19 November 2020 with 998 asymptomatic volunteers living in different rural or urban areas of 11 villages in southern Burkina Faso. Blood samples were taken from participants and subjected to microscopic examination for malaria parasites. Plasmodium falciparum A rapid diagnostic test for SARS-CoV-2 detection based on the presence of serum immunoglobulin G (IgG), A and M antibodies against the SARS-CoV-2 nucleocapsid (N) protein.

SARS-CoV-2 seroprevalence was estimated as the percentage of participants with anti-SARS-CoV-2 N antibodies. In addition, Nasopharyngeal swab Specimens were obtained from study participants for quantitative reverse transcription polymerase chain reaction (RT-qPCR) analysis and cycle threshold (Ct) values ​​were obtained. In addition, SARS-CoV-2 ribonucleic acid (RNA) was extracted from seropositive individual samples with Ct values ​​≤35 (n=19), subjected to whole-genome sequencing (WGS) analysis, and then subjected to genome live A rally was built.

Sequences were also analyzed by comparative genomics and phylogenetic analysis to identify SARS-CoV-2 lineages and clades using the PANGOLIN (Phylogenetic Assignment of Specified Global Outbreak Lineages) taxonomy. Demographic and clinical data obtained from participants included gender, temperature, and age.

result

Most participants (55%, n=549) were female and were divided into age groups 5-12, 13-20, 21-40, and 40+. Analysis showed a SARS-CoV-2 seroprevalence of 3.2% (n=32), a SARS-CoV-2 RT-qPCR prevalence of 2.5%, and a malaria incidence of 22% (n=219), with most co-infections. Examples were detected in older children. under 12 years old (42%) with no significant difference by gender.

The highest SARS-CoV-2 seroprevalence (5%) was reported in the West African urban city of Bobo-Dioulasso, significantly higher (7%) in individuals aged 40 years or older, 13 to 20 years old followed. (3%), 5-12 years (2%), 21-40 years (1%). November 2020 saw a significantly higher incidence of SARS-CoV-2 infection (6%). However, no significant gender-based differences were observed in SARS-CoV-2 seroprevalence and PCR positivity.

WGS analysis showed 13 SARS-CoV-2 strains circulating in Burkina Faso during the study period, A.19, A.21, B.1, B.1.1.118, and B.1.1. It is classified in the .404 family. 19B, 20A, and 20B clades. The circulation lineage found in Burkina Faso during the first wave of the pandemic was an early clade derived from the Wuhan strain. Most of the reported lineages have been previously described in Burkina Faso or neighboring countries. However, we also identified two less frequent strains (B.1.1.118 and B.1) that may have been imported into Burkina Faso from the United States or Europe.

None of the SARS-CoV-2 seropositive/RT-qPCR-positive specimens (n=7) demonstrated malaria co-infection, whereas malaria and COVID-19 were present in two (out of 17). Co-occurred in seronegative/RT-qPCR specimens. positive specimen. Of the remaining seropositive/RT-qPCR-negative individuals (n = 25), 8 showed co-infection with malaria. Thus, 2 confirmed and 8 suspected cases of her co-infection were each detected, 8 of which she was <14 years of age and 2 of which she was >40 years of age. Only one (out of two) RT-qPCR positive co-infection sample was sequenced and assigned the A.21 strain.

Most of the age groups most affected by the two diseases did not overlap. However, 10 co-infection cases were observed among young people. Serological tests measured total antibody titers (IgG, A, and M) against SARS-CoV-2, making it difficult to identify seropositive previous cases from current SARS-CoV-2 infection became. Infection or superinfection cannot be clearly defined.

Similar to the observed COVID-19 temporal trend, malaria cases increased significantly from 5% at the start of the study to 29% by the end of the study period. This demonstrates the potential impact of the COVID-19 pandemic on malaria transmission control.

Conclusion

Research results showed a low frequency of co-infection of COVID-19 and malaria in Burkina Faso (1%). The authors say the study is the first of its kind and provides data for estimating the true prevalence and circulating variants of SARS-CoV-2 infection in sub-Saharan Africa. I think so.

*Important Notices

medRxiv publishes non-peer-reviewed, preliminary scientific reports and should not be considered conclusive, to guide clinical practice/health-related actions, or to be treated as established information .