11 March 2021 Episode 116 News from Africa

Thu, 03/11/2021 - 15:50

Dear colleagues,

As announced I have been very busy in preparing several lectures.  For your convenience I add a lecture to be given tomorrow at the University in Antwerp. As it contains only freely available information, feel free to re-use the slides for your own purposes.

It is still a turbulent time at the vaccine and variant front, especially today with the -again- bad news on AstraZenca, with regard to possible thrombotic complications.  But instead of diving into those unconfirmed controversies, I’d rather like to briefly update you on Africa, partly based on reports from the “other” COVID platform, animated by Kristof Decoster and Wim Vandamme.

Ep 116-1: A high seroprevalence in ASYMPTOMATIC frontline HCW in Nigeria: already early on (April 2020?), there was a prevalence of 45 % antibodies. Their profile: young (30-40) women and men doctor or nurse, emergency dept.

Ep 116-2: In Kenyan blood donors, adjusted seroprevalence in April-June was 4.3 % (with clearly higher % in urban areas). This figure is similar to contemporary Europe.

Ep 116-3: A household-based survey in Zambia in July with remarkable results: 7.6 % rt-PCR positive and seroprevalence of 2.1 % and combined 10.2 %. The estimated number of SARS-CoV-2 infections in this are with 4.3 million inhabitants is 454 708, while only 4917 were officially reported. Thus an underestimation by a factor 92!!!

Ep 116-4 puts these results into perspective further.

Ep 116-5: Seroprevalence in 405 workers at the V§A Waterfront in Cape Town  (tourist and shopping) in August (after the first wave):  23.7 % positive, associated with living in informal housing, residing in a subdistrict with low income-per household, and having a low-earning occupation. Specificity and sensitivity were validated in this case (see Ep 116-7).

 

Ep 116-6:     Prevalence of anti-SARS-CoV-2 antibodies among blood donors in January 2021  Northern Cape, KwaZulu-Natal, Eastern Cape, and  Free State provinces of South Africa  

See table 1 p. 11. 

Ep 116-7 warns for Limited specificity of commercially available SARS-CoV-2 IgG ELISAs in serum samples of African origin.  Potential cross-reactivity should be ruled out.

Ep 116-8: the sad story of “COVID-negationism” in Tanzania, told by an anonymous journalist.

Ep 116-9: the long-term view by John Nkengasong, our most famous African ITM alumnus (and virologist, who preceded myself as head of the unit), who explains his diplomatic, but nevertheless audacious vision on the African Center for Disease Control, of which he is the head….

In conclusion:  

  • Africa may still be relatively spared from the worst clinical consequences of COVID thanks to its on average young and “healthy’ population (lower levels of NCD than in Europe).  South-Africa is hit harder than the more northern countries, most probably because it has an ‘”older” population with more NCD.
  • Nevertheless, it becomes evident that the epidemic is spreading to a high level in the general population.  There is huge underreporting of cases.
  • The question now is whether more virulent variants (such as the South-African one) could cause a new wave of infections with more important morbidity and mortality, even before there is any chance on vaccination.    

 

Sorry to be so brief and superficial. My next Episode will be a bit more thorough

Best wishes,

Guido

 

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