Browsing by Author "Jambo, Kondwani"

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    Evaluation of vaccine effectiveness amongst adults living with comorbidities (Diabetes, Hypertension & HIV) following routine introduction of COVID-19 Vaccine in Blantyre, Malawi: a prospective cohort study
    (Kamuzu University of Health Sciences, 2022-01-19) Jambo, Kondwani
    Study design: This is a prospective cohort study Problem: COVID-19 continues to claim lives globally since it was discovered in Wuhan China in December 2019. People with comorbidities like hypertension, diabetes mellitus and HIV have been shown to be at high risk of severe COVID-19 and mortality. To protect against hospitalization, severe disease and death, COVID-19 vaccines have been introduced globally, as well as in Malawi. These vaccines have been deemed highly effective in other settings. However, we do not know their effectiveness in Malawi, especially among high risk individuals. Broad and specific objectives: Broad objective: to assess the effectiveness of COVID-19 vaccination amongst adults living with chronic diseases (Diabetes, Hypertension and HIV) following routine introduction in Malawi. Specific objectives: Primary objective 1. To compare the rate of virologically-confirmed symptomatic COVID-19 disease in vaccinated (after full vaccination) vs. unvaccinated adults (>18 yrs.) with co-morbidities Secondary objectives 1. To determine the rate of virologically-confirmed hospitalised symptomatic COVID-19 disease in vaccinated (after full vaccination) and unvaccinated adults (>18 yrs.) with comorbidities 2. To contrast the rate of virologically-confirmed symptomatic COVID-19 disease in vaccinated (after one-dose) vs. unvaccinated adults (>18 yrs.) with co-morbidities 3. To assess the frequency of adverse events of special interest after immunization Exploratory 1. To compare the risk of virologically-confirmed symptomatic COVID-19 disease in vaccinated (after full vaccination) vs. unvaccinated adults (>18 yrs.) with co-morbidities and documented previous COVID-19 disease 2. To investigate the duration of vaccine-induced immunity in adults with co-morbidities identified by serology 3. To investigate the frequency of new SARS-CoV-2 variants in adults with co-morbidities 4. To assess adherence to COVID-19 vaccination schedule among vaccinated adults(>18yrs.) Methodology: Adult attendees (>18 years) to Blantyre chronic disease clinics (at Limbe, Zingwangwa, Ndirande and QECH) eligible for vaccination, living with co-morbidities (Diabetes, Hypertension & HIV) and are eligible to receive COVID-19 vaccines will be eligible to participate. Participants will be enrolled prior to or during the routine introduction of COVID-19 vaccination in these vulnerable populations, regardless of whether they intend to be vaccinated. Baseline information will be collected on demographics, comorbidities, and work- and community-related infection risk factors. Baseline samples to determine baseline immunity will be collected at enrolment and at 3 months intervals to build a serological profile of the population, testing for antibodies to SARS-CoV-2 that can distinguish between vaccine-induced and natural immunity. Cases of symptomatic and hospitalised COVID-19 will be ascertained through active follow-up, reporting by mobile phone and testing. Case confirmation will be by SARS-CoV-2 RT-PCR of symptomatic participants who meet a suspected case definition. Expected findings: The results of this project will inform strategies of managing COVID-19 in high risk individuals in Malawi, in order to halt the pandemic. Results dissemination: The results will be disseminated at local and international conference and manuscripts will be published in an international peer-reviewed journal, and shared with the Ministry of Health as well as College of Medicine research ethics committee (COMREC) of the Kamuzu University of Health Sciences (KUHeS).
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    Seroprevalence of SARS-CoV-2 antibodies in Malawi blood donors
    (Kamuzu University of Health Sciences & Malawi-Liverpool-Wellcome Trust, 2020-09-07) Jambo, Kondwani; Swarthout, Todd; M'baya, Bridon; Heyderman, Robert; Jere, Khuzwayo; French, Neil; Gordon, Stephen; Muula, Adamson; Chibwana, Marah; Kalata, Newton; Hosseinipour, Mina
    Type of study: Cross-sectional observation study. Problem: In low-income countries, such as Malawi, important public health measures including universal face mask use, social distancing or a lockdown, have been challenging to implement owing to socioeconomic constraints, leading to predictions that the COVID-19 pandemic would progress rapidly. However, due to limited capacity to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of the true burden of infection and death. SARS-CoV-2 serosurveys of blood donor samples in blood banks are supported by WHO as a potential useful tool for tracking the emergence and progression of the COVID-19 pandemic. Broad and Specific Objectives: Broad objective: to identify for SARS-CoV-2 antibodies in blood donors in Malawi, as a marker of past infection and an estimate of population exposure. Specific objectives: Primary objective: to estimate the seroprevalence of SARS CoV-2-specific antibodies in blood donor sera of different age-strata across the entire country. Secondary objectives a) to establish when COVID-19 started circulating in Malawi, and b) to determine the COVID-19 epidemic trajectory over time in Malawi Methodology: Repeated cross-sectional investigation of blood donors from across the country. Using the MBTS sample archive database, we will identify sera collected from multiple age groups, including 15-19, 20-29, 30-39, 40-49, 50-59 and 60+. We will conduct two serosurveys using sera collected between December 2019 to May 2020 (Serosurvey 1), and also those to be collected between June 2020 to December 2020 (Serosurvey 2). SARSCoV-2 antibodies will be measured from the sera using ELISA and Luminex-based IgG/IgM multiplex assay targeting Spike (S) and Nucleoprotein (N). We will also measure neutralisation potency of the detected SARS-CoV-2 antibodies. Study setting and period: The laboratory experiments will be conducted at the MLW laboratories. The study will be conducted between October 2020 to July 2021. Ethical considerations: At time of donation, blood donors provide consent to participate in studies of public health importance or those aimed at improving availability of supplies of safe blood. COVID-19 research qualifies for an activity of emergency Public Health importance. We will generate unique sample identifiers and will not have access to the donor details with identifiable names. Data Management and analysis: All data will be stored in secure password protected computers at the MLW. Only study investigators will have access to the data, unless prior collaborative agreements are in place or data has been released as part of open access. We will calculate population and age-specific seroprevalence of SARS CoV-2. These will be reported as proportions of SARS CoV-2 antibody positive individual in the total population or per age strata. We will also estimate the potential period of SARS-CoV-2 entry into Malawi, by using the latest known validated SARS-CoV-2 antibody positive sample. Expected findings: a) Prevalence of SARS CoV-2 exposure amongst blood donors, as a surrogate of population exposure, b) An estimate of potential time of SARS CoV-2 entry into Malawi. Dissemination: The results will be disseminated at local and international conference and manuscripts will be published in an international peer-reviewed journal, and policy-related findings will be shared via the MLW Policy unit. The results will also be shared with COMREC.