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Symptom prevalence and secondary attack rate of SARS-CoV-2 in rural Kenyan households : a prospective cohort study
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(2023) Symptom prevalence and secondary attack rate of SARS-CoV-2 in rural Kenyan households : a prospective cohort study. Influenza and Other Respiratory Viruses, 17 (9). e13185. doi:10.1111/irv.13185 ISSN 1750-2640.
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Official URL: https://doi.org/10.1111/irv.13185
Abstract
Background:
We estimated the secondary attack rate of SARS-CoV-2 among household contacts of PCR-confirmed cases of COVID-19 in rural Kenya and analysed risk factors for transmission.
Methods:
We enrolled incident PCR-confirmed cases and their household members. At baseline, a questionnaire, a blood sample, and naso-oropharyngeal swabs were collected. Household members were followed 4, 7, 10, 14, 21 and 28 days after the date of the first PCR-positive in the household; naso-oropharyngeal swabs were collected at each visit and used to define secondary cases. Blood samples were collected every 1–2 weeks. Symptoms were collected in a daily symptom diary. We used binomial regression to estimate secondary attack rates and survival analysis to analyse risk factors for transmission.
Results:
A total of 119 households with at least one positive household member were enrolled between October 2020 and September 2022, comprising 503 household members; 226 remained in follow-up at day 14 (45%). A total of 43 secondary cases arose within 14 days of identification of the primary case, and 81 household members remained negative. The 7-day secondary attack rate was 4% (95% CI 1%–10%), the 14-day secondary attack rate was 28% (95% CI 17%–40%). Of 38 secondary cases with data, eight reported symptoms (21%, 95% CI 8%–34%). Antibody to SARS-CoV-2 spike protein at enrolment was not associated with risk of becoming a secondary case.
Conclusion:
Households in our setting experienced a lower 7-day attack rate than a recent meta-analysis indicated as the global average (23%–43% depending on variant), and infection is mostly asymptomatic in our setting.
Item Type: | Journal Article | |||||||||||||||
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Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine | |||||||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) | |||||||||||||||
Library of Congress Subject Headings (LCSH): | COVID-19 (Disease) -- Kenya, COVID-19 (Disease) -- Transmission -- Kenya, COVID-19 (Disease) -- Epidemiology | |||||||||||||||
Journal or Publication Title: | Influenza and Other Respiratory Viruses | |||||||||||||||
Publisher: | Wiley-Blackwell Publishing Ltd. | |||||||||||||||
ISSN: | 1750-2640 | |||||||||||||||
Official Date: | 9 September 2023 | |||||||||||||||
Dates: |
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Volume: | 17 | |||||||||||||||
Number: | 9 | |||||||||||||||
Article Number: | e13185 | |||||||||||||||
DOI: | 10.1111/irv.13185 | |||||||||||||||
Status: | Peer Reviewed | |||||||||||||||
Publication Status: | Published | |||||||||||||||
Access rights to Published version: | Open Access (Creative Commons) | |||||||||||||||
Date of first compliant deposit: | 10 August 2023 | |||||||||||||||
Date of first compliant Open Access: | 29 September 2023 | |||||||||||||||
RIOXX Funder/Project Grant: |
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