Understanding the epidemiology of SARS-CoV-2 and the interrelation of COVID-19 with TB and HIV in Zambia (TREATS-COVID)

As the number of SARS-CoV-2 infections continue to rise globally, and experts predict that Sub-Saharan Africa will face adverse socio-economic and health consequences, there is considerable uncertainty about the epidemiology of the disease in SSA. There are now more than over 16,000 confirmed cases of COVID 19 across 52 countries in Africa, with close to 900 deaths. Zambia has currently reported and quarantined 48 confirmed cases and experienced two deaths and is gradually implementing more public health measures.

The TREATS-COVID study (June 2020-December 2021) is well placed to answer some of the most critical questions relating to the epidemiology of the SARS-CoV-2 virus in a typical urban town in Africa. The objective of this study is to measure the prevalence and spread of SARS-CoV-2 in Zambia, working with one urban community and extrapolating to the wider population using mathematical modelling.  We aim to conduct epidemiological and social science inquiry that will improve our understanding of SARS-CoV-2 transmissibility, susceptibility, disease severity, and risk factors and the inter-relationship between SARS-CoV-2 and TB/HIV. TREATS-COVID study will be embedded in an ongoing EDCTP clinical trial called TREATS.  It optimizes existing capacity and resources thereby enabling a rapid startup of activities while at the same time creating a unique opportunity to investigate the interaction of COVID-19 with both TB and HIV.

The overall target population is the entire population of the selected urban community (n=28,000 approximately). We will conduct SARS-CoV-2 prevalence surveys in a random selection of adults (15 years and above). We will follow up household contacts of COVID-19 cases to conduct contact tracing.

We will evaluate newly available testing modalities for SARS-CoV-2 as community-level point of care diagnostics such as Ag, Ab tests, Xpert® MTB/RIF-Covid and computer aided diagnostic software to read COVID chest x-rays. Community empowerment and buy-in will be a cornerstone in our study resulting in a community emergency preparedness plan. Social science enquiry will have a focus on stigma and economic impact.

We will harness on an existing strong collaboration within the TREATS consortium. The study will stimulate synergy in this new area between a leading African research group (Zambart) and European Partners-KNCV, Delft Imaging and the LSHTM, a UK based research centre. In addition, we will continue to work with other existing TREATS consortium partners Sheffield University and The Union, as well partners from the HPTN071/PopART trial Oxford University.
 

Observational Study 

Outcome Measures

1. To conduct epidemiological and social science inquiry that will improve our understanding of SARS-CoV-2 transmissibility, susceptibility, disease severity, and risk factors.
2. To measure the cumulative incidence of COVID-19 symptomatic disease in the general population (15 years and above), stratified by different subgroups.
3. To measure the prevalence of COVID-19 symptomatic disease in the general population (15 years and above).
4. To measure the sero-prevalence and sero-incidence of SARS-CoV-2 infection in a subset of the population, as a measure of the cumulative proportion of the general population who have been infected.
5. To measure the inter-relationship between COVID-19 and TB/HIV in terms of disease severity and clinical outcomes.
6. To conduct contact tracing and testing of all individuals living in households with confirmed COVID-19 cases and follow them for development of symptoms and disease (secondary attack rate).
    

EDCTP Grants

Measurement of Transmission
Social Science
Surveillance

Jul 2020 — Jul 2021

$585,260

Zambia

Clinical Epidemiology of COVID-19 in Malaria Settings