Publications by authors named "Mercy Mwangangi"

Background: We sought to estimate SARS-CoV-2 antibody seroprevalence within representative samples of the Kenyan population during the third year of the COVID-19 pandemic and the second year of COVID-19 vaccine use.

Methods: We conducted cross-sectional serosurveys among randomly selected, age-stratified samples of Health and Demographic Surveillance System (HDSS) residents in Kilifi and Nairobi. Anti-spike (anti-S) immunoglobulin G (IgG) serostatus was measured using a validated in-house ELISA and antibody concentrations estimated with reference to the WHO International Standard for anti-SARS-CoV-2 immunoglobulin.

View Article and Find Full Text PDF

Background: Most of the studies that have informed the public health response to the COVID-19 pandemic in Kenya have relied on samples that are not representative of the general population. We conducted population-based serosurveys at three Health and Demographic Surveillance Systems (HDSSs) to determine the cumulative incidence of infection with SARS-CoV-2.

Methods: We selected random age-stratified population-based samples at HDSSs in Kisumu, Nairobi and Kilifi, in Kenya.

View Article and Find Full Text PDF

Policymakers in Africa need robust estimates of the current and future spread of SARS-CoV-2. We used national surveillance PCR test, serological survey and mobility data to develop and fit a county-specific transmission model for Kenya up to the end of September 2020, which encompasses the first wave of SARS-CoV-2 transmission in the country. We estimate that the first wave of the SARS-CoV-2 pandemic peaked before the end of July 2020 in the major urban counties, with 30-50% of residents infected.

View Article and Find Full Text PDF

Introduction: The high proportion of SARS-CoV-2 infections that have remained undetected presents a challenge to tracking the progress of the pandemic and estimating the extent of population immunity.

Methods: We used residual blood samples from women attending antenatal care services at three hospitals in Kenya between August 2020 and October 2021and a validated IgG ELISA for SARS-Cov-2 spike protein and adjusted the results for assay sensitivity and specificity. We fitted a two-component mixture model as an alternative to the threshold analysis to estimate of the proportion of individuals with past SARS-CoV-2 infection.

View Article and Find Full Text PDF
Article Synopsis
  • - The study analyzed the cost-effectiveness of COVID-19 vaccination in Kenya, considering that at least 80% of the population had prior exposure to the virus due to natural immunity.
  • - Findings indicated that a slow vaccine roll-out targeting 30% of adults, especially those over 50, could prevent 54% of expected deaths and be cost-saving, while increased coverage beyond this was less effective in terms of cost relative to health outcomes.
  • - Overall, the research suggests that, given the existing immunity in the population, prioritizing younger adults for vaccination may not be a cost-effective strategy anymore.
View Article and Find Full Text PDF

Background: Detailed understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) regional transmission networks within sub-Saharan Africa is key for guiding local public health interventions against the pandemic.

Methods: Here, we analysed 1139 SARS-CoV-2 genomes from positive samples collected between March 2020 and February 2021 across six counties of Coastal Kenya (Mombasa, Kilifi, Taita Taveta, Kwale, Tana River, and Lamu) to infer virus introductions and local transmission patterns during the first two waves of infections. Virus importations were inferred using ancestral state reconstruction, and virus dispersal between counties was estimated using discrete phylogeographic analysis.

View Article and Find Full Text PDF

In October 2020, anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) G seroprevalence among truck drivers and their assistants (TDA) in Kenya was 42.3%, higher than among healthcare workers and blood donors. Truck drivers and their assistants transport essential supplies during the coronavirus disease 2019 pandemic, placing them at increased risk of being infected and of transmitting SARS-CoV-2 over a wide geographical area.

View Article and Find Full Text PDF

Policy decisions on COVID-19 interventions should be informed by a local, regional and national understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. Epidemic waves may result when restrictions are lifted or poorly adhered to, variants with new phenotypic properties successfully invade, or infection spreads to susceptible subpopulations. Three COVID-19 epidemic waves have been observed in Kenya.

View Article and Find Full Text PDF

Observed SARS-CoV-2 infections and deaths are low in tropical Africa raising questions about the extent of transmission. We measured SARS-CoV-2 IgG by ELISA in 9,922 blood donors across Kenya and adjusted for sampling bias and test performance. By 1st September 2020, 577 COVID-19 deaths were observed nationwide and seroprevalence was 9.

View Article and Find Full Text PDF

Background: Few studies have assessed the seroprevalence of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among healthcare workers (HCWs) in Africa. We report findings from a survey among HCWs in 3 counties in Kenya.

Methods: We recruited 684 HCWs from Kilifi (rural), Busia (rural), and Nairobi (urban) counties.

View Article and Find Full Text PDF

Introduction: We estimated unit costs for COVID-19 case management for patients with asymptomatic, mild-to-moderate, severe and critical COVID-19 disease in Kenya.

Methods: We estimated per-day unit costs of COVID-19 case management for patients. We used a bottom-up approach to estimate full economic costs and adopted a health system perspective and patient episode of care as our time horizon.

View Article and Find Full Text PDF
Article Synopsis
  • - There is limited information on how widely SARS-CoV-2 has spread in Africa, particularly in Kenya, where the first case was reported on March 12, 2020, but actual cases by July 31, 2020, were lower than expected with only 20,636 infections and 341 deaths.
  • - A study assessing the prevalence of antibodies against SARS-CoV-2 among blood donors in Kenya from April to June 2020 found a crude seroprevalence of 5.6%, indicating more people may have been exposed to the virus than reported cases suggest.
  • - The highest seroprevalence rates were found in urban areas: Mombasa at 8.0%,
View Article and Find Full Text PDF

Introduction: The clinical importance of frailty is increasing. Existing economic evaluations of interventions to manage frailty have limited time horizons, but even in older populations there may be important longer-term differences in costs and outcomes. This paper reports on the development of a cost-effectiveness model to predict publicly funded health and aged care costs and quality-adjusted life years (QALYs) over the remaining lifetime of frail Australians and a model-based cost-utility analysis of a physiotherapy-based intervention for frail individuals.

View Article and Find Full Text PDF