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How frequent was SARS-CoV-2 and malaria co-infection through the first wave of the pandemic?


In a current examine posted to the medRxiv* preprint server, researchers decided the prevalence of circulating extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants and the frequency of co-occurrence of coronavirus illness 2019 (COVID-19) and malaria in Burkina Faso, West Africa.

Examine: Prevalence of SARS-CoV-2 and co-occurrence/co-infection with malaria through the first wave of the pandemic (the Burkina Faso case). Picture Credit score: Christoph Burgstedt/Shutterstock


SARS-CoV-2 transmission in Africa has been reported to have a decrease incidence, comprising largely asymptomatic circumstances, and decrease related dying charges in comparison with developed nations. A larger proportion of kids and socioecological variability (i.e., low populace, heat climate, and educated immune responses towards infectious issues) and immediate enforcement of well being measures resembling authorities lockdowns can clarify the decrease incidence.

Research have documented that the COVID-19 pandemic impacted some nations (resembling Tunisia, Morocco, and South Africa) extra prominently, indicative of region-specific SARS-CoV-2 unfold; nevertheless, the findings might be on account of low and disproportionate ranges of diagnostic testing and surveillance measures.

Additional, malaria is endemic to Africa, the circumstances of which have elevated through the preliminary COVID-19 wave, which can have been on account of disruptions in malaria campaigns, and diagnostic and testing capacities through the preliminary pandemic wave.

In regards to the examine

Within the current population-based examine, researchers evaluated the frequency of COVID-19 and malaria co-infections within the Burkina Faso nation in West Africa.

The examine was performed on 998 asymptomatic volunteers residing in numerous rural or city areas throughout 11 villages in southern areas of Burkina Faso between 22 August and 19 November 2020. Blood samples had been obtained from the individuals and subjected to microscopic examination for the malaria parasite, Plasmodium falciparum detection (within the asexual and gametocyte phases), and speedy diagnostic assessments for SARS-CoV-2 detection based mostly on the presence of serum immunoglobulin G (IgG), A and M antibodies towards SARS-CoV-2 nucleocapsid (N) protein.

SARS-CoV-2 seroprevalence was estimated because the fraction of individuals with anti-SARS-CoV-2 N antibodies. As well as, nasopharyngeal swab specimens had been obtained from the examine individuals for quantitative reverse transcription-polymerase chain response (RT-qPCR) evaluation, and the cycle threshold (Ct) values had been obtained. Additional, SARS-CoV-2 ribonucleic acid (RNA) was extracted from seropositive people samples with Ct values ≤35 (n=19) and subjected to entire genome sequencing (WGS) evaluation, following which genome libraries had been constructed.

The sequences had been additionally analyzed by way of comparative genomic and phylogenetic analyses, and the PANGOLIN (phylogenetic task of named world outbreak lineages) classification was used to determine SARS-CoV-2 lineages and clades. Demographical and scientific information obtained from the individuals included intercourse, physique temperature, and age.


Most individuals (55%, n=549) had been ladies, and the people had been age-stratified into the next age teams: 5 years to 12 years, 13 years to twenty years, 21 years to 40 years, and above 40 years. The evaluation confirmed a 3.2% SARS-CoV-2 seroprevalence (n=32), 2.5% SARS-CoV-2 RT-qPCR positivity, and 22% malaria incidence (n=219) with most co-infection circumstances detected amongst youngsters aged <12 years (42%) with no important sex-based variations.

The very best SARS-CoV-2 seropositivity (5 %) was reported for the Bobo-Dioulasso metropolis in city areas of West Africa and was considerably larger amongst people aged above 40 years (seven %), adopted by these aged 13 years to twenty years (three %), 5 years to 12 years (two %), and 21 years to 40 years (one %). Considerably larger SARS-CoV-2 an infection incidence charges (six %) had been noticed in November 2020; nevertheless, no important sex-based variations had been noticed in SARS-CoV-2 seroprevalence and PCR positivity.

The WGS evaluation demonstrated 13 SARS-CoV-2 strains circulating in Burkina Faso through the examine interval, assigned to the A.19, A.21, B.1, B.1.1.118, and B.1.1.404 lineages clustered within the 19B, 20A and 20B clades. The circulating lineages present in Burkina Faso through the first wave of the pandemic had been early clades derived from the Wuhan pressure. A lot of the reported lineages have been beforehand described in Burkina Faso or neighboring nations. Nevertheless, we additionally recognized two much less frequent lineages (B.1.1.118 and B.1) that had been in all probability imported to Burkina-Faso from the USA or Europe.

Of the SARS-CoV-2 seropositive/RT-qPCR-positive specimens (n=7), none confirmed malaria co-infection, whereas malaria and COVID-19 co-occurred in two (out of 17) seronegative/RT-qPCR-positive specimens. Out of the remaining seropositive/RT-qPCR-negative people (n=25), eight confirmed malaria co-infection. Due to this fact, two and eight circumstances of confirmed and suspected co-infections had been detected, respectively, of which eight had been aged <14 years and two had been aged >40 years. Just one (out of two) RT-qPCR-positive co-infected samples was sequenced and assigned the A.21 lineage.

A lot of the age teams most affected by the 2 ailments didn’t present overlapping; nevertheless, ten co-infection circumstances had been noticed amongst children. The serology assessments measured complete antibody titers (IgG, A, and M) towards SARS-CoV-2, making it troublesome to delineate seropositive earlier an infection circumstances from present SARS-CoV-2 infections and, due to this fact, whether or not the info denoted a re-infection or a co-infection can’t be outlined clearly.

Much like the noticed COVID-19 temporal traits, malaria circumstances elevated considerably from 5 % at examine graduation to 29% by the top of the examine interval, indicative of a possible impression on malaria an infection management as a result of COVID-19 pandemic.


The examine findings confirmed a low frequency of COVID-19 and malaria co-infections (1%) in Burkina Faso. The authors imagine that the current examine is the primary of its form and offers information for estimating the true prevalence and circulating variants of SARS-CoV-2 infections in Sub-Saharan Africa.

*Essential discover

medRxiv publishes preliminary scientific studies that aren’t peer-reviewed and, due to this fact, shouldn’t be thought to be conclusive, information scientific observe/health-related conduct, or handled as established data.



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