Investigation of Four Clusters of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Rwanda, 2020

Olivier Nsekuye, Edson Rwagasore, Marie Aime Muhimpundu, Ziad El-Khatib, Daniel Ntabanganyimana, Eric Noël Kamayirese, Laurent Ruyange, Angela Umutoni, Adeline Kabeja Adeline, Joseph Ntaganira, Sabin Nsazimana and Jared Omolo
Additional contact information
Olivier Nsekuye: Blood Transfusion Division, Rwanda Biomedical Center (RBC), Kigali 7162, Rwanda
Edson Rwagasore: Public Health Surveillance and Epidemic, Rwanda Biomedical Center (RBC), Kigali 7162, Rwanda
Marie Aime Muhimpundu: Public Health Surveillance and Epidemic, Rwanda Biomedical Center (RBC), Kigali 7162, Rwanda
Ziad El-Khatib: Bill and Joyce Cumming Institute of Global Health, University of Global Health Equity, Kigali 6955, Rwanda
Daniel Ntabanganyimana: Rwanda Field Epidemiology and Laboratory Training Program, Department of Epidemiology and Biostatistics, University of Rwanda, Kigali 3286, Rwanda
Eric Noël Kamayirese: Rwanda Field Epidemiology and Laboratory Training Program, Department of Epidemiology and Biostatistics, University of Rwanda, Kigali 3286, Rwanda
Laurent Ruyange: Rwanda Field Epidemiology and Laboratory Training Program, Department of Epidemiology and Biostatistics, University of Rwanda, Kigali 3286, Rwanda
Angela Umutoni: Public Health Surveillance and Epidemic, Rwanda Biomedical Center (RBC), Kigali 7162, Rwanda
Adeline Kabeja Adeline: Public Health Surveillance and Epidemic, Rwanda Biomedical Center (RBC), Kigali 7162, Rwanda
Joseph Ntaganira: Rwanda Field Epidemiology and Laboratory Training Program, Department of Epidemiology and Biostatistics, University of Rwanda, Kigali 3286, Rwanda
Sabin Nsazimana: Rwanda Biomedical Center (RBC), Kigali 7162, Rwanda
Jared Omolo: Rwanda Field Epidemiology and Laboratory Training Program, Department of Epidemiology and Biostatistics, University of Rwanda, Kigali 3286, Rwanda

IJERPH, 2021, vol. 18, issue 13, 1-10

Abstract: We reported the findings of the first Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) four clusters identified in Rwanda. Case-investigations included contact elicitation, testing, and isolation/quarantine of confirmed cases. Socio-demographic and clinical data on cases and contacts were collected. A confirmed case was a person with laboratory confirmation of SARS-CoV-2 infection (PCR) while a contact was any person who had contact with a SARS-CoV-2 confirmed case within 72 h prior, to 14 days after symptom onset; or 14 days before collection of the laboratory-positive sample for asymptomatic cases. High risk contacts were those who had come into unprotected face-to-face contact or had been in a closed environment with a SARS-CoV-2 case for >15 min. Forty cases were reported from four clusters by 22 April 2020, accounting for 61% of locally transmitted cases within six weeks. Clusters A, B, C and D were associated with two nightclubs, one house party, and different families or households living in the same compound (multi-family dwelling). Thirty-six of the 1035 contacts tested were positive (secondary attack rate: 3.5%). Positivity rates were highest among the high-risk contacts compared to low-risk contacts (10% vs. 2.2%). Index cases in three of the clusters were imported through international travelling. Fifteen of the 40 cases (38%) were asymptomatic while 13/25 (52%) and 8/25 (32%) of symptomatic cases had a cough and fever respectively. Gatherings in closed spaces were the main early drivers of transmission. Systematic case-investigations contact tracing and testing likely contributed to the early containment of SARS-CoV-2 in Rwanda.

Keywords: COVID19; transmission; Rwanda; infectious diseases; cluster analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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