High SARS-CoV-2 incidence and asymptomatic fraction during Delta and Omicron BA.1 waves in The Gambia

Sheikh Jarju, Rhys D. Wenlock, Madikoi Danso, Dawda Jobe, Ya Jankey Jagne, Alansana Darboe, Michelle Kumado, Yusupha Jallow, Mamlie Touray, Ebrima A. Ceesay, Hoja Gaye, Biran Gaye, Abdoulie Tunkara, Sheriff Kandeh, Marie Gomes, Ellen Lena Sylva, Fatoumata Toure, Hailey Hornsby, Benjamin B. Lindsey, Martin J. Nicklin, Jon R. Sayers, Abdul K. Sesay, Adam Kucharski, David Hodgson, Beate Kampmann () and Thushan I. Silva ()
Additional contact information
Sheikh Jarju: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Rhys D. Wenlock: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Madikoi Danso: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Dawda Jobe: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Ya Jankey Jagne: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Alansana Darboe: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Michelle Kumado: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Yusupha Jallow: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Mamlie Touray: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Ebrima A. Ceesay: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Hoja Gaye: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Biran Gaye: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Abdoulie Tunkara: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Sheriff Kandeh: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Marie Gomes: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Ellen Lena Sylva: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Fatoumata Toure: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Hailey Hornsby: The University of Sheffield
Benjamin B. Lindsey: The University of Sheffield
Martin J. Nicklin: The University of Sheffield
Jon R. Sayers: The University of Sheffield
Abdul K. Sesay: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Adam Kucharski: London School of Hygiene and Tropical Medicine
David Hodgson: London School of Hygiene and Tropical Medicine
Beate Kampmann: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine
Thushan I. Silva: Medical Research Council The Gambia at the London School of Hygiene and Tropical Medicine

Nature Communications, 2024, vol. 15, issue 1, 1-10

Abstract: Abstract Little is known about SARS-CoV-2 infection risk in African countries with high levels of infection-driven immunity and low vaccine coverage. We conducted a prospective cohort study of 349 participants from 52 households in The Gambia between March 2021 and June 2022, with routine weekly SARS-CoV-2 RT-PCR and 6-monthly SARS-CoV-2 serology. Attack rates of 45% and 57% were seen during Delta and Omicron BA.1 waves respectively. Eighty-four percent of RT-PCR-positive infections were asymptomatic. Children under 5-years had a lower incidence of infection than 18-49-year-olds. One prior SARS-CoV-2 infection reduced infection risk during the Delta wave only, with immunity from ≥2 prior infections required to reduce the risk of infection with early Omicron lineage viruses. In an African population with high levels of infection-driven immunity and low vaccine coverage, we find high attack rates during SARS-CoV-2 waves, with a high proportion of asymptomatic infections and young children remaining relatively protected from infection.

Date: 2024
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DOI: 10.1038/s41467-024-48098-3

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