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. 2022 Sep 8;2(9):e0000951.
doi: 10.1371/journal.pgph.0000951. eCollection 2022.

First cases of SARS-CoV-2 infection and secondary transmission in Kisumu, Kenya

Beth A Tippett Barr  1   2 , Amy Herman-Roloff  1 , Margaret Mburu  3 , Pamela M Murnane  4 , Norton Sang  5 , Elizabeth Bukusi  5 , Elizabeth Oele  6 , Albert Odhiambo  6 , Jayne Lewis-Kulzer  4 , Clayton O Onyango  1 , Elizabeth Hunsperger  1 , Francesca Odhiambo  5 , Rachel H Joseph  1 , Peninah Munyua  1 , Kephas Othieno  3 , Edwin Mulwa  5 , Victor Akelo  1 , Erick Muok  3 , Marc Bulterys  1 , Charles Nzioka  7 , Craig R Cohen  4
Affiliations

First cases of SARS-CoV-2 infection and secondary transmission in Kisumu, Kenya

Beth A Tippett Barr et al. PLOS Glob Public Health. .

Abstract

We investigated the first 152 laboratory-confirmed SARS-CoV-2 cases (125 primary and 27 secondary) and their 248 close contacts in Kisumu County, Kenya. Conducted June 10-October 8, 2020, this study included interviews and sample collection at enrolment and 14-21 days later. Median age was 35 years (IQR 28-44); 69.0% reported COVID-19 related symptoms, most commonly cough (60.0%), headache (55.2%), fever (53.3%) and loss of taste or smell (43.8%). One in five were hospitalized, 34.4% >25 years of age had at least one comorbidity, and all deaths had comorbidities. Adults ≥25 years with a comorbidity were 3.15 (95% CI 1.37-7.26) times more likely to have been hospitalized or died than participants without a comorbidity. Infectious comorbidities included HIV, tuberculosis, and malaria, but no current cases of influenza, respiratory syncytial virus, dengue fever, leptospirosis or chikungunya were identified. Thirteen (10.4%) of the 125 primary infections transmitted COVID-19 to 27 close contacts, 158 (63.7%) of whom resided or worked within the same household. Thirty-one percent (4 of 13) of those who transmitted COVID-19 to secondary cases were health care workers; no known secondary transmissions occurred between health care workers. This rapid assessment early in the course of the COVID-19 pandemic identified some context-specific characteristics which conflicted with the national line-listing of cases, and which have been substantiated in the year since. These included over two-thirds of cases reporting the development of symptoms during the two weeks after diagnosis, compared to the 7% of cases reported nationally; over half of cases reporting headaches, and nearly half of all cases reporting loss of taste and smell, none of which were reported at the time by the World Health Organization to be common symptoms. This study highlights the importance of rapid in-depth assessments of outbreaks in understanding the local epidemiology and response measures required.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study flow for the first few cases of COVID-19 in Kisumu, Kenya, June-October 2020.
Fig 2
Fig 2. Weekly occupation trends among cases, FFX study, Kisumu, Kenya (June-October 2020).
Fig 3
Fig 3. Summary of COVID-19 deaths in Kisumu, FFX Study, Kenya, June-October 2020.
Fig 4
Fig 4. Visual Representation of Secondary Transmission, FFX Study, Kisumu, Kenya, June-October 2020.
See this image and copyright information in PMC

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