STREngthening COronavirus Disease 2019 (COVID-19) Surveillance in Africa (STREESCO)

STREngthening Epidemiological Surveillance in Benin and Burkina Faso for an Effective Response to COVID-19

The aim of this observational study was to develop, with the intended users, an epidemic surveillance and response system that will be effective, sensitive, coordinated and appropriate.

The STREESCO project aims to

• Implement active epidemiological surveillance of suspected cases in Benin at strategic sites in accordance with the World Health Organization (WHO) protocol, in support of the national strategy for responding to the CoVID-19 virus.
• To strengthen this national strategy by developing a clinico-epidemiological surveillance system in remote areas of Benin (health centre approach) and Burkina Faso (population survey approach).
• To gain a better understanding of the dynamics of the epidemic and its parameters in Africa thanks to a modern biostatistical and geo-epidemiological analysis of the data collected as part of this project.

Study Overview

• Status: Completed
• Conditions: COVID-19; SARS CoV 2 Infection; COVID-19 Pandemic

Detailed Description

Within the framework of the health systems set up by the Benin health authorities, the project aims to develop, with the intended users, an epidemic surveillance and response system that will be effective, sensitive, coordinated and adapted to a context where resources are limited. Following the start of data collection on 01 March 2021, new reforms to the response strategy against CoVID-19 in Benin have led the investigators to opt for a new strategy in order to meet the objectives of the study. The epidemiological surveillance system will be adapted to the reforms, and data collected and processed prospectively on the dynamics of the epidemic will be collected in CoVID-19 screening centres and in public and private health centres. This is the scientific data needed to issue an early warning signal and enable the healthcare system to respond appropriately. The information system will be based on (i) epidemiological surveys in the field, (ii) virological, serological and antigenic tests, (iii) indicators that will enable action to be monitored, adaptation to the epidemic to be assessed and the response capacity of health structures to be controlled. Analysis (biostatistics, geo-epidemiology) of the data collected will provide useful knowledge for a better understanding of the dynamics of the epidemic. Finally, the project will encourage collaboration between African and European researchers and strengthen the capacity of African institutions to set up an epidemic surveillance system.

• Study Type: Observational
• Enrollment (Actual): 7000

Contacts and Locations

Study Locations

• Benin
  • Atlantique
    • Abomey Calavi, Atlantique, Benin, 04BP1114
      • Institut de Recherche Clinique du Bénin

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

This surveillance was carried out in 03 strategic sites: in Cotonou, the economic capital, in Allada, a town on the border of the cordon sanitaire set up in March 2020, and in Natitingou, a town in northern Benin outside the cordon sanitaire. It was based in the health units involved in the response to COVID-19 at the 03 strategic sites. Initially, we included volunteers for COVID-19 screening, contact cases of positive subjects, and health workers present in the centres. Secondly, The study population consisted of pregnant women in the third trimester (≥ 28 weeks) of pregnancy seen for antenatal care (ANC) in the study maternity units of the 03 strategic sites were surveyed in order to describe their serological status with respect to SARS-CoV-2 infection.

Description

Inclusion Criteria:

• All volunteering for COVID-19 screening in health units dedicated to COVID-19 activities.
• Having benefited from a COVID-19 test.
• Give free and informed consent to participate in the study.

Exclusion Criteria:

• Subjects who did not give free and informed consent to participate in the study.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Average number of contact cases per person infected with SARS-CoV-2 across all the study sites was as follows	Identify the number of contact cases per subject testing positive for SARS-CoV-2 infection at each of the strategic sites.	9 months
Factors associated with SARS-CoV-2 infection in volunteers screened at 03 strategic sites	Multivariate logistic regression model on sociodemographic, anthropometric, clinical and environmental characteristics of volunteer subjects screened for SARS-CoV-2 infection	9 months
Clusters of cases in the area of each strategic site (radius, period, relative risk)	Analysis of the spatial distribution of positive cases of SARS-CoV-2 infection on each of the strategic sites	9 months
Intra-district incidence rate on the 03 strategic sites	Number of positive cases for SARS-CoV-2 infection divided by the total number of the population multiplied by 1000.	9 months
Basic reproduction number for each strategic site and overall	Bayesian approach to quantify transmissibility over time during the epidemic at each site and overall.	9 months
Proportion of health workers infected with SARS-CoV-2 by strategic sites	Total number of health workers with a positive COVID-19 test divided by the total number of health workers tested in the study.	9 months
Factors associated with SARS-CoV-2 infection in health workers at 03 strategic sites	Multivariate logistic regression model on sociodemographic, anthropometric, clinical and environmental characteristics, prevention and control measures among health workers for SARS-CoV-2 infection.	9 months
Factors associated with SARS-CoV-2 sero-infection in pregnant women in the 3rd trimester at 03 strategic sites	Multivariate logistic regression model on sociodemographic, anthropometric, clinical, linked to the course of pregnancy and vaccination status characteristics in pregnant women in the 3rd trimester at 03 strategic sites	3 months
Proportion of subjects infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by strategic sites (suspected cases, contact cases)	Total number of subjects with a positive COVID-19 test divided by the total number of volunteers tested in the study.	9 months
Environmental factors associated with incidence rates and hotspots	Binomial mixed generalized additive model (GAMM)	9 months
Seroprevalence of SARS-CoV-2 infection among pregnant women in the 3rd trimester in maternity wards of strategic study sites	Number of pregnant women with a positive Rapid Diagnostic Test (RDT) divided by the total number of pregnant women tested during the study.	3 months

Collaborators and Investigators

• Sponsor: Institut de Recherche pour le Developpement
• Collaborators: European and Developing Countries Clinical Trials Partnership (EDCTP); Barcelona Institute for Global Health; Institut de Recherche Clinique du Benin; Ministère de la Santé - Bénin; Ministère de la Santé et de Hygiène Publique - Burkina Faso
• Investigators: Principal Investigator: Achille MASSOUGBODJI, Institut de Recherche Clinique du Bénin; Study Director: Gilles COTTRELL, Institut de Recherche pour le Développement - France; Study Director: Raquel GONZALEZ, Fundación Privada Instituto de Salud Global Barcelona; Study Chair: Anges YADOULETON, Ministère de la Santé - Bénin; Study Chair: Boukary OUEDRAOGO, Ministère de la Santé - Burkina Faso

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2021
• Primary Completion (Actual): July 30, 2022
• Study Completion (Actual): July 30, 2022

Study Registration Dates

• First Submitted: December 12, 2023
• First Submitted That Met QC Criteria: December 12, 2023
• First Posted (Actual): December 14, 2023

Study Record Updates

• Last Update Posted (Estimated): December 21, 2023
• Last Update Submitted That Met QC Criteria: December 14, 2023
• Last Verified: December 1, 2023

More Information

Terms related to this study

• Keywords: COVID-19; Benin; dynamics; Epidemiological surveillance; strategic sites
• Additional Relevant MeSH Terms: Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Virus Diseases; Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Pneumonia, Viral; Pneumonia; Lung Diseases; COVID-19
• Other Study ID Numbers: RIA2020EF-2923

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No