Transmission networks of SARS-CoV-2 in Coastal Kenya during the first two waves: A retrospective genomic study.

Charles N Agoti ORCID logo; Lynette Isabella Ochola-Oyier; Simon Dellicour ORCID logo; Khadija Said Mohammed; Arnold W Lambisia; Zaydah R de Laurent; John M Morobe ORCID logo; Maureen W Mburu; Donwilliams O Omuoyo ORCID logo; Edidah M Ongera; +26 more... Leonard Ndwiga; Eric Maitha; Benson Kitole; Thani Suleiman; Mohamed Mwakinangu; John K Nyambu; John Otieno; Barke Salim; Jennifer Musyoki; Nickson Murunga; Edward Otieno ORCID logo; John N Kiiru; Kadondi Kasera; Patrick Amoth; Mercy Mwangangi; Rashid Aman; Samson Kinyanjui; George Warimwe; My Phan ORCID logo; Ambrose Agweyu ORCID logo; Matthew Cotten ORCID logo; Edwine Barasa; Benjamin Tsofa ORCID logo; D James Nokes ORCID logo; Philip Bejon; George Githinji ORCID logo; (2022) Transmission networks of SARS-CoV-2 in Coastal Kenya during the first two waves: A retrospective genomic study. eLife, 11. ISSN 2050-084X DOI: 10.7554/eLife.71703
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BACKGROUND: Detailed understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) regional transmission networks within sub-Saharan Africa is key for guiding local public health interventions against the pandemic. METHODS: Here, we analysed 1139 SARS-CoV-2 genomes from positive samples collected between March 2020 and February 2021 across six counties of Coastal Kenya (Mombasa, Kilifi, Taita Taveta, Kwale, Tana River, and Lamu) to infer virus introductions and local transmission patterns during the first two waves of infections. Virus importations were inferred using ancestral state reconstruction, and virus dispersal between counties was estimated using discrete phylogeographic analysis. RESULTS: During Wave 1, 23 distinct Pango lineages were detected across the six counties, while during Wave 2, 29 lineages were detected; 9 of which occurred in both waves and 4 seemed to be Kenya specific (B.1.530, B.1.549, B.1.596.1, and N.8). Most of the sequenced infections belonged to lineage B.1 (n = 723, 63%), which predominated in both Wave 1 (73%, followed by lineages N.8 [6%] and B.1.1 [6%]) and Wave 2 (56%, followed by lineages B.1.549 [21%] and B.1.530 [5%]). Over the study period, we estimated 280 SARS-CoV-2 virus importations into Coastal Kenya. Mombasa City, a vital tourist and commercial centre for the region, was a major route for virus imports, most of which occurred during Wave 1, when many Coronavirus Disease 2019 (COVID-19) government restrictions were still in force. In Wave 2, inter-county transmission predominated, resulting in the emergence of local transmission chains and diversity. CONCLUSIONS: Our analysis supports moving COVID-19 control strategies in the region from a focus on international travel to strategies that will reduce local transmission. FUNDING: This work was funded by The Wellcome (grant numbers: 220985, 203077/Z/16/Z, 220977/Z/20/Z, and 222574/Z/21/Z) and the National Institute for Health and Care Research (NIHR), project references: 17/63/and 16/136/33 using UK Aid from the UK government to support global health research, The UK Foreign, Commonwealth and Development Office. The views expressed in this publication are those of the author(s) and not necessarily those of the funding agencies.


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