Identification of transmission chains and clusters associated with COVID-19 in Tunisia.


Journal

BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551

Informations de publication

Date de publication:
19 May 2021
Historique:
received: 13 10 2020
accepted: 22 04 2021
entrez: 20 5 2021
pubmed: 21 5 2021
medline: 2 6 2021
Statut: epublish

Résumé

The aim of this study was to characterize the transmission chains and clusters of COVID-19 infection in Tunisia. All cases were confirmed by Reverse Transcriptase Polymerase Chain Reaction of a nasopharyngeal specimen. Contact tracing is undertaken for all confirmed cases in order to identify close contacts that will be systematically screened and quarantined. Transmission chains were identified based on field investigation, contact tracing, results of screening tests and by assessing all probable mode of transmission and interactions. As of May 18, 2020, 656 cases out of a total of 1043 confirmed cases of Coronavirus disease 2019 belong to 127 transmission chains identified during the epidemic (mean age 42.36 years, Standard deviation 19.56 and sex ratio 0.86). The virus transmission is the most concentrated in the governorate of Tunis (31.5%), Ariana (10.2%) and Ben Arous (10.2%). Virus transmission occurred 50 times (9.72% of secondary transmission events) between two different governorates. A maximum of seven generations of secondary infection was identified, whereas 62% of these secondary infections belong the first generation. A total of 11 "super spreader" cases were identified in this investigation. Four large clusters have been identified. The evolution of secondary cases highlighted two peaks: one in 2nd April and a second in 16 Correct contact tracing and early active case finding is useful to identify transmission chains and source of infection in order to contain the widespread transmission in the community.

Sections du résumé

BACKGROUND BACKGROUND
The aim of this study was to characterize the transmission chains and clusters of COVID-19 infection in Tunisia.
METHODS METHODS
All cases were confirmed by Reverse Transcriptase Polymerase Chain Reaction of a nasopharyngeal specimen. Contact tracing is undertaken for all confirmed cases in order to identify close contacts that will be systematically screened and quarantined. Transmission chains were identified based on field investigation, contact tracing, results of screening tests and by assessing all probable mode of transmission and interactions.
RESULTS RESULTS
As of May 18, 2020, 656 cases out of a total of 1043 confirmed cases of Coronavirus disease 2019 belong to 127 transmission chains identified during the epidemic (mean age 42.36 years, Standard deviation 19.56 and sex ratio 0.86). The virus transmission is the most concentrated in the governorate of Tunis (31.5%), Ariana (10.2%) and Ben Arous (10.2%). Virus transmission occurred 50 times (9.72% of secondary transmission events) between two different governorates. A maximum of seven generations of secondary infection was identified, whereas 62% of these secondary infections belong the first generation. A total of 11 "super spreader" cases were identified in this investigation. Four large clusters have been identified. The evolution of secondary cases highlighted two peaks: one in 2nd April and a second in 16
CONCLUSION CONCLUSIONS
Correct contact tracing and early active case finding is useful to identify transmission chains and source of infection in order to contain the widespread transmission in the community.

Identifiants

pubmed: 34011266
doi: 10.1186/s12879-021-06107-6
pii: 10.1186/s12879-021-06107-6
pmc: PMC8132040
doi:

Substances chimiques

RNA, Viral 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

453

Références

N Engl J Med. 2003 May 15;348(20):1977-85
pubmed: 12671062
Tunis Med. 2020 Apr;98(4):258-260
pubmed: 32395787
Lancet Glob Health. 2020 Apr;8(4):e488-e496
pubmed: 32119825
Lancet. 2003 May 24;361(9371):1767-72
pubmed: 12781535
Clin Infect Dis. 2016 Feb 15;62(4):477-483
pubmed: 26565003
J Korean Med Sci. 2017 May;32(5):744-749
pubmed: 28378546
BMC Infect Dis. 2020 Dec 2;20(1):914
pubmed: 33267823
Lancet. 2016 Sep 3;388(10048):994-1001
pubmed: 27402381
BMJ. 2020 Feb 19;368:m627
pubmed: 32075791
Emerg Microbes Infect. 2020 Dec;9(1):386-389
pubmed: 32065057
Lancet Infect Dis. 2020 Jul;20(7):809-815
pubmed: 32330439
JAMA. 2020 Apr 28;323(16):1610-1612
pubmed: 32129805
Infect Dis Model. 2020 Feb 29;5:264-270
pubmed: 32190785

Auteurs

Mouna Safer (M)

National Observatory of New and Emerging Diseases, Ministry Of Health, Tunis, Tunisia. safermuna@yahoo.fr.
Cardio Vascular Disease Epidemiology and Prevention Research Laboratory, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia. safermuna@yahoo.fr.

Hejer Letaief (H)

National Observatory of New and Emerging Diseases, Ministry Of Health, Tunis, Tunisia.
Cardio Vascular Disease Epidemiology and Prevention Research Laboratory, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.

Aicha Hechaichi (A)

National Observatory of New and Emerging Diseases, Ministry Of Health, Tunis, Tunisia.
Cardio Vascular Disease Epidemiology and Prevention Research Laboratory, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.

Chahida Harizi (C)

Department of Epidemiology and Statistics, Abderrahman Mami Hospital, Ariana, Tunisia.

Sonia Dhaouadi (S)

National Observatory of New and Emerging Diseases, Ministry Of Health, Tunis, Tunisia.

Leila Bouabid (L)

National Observatory of New and Emerging Diseases, Ministry Of Health, Tunis, Tunisia.

Sondes Darouiche (S)

National Observatory of New and Emerging Diseases, Ministry Of Health, Tunis, Tunisia.

Donia Gharbi (D)

National Observatory of New and Emerging Diseases, Ministry Of Health, Tunis, Tunisia.

Nawel Elmili (N)

National Observatory of New and Emerging Diseases, Ministry Of Health, Tunis, Tunisia.

Hamida Ben Salah (H)

National Observatory of New and Emerging Diseases, Ministry Of Health, Tunis, Tunisia.

Mongi Hammami (M)

National Observatory of New and Emerging Diseases, Ministry Of Health, Tunis, Tunisia.

Khouloud Talmoudi (K)

National Observatory of New and Emerging Diseases, Ministry Of Health, Tunis, Tunisia.

Rim Moussa (R)

Public Health Surveillance Regional Departments, Tunis, Tunisia.

Nejib Charaa (N)

Public Health Surveillance Regional Departments, Tunis, Tunisia.

Hasna Termiz (H)

Public Health Surveillance Regional Departments, Tunis, Tunisia.

Fethi Ltaief (F)

Public Health Surveillance Regional Departments, Tunis, Tunisia.

Habib Tounekti (H)

Public Health Surveillance Regional Departments, Tunis, Tunisia.

Mohamed Makhlouf (M)

Public Health Surveillance Regional Departments, Tunis, Tunisia.

Asma Belguith Sriha (A)

Department of Community and Preventive Medicine Faculty of Medicine, University of Monastir Tunisia, Tunis, Tunisia.

Manel Ben Fredj (M)

Department of Community and Preventive Medicine Faculty of Medicine, University of Monastir Tunisia, Tunis, Tunisia.

Sonia Khalfallah (S)

Public Health Surveillance Regional Departments, Tunis, Tunisia.

Houcine Jabrane (H)

Public Health Surveillance Regional Departments, Tunis, Tunisia.

Selma Mchirgui (S)

Public Health Surveillance Regional Departments, Tunis, Tunisia.

Chedli Amich (C)

Public Health Surveillance Regional Departments, Tunis, Tunisia.

Radhia Dabghi (R)

Public Health Surveillance Regional Departments, Tunis, Tunisia.

Zid Anez (Z)

Public Health Surveillance Regional Departments, Tunis, Tunisia.

Latifa Abdelkader (L)

Public Health Surveillance Regional Departments, Tunis, Tunisia.

Moncef Mhamdi (M)

Public Health Surveillance Regional Departments, Tunis, Tunisia.

Nabil Ouerfeli (N)

Public Health Surveillance Regional Departments, Tunis, Tunisia.

Salah Zoghlami (S)

Public Health Surveillance Regional Departments, Tunis, Tunisia.

Souha Bougatef (S)

National Observatory of New and Emerging Diseases, Ministry Of Health, Tunis, Tunisia.
Cardio Vascular Disease Epidemiology and Prevention Research Laboratory, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.

Mohamed Kouni Chahed (MK)

Department of Epidemiology and Public Health, Faculty of Medicine of Tunis, Tunis El-Manar University, Tunis, Tunisia.

Nissaf Bouafif Ben Alaya (N)

National Observatory of New and Emerging Diseases, Ministry Of Health, Tunis, Tunisia.
Cardio Vascular Disease Epidemiology and Prevention Research Laboratory, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH