Completed Infection & Immunity Public Health & Healthcare

Characterization of SARS-CoV-2 transmission dynamics, clinical features and disease impact in South Africa, a setting with high HIV prevalence

Funder Wellcome/DFID Charity-funded
Recipient organisation National Institute for Communicable Diseases of the National Health Laboratory Service
Funding £2.0M
Period Apr 2020 — Jun 2022

In plain English

AI plain-English summary

South African researchers are tracking how SARS-CoV-2 spreads through households and communities where one in five adults lives with HIV. The project combines multiple surveillance methods—testing patients with respiratory symptoms at clinics and hospitals, collecting blood samples over time, monitoring Google search trends, and forecasting outbreaks up to four weeks ahead—to capture a complete picture of the virus’s behaviour in a setting very different from Europe or North America. This matters because most early COVID-19 data came from wealthy countries with low HIV rates. Factors common in South Africa—malnutrition, tuberculosis, limited healthcare access, and a high HIV burden—could alter how the virus transmits, who gets severely ill, and how long immunity lasts. Without this knowledge, public health responses in similar settings remain guesswork. If successful, the research will identify which groups face the highest risk of severe COVID-19, estimate the true burden of mild and fatal illness, and predict when healthcare systems will be overwhelmed. This directly informs decisions about where to deploy testing, protective equipment, and hospital beds. The digital surveillance component also provides a low-cost early warning system that other African countries could adopt.

View original technical description
Factors prevalent in Africa such as malnutrition, HIV, tuberculosis and limited access to healthcare, among others, may impact both transmission dynamics and disease progression associated with SARS-CoV-2 infection as well as the burden on the healthcare system and society.We aim to characterize key transmissibility and clinical features of and the antibody response to SARS-CoV-2 as well as to enhance surveillance for COVID-19, identify groups at increased risk of severe illness, estimate the disease burden of medically- and non-medically attended mild, severe-non-fatal and fatal illness and forecast the impact of the outbreak on the healthcare system and the society in South Africa. Particular emphasis will be given to HIV-infected individuals. The aims will be achieved through the implementation of shedding and household transmission studies, collection of sequential serum samples, enhanced facility-based (hospitals and clinics) surveillance among patients with mild and severe respiratory illness in well-established population-based surveillance sites where incidence can be calculated, and healthcare utilization and serological surveys in selected communities. In addition, digital surveillance (based on Google searches) will be used to complement virological surveillance and nowcasting and short-term forecasting (up to 4 weeks) will be implemented over the duration of the epidemic.

View the original record at the funder ↗

Researchers

Cheryl Cohen (EPMC Awardee)

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Original classification

Research Grant

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