The African Network for Improved Diagnostics, Epidemiology and Management of common infectious Agents

• Published in: BMC infectious diseases 2021-06, Vol.21 (1), p.1-539, Article 539
• Main Authors: Schubert, Grit, Achi, Vincent, Ahuka, Steve, Belarbi, Essia, Bourhaima, Ouattara, Eckmanns, Tim, Johnstone, Siobhan, Kabore, Firmin, Kra, Ouffoue, Mendes, Adriano, Ouedraogo, Abdoul-Salam, Poda, Armel, Some, Arsène Satouro, Tomczyk, Sara, Couacy-Hymann, Emmanuel, Kayembe, Jean-Marie, Meda, Nicolas, Muyembe Tamfum, Jean-Jacques, Ouangraoua, Soumeya, Page, Nicola, Venter, Marietjie, Leendertz, Fabian H, Akoua-Koffi, Chantal, Kouadio, Vincent Assé, Aka-Tano, Aude, Diarrassouba, Adoulaye, Anoh, Etilé, Traoré, Adjaratou, Sounan, Fidèle Touré, Karidioula, Safiatou, Kizito, Gabriel Mbunsu, Izizag, Benilde Bepouka, Mpwekela, Nicole, Kabengele, Benoit, Alama, Nicole, Tshiani, Olivier, Lusamaki, Eddy Kinganda, Muyembe, Baby, Mitongo, Naomie, Manienga, John, Lionzo, Franck, Mbandu, Alliance, Makiala, Sheila, Sin, Muna Abu, Gröschner, Karin, Köhler, Susanne, Niendorf, Sandra, Nowak, Kathrin, Pitzinger, Paul, Sachse, Andreas, Vietor, Ann Christin, Thomas, Juno, Walaza, Sibongile, de Gouvea, Linda, von Mollendorf, Claire, Quan, Vanessa, Keddy, Karen, Smith, Anthony, Ramalwa, Ntsieni, Avenant, Theunis, du Plessis, Nicolette, Menu, Kgothatso, Pretorius, Marthi, McIntyre, Caitlyn, Bonnet, Elise, Jeal, Rebecca
• Format: Article
• Language: English
• Subjects: Acute febrile disease of unknown cause; Acute gastrointestinal infections; Acute respiratory tract infections; Aetiologies; Algorithms; Antibiotics; Antimicrobial agents; Antimicrobial resistance; Bacteriology; Bayesian analysis; Community-acquired infections; Coronaviruses; COVID-19; Demography; Diagnosis; Diagnostic systems; Disease transmission; E coli; Economic analysis; Epidemiology; Fever; Gastrointestinal diseases; Genomic analysis; Health care facilities; Hospitals; Hyperthermia; Illnesses; Infections; Infectious diseases; Investigations; Laboratories; Low income groups; Malaria; Methods; Mortality; Next-generation sequencing; Pandemics; Pathogens; Pneumonia; Polymerase chain reaction; Population density; Public health; Quality management; Respiratory diseases; Respiratory tract infections; Risk analysis; Risk factors; Rural areas; Sentinel health events; Sentinel surveillance; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Streptococcus infections; Study Protocol; Sub-Saharan Africa; Surveillance; Tropical diseases; Viral diseases; Zoonoses
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-021-06238-w

In sub-Saharan Africa, acute respiratory infections (ARI), acute gastrointestinal infections (GI) and acute febrile disease of unknown cause (AFDUC) have a large disease burden, especially among children, while respective aetiologies often remain unresolved. The need for robust infectious disease surveillance to detect emerging pathogens along with common human pathogens has been highlighted by the ongoing novel coronavirus disease 2019 (COVID-19) pandemic. The African Network for Improved Diagnostics, Epidemiology and Management of Common Infectious Agents (ANDEMIA) is a sentinel surveillance study on the aetiology and clinical characteristics of ARI, GI and AFDUC in sub-Saharan Africa. ANDEMIA includes 12 urban and rural health care facilities in four African countries (Côte d'Ivoire, Burkina Faso, Democratic Republic of the Congo and Republic of South Africa). It was piloted in 2018 in Côte d'Ivoire and the initial phase will run from 2019 to 2021. Case definitions for ARI, GI and AFDUC were established, as well as syndrome-specific sampling algorithms including the collection of blood, naso- and oropharyngeal swabs and stool. Samples are tested using comprehensive diagnostic protocols, ranging from classic bacteriology and antimicrobial resistance screening to multiplex real-time polymerase chain reaction (PCR) systems and High Throughput Sequencing. In March 2020, PCR testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and analysis of full genomic information was included in the study. Standardised questionnaires collect relevant clinical, demographic, socio-economic and behavioural data for epidemiologic analyses. Controls are enrolled over a 12-month period for a nested case-control study. Data will be assessed descriptively and aetiologies will be evaluated using a latent class analysis among cases. Among cases and controls, an integrated analytic approach using logistic regression and Bayesian estimation will be employed to improve the assessment of aetiology and associated risk factors. ANDEMIA aims to expand our understanding of ARI, GI and AFDUC aetiologies in sub-Saharan Africa using a comprehensive laboratory diagnostics strategy. It will foster early detection of emerging threats and continued monitoring of important common pathogens. The network collaboration will be strengthened and site diagnostic capacities will be reinforced to improve quality management and patient care.