Towards COVID-19 Containment: Serological, Faecal and Wastewater Epidemiological Surveillance of SARS-CoV-2 in Support of Home-Based Isolation and Care in Kenya

The Corona virus epidemic continues to cause massive disruptions to human activities globally and negatively impact locally on Kenyans lives. Urgent measures are therefore needed to stem the tide and avert further disruptions. The project seeks to develop a multifaceted COVID-19 surveillance tool to support the evaluation of the home-based isolation and care system in Kenya. It has its objectives, to profile SARS-COV-2 RNA load in faecal samples; to develop a COVID-19 surveillance tool using SARS-COV-2 antibody profiling and wastewater-based epidemiological surveillance; to assess the success of the home-based isolation and care system when supported with COVID-19 surveillance data; and to develop a COVID-19 Geo App surveillance platform for collection and dissemination of the research findings to stakeholders. We propose to use serology to identify immunoglobulin antibodies (IgG and IgM) to understand the antibody kinetics in asymptomatic and symptomatic infections and wastewater-based epidemiology to measure biomarkers from the SARS-CoV-2 in sewage to identify extent of community infections. In this respect we will establish the community transmission patterns to produce spatiotemporal risk maps of SARS-CoV-2 circulation in Kenya. We will further assess and evaluate the recently launched Kenyan government guidelines for the home-based isolation and care of Covid-19 patients. In addition, we propose a complimentary non-invasive method of detecting COVID-19 in the general population that involves the use of human faecal waste. This study has the potential impact of slowing the spread of the COVID-19 including development of novel diagnostics, expansion of surveillance and response systems, strengthening the home-based care and surveillance system and increasing the body of knowledge towards COVID-19 containment in Kenya. Expected Outputs The study will provide i. New data on extent of COVID-19 infection in Kenya and a develop protocol for the use of faecal samples in SARS-CoV-2 RNA detection. ii. New data on the plasma antibody profiles and kinetics in asymptomatic and symptomatic individuals. iii. An identification of COVID-19 infection hotspots in Kenya and map the trends of SARS-CoV-2 community circulation in infection hotspots. iv. Knowledge on the local understanding and experiences of HBIC; data on achievement and challenges in implementation of HBIC; Evidence based policy briefs on HBIC and integrated community-based approaches. v. A real-time COVID-19 surveillance tool; a pool of trained personnel capable of using the Geo App for data input and interpretation; and enhanced contact tracing strategy