Jagne, Ya Jankey; Jobe, Dawda; Darboe, Alansana; Danso, Madikoi; Barratt, Natalie; Gomez, Marie; Wenlock, Rhys; Jarju, Sheikh; Sylva, Ellen Lena; Touray, Aji Fatou; +14 more... Toure, Fatoumata; Kumado, Michelle; Saso, Anja; Zafred, Domen; Nicklin, Martin; Sayers, Jon; Hornsby, Hailey; Lindsey, Benjamin; Sesay, Abdul Karim; Temperton, Nigel; Kucharski, Adam; Hodgson, David; de Silva, Thushan; Kampmann, Beate; (2025) Compartmentalised mucosal and blood immunity to SARS-CoV-2 is associated with high seroprevalence before the Delta wave in Africa. Communications Medicine, 5. p. 178. DOI: https://doi.org/10.1038/s43856-025-00902-x
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Abstract
Background: The reported number of SARS-CoV-2 cases and deaths are lower in Africa compared to many high-income countries. However, in African cohorts, detailed characterisation of SARS-CoV-2 mucosal and T cell immunity are limited. We assessed the SARS-CoV-2-specific immune landscape in The Gambia during the presence of the pre-Delta variant in July 2021. Methods: A cross-sectional assessment of SARS-CoV-2 immunity in 349 unvaccinated individuals from 52 Gambian households was performed between March–June 2021. SARS-CoV-2 spike (S) and nucleocapsid (N) specific binding antibodies were measured by ELISA, variant-specific serum neutralizing-antibodies (NAb) by viral pseudotype assays and nasal fluid IgA by mesoscale discovery assay. SARS-CoV-2 T-cell responses were evaluated using ELISpot assay. Results: We show that adjusted anti-Spike antibody seroprevalence is 56.7% (95% confidence interval (CI) 49.0-64.0), with lower rates in children <5 years (26.2%, 13.9-43.8) and 5-17 years (46.4%, 36.2-56.7) compared to adults 18-49 years (78.4%, 68.8–85.8). Among spike-seropositive individuals, NAb titres are highest against Alpha variant (median IC50 110), with 27% showing pre-existing Delta variant titres >1:50. T-cell responses are higher in spike-seropositive individuals, although 34% of spike-seronegative individuals show responses to at least one antigen pool. We observe strong correlations within SARS-CoV-2 T-cell, mucosal IgA, and serum NAb responses. Conclusions: High SARS-CoV-2 seroprevalence in The-Gambia induce mucosal and blood immunity, reducing Delta and Omicron impact. Children are relatively protected from infection. T-cell responses in seronegative individuals may indicate either pre-pandemic cross-reactivity or individuals with a T-cell dominated response to SARS-CoV-2 infection with absent or poor humoral responses.
Item Type | Article |
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Faculty and Department |
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology & Dynamics (2023-) Faculty of Infectious and Tropical Diseases > Dept of Clinical Research MRC Gambia > Child Survival Theme |
Research Centre | Centre for the Mathematical Modelling of Infectious Diseases |
Elements ID | 240466 |
Official URL | https://doi.org/10.1038/s43856-025-00902-x |
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