TY - JOUR
AU - McCormack, Mhairi J.
AU - Banda, Louis
AU - Kasenda, Stephen
AU - Hughes, Ellen C.
AU - Leonhard, Lina
AU - Chauma Mwale, Annie
AU - McLean, Estelle
AU - Price, Alison
AU - Crampin, Amelia
AU - Chaima, David
AU - Amoah, Abena S.
AU - Nyirenda, Tonney S.
AU - Ho, Antonia
AU - Willett, Brian J.
PY - 2025
DA - October
TI - Characterising protective immune responses to SARS-CoV-2 in urban and rural Malawi between February 2021 and April 2022
JO - Scientific Reports
VL - 15
DO - https://doi.org/10.1038/s41598-025-22599-7
AB - SARS-CoV-2 transmission in Malawi remains unclear due to high proportions of mild/asymptomatic infections and limited diagnostics. Existing seroprevalence studies in Malawi have primarily used convenience samples and enzyme-linked immunosorbent assays (ELISAs). We assessed SARSCoV-2 neutralisation in a longitudinal Malawian population-based cohort, assessing protective immunity post-infection and vaccination. Sera were obtained from rural (Karonga, n = 958) and urban (Lilongwe, n = 918) based participants at three-monthly intervals (February 2021-April 2022). Neutralising antibodies against SARS-CoV-2 were measured using human immunodeficiency (HIV)based pseudotype assays in HIV-uninfected participants, and vesicular stomatitis virus-based assays in HIV-infected participants and an HIV-uninfected subset. Nucleocapsid ELISAs identified vaccinated participants also infected. SARS-CoV-2 neutralisation profiles increased in complexity over time from rising vaccination coverage and emerging variants. Neutralising antibody prevalence was higher in Lilongwe than Karonga (68.1% (CI 63.5–72.4) vs. 45.4% (CI 41.6–49.3), Survey 4). Hybrid immune and solely vaccinated participants exhibited higher titres than those solely infected. Children &lt; 15 years had the lowest neutralising antibody titres among infected (not vaccinated) participants. People living with HIV had lower neutralising responses than those HIV-uninfected, particularly post vaccination. We therefore recommend surveillance of children and people living with HIV as low neutralisation responses increase reinfection risk. COVID-19 vaccination should be prioritised for HIV-infected individuals.
PB - Springer Nature
UR - https://eprints.gla.ac.uk/368091/
KW - Coronavirus (COVID-19)
KW - Immunisation and screening
ER