The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019 rapidly escalated into a global health emergency and pandemic. The spread of the virus, affecting millions, was largely facilitated by the ease of international travel. To balance public health measures with essential cross-border mobility between the Democratic Republic of Congo (DRC) and other countries, a traveler surveillance program was implemented. This study aimed to review the first six months of COVID-19 pandemic surveillance by screening international travelers in Kinshasa. A multicentric cross-sectional study was conducted between August 2020 and February 2021 across six COVID-19 screening sites affiliated with the National Institute of Biomedical Research (INRB). Data collected included sociodemographic characteristics, travel history, RT-PCR test results, and viral sequencing information. Among the 190,809 travelers included in the study, 4.7% tested positive for SARS-CoV-2. Most positive cases were between the ages of 21 and 60. Outbound travelers exhibited a higher positivity rate (6.1%). The predominant variant detected was 20E (EU1). Multivariate analysis identified age ? 80, female gender, and outbound travel as factors significantly associated with increased infection risk. These findings underscore the critical role of targeted traveler surveillance in mitigating the international spread of imported and exported infectious diseases.
References
[1]
WHO (Word Health Organization) (2020) Director-General’s Remarks at the Media Briefing on 2019-nCoV on 11 February 2020.
[2]
WHO (Word Health Organization) (2020) Statement on the Second Meeting of the International Health Regulations (2005) Emergency Committee Regarding the Outbreak of Novel Coronavirus (2019-nCoV).
[3]
Petersen, E., McCloskey, B., Hui, D.S., Kock, R., Ntoumi, F., Memish, Z.A., et al. (2020) COVID-19 Travel Restrictions and the International Health Regulations—Call for an Open Debate on Easing of Travel Restrictions. International Journal of Infectious Diseases, 94, 88-90. https://doi.org/10.1016/j.ijid.2020.04.029
[4]
Cucinotta, D. and Vanelli, M. (2020) WHO Declares COVID-19 a Pandemic. Acta Bio Medica Atenei Parmensis, 91, 157-160.
[5]
Otshudiema, J.O., Folefack, G.L.T., Nsio, J.M., Mbala-Kingebeni, P., Kakema, C.H., Kosianza, J.B., et al. (2022) Epidemiological Comparison of Four COVID-19 Waves in the Democratic Republic of the Congo, March 2020-January 2022. Journal of Epidemiology and Global Health, 12, 316-327. https://doi.org/10.1007/s44197-022-00052-6
[6]
Matangila, J.R., Nyembu, R.K., Telo, G.M., Ngoy, C.D., Sakobo, T.M., Massolo, J.M., et al. (2020) Clinical Characteristics of COVID-19 Patients Hospitalized at Clinique Ngaliema, a Public Hospital in Kinshasa, in the Democratic Republic of Congo: A Retrospective Cohort Study. PLOS ONE, 15, e0244272. https://doi.org/10.1371/journal.pone.0244272
[7]
Waechter, C. (2021) Manifestations cliniques et paracliniques de la COVID-19, diagnostic virologique. NPG Neurologie-Psychiatrie-Gériatrie, 21, 297-303. https://doi.org/10.1016/j.npg.2021.05.011
[8]
Desvaux, É. and Faucher, J. (2020) Covid-19: Aspects cliniques et principaux éléments de prise en charge. Revue Francophone des Laboratoires, 2020, 40-47. https://doi.org/10.1016/s1773-035x(20)30312-9
[9]
Kiang, M.V., Chin, E.T., Huynh, B.Q., Chapman, L.A.C., Rodríguez-Barraquer, I., Greenhouse, B., et al. (2021) Routine Asymptomatic Testing Strategies for Airline Travel during the COVID-19 Pandemic: A Simulation Study. The Lancet Infectious Diseases, 21, 929-938. https://doi.org/10.1016/s1473-3099(21)00134-1
[10]
WHO (Word Health Organization) (2023) Tracking SARS-CoV-2 Variants.
[11]
Akande, O.W., Elimian, K.O., Igumbor, E., Dunkwu, L., Kaduru, C., Olopha, O.O., et al. (2021) Epidemiological Comparison of the First and Second Waves of the COVID-19 Pandemic in Nigeria, February 2020-April 2021. BMJ Global Health, 6, e007076. https://doi.org/10.1136/bmjgh-2021-007076
[12]
Aleem, A., Samad, A.B.A. and Vaqar, S. (2023) Emerging Variants of SARS-CoV-2 and Novel Therapeutics against Coronavirus (COVID-19). StatPearls Publishing.
[13]
Mandina, M.N., Makulo, J.R., Wumba, R.D., Bepouka, B., Odio, J.O., Nkodila, A.N., et al. (2022) Epidemiological, Clinical Characteristics and Mortality of Patients Infected with Sars-Cov-2 Admitted to Kinshasa University Hospital (KUH), the Democratic Republic of the Congo from March 24th, 2020, to January 30th, 2021: Two Waves, Two Faces? Annales Africaines de Medecine, 15, e4681-e4690. https://doi.org/10.4314/aamed.v15i3.5
[14]
WHO (Word Health Organization) (2020) Covid-19 in the World. 2020 Report.
[15]
Pustahija, T., Ristić, M., Medić, S., Vuković, V., Štrbac, M., Rajčević, S., et al. (2021) Epidemiological Characteristics of COVID-19 Travel-Associated Cases in Vojvodina, Serbia, during 2020. PLOS ONE, 16, e0261840. https://doi.org/10.1371/journal.pone.0261840
[16]
Maxime Gautier (2023) Number of Coronavirus Infections by Country as of January 8, 2023. Statista.
Wilson, K., Halabi, S. and Gostin, L.O. (2020) The International Health Regulations (2005), the Threat of Populism and the COVID-19 Pandemic. Globalization and Health, 16, Article No. 70. https://doi.org/10.1186/s12992-020-00600-4
[19]
WHO (Word Health Organization) (2020) COVID-19 Diagnostic Testing in the Context of International Travel. Scientific Information Document.
[20]
Mayala, G.M., Malonga, L.N., Lombela, G.W. and Kayembe, J.N. (2022) Première année de la pandémie à COVID-19 en République Démocratique du Congo: Revue de la gestion d’une crise dans un système de santé décentralisé. Annales Africaines de Medecine, 15, e4561-e4576. https://doi.org/10.4314/aamed.v15i2.5
[21]
DRC (Democratic Republic of the Congo) (2020) Ordinance No 20/014 of March 24, 2020, Proclaiming a State of Health Emergency to Deal with the Covid-19 Epidemic. https://natlex.ilo.org/dyn/natlex2/r/natlex/fe/details?p3_isn=110917
[22]
Organization Internationale de la Francophonie (2020) Monitoring the Economic Impact of Covid-19 in the 54 Member States and Governments of the OIF. Organization Mondiale de la Francophonie, Report 2020-2021.
[23]
DRC (Democratic Republic of the Congo) (2020) Address by His Excellency Felix-Antoine Tshisekedi Tshilombo, President of the Democratic Republic of the Congo, Head of State, on the End of the State of Emergency.
[24]
DRC (Democratic Republic of the Congo) (2020) Barrier Measures to Combat the Covid-19 Pandemic. Decree 20/023 of October 1, 2020.
[25]
DRC (Democratic Republic of the Congo) (2021) Ministry of Public Health, Hygiene and Prevention. Arrêté ministériel No 1250/CAB/MIN/SPHP/011/DC/SAC/2021 du 25 novembre 2021 portant création de la commission Covid-19 voyage.
[26]
WHO (Word Health Organization) (2020) Management of Ill Travelers at Points of Entry—Airports, Seaports, and International Border Crossings in the Context of the COVID-19 Outbreak. Interim guidelines February 16, 2020.
[27]
Bielecki, M., Patel, D., Hinkelbein, J., Komorowski, M., Kester, J., Ebrahim, S., et al. (2021) Air Travel and COVID-19 Prevention in the Pandemic and Peri-Pandemic Period: A Narrative Review. Travel Medicine and Infectious Disease, 39, Article 101915. https://doi.org/10.1016/j.tmaid.2020.101915
[28]
Wilson, N., Baker, M.G., Blakely, T. and Eichner, M. (2021) Estimating the Impact of Control Measures to Prevent Outbreaks of COVID-19 Associated with Air Travel into a Covid-19-Free Country. Scientific Reports, 11, Article No. 10766. https://doi.org/10.1038/s41598-021-89807-y
[29]
Clifford, S., Quilty, B.J., Russell, T.W., Liu, Y., Chan, Y.D., Pearson, C.A.B., et al. (2021) Strategies to Reduce the Risk of Sars-Cov-2 Importation from International Travelers: Modelling Estimations for the United Kingdom, July 2020. Eurosurveillance, 26, pii2001440. https://doi.org/10.2807/1560-7917.es.2021.26.39.2001440
[30]
Khanh, N.C., Thai, P.Q., Quach, H., Thi, N.H., Dinh, P.C., Duong, T.N., et al. (2020) Transmission of Sars-Cov 2 during Long-Haul Flight. Emerging Infectious Diseases, 26, 2617-2624. https://doi.org/10.3201/eid2611.203299
Burns, J., Movsisyan, A., Stratil, J.M., Biallas, R.L., Coenen, M., Emmert-Fees, K.M., et al. (2021) International Travel-Related Control Measures to Contain the COVID-19 Pandemic: A Rapid Review. Cochrane Database of Systematic Reviews, 2021, CD01371. https://doi.org/10.1002/14651858.cd013717.pub2
[34]
Zhang, J., Qin, F., Qin, X., Li, J., Tian, S., Lou, J., et al. (2021) Transmission of Sars-Cov-2 during Air Travel: A Descriptive and Modelling Study. Annals of Medicine, 53, 1569-1575. https://doi.org/10.1080/07853890.2021.1973084
[35]
Tsuboi, M., Hachiya, M., Ohtsu, H., Akashi, H., Miyoshi, C. and Umeda, T. (2021) Epidemiology and Risk of Coronavirus Disease 2019 among Travelers at Airport and Port Quarantine Stations across Japan: A Nationwide Descriptive Analysis and an Individually Matched Case-Control Study. Clinical Infectious Diseases, 74, 1614-1622. https://doi.org/10.1093/cid/ciab659
[36]
Lunney, M., Ronksley, P.E., Weaver, R.G., Barnieh, L., Blue, N., Avey, M.T., et al. (2021) COVID-19 Infection among International Travelers: A Prospective Analysis. BMJ Open, 11, e050667. https://doi.org/10.1136/bmjopen-2021-050667