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Genomic surveillance reveals the spread patterns of SARS-CoV-2 in coastal Kenya during the first two waves
Charles N. Agoti; Lynette Isabella Ochola-Oyier; Khadija Said Mohammed; Arnold W Lambisia; Zaydah R de Laurent; John M Morobe; Maureen W Mburu; Donwilliams O Omuoyo; Edidah M Ongera; Leoard Ndwiga; Eric Maitha; Benson Kitole; Thani Suleiman; Mohamed Mwakinangu; John Nyambu; John Otieno; Barke Salim; Jennifer Musyoki; Nickson Murunga; Edward Otieno; John Kiiru; Kadondi Kasera; Patrick Amoth; Mercy Mwangangi; Rashid Aman; Samson Kinyanjui; George Warimwe; My Phan; Ambrose Agweyu; Matthew Cotten; Edwine Barasa; Benjamin Tsofa; D James Nokes; Philip Bejon; George Githinji.
  • Charles N. Agoti; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • Lynette Isabella Ochola-Oyier; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • Khadija Said Mohammed; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • Arnold W Lambisia; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • Zaydah R de Laurent; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • John M Morobe; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • Maureen W Mburu; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • Donwilliams O Omuoyo; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • Edidah M Ongera; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • Leoard Ndwiga; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • Eric Maitha; Ministry of Health, Kenya
  • Benson Kitole; Ministry of Health, Kenya
  • Thani Suleiman; Ministry of Health, Kenya
  • Mohamed Mwakinangu; Ministry of Health, Kenya
  • John Nyambu; Ministry of Health, Kenya
  • John Otieno; Ministry of Health, Kenya
  • Barke Salim; Ministry of Health, Kenya
  • Jennifer Musyoki; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • Nickson Murunga; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • Edward Otieno; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • John Kiiru; Ministry of Health, Kenya
  • Kadondi Kasera; Ministry of Health, Kenya
  • Patrick Amoth; Ministry of Health, Kenya
  • Mercy Mwangangi; Ministry of Health, Kenya
  • Rashid Aman; Ministry of Health, Kenya
  • Samson Kinyanjui; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • George Warimwe; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • My Phan; Medical Research Centre/ Uganda Virus Research Institute, Entebbe, Uganda
  • Ambrose Agweyu; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • Matthew Cotten; Medical Research Centre/ Uganda Virus Research Institute, Entebbe, Uganda
  • Edwine Barasa; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • Benjamin Tsofa; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • D James Nokes; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • Philip Bejon; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
  • George Githinji; Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme (KWTRP), Kilifi, Kenya
Preprint En | PREPRINT-MEDRXIV | ID: ppmedrxiv-21259583
BackgroundThe transmission networks of SARS-CoV-2 in sub-Saharan Africa remain poorly understood. MethodsWe undertook phylogenetic analysis of 747 SARS-CoV-2 positive samples collected across six counties in coastal Kenya during the first two waves (March 2020 - February 2021). Viral imports and exports from the region were inferred using ancestral state reconstruction (ASR) approach. ResultsThe genomes were classified into 35 Pango lineages, six of which accounted for 79% of the sequenced infections B.1 (49%), B.1.535 (11%), B.1.530 (6%), B.1.549 (4%), B.1.333 (4%) and B.1.1 (4%). Four identified lineages were Kenya specific. In a contemporaneous global subsample, 990 lineages were documented, 261 for Africa and 97 for Eastern Africa. ASR analysis identified >300 virus location transition events during the period, these comprising 69 viral imports into Coastal Kenya; 93 viral exports from coastal Kenya; and 191 inter-county import/export events. Most international viral imports (58%) and exports (92%) occurred through Mombasa City, a key touristic and commercial Coastal Kenya center; and many occurred prior to June 2020, when stringent local COVID-19 restriction measures were enforced. After this period, local virus transmission dominated, and distinct local phylogenies were seen. ConclusionsOur analysis supports moving control strategies from a focus on international travel to local transmission. FundingThis work was funded by Wellcome (grant# 220985) and the National Institute for Health Research (NIHR), project references 17/63/and 16/136/33 using UK aid from the UK Government to support global health research, The UK Foreign, Commonwealth and Development Office.

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