Background

The Network will apply optimised and validated serological sampling, analysis, and reporting of exposures to emerging and endemic neglected tropical infectious diseases of regional importance.

The project leverages both robotic ELISA and Luminex multiplex high throughput platforms in order to efficiently and sustainably surveil several dozen infections/vaccinations. The sampling strategy is a pragmatic approach of age-stratified anonymised residual blood specimens from networks of 25 hospitals in Indonesia and 20 in Viet Nam, based on existing efforts active in Viet Nam since 2009 and recently expanded throughout the entire country.

The project joins academic research partners from the University of Oxford’s clinical research units in Indonesia and Viet Nam with researchers within the respective Ministry of Health in both nations.

The first year of effort focuses exclusively on serological surveillance of SARS-CoV-2 through three distinct workstreams:

• Establishing routine national serological surveillance by ELISA;
• Cross-sectional surveys for exposure to SARS-CoV-2 at selected sites; and
• Following two longitudinal cohorts for serological assessment by ELISA over a 1-year period, where enrollment in one cohort immediately follows qPCR positivity for SARS-CoV-2, and in the other immediately follows vaccination against COVID-19.

Year 1 will also see the optimising and validation of a multiplex Luminex assay for six distinct SARS-CoV-2 antigenic targets and three distinct immunoglobulins (A, M, and G), along with Spike S1 and Spike N proteins of MERS-CoV, and four seasonal coronaviruses.

The same multiplex assay will later include eight emerging infections (e.g. Nipah, Zika, and Japanese encephalitis viruses), neglected tropical infections (e.g., Dengue, malaria, filariasis, leprosy, and intestinal helminthiases), and vaccine-preventable infections (e.g. measles, diphtheria, and tetanus).

That multiplex serological assay will constitute the basis of routine national serological surveillance, and the project aims to build that capacity within Ministry of Health facilities in Indonesia and Viet Nam and to turn those facilities over to the respective authorities at the end of the 5-year life of the project.

A hospital-based nationwide sero-surveillance network in Viet Nam

This project aims to establish and run a nationally representative serum bank for Viet Nam, as a resource for researchers and policymakers to understand infectious disease emergence, transmission, immunity and vaccination in the population.

The serum bank periodically collects age-stratified residual serum samples from hospital labs in order to establish both a cross-sectional and longitudinal collection.

The platform’s strategic importance has been accentuated by COVID-19 and is as follows:

• It enhances OUCRU’s relevance to and impact upon public health in Viet Nam, supporting outbreak responses and prevention.
• It creates a substantial long-term longitudinal research resource, allowing OUCRU to address multiple research questions concerning the epidemiology of emerging and vaccine-preventable infectious diseases, but also infectious diseases for which the transmission is difficult to understand, either because part of it is not directly tractable (e.g. TB or COVID-19), or because of complex immunological processes (e.g. dengue, influenza).
• Vaccine-preventable and emerging infections, and the serum bank itself, is a part of the strategic vision for OUCRU in the applications for bridging and core funding with Wellcome.

Studies on influenza, tetanus and measles have been completed.

We are awaiting funding for large-scale COVID-19 research in the current and future collections to study background immunity, population-level exposure (currently very low due to Viet Nam’s successful COVID-19 response) and vaccine coverage.