Vaccine Preventable Disease Seroprevalence in a Nationwide Assessment of Timor-Leste (VASINA-TL): Study protocol for a population-representative cross-sectional serosurvey

Paul Arkell; Sarah L. Sheridan; Nelson Martins; Maria Y. Tanesi; Nelia Gomes; Salvador Amaral; Tessa Oakley; Vanessa Solano; Michael David; Anthony D.K. Draper; Nevio Sarmento; Endang da Silva; Lucsendar Alves; Carlito Freitas; Filipe de Neri Machado; Celia Gusmão; Ismael da Costa Barreto; Nicholas S.S. Fancourt; Kristine Macartney; Jennifer Yan; Joshua R. Francis

doi:10.1136/bmjopen-2022-071381

Vaccine Preventable Disease Seroprevalence in a Nationwide Assessment of Timor-Leste (VASINA-TL): Study protocol for a population-representative cross-sectional serosurvey

Paul Arkell, Sarah L. Sheridan, Nelson Martins, Maria Y. Tanesi, Nelia Gomes, Salvador Amaral, Tessa Oakley, Vanessa Solano, Michael David, Anthony D.K. Draper, Nevio Sarmento, Endang da Silva, Lucsendar Alves, Carlito Freitas, Filipe de Neri Machado, Celia Gusmão, Ismael da Costa Barreto, Nicholas S.S. Fancourt, Kristine Macartney, Jennifer YanJoshua R. Francis

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Abstract

INTRODUCTION: Historic disruption in health infrastructure combined with data from a recent vaccine coverage survey suggests there are likely significant immunity gaps to vaccine preventable diseases and high risk of outbreaks in Timor-Leste. Community-based serological surveillance is an important tool to augment understanding of population-level immunity achieved through vaccine coverage and/or derived from prior infection. METHODS AND ANALYSIS: This national population-representative serosurvey will take a three-stage cluster sample and aims to include 5600 individuals above 1 year of age. Serum samples will be collected by phlebotomy and analysed for measles IgG, rubella IgG, SARS-CoV-2 antispike protein IgG, hepatitis B surface antibody and hepatitis B core antigen using commercially available chemiluminescent immunoassays or ELISA. In addition to crude prevalence estimates and to account for differences in Timor-Leste's age structure, stratified age-standardised prevalence estimates will be calculated, using Asia in 2013 as the standard population. Additionally, this survey will derive a national asset of serum and dried blood spot samples which can be used for further investigation of infectious disease seroepidemiology and/or validation of existing and novel serological assays for infectious diseases. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the Research Ethics and Technical Committee of the Instituto Nacional da Saúde, Timor-Leste and the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research, Australia. Co-designing this study with Timor-Leste's Ministry-of-Health and other relevant partner organisations will allow immediate translation of findings into public health policy, which may include changes to routine immunisation service delivery and/or plans for supplementary immunisation activities.

Original language	English
Article number	e071381
Pages (from-to)	1-10
Number of pages	10
Journal	BMJ Open
Volume	13
Issue number	5
DOIs	https://doi.org/10.1136/bmjopen-2022-071381
Publication status	Published - 18 May 2023

Bibliographical note

Funding Information:
This work was supported by the Department for Foreign Affairs and Trade, Australian Government (Complex Grant Agreement Number 75889).

Publisher Copyright:
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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78160476-oaFinal published version, 1.18 MBLicence: CC BY-NC

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Arkell, P., Sheridan, S. L., Martins, N., Tanesi, M. Y., Gomes, N., Amaral, S., Oakley, T., Solano, V., David, M., Draper, A. D. K., Sarmento, N., da Silva, E., Alves, L., Freitas, C., Machado, F. D. N., Gusmão, C., da Costa Barreto, I., Fancourt, N. S. S., Macartney, K., ... Francis, J. R. (2023). Vaccine Preventable Disease Seroprevalence in a Nationwide Assessment of Timor-Leste (VASINA-TL): Study protocol for a population-representative cross-sectional serosurvey. BMJ Open, 13(5), 1-10. Article e071381. https://doi.org/10.1136/bmjopen-2022-071381

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title = "Vaccine Preventable Disease Seroprevalence in a Nationwide Assessment of Timor-Leste (VASINA-TL): Study protocol for a population-representative cross-sectional serosurvey",

abstract = "INTRODUCTION: Historic disruption in health infrastructure combined with data from a recent vaccine coverage survey suggests there are likely significant immunity gaps to vaccine preventable diseases and high risk of outbreaks in Timor-Leste. Community-based serological surveillance is an important tool to augment understanding of population-level immunity achieved through vaccine coverage and/or derived from prior infection. METHODS AND ANALYSIS: This national population-representative serosurvey will take a three-stage cluster sample and aims to include 5600 individuals above 1 year of age. Serum samples will be collected by phlebotomy and analysed for measles IgG, rubella IgG, SARS-CoV-2 antispike protein IgG, hepatitis B surface antibody and hepatitis B core antigen using commercially available chemiluminescent immunoassays or ELISA. In addition to crude prevalence estimates and to account for differences in Timor-Leste's age structure, stratified age-standardised prevalence estimates will be calculated, using Asia in 2013 as the standard population. Additionally, this survey will derive a national asset of serum and dried blood spot samples which can be used for further investigation of infectious disease seroepidemiology and/or validation of existing and novel serological assays for infectious diseases. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the Research Ethics and Technical Committee of the Instituto Nacional da Sa{\'u}de, Timor-Leste and the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research, Australia. Co-designing this study with Timor-Leste's Ministry-of-Health and other relevant partner organisations will allow immediate translation of findings into public health policy, which may include changes to routine immunisation service delivery and/or plans for supplementary immunisation activities.",

keywords = "Diagnostic microbiology, EPIDEMIOLOGIC STUDIES, Epidemiology, Public health, STATISTICS \& RESEARCH METHODS",

author = "Paul Arkell and Sheridan, \{Sarah L.\} and Nelson Martins and Tanesi, \{Maria Y.\} and Nelia Gomes and Salvador Amaral and Tessa Oakley and Vanessa Solano and Michael David and Draper, \{Anthony D.K.\} and Nevio Sarmento and \{da Silva\}, Endang and Lucsendar Alves and Carlito Freitas and Machado, \{Filipe de Neri\} and Celia Gusm{\~a}o and \{da Costa Barreto\}, Ismael and Fancourt, \{Nicholas S.S.\} and Kristine Macartney and Jennifer Yan and Francis, \{Joshua R.\}",

note = "Funding Information: This work was supported by the Department for Foreign Affairs and Trade, Australian Government (Complex Grant Agreement Number 75889). Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2023",

month = may,

day = "18",

doi = "10.1136/bmjopen-2022-071381",

language = "English",

volume = "13",

pages = "1--10",

journal = "BMJ Open",

issn = "2044-6055",

publisher = "British Medical Journal Publishing Group (BMJ Publishing)",

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Arkell, P, Sheridan, SL, Martins, N, Tanesi, MY, Gomes, N, Amaral, S, Oakley, T, Solano, V, David, M, Draper, ADK, Sarmento, N, da Silva, E, Alves, L, Freitas, C, Machado, FDN, Gusmão, C, da Costa Barreto, I, Fancourt, NSS, Macartney, K, Yan, J & Francis, JR 2023, 'Vaccine Preventable Disease Seroprevalence in a Nationwide Assessment of Timor-Leste (VASINA-TL): Study protocol for a population-representative cross-sectional serosurvey', BMJ Open, vol. 13, no. 5, e071381, pp. 1-10. https://doi.org/10.1136/bmjopen-2022-071381

TY - JOUR

T1 - Vaccine Preventable Disease Seroprevalence in a Nationwide Assessment of Timor-Leste (VASINA-TL)

T2 - Study protocol for a population-representative cross-sectional serosurvey

AU - Arkell, Paul

AU - Sheridan, Sarah L.

AU - Martins, Nelson

AU - Tanesi, Maria Y.

AU - Gomes, Nelia

AU - Amaral, Salvador

AU - Oakley, Tessa

AU - Solano, Vanessa

AU - David, Michael

AU - Draper, Anthony D.K.

AU - Sarmento, Nevio

AU - da Silva, Endang

AU - Alves, Lucsendar

AU - Freitas, Carlito

AU - Machado, Filipe de Neri

AU - Gusmão, Celia

AU - da Costa Barreto, Ismael

AU - Fancourt, Nicholas S.S.

AU - Macartney, Kristine

AU - Yan, Jennifer

AU - Francis, Joshua R.

N1 - Funding Information: This work was supported by the Department for Foreign Affairs and Trade, Australian Government (Complex Grant Agreement Number 75889). Publisher Copyright: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2023/5/18

Y1 - 2023/5/18

N2 - INTRODUCTION: Historic disruption in health infrastructure combined with data from a recent vaccine coverage survey suggests there are likely significant immunity gaps to vaccine preventable diseases and high risk of outbreaks in Timor-Leste. Community-based serological surveillance is an important tool to augment understanding of population-level immunity achieved through vaccine coverage and/or derived from prior infection. METHODS AND ANALYSIS: This national population-representative serosurvey will take a three-stage cluster sample and aims to include 5600 individuals above 1 year of age. Serum samples will be collected by phlebotomy and analysed for measles IgG, rubella IgG, SARS-CoV-2 antispike protein IgG, hepatitis B surface antibody and hepatitis B core antigen using commercially available chemiluminescent immunoassays or ELISA. In addition to crude prevalence estimates and to account for differences in Timor-Leste's age structure, stratified age-standardised prevalence estimates will be calculated, using Asia in 2013 as the standard population. Additionally, this survey will derive a national asset of serum and dried blood spot samples which can be used for further investigation of infectious disease seroepidemiology and/or validation of existing and novel serological assays for infectious diseases. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the Research Ethics and Technical Committee of the Instituto Nacional da Saúde, Timor-Leste and the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research, Australia. Co-designing this study with Timor-Leste's Ministry-of-Health and other relevant partner organisations will allow immediate translation of findings into public health policy, which may include changes to routine immunisation service delivery and/or plans for supplementary immunisation activities.

AB - INTRODUCTION: Historic disruption in health infrastructure combined with data from a recent vaccine coverage survey suggests there are likely significant immunity gaps to vaccine preventable diseases and high risk of outbreaks in Timor-Leste. Community-based serological surveillance is an important tool to augment understanding of population-level immunity achieved through vaccine coverage and/or derived from prior infection. METHODS AND ANALYSIS: This national population-representative serosurvey will take a three-stage cluster sample and aims to include 5600 individuals above 1 year of age. Serum samples will be collected by phlebotomy and analysed for measles IgG, rubella IgG, SARS-CoV-2 antispike protein IgG, hepatitis B surface antibody and hepatitis B core antigen using commercially available chemiluminescent immunoassays or ELISA. In addition to crude prevalence estimates and to account for differences in Timor-Leste's age structure, stratified age-standardised prevalence estimates will be calculated, using Asia in 2013 as the standard population. Additionally, this survey will derive a national asset of serum and dried blood spot samples which can be used for further investigation of infectious disease seroepidemiology and/or validation of existing and novel serological assays for infectious diseases. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the Research Ethics and Technical Committee of the Instituto Nacional da Saúde, Timor-Leste and the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research, Australia. Co-designing this study with Timor-Leste's Ministry-of-Health and other relevant partner organisations will allow immediate translation of findings into public health policy, which may include changes to routine immunisation service delivery and/or plans for supplementary immunisation activities.

KW - Diagnostic microbiology

KW - EPIDEMIOLOGIC STUDIES

KW - Epidemiology

KW - Public health

KW - STATISTICS & RESEARCH METHODS

UR - https://www.scopus.com/pages/publications/85159768521

U2 - 10.1136/bmjopen-2022-071381

DO - 10.1136/bmjopen-2022-071381

M3 - Article

C2 - 37202138

AN - SCOPUS:85159768521

SN - 2044-6055

VL - 13

SP - 1

EP - 10

JO - BMJ Open

JF - BMJ Open

IS - 5

M1 - e071381

ER -

Vaccine Preventable Disease Seroprevalence in a Nationwide Assessment of Timor-Leste (VASINA-TL): Study protocol for a population-representative cross-sectional serosurvey

Abstract

Bibliographical note

UN SDGs

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