{"refrec":{"BRefID":448642,"RR":"<b>Lambisia, A.W.; Nyiro, J.; Githinji, G.; Katama, E.N.; Moraa, E.; Morobe, J.M.; Mutunga, M.; Maina, G.; Bejon, P.; Phan, M.V.T.; Cotten, M.; Dellicour, S.; Ochola-Oyier, L.I.; Sande, C.; Holmes, E.C.; Nyagwange, J.; Agoti, C.N.</b> (2026). Longitudinal Epidemiology and Variant Dynamics of SARS-CoV-2 in Coastal Kenya (2020-2025): Clinical Features and Wave Patterns. <i>Open Forum Infectious Diseases 13(3)</i>: ofag084. <a href=\"https://dx.doi.org/10.1093/ofid/ofag084\" target=\"_blank\">https://dx.doi.org/10.1093/ofid/ofag084</a>","BEntID":446480,"PublicFlag":1,"CheckedFlag":1,"wosflag":1,"vabbflag":null,"RefStringPartII":". <i>Open Forum Infectious Diseases 13(3)</i>: ofag084. <a href=\"https://dx.doi.org/10.1093/ofid/ofag084\" target=\"_blank\">https://dx.doi.org/10.1093/ofid/ofag084</a>","DocTypID":8,"DocType":"Journal article","MarineFlag":0,"FreshFlag":0,"BrackishFlag":0,"TerrestrialFlag":0,"Authorstring":"Lambisia, A.W.; Nyiro, J.; Githinji, G.; Katama, E.N.; Moraa, E.; Morobe, J.M.; Mutunga, M.; Maina, G.; Bejon, P.; Phan, M.V.T.; Cotten, M.; Dellicour, S.; Ochola-Oyier, L.I.; Sande, C.; Holmes, E.C.; Nyagwange, J.; Agoti, C.N.","OrigTitleTranslFlag":0,"Authorstringtrunc":"Lambisia, A.W. <i>et al.</i>","Englishabstract":"Background SARS-CoV-2 is a major cause of outpatient-attended acute respiratory infections (ARIs). Data from Africa are limited on SARS-CoV-2 infection, variants, symptom profile, and longitudinal trends for outpatient presentation. Methods Starting December 2020, we established ARI surveillance at 5 outpatient clinics in coastal Kenya, recruiting similar to 15 participants (any age) per week per clinic for SARS-CoV-2 testing and genome analysis. Participants provided respiratory samples, demographic details, and vaccination and symptom data. We compared SARS-CoV-2 clinical and molecular epidemiology before and during Omicron waves using multivariate logistic regression. Results By February 2025, we had recruited 14 562 ARI cases, with 1053 (7.2%) testing positive for SARS-CoV-2. The median age of cases was 25 years (IQR, 15-41) and 65.0% were female. Nine infection waves were recorded, with positivity ranging 8.2% to 25.6%. Interwave intervals increased from <= 3 months in 2021 to >= 6 months in 2024. Sixty-eight PANGO lineages were identified from 782 (74.2%) sequenced cases, with 4 predominating local waves (AY.116, BQ.1.8, FY.4.1, LF.7.3.2), which were rare globally (<0.5%) during their detection period. Overall, common symptoms among positive cases were cough (91.5%), nasal discharge (76.7%), and fever (53.1%). Loss of sense of smell was strongly predictive of COVID-19 in the pre-Omicron era, but body malaise, sore throat, joint pain, and nasal discharge were predictive during the Omicron period. Conclusions SARS-CoV-2 increasingly shows seasonal annual patterns in coastal Kenya, with its clinical features resembling established endemic respiratory viruses. Its case burden is most pronounced in young adults. Locally dominant genetic variants may differ from those globally.","AbstractOtherLang":null,"BibLvlCode":"AS","StandardTitle":"Longitudinal Epidemiology and Variant Dynamics of SARS-CoV-2 in Coastal Kenya (2020-2025): Clinical Features and Wave Patterns","OrigTitleLangCode":"en","OrigTitleLangCodeExtended":"eng","OrigTitleLangID":15,"DateLastModified":{"date":"2026-10-05 01:50:03.718606","timezone_type":1,"timezone":"+02:00"},"AuthorKeywords":"coastal Kenya;covid-19;SARS-CoV-2;symptoms;waves;definition","OtherDescriptors":null,"Notes":null,"AnaPub":2026,"MonPub":null,"DateUpdate":"2026-09-28","DateCreate":"2026-09-28","SecASFANote":null,"ConfID":null,"PeerRev":1,"VlizCoreFlag":1,"WoScode":"WOS:001717231800001","VABBcode":null,"OpenAcc":0,"DOI":"10.1093/ofid/ofag084"},"refs":null,"anarec":{"AnaID":448642,"PubliDate":2026,"Pagination":"ofag084","XtraPublOfAnaID":null,"ISBN":null,"Volume":"13","Issue":"3","BRefMon":null,"BRefMonRR":null,"BRefXtra":null,"BRefXtraRR":null,"SerBRefID":369854,"SerRR":"Open Forum Infectious Diseases. 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