@phdthesis{Klein2015, author = {Klein, Dennis}, title = {The pathogenic role of endogenous antibodies in a mouse model for Charcot-Marie-Tooth 1B neuropathy}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-121941}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2015}, abstract = {Charcot-Marie-Tooth (CMT) type 1 neuropathies are a genetically heterogeneous group of non-treatable inherited disorders affecting the peripheral nervous system that lead to sensory and motor dysfunction. Secondary low grade inflammation, implicating the innate and adaptive immune system, could previously be identified as a substantial disease modifier in two mouse models for CMT1, CMT1B and 1X, respectively. However, the exact mechanism how the adaptive immune system contributes to disease pathogenesis is not completely understood. Based on observations that the accumulation of endogenous antibodies to myelin components is important for rapid myelin clearance after nerve injury during Wallerian degeneration, a possibly similar mechanism was considered for endogenous antibodies as disease amplifier in mice heterozygously deficient for P0 (P0het), mimicking some typical features of CMT1B. In this study an increased antibody deposition was detected in the affected peripheral nerves of P0het myelin mutant mice. By crossbreeding P0het mutants with mice specifically lacking B-lymphocytes, and therefore antibodies (JHD-/-), a decline of endoneurial macrophages together with a substantially ameliorated demyelination could be demonstrated in 6-month-old mutant mice. Moreover, reconstitution with murine IgGs reverted the neuropathic phenotype, substantiating that endogenous antibodies are potentially pathogenic at this early stage of disease. Unexpectedly, in 12-months-old P0het mutants, JHD deficiency resulted in disease aggravation accompanied by an increased inflammatory reaction and M2-polarized macrophage response. These observations suggest that in a mouse model for CMT1B, the lack of endogenous antibodies has a dichotomous effect: ameliorating early macrophage-mediated demyelination, as opposed to increasing inflammatory reactions leading to disease aggravation at older ages.}, subject = {Maus}, language = {en} } @article{RovitusoDuffySchroeteretal.2015, author = {Rovituso, Damiano M. and Duffy, Catharina E. and Schroeter, Michael and Kaiser, Claudia C. and Kleinschnitz, Christoph and Bayas, Antonios and Elsner, Rebecca and Kuerten, Stefanie}, title = {The brain antigen-specific B cell response correlates with glatiramer acetate responsiveness in relapsing-remitting multiple sclerosis patients}, series = {Scientific Reports}, volume = {5}, journal = {Scientific Reports}, number = {14265}, doi = {10.1038/srep14265}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-148172}, year = {2015}, abstract = {B cells have only recently begun to attract attention in the immunopathology of multiple sclerosis (MS). Suitable markers for the prediction of treatment success with immunomodulatory drugs are still missing. Here we evaluated the B cell response to brain antigens in n = 34 relapsing-remitting MS (RRMS) patients treated with glatiramer acetate (GA) using the enzyme-linked immunospot technique (ELISPOT). Our data demonstrate that patients can be subdivided into responders that show brain-specific B cell reactivity in the blood and patients without this reactivity. Only in patients that classified as B cell responders, there was a significant positive correlation between treatment duration and the time since last relapse in our study. This correlation was GA-specific because it was absent in a control group that consisted of interferon-\(\beta\) (IFN-\(\beta\))-treated RRMS patients (n = 23). These data suggest that GA has an effect on brain-reactive B cells in a subset of patients and that only this subset benefits from treatment. The detection of brain-reactive B cells is likely to be a suitable tool to identify drug responders.}, language = {en} } @phdthesis{Hartmann2014, author = {Hartmann, Sonja}, title = {Relevance of antibodies targeting the beta1-adrenergic receptor for renal function}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-106285}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2014}, abstract = {Functionally active (conformational) autoantibodies directed against the β1-adrenergic receptor (β1-AR) are supposed to have a pathogenic relevance in human heart failure, particularly in idiopathic dilated cardiomyopathy (DCM). Prevalence of anti-β1-autoantibodies (anti-β1-aabs) in the healthy population is almost negligible, whereas it amounts to up to 30\% in heart failure patients with idiopathic DCM. As β1-ARs are not restricted to the heart and are also highly expressed in particular segments of the nephron, it is conceivable that such autoantibodies might also affect kidney function to some extent through the activation of renal β1-ARs. In the kidney, β1-ARs are highly abundant in the juxtaglomerular apparatus, the distal convoluted tubules, the collecting duct, and the renal arteries. However, the functional significance of β1-ARs at these particular sites along the nephron is poorly understood, as are the effects of conformational stimulating anti-β1-aabs on renal β1-ARs. From the available literature, it is well known that the β1-adrenergic system is involved in, e.g., the regulation of renin-secretion from juxtaglomerular cells. In addition, the β1-adrenergic system is thought to be involved in the regulation of the urine pH via type B-intercalated cells in the collecting duct. In contrast, the regulation of salt- and fluid-secretion in the medullary collecting duct appears to occur independently from the SNS. As a consequence, the present work aimed to unravel the potential pathophysiological links between renal function, alterations in the cardiovascular system, and circulating agonist-like anti- β1-abs. We analyzed possible renal effects of anti-β1-abs in a human-analogous rat model. After immunization with a GST-fusion protein containing the second extracellular loop (β1-ECII) of the human β1-AR, Lewis-rats develop functionally active, stimulating, conformational anti-β1-ECII-abs. Within the first 6 months, anti-β1-ECII-ab-positive animals develop a hypertensive phenotype, which after 9 months evolves into a DCM phenotype. In n=40 GST/ β1-ECII-immunized Lewis rats and n=40 age-matched, 0.9\% NaCl-injected control animals, we sequentially (i.e. at months 1, 2, 3, 6, 9, 12, 15, and 18 after start of immunization) analyzed the changes in renal function on a molecular, functional, and structural level. We could show that the presence of stimulating anti-β1-ECII-abs - even though having detrimental effects on the heart - has only a minor impact on kidney function and structure. Within the first 3 months after induction of anti-β1-ECII-abs, the levels and activity of renin were significantly increased in immunized compared to corresponding control animals, which was confirmed by experiments on isolated perfused kidneys, in which anti-β1-ECII-abs were able to directly induce the liberation of renin. However, within several weeks the initial anti-β1-ECII-ab-mediated RAAS activation was counter-regulated by auto-regulatory mechanisms activated in the kidney. Similarly, glomerular filtration rate (GFR) and renal blood flow (RBF) were initially decreased in the presence of the stimulating anti-β1-ECII-abs, but returned to control values within 3 months after immunization of the animals. Although expression of several pro-fibrotic markers was significantly up-regulated in anti-β1-ECII-ab-positive rats, no significant differences were noted on a histomorphological level with regard to the occurrence of renal fibrosis, glomerular damage, tubular damage, and perivascular fibrosis. Only a mild decrease in glomerular filtration function was observed in the kidneys of anti-β1-ECII-ab-positive animals from immunization-month 12 on, apparent by increased levels of urinary protein. Even though anti-β1-ECII-abs were able to induce mild changes in renal function, their effects were not strong enough to critically damage the kidneys in our rat-model. Differences between immunized anti-β1-ECII-ab-positive and corresponding control rats at later time-points (that is, from immunization-month 12 on) are most likely secondary to the progressive heart failure phenotype that immunized animals develop in the course of the experiment. The present study is the first to focus on the effects of stimulating anti-β1-ECII-abs on the kidney, and on the prevalence of these effects for the heart (referred to as cardio-renal crosstalk). Although our results were obtained in a rat model, they might contribute to better understand the situation in anti-β1-AR-aab-positive human patients. Following the results of our experiments, treatment of such patients should focus on direct and specific neutralization/elimination of stimulating anti-β1-ECII-aab or at least comprise therapeutic strategies that counteract the anti-β1-ECII-aab-effects on the heart by standard treatment for heart failure (i.e. ACE inhibitors, AT1-receptor blockers, and β-blockers) according to current guidelines.}, subject = {Nierenfunktion}, language = {en} } @article{FellerThomKochetal.2013, author = {Feller, Tatjana and Thom, Pascal and Koch, Natalie and Spiegel, Holger and Addai-Mensah, Otchere and Fischer, Rainer and Reimann, Andreas and Pradel, Gabriele and Fendel, Rolf and Schillberg, Stefan and Scheuermayer, Matthias and Schinkel, Helga}, title = {Plant-Based Production of Recombinant Plasmodium Surface Protein Pf38 and Evaluation of its Potential as a Vaccine Candidate}, series = {PLOS ONE}, volume = {8}, journal = {PLOS ONE}, number = {11}, issn = {1932-6203}, doi = {10.1371/journal.pone.0079920}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-128221}, pages = {e79920}, year = {2013}, abstract = {Pf38 is a surface protein of the malarial parasite Plasmodium falciparum. In this study, we produced and purified recombinant Pf38 and a fusion protein composed of red fluorescent protein and Pf38 (RFP-Pf38) using a transient expression system in the plant Nicotiana benthamiana. To our knowledge, this is the first description of the production of recombinant Pf38. To verify the quality of the recombinant Pf38, plasma from semi-immune African donors was used to confirm specific binding to Pf38. ELISA measurements revealed that immune responses to Pf38 in this African subset were comparable to reactivities to AMA-1 and \(MSP1_{19}\). Pf38 and RFP-Pf38 were successfully used to immunise mice, although titres from these mice were low (on average 1:11.000 and 1:39.000, respectively). In immune fluorescence assays, the purified IgG fraction from the sera of immunised mice recognised Pf38 on the surface of schizonts, gametocytes, macrogametes and zygotes, but not sporozoites. Growth inhibition assays using \(\alpha Pf38\) antibodies demonstrated strong inhibition \((\geq 60 \\% ) \) of the growth of blood-stage P. falciparum. The development of zygotes was also effectively inhibited by \(\alpha Pf38\) antibodies, as determined by the zygote development assay. Collectively, these results suggest that Pf38 is an interesting candidate for the development of a malaria vaccine.}, language = {en} } @article{BeissSpiegelBoesetal.2015, author = {Beiss, Veronique and Spiegel, Holger and Boes, Alexander and Scheuermayer, Matthias and Reimann, Andreas and Schillberg, Stefan and Fischer, Rainer}, title = {Plant expression and characterization of the transmission-blocking vaccine candidate PfGAP50}, series = {BMC Biotechnology}, volume = {15}, journal = {BMC Biotechnology}, number = {108}, doi = {10.1186/s12896-015-0225-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-137327}, year = {2015}, abstract = {Background: Despite the limited success after decades of intensive research and development efforts, vaccination still represents the most promising strategy to significantly reduce the disease burden in malaria endemic regions. Besides the ultimate goal of inducing sterile protection in vaccinated individuals, the prevention of transmission by so-called transmission blocking vaccines (TBVs) is being regarded as an important feature of an efficient malaria eradication strategy. Recently, Plasmodium falciparum GAP50 (PfGAP50), a 44.6 kDa transmembrane protein that forms an essential part of the invasion machinery (glideosome) multi-protein complex, has been proposed as novel potential transmission-blocking candidate. Plant-based expression systems combine the advantages of eukaryotic expression with a up-scaling potential and a good product safety profile suitable for vaccine production. In this study we investigated the feasibility to use the transient plant expression to produce PfGAP50 suitable for the induction of parasite specific inhibitory antibodies. Results: We performed the transient expression of recombinant PfGAP50 in Nicotiana benthamiana leaves using endoplasmatic reticulum (ER) and plastid targeting. After IMAC-purification the protein yield and integrity was investigated by SDS-PAGE and Western Blot. Rabbit immune IgG derived by the immunization with the plastidtargeted variant of PfGAP50 was analyzed by immune fluorescence assay (IFA) and zygote inhibition assay (ZIA). PfGAP50 could be produced in both subcellular compartments at different yields IMAC (Immobilized Metal Affinity Chromatography) purification from extract yielded up to 4.1 mu g/g recombinant protein per fresh leaf material for ER-retarded and 16.2 mu g/g recombinant protein per fresh leave material for plasmid targeted PfGAP50, respectively. IgG from rabbit sera generated by immunization with the recombinant protein specifically recognized different parasite stages in immunofluorescence assay. Furthermore up to 55 \% inhibition in an in vitro zygote inhibition assay could be achieved using PfGAP50-specific rabbit immune IgG. Conclusions: The results of this study demonstrate that the plant-produced PfGAP50 is functional regarding the presentation of inhibitory epitopes and could be considered as component of a transmission-blocking malaria vaccine formulation.}, language = {en} } @article{RudelFaulstichBoettcheretal.2013, author = {Rudel, Thomas and Faulstich, Michaela and B{\"o}ttcher, Jan-Peter and Meyer, Thomas F. and Fraunholz, Martin}, title = {Pilus Phase Variation Switches Gonococcal Adherence to Invasion by Caveolin-1-Dependent Host Cell Signaling}, series = {PLoS Pathogens}, journal = {PLoS Pathogens}, doi = {10.1371/journal.ppat.1003373}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-96679}, year = {2013}, abstract = {Many pathogenic bacteria cause local infections but occasionally invade into the blood stream, often with fatal outcome. Very little is known about the mechanism underlying the switch from local to invasive infection. In the case of Neisseria gonorrhoeae, phase variable type 4 pili (T4P) stabilize local infection by mediating microcolony formation and inducing anti-invasive signals. Outer membrane porin PorBIA, in contrast, is associated with disseminated infection and facilitates the efficient invasion of gonococci into host cells. Here we demonstrate that loss of pili by natural pilus phase variation is a prerequisite for the transition from local to invasive infection. Unexpectedly, both T4P-mediated inhibition of invasion and PorBIA-triggered invasion utilize membrane rafts and signaling pathways that depend on caveolin-1-Y14 phosphorylation (Cav1-pY14). We identified p85 regulatory subunit of PI3 kinase (PI3K) and phospholipase Cγ1 as new, exclusive and essential interaction partners for Cav1-pY14 in the course of PorBIA-induced invasion. Active PI3K induces the uptake of gonococci via a new invasion pathway involving protein kinase D1. Our data describe a novel route of bacterial entry into epithelial cells and offer the first mechanistic insight into the switch from local to invasive gonococcal infection.}, language = {en} } @article{BrandtZimmermannKaufholdetal.2012, author = {Brandt, Alexander U. and Zimmermann, Hanna and Kaufhold, Falko and Promesberger, Julia and Schippling, Sven and Finis, David and Aktas, Orhan and Geis, Christian and Ringelstein, Marius and Ringelstein, E. Bernd and Hartung, Hans-Peter and Paul, Friedemann and Kleffner, Ilka and D{\"o}rr, Jan}, title = {Patterns of Retinal Damage Facilitate Differential Diagnosis between Susac Syndrome and MS}, series = {PLoS One}, volume = {7}, journal = {PLoS One}, number = {6}, doi = {10.1371/journal.pone.0038741}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-134013}, pages = {e38741}, year = {2012}, abstract = {Susac syndrome, a rare but probably underdiagnosed combination of encephalopathy, hearing loss, and visual deficits due to branch retinal artery occlusion of unknown aetiology has to be considered as differential diagnosis in various conditions. Particularly, differentiation from multiple sclerosis is often challenging since both clinical presentation and diagnostic findings may overlap. Optical coherence tomography is a powerful and easy to perform diagnostic tool to analyse the morphological integrity of retinal structures and is increasingly established to depict characteristic patterns of retinal pathology in multiple sclerosis. Against this background we hypothesised that differential patterns of retinal pathology facilitate a reliable differentiation between Susac syndrome and multiple sclerosis. In this multicenter cross-sectional observational study optical coherence tomography was performed in nine patients with a definite diagnosis of Susac syndrome. Data were compared with age-, sex-, and disease duration-matched relapsing remitting multiple sclerosis patients with and without a history of optic neuritis, and with healthy controls. Using generalised estimating equation models, Susac patients showed a significant reduction in either or both retinal nerve fibre layer thickness and total macular volume in comparison to both healthy controls and relapsing remitting multiple sclerosis patients. However, in contrast to the multiple sclerosis patients this reduction was not distributed over the entire scanning area but showed a distinct sectorial loss especially in the macular measurements. We therefore conclude that patients with Susac syndrome show distinct abnormalities in optical coherence tomography in comparison to multiple sclerosis patients. These findings recommend optical coherence tomography as a promising tool for differentiating Susac syndrome from MS.}, language = {en} } @article{BoivinBeyersdorfPalmetal.2015, author = {Boivin, Val{\´e}rie and Beyersdorf, Niklas and Palm, Dieter and Nikolaev, Viacheslav O. and Schlipp, Angela and M{\"u}ller, Justus and Schmidt, Doris and Kocoski, Vladimir and Kerkau, Thomas and H{\"u}nig, Thomas and Ertl, Georg and Lohse, Martin J. and Jahns, Roland}, title = {Novel Receptor-Derived Cyclopeptides to Treat Heart Failure Caused by \(Anti-β_1-Adrenoceptor\) Antibodies in a Human-Analogous Rat Model}, series = {PLoS One}, volume = {10}, journal = {PLoS One}, number = {2}, doi = {10.1371/journal.pone.0117589}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126028}, pages = {e0117589}, year = {2015}, abstract = {Despite recent therapeutic advances the prognosis of heart failure remains poor. Recent research suggests that heart failure is a heterogeneous syndrome and that many patients have stimulating auto-antibodies directed against the second extracellular loop of the \(β_1\) adrenergic receptor \((β_1EC2)\). In a human-analogous rat model such antibodies cause myocyte damage and heart failure. Here we used this model to test a novel antibody-directed strategy aiming to prevent and/or treat antibody-induced cardiomyopathy. To generate heart failure, we immunised n = 76/114 rats with a fusion protein containing the human β1EC2 (amino-acids 195-225) every 4 weeks; n = 38/114 rats were control-injected with 0.9\% NaCl. Intravenous application of a novel cyclic peptide mimicking \(β_1EC2\) (\(β_1EC2-CP\), 1.0 mg/kg every 4 weeks) or administration of the \(β_1-blocker\) bisoprolol (15 mg/kg/day orally) was initiated either 6 weeks (cardiac function still normal, prevention-study, n = 24 (16 treated vs. 8 untreated)) or 8.5 months after the 1st immunisation (onset of cardiomyopathy, therapy-study, n = 52 (40 treated vs. 12 untreated)); n = 8/52 rats from the therapy-study received \(β_1EC2-CP/bisoprolol\) co-treatment. We found that \(β_1EC2-CP\) prevented and (alone or as add-on drug) treated antibody-induced cardiac damage in the rat, and that its efficacy was superior to mono-treatment with bisoprolol, a standard drug in heart failure. While bisoprolol mono-therapy was able to stop disease-progression, \(β_1EC2-CP\) mono-therapy -or as an add-on to bisoprolol- almost fully reversed antibody-induced cardiac damage. The cyclo¬peptide acted both by scavenging free \(anti-β_1EC2-antibodies\) and by targeting \(β_1EC2\)-specific memory B-cells involved in antibody-production. Our model provides the basis for the clinical translation of a novel double-acting therapeutic strategy that scavenges harmful \(anti-β_1EC2-antibodies\) and also selectively depletes memory B-cells involved in the production of such antibodies. Treatment with immuno-modulating cyclopeptides alone or as an add-on to \(β_1\)-blockade represents a promising new therapeutic option in immune-mediated heart failure.}, language = {en} } @article{GeisWeishauptGruenewaldetal.2011, author = {Geis, Christian and Weishaupt, Andreas and Gr{\"u}newald, Benedikt and Wultsch, Thomas and Reif, Andreas and Gerlach, Manfred and Dirkx, Ron and Solimena, Michele and Toyka, Klaus V and Folli, Franco and Perani, Daniela and Heckmann, Manfred and Sommer, Claudia}, title = {Human Stiff-Person Syndrome IgG Induces Anxious Behavior in Rats}, series = {Plos One}, volume = {6}, journal = {Plos One}, number = {2}, doi = {10.1371/journal.pone.0016775}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-140506}, pages = {e16775}, year = {2011}, abstract = {Background: Anxiety is a heterogeneous behavioral domain playing a role in a variety of neuropsychiatric diseases. While anxiety is the cardinal symptom in disorders such as panic disorder, co-morbid anxious behavior can occur in a variety of diseases. Stiff person syndrome (SPS) is a CNS disorder characterized by increased muscle tone and prominent agoraphobia and anxiety. Most patients have high-titer antibodies against glutamate decarboxylase (GAD) 65. The pathogenic role of these autoantibodies is unclear. Methodology/Principal Findings: We re-investigated a 53 year old woman with SPS and profound anxiety for GABA-A receptor binding in the amygdala with (11) C-flumazenil PET scan and studied the potential pathogenic role of purified IgG from her plasma filtrates containing high-titer antibodies against GAD 65. We passively transferred the IgG fraction intrathecally into rats and analyzed the effects using behavioral and in vivo electrophysiological methods. In cell culture, we measured the effect of patient IgG on GABA release from hippocampal neurons. Repetitive intrathecal application of purified patient IgG in rats resulted in an anxious phenotype resembling the core symptoms of the patient. Patient IgG selectively bound to rat amygdala, hippocampus, and frontal cortical areas. In cultured rat hippocampal neurons, patient IgG inhibited GABA release. In line with these experimental results, the GABA-A receptor binding potential was reduced in the patient's amygdala/hippocampus complex. No motor abnormalities were found in recipient rats. Conclusion/Significance: The observations in rats after passive transfer lead us to propose that anxiety-like behavior can be induced in rats by passive transfer of IgG from a SPS patient positive for anti-GAD 65 antibodies. Anxiety, in this case, thus may be an antibody-mediated phenomenon with consecutive disturbance of GABAergic signaling in the amygdala region.}, language = {en} } @article{NyawaleMoremiMohamedetal.2022, author = {Nyawale, Helmut A. and Moremi, Nyambura and Mohamed, Mohamed and Njwalila, Johnson and Silago, Vitus and Krone, Manuel and Konje, Eveline T. and Mirambo, Mariam M. and Mshana, Stephen E.}, title = {High seroprevalence of SARS-CoV-2 in Mwanza, northwestern Tanzania: a population-based survey}, series = {International Journal of Environmental Research and Public Health}, volume = {19}, journal = {International Journal of Environmental Research and Public Health}, number = {18}, issn = {1660-4601}, doi = {10.3390/ijerph191811664}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-288134}, year = {2022}, abstract = {The transmission of the SARS-CoV-2 virus, which causes COVID-19, has been documented worldwide. However, the evidence of the extent to which transmission has occurred in different countries is still to be established. Understanding the magnitude and distribution of SARS-CoV-2 through seroprevalence studies is important in designing control and preventive strategies in communities. This study investigated the seropositivity of the SARS-CoV-2 virus antibodies in the communities of three different districts in the Mwanza region, Tanzania. A household cross-sectional survey was conducted in September 2021 using the modified African Centre for Disease and Prevention (ACDC) survey protocol. A blood sample was obtained from one member of each of the selected households who consented to take part in the survey. Immunochromatographic rapid test kits were used to detect IgM and IgG SARS-CoV-2 antibodies, followed by descriptive data analysis. Overall, 805 participants were enrolled in the study with a median age of 35 (interquartile range (IQR):27-47) years. The overall SARS-CoV-2 seropositivity was 50.4\% (95\%CI: 46.9-53.8\%). The IgG and IgM seropositivity of the SARS-CoV-2 antibodies was 49.3\% and 7.2\%, respectively, with 6.1\% being both IgG and IgM seropositive. A history of runny nose (aOR: 1.84, 95\%CI: 1.03-3.5, p = 0.036), loss of taste (aOR: 1.84, 95\%CI: 1.12-4.48, p = 0.023), and living in Ukerewe (aOR: 3.55, 95\%CI: 1.68-7.47, p = 0.001) and Magu (aOR: 2.89, 95\%CI: 1.34-6.25, p= 0.007) were all independently associated with SARS-CoV-2 IgM seropositivity. Out of the studied factors, living in the Ukerewe district was independently associated with IgG seropositivity (aOR 1.29, CI 1.08-1.54, p = 0.004). Twenty months after the first case of COVID-19 in Tanzania, about half of the studied population in Mwanza was seropositive for SARS-CoV-2.}, language = {en} }