A three-phase population based sero-epidemiological study: Assessing the trend in prevalence of SARS-CoV-2 during COVID-19 pandemic in Jordan

Abstract

The evolution of the COVID-19 pandemic in Jordan during the first 10 months of the epidemic was peculiar and can be easily categorized in three different phases: a first period featuring a very low number of reported cases, a second period with exponential growth from August with up to 8000 cases on the 18th November 2020, and a third phase with steady and progressive decline of the epidemiological curve. With the aim of better determine the entity of the population exposed to SARS-CoV-2, the Jordan Ministry of Health with the support of the WHO launched three rounds of the nationwide sero-prevalence survey. Using population proportionate to size (PPS) methodology, around 5000 individuals were selected from all Jordan governorates. Blood samples were collected from all participants and ELISA assays for total IgM, IgG antibodies to COVID-19 were used for testing at the National Public Health Laboratory. Results revealed that seroprevalence dramatically increased over time, with only a tiny fraction of seropositive individuals in August (0.3%), to increase up to more than 20-fold in October (7.0%) and to reach one-third of the overall population exposed by the end of 2020 (34.2%). While non age-specific trends were detected in infection rates across different age categories, in all three rounds of the seroprevalence study two out of three positive participants did not report any sign and/or symptom compatible with COVID-19. The serial cross-sectional surveys experience in Jordan allowed to gain additional insights of the epidemic over time in combination with context-specific aspects like adherence to public health and social measures (PHSM). On the other hand, such findings would be helpful for planning of public health mitigation measures like vaccinations and tailored restriction policies.

Seroprevalence of SARS-CoV-2 antibodies in the general population of Oman: results from four successive nationwide sero-epidemiological surveys

“…The low estimated seroprevalence among residents of Oman in the first two cycles is comparable to other population-based studies that have been conducted around the same period or before it (Bellizzi et al, 2021;Pollán et al, 2020;Alsuwaidi et al, 2021) Over the 19 study weeks, we observed an increase in seroprevalence from about 5% to about 22% which is to be expected considering time to seroconversion after symptoms and that the peak of the first wave of the epidemic was reached the week before the start of the first cycle, and the fourth cycle was conducted after the end of the second peak (see Figures 1 and 2). The increase in seroprevalence was similar to findings from other studies (Stringhini et al, 2020;Bellizzi et al, 2021;Murhekar et al, 2021;Hallal et al, 2020).…”

“…There was also earlier spread in the governorates on the borders of other countries. Regional variations in SARS-CoV-2 seroprevalence have also been reported in many other countries (Bellizzi et al, 2021;Pollán et al, 2020;Alsuwaidi et al, 2021;Poustchi et al, 2021;Núñez-Zapata et al, 2021).…”

“…The overall quality of seroprevalence studies is low, the majority of studies use convenience samples and rely on small or non-random sampling of participants while only a few used national-scale and multistage or stratified random sampling to select study participants (Chen et al, 2021;Bellizzi et al, 2021). This study aimed to assess SARS-CoV-2 seroprevalence in the general population in Oman and to assess the longitudinal changes in antibody levels over time within the first 11 months of the pandemic prior to the launch of the national vaccination campaign, and how the changes correlate with time, sex, age, districts, and nationalities, and to the disease prevalence in the community.…”

Seroprevalence of SARS-CoV-2 Antibodies among vaccinated and non-vaccinated adults in the West Bank: Results of a repeated cross-sectional study

“…This is result is consistent with other studies which found a statistical significance between IgG positivity and gender, [14], [15]. At the regional level, a three phased seroprevalence survey was conducted in Jordan, where results revealed that seroprevalence dramatically increased over time, with only a tiny fraction of seropositive individuals in August (0.3%), to increase up to more than 20-fold in October (7.0%) and to reach one-third of the overall population exposed by the end of 2020 (34.2%), [15]. Such results are compatible with similar seroprevalence survey conducted by the Palestinian ministry of health and WHO at the end of 2020.…”

Anti-SARS-CoV-2 Antibody Responses 5 Months Post Complete Vaccination of Moroccan Healthcare Workers

“…Since the emergence of SARS-CoV-2, assessing and understanding the kinetics and protective role of the human immune response against this virus, has been of a high priority and relevance [ 4 ]. For this purpose, different investigations have conducted several seroepidemiological surveys worldwide to measure the seroprevalence of antibodies against SARS-CoV-2 [ 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. These studies have demonstrated the importance of the humoral immune response for the elimination of viral infection, and the important role of understanding the dynamics of antibodies against SARS-CoV-2, which help not only in assessing immunological levels and predicting potential immune protection, but also in the development of vaccine and immune therapy strategies [ 12 ].…”