High SARS-CoV-2 Seroprevalence in Healthcare Workers in Bukavu, Eastern Democratic Republic of Congo

Mukwege, Denis; Byabène, Aline Kusinza; Akonkwa, Eric Mungu; Dahma, Hafid; Dauby, Nicolás; Buhendwa, Jean Paul Cikwanine; Coadou, Anne Le; Montesinos, Isabel; Bruyneel, Marie; Cadière, Guy Bernard; Vandenberg, Olivier; Laethem, Y. Van

doi:10.4269/ajtmh.20-1526

Cited by 46 publications

(65 citation statements)

References 21 publications

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“…A less contained, widespread outbreak was generated when transmission and migration rates were high (R 0 = 2.8 and migration = 200 000 dtpmi); cumulative incidence was 78% and 63% in urban and rural areas, respectively, and 68% ± 2% at the country level (Figure 2). This range of cumulative incidence was consistent with seroprevalence rates in SSA [10,11,12,13,14].…”

supporting

confidence: 82%

Rural prioritization may increase the impact of COVID-19 vaccines in Sub-Saharan Africa due to ongoing internal migration: A modeling study

Selvaraj¹,

Wagner²,

Chao³

et al. 2021

Preprint

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How COVID-19 vaccine is distributed within low- and middle-income countries has received little attention outside of equity or logistical concerns but may ultimately affect campaign impact in terms of infections, severe cases, or deaths averted. In this study we examined whether subnational (urban-rural) prioritization may affect the cumulative two-year impact on disease transmission and burden of a vaccination campaign using an agent-based model of COVID-19 in a representative Sub-Saharan Africa country setting. We simulated a range of vaccination strategies that differed by urban-rural prioritization, age group prioritization, timing of introduction, and final coverage level. Urban prioritization averted more infections in only a narrow set of scenarios, when internal migration rates were low and vaccination was started by day 30 of an outbreak. Rural prioritization was the optimal strategy for all other scenarios, e.g., with higher internal migration rates or later start dates, due to the presence of a large immunological naive rural population. Among other factors, timing of the vaccination campaign was important to determining maximum impact, and delays as short as 30 days prevented larger campaigns from having the same impact as smaller campaigns that began earlier. The optimal age group for prioritization depended on choice of metric, as prioritizing older adults consistently averted more deaths across all of the scenarios. While guidelines exist for these latter factors, urban-rural allocation is an orthogonal factor that we predict to affect impact and warrants consideration as countries plan the scale-up of their vaccination campaigns.

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supporting

confidence: 82%

Rural prioritization may increase the impact of COVID-19 vaccines in Sub-Saharan Africa due to ongoing internal migration: A modeling study

Selvaraj¹,

Wagner²,

Chao³

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…The estimated seroprevalence with 95% CI for each of the participating hospitals was shown in Fig.2and Table1, ranging from 24.5-48.0%. We did not nd association between seropositivity and participants' demographic and clinical features given in Table1, except history of contact with con rmed or con rmed COVID-19 contact. Non-signi cant seroprevalence difference was observed between females (42.4% [95% CI 39.4-45.55]) and males (39.6% [95% CI 36.6-42.7]).…”

mentioning

confidence: 59%

“…While the high seroprevalence rates observed among the different geographically located hospitals are approaching those of high-incidence countries like Brazil [17], they are in agreement with several other SARS-CoV-2 seroprevalence studies from sub-Saharan Africa that, like Ethiopia, have reported much lower rates of RT-PCR con rmed cases and deaths. For example, higher anti-SARS-CoV-2 antibody seroprevalence has been reported in South Sudan (30-60.6%) [18], Democratic Republic of Congo (8%-36) [19] and Nigeria (25%-45) [20] depending on the population sampled and the serological test use.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the total population of 1.3 billion, Africa stands out as the region least affected by the Severe Acute Respiratory Syndrome-Corona-Virus-2 (SARS-CoV-2) and coronavirus disease-2019 (COVID- 19) pandemic. As of May 23rd, 2021 [1], the total reported case number had risen to 4,748,581 with 128,213 reported deaths, representing 2.9% and 3.7% of global cases and deaths, respectively.…”

Section: Introductionmentioning

confidence: 99%

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High Seroprevalence of Anti-SARS-CoV-2 Antibodies Among Ethiopian Healthcare Workers

Gelanew

Seyoum

Mulu

et al. 2021

Preprint

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BackgroundCOVID-19 pandemic has a devastating impact on the economies and health care system of sub-Saharan Africa. Healthcare workers (HWs), the main actors of the health system, are at higher-risk because of their occupation. Serology-based estimates of SARS-CoV-2 infection among HWs represent a measure of HWs’ exposure to the virus and a guide to the prevalence of SARS-CoV-2 in the community. This information is currently lacking in Ethiopia and other African countries. This study aimed to develop an in-house antibody testing assay, assess the prevalence of SARS-CoV-2 antibodies among Ethiopian high-risk frontline HWs.MethodsA cross-sectional seroprevalence study was conducted among HWs in five public hospitals located in different geographic regions of Ethiopia. Socio-demographic and clinical data were collected using questionnaire-based interviews. From consenting HWs, blood samples were collected between December 2020 and February 2021, the period between the two peaks of COVID-19 in Ethiopia. The collected sera were tested using an in-house immunoglobin G (IgG) enzyme-linked immunosorbent assay (ELISA) for SARS-CoV-2 specific antibodies on sera collected from HWs. Results Of 1,997 HWs who provided a blood sample, demographic and clinical data, 50.5% were female, 74.0% had no symptoms compatible with COVID-19, and 29.0% had history of contact with suspected or confirmed patient with SARS-CoV-2 infection. The overall seroprevalence was 39.6%. The lowest (24.5%) and the highest (48.0%) seroprevalence rates were found in Hiwot Fana Specialized Hospital in Harar and ALERT Hospital in Addis Ababa, respectively. Of the 821 seropositive HWs, 224(27.3%) had history of symptoms consistent with COVID-19. A history of close contact with suspected/confirmed COVID-19 cases was strongly associated with seropositivity (Adjusted odds Ratio (AOR) =1.4, 95% CI 1.1-1.8; p=0.015). ConclusionHigh SARS-CoV-2 seroprevalence levels were observed in the five Ethiopian hospitals. These findings highlight the significant burden of asymptomatic infection in Ethiopia, and may reflect the scale of transmission in the general population.

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“…While the high seroprevalence rates observed among the different geographically located hospitals are approaching those of high-incidence countries like Brazil 18 , they are in agreement with several other SARS-CoV-2 seroprevalence studies from sub-Saharan Africa that, like Ethiopia, have reported much lower rates of RT-PCR confirmed cases and deaths. For example, higher anti-SARS-CoV-2 antibody seroprevalence has been reported in South Sudan (30% to 60.6%) 19 , Democratic Republic of Congo (8%-36) 20 and Nigeria (25%-45) 21 depending on the population sampled and the serological test use. Taken together these studies indicate that SARS-CoV-2 has spread widely in sub-Saharan Africa 22 .…”

Section: Factors Associated With Anti-sars-cov-2 Rbd Igg Antibodies Positivitymentioning

confidence: 99%

High Seroprevalence of anti-SARS-CoV-2 antibodies among Ethiopian healthcare workers

Gelanew

Seyoum

Mulu

et al. 2021

Preprint

View full text Add to dashboard Cite

COVID-19 pandemic has a devastating impact on the economies and health care system of sub-Saharan Africa. Healthcare workers (HWs), the main actors of the health system, are at higher-risk because of their occupation. Serology-based estaimates of SARS-CoV-2 infection among HWs represent a measure of HWs level of exposure to the virus and a guide to the prevalence of SARS-CoV-2 in the community. This information is currently lacking in Ethiopia. This study aims to develop an in-house antibody testing assay and assess the prevalence of SARS-CoV-2 antibodies among Ethiopian high-risk front-line HWs. A cross-sectional seroprevalence study was conducted among HWs in five public hospitals located in different geographic regions of Ethiopia. Socio-demographic and clinical data were collected using questionnaire-based interviews. From consenting HWs, blood samples were collected between December 2020 and February 2021, the period between the two peaks of COVID-19 in Ethiopia. The collected sera were tested using an in-house immunoglobin G (IgG) enzyme-linked immunosorbent assay (ELISA) for SARS-CoV-2 specific antibodies on sera collected from HWs. Of 1,997 HWs who provided a blood sample, demographic and clinical data, 50.5% were female, 74.0% had no symptoms compatible with COVID-19, and 29.0% had history of contact with suspected or confirmed patient with SARS-CoV-2 infection. The overall seroprevalence was 39.6%. The lowest (24.5%) and the highest (48.0%) seroprevalence rates were found in Hiwot Fana Specialized Hospital in Harar and ALERT Hospital in Addis Ababa, respectively. Of the 821 seropositive HWs, 224(27.3%) had history of symptoms consistent with COVID-19. A history of close contact with suspected/confirmed COVID-19 cases was strongly associated with seropositivity (Adjusted odds Ratio (AOR) =1.4, 95% CI 1.1-1.8; p=0.015). High SARS-CoV-2 seroprevalence levels were observed in the five Ethiopian hospitals. These findings highlight the significant burden of asymptomatic infection in Ethiopia, and may reflect the scale of transmission in the general population.

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High SARS-CoV-2 Seroprevalence in Healthcare Workers in Bukavu, Eastern Democratic Republic of Congo

Cited by 46 publications

References 21 publications

Rural prioritization may increase the impact of COVID-19 vaccines in Sub-Saharan Africa due to ongoing internal migration: A modeling study

Rural prioritization may increase the impact of COVID-19 vaccines in Sub-Saharan Africa due to ongoing internal migration: A modeling study

High Seroprevalence of Anti-SARS-CoV-2 Antibodies Among Ethiopian Healthcare Workers

High Seroprevalence of anti-SARS-CoV-2 antibodies among Ethiopian healthcare workers

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