Prevalence of Severe Acute Respiratory Syndrome Coronavirus 2 Among Healthcare Workers—Zambia, July 2020

Abstract

Introduction Healthcare workers (HCWs) in Zambia have become infected with SARS-CoV-2, the virus that causes coronavirus disease (COVID-19). However, SARS-CoV-2 prevalence among HCWs is not known in Zambia. Methods We conducted a cross-sectional SARS-CoV-2 prevalence survey among Zambian HCWs in twenty health facilities in six districts in July 2020. Participants were tested for SARS-CoV-2 infection using polymerase chain reaction (PCR) and for SARS-CoV-2 antibodies using enzyme-linked immunosorbent assay (ELISA). Prevalence estimates and 95% confidence intervals (CIs), adjusted for health facility clustering, were calculated for each test separately and a combined measure for those who had PCR and ELISA performed. Results In total, 660 HCWs participated in the study, with 450 (68.2%) providing nasopharyngeal swab for PCR and 575 (87.1%) providing a blood specimen for ELISA. Sixty-six percent of participants were females and the median age was 31.5 years (interquartile range 26.2–39.8 years). The overall prevalence of the combined measure was 9.3% (95% CI 3.8%–14.7%). PCR-positive prevalence of SARS-CoV-2 was 6.6% (95% CI 2.0%–11.1%) and ELISA-positive prevalence was 2.2% (95% CI 0.5%–3.9%). Conclusions SARS-CoV-2 prevalence among HCWs was similar to a population-based estimate (10.6%) during a period of community transmission in Zambia. Public health measures such as establishing COVID-19 treatment centers before the first cases, screening for COVID-19 symptoms among patients accessing health facilities, infection prevention and control trainings, and targeted distribution of personal protective equipment based on exposure risk might have prevented increased SARS-CoV-2 transmission among Zambian HCWs.

Seroprevalence and risk factors of COVID-19 in healthcare workers from 11 African countries: a scoping review and appraisal of existing evidence

“…, 2021 ). No association between seropositivity and use of IPC measures could be found, but in-person attendance at work/school and frequent market visits (3–5 visits/month) were found to be risk factors (OR = 4.8, CI 1.6–13.9; OR = 3.0, CI 1.3–7.0, respectively; Fwoloshi et al. , 2021 ).…”

“…, 2021 ) and specificity from 85.0% ( Halatoko et al. , 2020 ) to 100% ( Fwoloshi et al. , 2021 ; Mostafa et al.…”

“…, 2021 ), Togo ( Halatoko et al. , 2020 ), Zambia ( Fwoloshi et al. , 2021 ) and Zimbabwe ( Rusakaniko et al.…”

“…Two studies reported higher risk of seropositivity for nurses (OR = 4.7, CI 2.0–11.2; OR = 3.0, CI 1.6–5.5; reference group physicians, respectively; Mostafa et al. , 2020 ; 2021 ), and one study reported higher risks for non-clinical HCWs (OR 7.8, CI 1.7–34.9, reference group nurses; Fwoloshi et al. , 2021 ).…”

“…Only one specified existence of dedicated wards ( Kassem et al. , 2020 ) or that HCWs were specifically trained in COVID-19 IPC measures ( Fwoloshi et al. , 2021 ).…”