Seroprevalence and lethality by SARS-CoV-2 in indigenous populations of Latin America and the Caribbean: a systematic review

Abstract

Background Latin America and the Caribbean (LAC) has presented some of the highest numbers of cases and deaths due to COVID-19 in the world. Even though indigenous communities represent 8% of the total population in this region, the impact of COVID-19 on this historically vulnerable population has only been briefly explored. Thus, this study aimed to estimate the seroprevalence and lethality attributable to SARS-CoV-2 in the indigenous population of LAC. Methods A systematic review was conducted utilizing multiple databases (registry PROSPERO: CRD42020207862). Studies published in English, Spanish or Portuguese were selected between December 1st, 2019, and April 14th, 2021. The evaluation of the quality of the study was carried out utilizing the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. A qualitative synthesis of the data analyzed was conducted following the MOOSE and PRISMA declarations. Results Fifteen studies met the inclusion criteria. Eleven studies were carried out in a Brazilian population, three in a Mexican population, and one in a Colombian population. Four studies reported data about the seroprevalence of SARS-CoV-2 in indigenous populations of Brazil (range: 4.2–81.65%). Twelve studies reported lethality in indigenous people (eight in Brazil, three in Mexico, and one in Colombia). In Brazil, a lethality of 53.30% was described in a hospital setting and between 1.83% and 4.03% in community studies. In Mexico, the lethality of COVID-19 ranged between 16.5% and 19.9%. Meanwhile, in Colombia, a lethality of 3.41% was reported. Most studies were deemed to be of good quality. Conclusions Despite COVID-19 affecting indigenous populations of LAC, there is limited evidence of the seroprevalence and lethality of the infection by SARS-CoV-2 in this population. Future investigations should ensure standardized methods that allow comparability among studies and ensure the precision of the results obtained.

COVID‐19 in Latin America and the Caribbean: Two years of the pandemic

“…Similarly, the indigenous populations in LAC have had struggles with vaccination, mainly due to poor access to immunisation services [ 99 , 100 ]. High seroprevalence and lethality due to SARS‐CoV‐2 has been found in this vulnerable population [ 101 ]. Governments have been called to consider the difficult logistical challenges with the provision of vaccines in remote areas, like the Amazon jungle [ 100 ].…”

SARS-CoV-2 seroprevalence, vaccination, and hesitancy in agricultural workers in Guatemala

“…A meta-analysis of seroprevalence studies carried out in various countries around the world showed that by 2020, seroprevalence was low in the general population (median 4.5%, IQR 2.4-8.4%). [2][3][4] Most seroprevalence studies have been performed for convenience in urban populations. The objective of this study was to evaluate the seroprevalence of rural agricultural workers in Guatemala, the vaccination coverage against COVID-19, and the level of hesitancy and perception of these workers to vaccination.…”

The dynamics and determinants of specific systemic and mucosal antibody responses to SARS-CoV-2 in three adult cohorts in the Ecuadorian Andes: a study protocol

“…[1][2][3] Numerous seroprevalence studies have been conducted in the Latin American region, both population-based studies and studies focusing on specific populations (healthcare (HCW) or first-line workers, prison workers, indigenous populations, elderly populations, etc). [4][5][6][7][8][9][10][11][12][13][14][15] The reported seroprevalence is highly heterogenous between studies (10,4% -68,1 %), varying by study population, characteristics of the COVID-19 epidemic at the time of sampling, and differences in sociodemographic factors. [4][5][6][7][8][9][10][11][12][13][14][15] Factors associated with increasing risk of seropositivity include ethnicity (indigenous or Afro-descent), presence of COVID-19 symptoms, past history of COVID-19 or close contacts, lower educational level, and working night shifts (for HCW) or in a prison.…”

“…[4][5][6][7][8][9][10][11][12][13][14][15] The reported seroprevalence is highly heterogenous between studies (10,4% -68,1 %), varying by study population, characteristics of the COVID-19 epidemic at the time of sampling, and differences in sociodemographic factors. [4][5][6][7][8][9][10][11][12][13][14][15] Factors associated with increasing risk of seropositivity include ethnicity (indigenous or Afro-descent), presence of COVID-19 symptoms, past history of COVID-19 or close contacts, lower educational level, and working night shifts (for HCW) or in a prison. [4][5][6][7][8][9][10][11][12][13][14][15] Among these studies, a cross-sectional study in 2020 of 3,124 children aged 5 to 17 years in 10 Colombian cities reported highly variable seroprevalence ranging from 25.0% in Medellin to 63.9% in Guapi, the latter a coastal city with a high proportion of Afro-Colombians with the poorest living conditions.…”

“…[4][5][6][7][8][9][10][11][12][13][14][15] Factors associated with increasing risk of seropositivity include ethnicity (indigenous or Afro-descent), presence of COVID-19 symptoms, past history of COVID-19 or close contacts, lower educational level, and working night shifts (for HCW) or in a prison. [4][5][6][7][8][9][10][11][12][13][14][15] Among these studies, a cross-sectional study in 2020 of 3,124 children aged 5 to 17 years in 10 Colombian cities reported highly variable seroprevalence ranging from 25.0% in Medellin to 63.9% in Guapi, the latter a coastal city with a high proportion of Afro-Colombians with the poorest living conditions. 10 Further, a cross-sectional study in 2021 from Brazil of six indigenous groups in the Amazon region showed a high average seroprevalence for anti-SARS-CoV-2 IgG (68.1%).…”