Seroprevalence of SARS-CoV-2 antibodies and retrospective mortality in a refugee camp, Dagahaley, Kenya

Abstract

Background Camps of forcibly displaced populations are considered to be at risk of large COVID-19 outbreaks. Low screening rates and limited surveillance led us to conduct a study in Dagahaley camp, located in the Dadaab refugee complex in Kenya to estimate SARS-COV-2 seroprevalence and, mortality and to identify changes in access to care during the pandemic. Methods To estimate seroprevalence, a cross-sectional survey was conducted among a sample of individuals (n = 587) seeking care at the two main health centres and among all household members (n = 619) of community health workers and traditional birth attendants working in the camp. A rapid immunologic assay was used (BIOSYNEX® COVID‐19 BSS [IgG/IgM]) and adjusted for test performance and mismatch between the sampled population and that of the general camp population. To estimate mortality, all households (n = 12860) were exhaustively interviewed in the camp about deaths occurring from January 2019 through March 2021. Results In total 1206 participants were included in the seroprevalence study, 8% (95% CI: 6.6%-9.7%) had a positive serologic test. After adjusting for test performance and standardizing on age, a seroprevalence of 5.8% was estimated (95% CI: 1.6%-8.4%). The mortality rate for 10,000 persons per day was 0.05 (95% CI 0.05–0.06) prior to the pandemic and 0.07 (95% CI 0.06–0.08) during the pandemic, representing a significant 42% increase (p<0.001). Médecins Sans Frontières health centre consultations and hospital admissions decreased by 38% and 37% respectively. Conclusion The number of infected people was estimated 67 times higher than the number of reported cases. Participants aged 50 years or more were among the most affected. The mortality survey shows an increase in the mortality rate during the pandemic compared to before the pandemic. A decline in attendance at health facilities was observed and sustained despite the easing of restrictions.

Large Diffusion of Severe Acute Respiratory Syndrome Coronavirus 2 After the Successive Epidemiological Waves, Including Omicron, in Guinea and Cameroon: Implications for Vaccine Strategies

“…Additionally, like in other surveys [ 9 , 10 , 14 , 15 , 23 ], seroprevalence increased with age categories and was significantly higher among adults aged >40 years, with a seroprevalence of 84% in both countries for this age group compared to a seroprevalence of <70% among youth aged <19 years. Our previous surveys [ 9 ] showed that in Cameroon, seroprevalence was 13.1% (95% CI, 9.3%–18.3%) in the younger age group (<19 years) and 22.9% (95% CI, 17.5%–29.2%) in the older age group (>40 years) at the time of the first survey just before the start of the second wave of COVID-19.…”

“…Between the first and third surveys, done just before and after the second wave, respectively, seroprevalence increased from 18.9% (95% CI, 12.1%–28.4%) to 35.5% (95% CI, 31.3%–39.8%) among those <19 years of age and from 22.6% (95% CI, 16.3%–30.6%) to 58.9% (95% CI, 52.6%–64.9%) among those >40 years of age. As reported in these studies and in most seroprevalence studies conducted in Africa, seroprevalence was significantly associated with age [ 9 , 10 , 14 , 15 , 23 ].…”

COVID-19 epidemiology and changes in health service utilization in Uganda’s refugee settlements during the first year of the pandemic

“…One qualitative study reported on the impact of COVID-19 on utilization and access to maternal services among eleven refugee women in urban Kenya [ 16 ]. Another article estimated the mortality rate and seroprevalence of SARS-CoV-2 antibodies among residents in a refugee camp in Kenya as well as compared consultations at health centers before and during the pandemic [ 17 ].…”

Maleficent Comrades: War in Ukraine and COVID-19

“…In the recent cross-sectional study performed in the Dagahaley refugee camp in Kenya, the seroprevalence of SARS-CoV-2 antibodies was estimated among individuals (n = 587) who were seeking care and among all household members (n = 619) of the community of health workers working in the camp. 13 In this study, the number of infected people was estimated to be 67 times higher outside the camps than the number of reported cases, and the individuals over 50 years of age were particularly vulnerable. Among the refugees, an additional health issue was mental health problems associated with the COVID-19 pandemic.…”