Chibwana, Marah, Jere, Khuzwayo ORCID: 0000-0003-3376-8529, Kamn’gona, Raphael, Mandolo, Jonathan, Katunga-Phiri, Vincent, Tembo, Dumizulu, Mitole, Ndaona, Musasa, Samantha, Sichone, Simon, Lakudzala, Agness et al (show 12 more authors)
(2020)
High SARS-CoV-2 seroprevalence in Health Care Workers but relatively low numbers of deaths in urban Malawi.
medRxiv, 1 (08-04).
2020.07.30.20164970-.
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Abstract
<h4>Background</h4> In low-income countries, like Malawi, important public health measures including social distancing or a lockdown, have been challenging to implement owing to socioeconomic constraints, leading to predictions that the COVID-19 pandemic would progress rapidly. However, due to limited capacity to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of the true burden of infection and death. We, therefore, conducted a SARS-CoV-2 serosurvey amongst health care workers (HCW) in Blantyre city to estimate the cumulative incidence of SARS-CoV-2 infection in urban Malawi. <h4>Methods</h4> Five hundred otherwise asymptomatic HCWs were recruited from Blantyre City (Malawi) from 22 nd May 2020 to 19 th June 2020 and serum samples were collected all participants. A commercial ELISA was used to measure SARS-CoV-2 IgG antibodies in serum. We run local negative samples (2018 - 2019) to verify the specificity of the assay. To estimate the seroprevalence of SARS CoV-2 antibodies, we adjusted the proportion of positive results based on local specificity of the assay. <h4>Results</h4> Eighty-four participants tested positive for SARS-CoV-2 antibodies. The HCW with a positive SARS-CoV-2 antibody result came from different parts of the city. The adjusted seroprevalence of SARS-CoV-2 antibodies was 12.3% [CI 9.0–15.7]. Using age-stratified infection fatality estimates reported from elsewhere, we found that at the observed adjusted seroprevalence, the number of predicted deaths was 8 times the number of reported deaths. <h4>Conclusion</h4> The high seroprevalence of SARS-CoV-2 antibodies among HCW and the discrepancy in the predicted versus reported deaths, suggests that there was early exposure but slow progression of COVID-19 epidemic in urban Malawi. This highlights the urgent need for development of locally parameterised mathematical models to more accurately predict the trajectory of the epidemic in sub-Saharan Africa for better evidence-based policy decisions and public health response planning.
Item Type: | Article |
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Uncontrolled Keywords: | COVID-19, IgG, Malawi, SARS-CoV-2, Seroprevalence |
Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences |
Depositing User: | Symplectic Admin |
Date Deposited: | 24 Nov 2022 10:10 |
Last Modified: | 15 Mar 2024 04:24 |
DOI: | 10.1101/2020.07.30.20164970 |
Related URLs: | |
URI: | https://livrepository.liverpool.ac.uk/id/eprint/3166357 |