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SARS-CoV-2 prevalence and immunity: a hospital-based study from Malawi
BACKGROUND: COVID-19 transmission and disease dynamics in sub-Saharan Africa are not well understood. Our study aims to provide insight into COVID-19 epidemiology in Malawi by estimating SARS-CoV-2 prevalence and immunity after SARS-CoV-2 infection in a hospital-based setting. METHODS: We conducted...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8679501/ https://www.ncbi.nlm.nih.gov/pubmed/34929356 http://dx.doi.org/10.1016/j.ijid.2021.12.336 |
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author | Meinus, C. Singer, R. Nandi, B. Jagot, O. Becker-Ziaja, B. Karo, B. Mvula, B. Jansen, A. Baumann, J. Schultz, A. |
author_facet | Meinus, C. Singer, R. Nandi, B. Jagot, O. Becker-Ziaja, B. Karo, B. Mvula, B. Jansen, A. Baumann, J. Schultz, A. |
author_sort | Meinus, C. |
collection | PubMed |
description | BACKGROUND: COVID-19 transmission and disease dynamics in sub-Saharan Africa are not well understood. Our study aims to provide insight into COVID-19 epidemiology in Malawi by estimating SARS-CoV-2 prevalence and immunity after SARS-CoV-2 infection in a hospital-based setting. METHODS: We conducted a hospital-based, convenience sampling, cross-sectional survey for SARS-CoV-2 in Lilongwe, Malawi. Participants answered a questionnaire and were tested for SARS-CoV-2 by enzyme-linked immunosorbent assay and real-time reverse-transcription polymerase chain reaction (RT-PCR). A surrogate virus neutralization test (sVNT) was performed in seropositive samples to estimate immunity. Poisson regression was used to assess SARS-CoV-2 point prevalence association with demographic and behavioral variables. FINDINGS: The study included 930 participants. We found a combined point prevalence of 10.1%. Separately analyzed, RT-PCR positivity was 2.0%, and seropositivity was 9.3%. Of tested seropositive samples, 90.1% were sVNT positive. We found a high rate (45.7%) of asymptomatic SARS-CoV-2 infection. SARS-CoV-2 point prevalence was significantly associated with being a healthcare worker. INTERPRETATION: Our study suggests that official data underestimate COVID-19 transmission. Using sVNTs to estimate immunity in Malawi is feasible and revealed considerable post-infection immunity in our cohort. Subclinical infection and transmission are probably a game-changer in surveillance, mitigation and vaccination strategies. |
format | Online Article Text |
id | pubmed-8679501 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. |
record_format | MEDLINE/PubMed |
spelling | pubmed-86795012021-12-17 SARS-CoV-2 prevalence and immunity: a hospital-based study from Malawi Meinus, C. Singer, R. Nandi, B. Jagot, O. Becker-Ziaja, B. Karo, B. Mvula, B. Jansen, A. Baumann, J. Schultz, A. Int J Infect Dis Article BACKGROUND: COVID-19 transmission and disease dynamics in sub-Saharan Africa are not well understood. Our study aims to provide insight into COVID-19 epidemiology in Malawi by estimating SARS-CoV-2 prevalence and immunity after SARS-CoV-2 infection in a hospital-based setting. METHODS: We conducted a hospital-based, convenience sampling, cross-sectional survey for SARS-CoV-2 in Lilongwe, Malawi. Participants answered a questionnaire and were tested for SARS-CoV-2 by enzyme-linked immunosorbent assay and real-time reverse-transcription polymerase chain reaction (RT-PCR). A surrogate virus neutralization test (sVNT) was performed in seropositive samples to estimate immunity. Poisson regression was used to assess SARS-CoV-2 point prevalence association with demographic and behavioral variables. FINDINGS: The study included 930 participants. We found a combined point prevalence of 10.1%. Separately analyzed, RT-PCR positivity was 2.0%, and seropositivity was 9.3%. Of tested seropositive samples, 90.1% were sVNT positive. We found a high rate (45.7%) of asymptomatic SARS-CoV-2 infection. SARS-CoV-2 point prevalence was significantly associated with being a healthcare worker. INTERPRETATION: Our study suggests that official data underestimate COVID-19 transmission. Using sVNTs to estimate immunity in Malawi is feasible and revealed considerable post-infection immunity in our cohort. Subclinical infection and transmission are probably a game-changer in surveillance, mitigation and vaccination strategies. The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. 2022-03 2021-12-17 /pmc/articles/PMC8679501/ /pubmed/34929356 http://dx.doi.org/10.1016/j.ijid.2021.12.336 Text en © 2022 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Meinus, C. Singer, R. Nandi, B. Jagot, O. Becker-Ziaja, B. Karo, B. Mvula, B. Jansen, A. Baumann, J. Schultz, A. SARS-CoV-2 prevalence and immunity: a hospital-based study from Malawi |
title | SARS-CoV-2 prevalence and immunity: a hospital-based study from Malawi |
title_full | SARS-CoV-2 prevalence and immunity: a hospital-based study from Malawi |
title_fullStr | SARS-CoV-2 prevalence and immunity: a hospital-based study from Malawi |
title_full_unstemmed | SARS-CoV-2 prevalence and immunity: a hospital-based study from Malawi |
title_short | SARS-CoV-2 prevalence and immunity: a hospital-based study from Malawi |
title_sort | sars-cov-2 prevalence and immunity: a hospital-based study from malawi |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8679501/ https://www.ncbi.nlm.nih.gov/pubmed/34929356 http://dx.doi.org/10.1016/j.ijid.2021.12.336 |
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