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. 2022 May:118:256-263.
doi: 10.1016/j.ijid.2022.03.021. Epub 2022 Mar 16.

SARS-CoV-2 seroprevalence and associated risk factors in periurban Zambia: a population-based study

K Shanaube  1 , A Schaap  2 , E Klinkenberg  3 , S Floyd  3 , J Bwalya  4 , M Cheeba  4 , P de Haas  5 , B Kosloff  2 , M Ruperez  3 , R Hayes  3 , H Ayles  2
Affiliations

SARS-CoV-2 seroprevalence and associated risk factors in periurban Zambia: a population-based study

K Shanaube et al. Int J Infect Dis. 2022 May.

Abstract

Background: We nested a seroprevalence survey within the TREATS (Tuberculosis Reduction through Expanded Antiretroviral Treatment and Screening) project. We aimed to measure the seroprevalence of SARS-CoV-2 infection and investigate associated risk factors in one community (population ∼27,000) with high prevalence of TB/HIV in Zambia.

Methods: The study design was cross-sectional. A random sample of 3592 individuals aged ≥15 years enrolled in the TREATS TB-prevalence survey were selected for antibody testing. Randomly selected blocks of residence were visited between October 2020 and March 2021. Antibodies against SARS-CoV-2 were detected using Abbott- ARCHITECT SARS-CoV-2 IgG assay.

Results: A total of 3035/3526 (86.1%) individuals had a blood sample taken. Antibody testing results were available for 2917/3035 (96.1%) participants. Overall, 401/2977 (13.5%) individuals tested positive for IgG antibodies. Seroprevalence was similar by sex (12.7% men vs 14.0% women) and was lowest in the youngest age group 15-19 years (9.7%) and similar in ages 20 years and older (∼15%). We found no evidence of an association between seroprevalence and HIV-status or TB. There was strong evidence (p <0.001) of variation by time of enrollment, with prevalence varying from 2.8% (95% CI 0.8-4.9) among those recruited in December 2020 to 33.7% (95% CI 27.7-39.7) among those recruited in mid-February 2021.

Conclusion: Seroprevalence was 13.5% but there was substantial variation over time, with a sharp increase to approximately 35% toward the end of the second epidemic wave.

Keywords: COVID-19; Population-based survey; SARS-CoV-2; Seroprevalence; TB/HIV; Zambia.

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Figures

Figure 1
Figure 1
Summary of study procedures
Figure 2
Figure 2
Participants enrolled in the study in Kabwe district, Zambia 2020/2021
Figure 3
Figure 3
Variation of SARS-CoV-2 Seroprevalence by time of enrolment
See this image and copyright information in PMC

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