Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Feb 8;52(1):32-43.
doi: 10.1093/ije/dyac178.

Limitations introduced by a low participation rate of SARS-CoV-2 seroprevalence data

Olivia Pluss  1 , Harlan Campbell  2 , Laura Pezzi  3 , Ivonne Morales  4   5 , Yannik Roell  1 , Talia M Quandelacy  6 , Rahul Krishan Arora  7   8 , Emily Boucher  9   10 , Molly M Lamb  1   6 , May Chu  1 , Till Bärnighausen  5 , Thomas Jaenisch  1   5   6
Affiliations
Review

Limitations introduced by a low participation rate of SARS-CoV-2 seroprevalence data

Olivia Pluss et al. Int J Epidemiol. .

Abstract

Background: There has been a large influx of COVID-19 seroprevalence studies, but comparability between the seroprevalence estimates has been an issue because of heterogeneities in testing platforms and study methodology. One potential source of heterogeneity is the response or participation rate.

Methods: We conducted a review of participation rates (PR) in SARS-CoV-2 seroprevalence studies collected by SeroTracker and examined their effect on the validity of study conclusions. PR was calculated as the count of participants for whom the investigators had collected a valid sample, divided by the number of people invited to participate in the study. A multivariable beta generalized linear model with logit link was fitted to determine if the PR of international household and community-based seroprevalence studies was associated with the factors of interest, from 1 December 2019 to 10 March 2021.

Results: We identified 90 papers based on screening and were able to calculate the PR for 35 out of 90 papers (39%), with a median PR of 70% and an interquartile range of 40.92; 61% of the studies did not report PR.

Conclusions: Many SARS-CoV-2 seroprevalence studies do not report PR. It is unclear what the median PR rate would be had a larger portion not had limitations in reporting. Low participation rates indicate limited representativeness of results. Non-probabilistic sampling frames were associated with higher participation rates but may be less representative. Standardized definitions of participation rate and data reporting necessary for the PR calculations are essential for understanding the representativeness of seroprevalence estimates in the population of interest.

Keywords: COVID-19; Response rate; SARS-CoV-2; diagnostic testing; participation rate; representativeness; sero-surveys; serology; seroprevalence; validity.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flowchart of studies selected for inclusion in the analysis
Figure 2
Figure 2
Seroprevalence rate by sampling date with point sizes representing participation rate and colour representing the origin of study. NA indicates studies without a participation rate reported
Figure 3
Figure 3
Anti-SARS-CoV-2 seroprevalence (ordered from low to high) in 35 studies, with corresponding 95% confidence intervals (CI) [either reported within the study (dashed line) or calculated (solid line)] and Manski bounds
See this image and copyright information in PMC

References

    1. Chen X, Chen Z, Azman AS. et al. Serological evidence of human infection with SARS-CoV-2: a systematic review and meta-analysis. Lancet Glob Health 2021;9:e598–609. - PMC - PubMed
    1. Oran DP, Topol EJ.. The proportion of SARS-CoV-2 infections that are asymptomatic : a systematic review. Ann Intern Med 2021;174:655–62. - PMC - PubMed
    1. Campbell H, Gustafson P.. Inferring the COVID-19 IFR with a simple Bayesian evidence synthesis of seroprevalence study data and imprecise mortality data. medRxiv 2021. doi:10.1101/2021.05.12.21256975, preprint: not peer reviewed. - DOI
    1. Clapham H, Hay J, Routledge I. et al. Seroepidemiologic study designs for determining SARS-COV-2 transmission and immunity. Emerg Infect Dis 2020;26:1978–86. - PMC - PubMed
    1. Arora RK, Joseph A, Van Wyk J. et al. SeroTracker: a global SARS-CoV-2 seroprevalence dashboard. Lancet Infect Dis 2021;21:e75–76. - PMC - PubMed

Publication types

Substances

Grants and funding