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Meta-Analysis
. 2023 May 16;21(1):34.
doi: 10.1186/s12961-023-00973-z.

A framework for seroepidemiologic investigations in future pandemics: insights from an evaluation of WHO's Unity Studies initiative

Karen Hennessey  1 , Lorenzo Pezzoli  2 , Carsten Mantel  2
Affiliations
Meta-Analysis

A framework for seroepidemiologic investigations in future pandemics: insights from an evaluation of WHO's Unity Studies initiative

Karen Hennessey et al. Health Res Policy Syst. .

Abstract

Background: The WHO Unity Studies initiative supports countries, especially low- and middle-income countries (LMICs), in conducting seroepidemiologic studies for rapidly informing responses to the COVID-19 pandemic. Ten generic study protocols were developed which standardized epidemiologic and laboratory methods. WHO provided technical support, serological assays and funding for study implementation. An external evaluation was conducted to assess (1) the usefulness of study findings in guiding response strategies, (2) management and support to conduct studies and (3) capacity built from engagement with the initiative.

Methods: The evaluation focused on the three most frequently used protocols, namely first few cases, household transmission and population-based serosurvey, 66% of 339 studies tracked by WHO. All 158 principal investigators (PIs) with contact information were invited to complete an online survey. A total of 19 PIs (randomly selected within WHO regions), 14 WHO Unity focal points at the country, regional and global levels, 12 WHO global-level stakeholders and eight external partners were invited to be interviewed. Interviews were coded in MAXQDA™, synthesized into findings and cross-verified by a second reviewer.

Results: Among 69 (44%) survey respondents, 61 (88%) were from LMICs. Ninety-five percent gave positive feedback on technical support, 87% reported that findings contributed to COVID-19 understanding, 65% to guiding public health and social measures, and 58% to guiding vaccination policy. Survey and interview group responses showed that the main technical barriers to using study findings were study quality, variations in study methods (challenge for meta-analysis), completeness of reporting study details and clarity of communicating findings. Untimely study findings were another barrier, caused by delays in ethical clearance, receipt of serological assays and approval to share findings. There was strong agreement that the initiative created equitable research opportunities, connected expertise and facilitated study implementation. Around 90% of respondents agreed the initiative should continue in the future.

Conclusions: The Unity Studies initiative created a highly valued community of practice, contributed to study implementation and research equity, and serves as a valuable framework for future pandemics. To strengthen this platform, WHO should establish emergency-mode procedures to facilitate timeliness and continue to build capacity to rapidly conduct high-quality studies and communicate findings in a format friendly to decision-makers.

Keywords: COVID-19; Pandemic preparedness; SARS-CoV-2; Seroepidemiologic investigations.

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Conflict of interest statement

While this external evaluation was commissioned and funded by WHO, MMGH is an independent consulting firm.

Figures

Fig. 1
Fig. 1
Twelve thematic evaluation areas used for coding interview data, shown in the context of pandemic and Unity Studies stages
Fig. 2
Fig. 2
The biggest value of Unity Studies as reported by PIs (from survey and interviews), WHO Unity Studies focal points and stakeholders and external partners
See this image and copyright information in PMC

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