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Clinical Trial
. 2023 May 16;23(1):898.
doi: 10.1186/s12889-023-15806-5.

SARS-CoV-2 infection prevention and control measures in Belgian schools between December 2020 and June 2021 and their association with seroprevalence: a cross-sectional analysis of a prospective cohort study

Milena Callies #  1 , Ines Kabouche #  2 , Isabelle Desombere  3 , Joanna Merckx  4 , Mathieu Roelants  5 , Melissa Vermeulen  2 , Els Duysburgh  2
Affiliations
Clinical Trial

SARS-CoV-2 infection prevention and control measures in Belgian schools between December 2020 and June 2021 and their association with seroprevalence: a cross-sectional analysis of a prospective cohort study

Milena Callies et al. BMC Public Health. .

Abstract

Background: To protect school-aged children from the potential consequences of a new viral infection, public health authorities recommended to implement infection prevention and control (IPC) measures in school settings. Few studies evaluated the implementation of these measures and their effect on SARS-CoV-2 infection rates among pupils and staff. The aim of this study was to describe the implementation of infection prevention and control (IPC) measures in Belgian schools and assess its relation to the prevalence of anti-SARS-CoV-2 antibodies among pupils and staff.

Methods: We conducted a prospective cohort study in a representative sample of primary and secondary schools in Belgium between December 2020 and June 2021. The implementation of IPC measures in schools was assessed using a questionnaire. Schools were classified according to their compliance with the implementation of IPC measures as 'poor', 'moderate' or 'thorough'. Saliva samples were collected from pupils and staff to determine the SARS-CoV-2 seroprevalence. To assess the association between the strength of implementation of IPC measures and SARS-CoV-2 seroprevalence among pupils and staff, we conducted a cross-sectional analysis using the data collected in December 2020/January 2021.

Results: A variety of IPC measures (ventilation, hygiene and physical distancing) was implemented by more than 60% of schools, with most attention placed on hygiene measures. In January 2021, poor implementation of IPC measures was associated with an increase in anti-SARS-CoV-2 antibody prevalence among pupils from 8.6% (95%CI: 4.5 - 16.6) to 16.7% (95%CI: 10.2 - 27.4) and staff from 11.5% (95%CI: 8.1 - 16.4) to 17.6% (95%CI: 11.5 - 27.0). This association was only statistically significant for the assessment of all IPC measures together in the population comprised of pupils and staff.

Conclusions: Belgian schools were relatively compliant with recommended IPC measures at the school level. Higher SARS-CoV-2 seroprevalence among pupils and staff was found in schools with poor implementation of IPC measures, compared to schools with thorough implementation.

Trial registration: This trial is registered under the NCT04613817 ClinicalTrials.gov Identifier on November 3, 2020.

Keywords: Belgium; Infection prevention and control; SARS-CoV-2; School staff; School-aged children; Seroprevalence.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Prevalence of anti-SARS-CoV-2 antibodies according to the degree of IPC measure implementation Data collected at December 2020/January 2021 in Belgian schools among pupils and staff. The black lines indicate the upper and lower 95% confidence intervals. IPC Infection prevention and control
Fig. 2
Fig. 2
Prevalence of anti-SARS-CoV-2 antibodies according to the degree of subcategory IPC measures implementation. A Ventilation IPC measures, B Hygiene IPC measures, C Physical distancing measures Data collected at December 2020/January 2021 in Belgian schools among pupils and staff. The black lines indicate the upper and lower 95% confidence intervals. IPC Infection prevention and control
See this image and copyright information in PMC

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