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. 2023 Oct 1;17(10):e13193.
doi: 10.1111/irv.13193. eCollection 2023 Oct.

The seroprevalence of SARS-CoV-2 infection in Malaysia: 7 August to 11 October 2020

Zhuo-Lin Chong  1 , Wan Shakira Rodzlan Hasani  2 , Filza Noor Asari  1 , Eida Nurhadzira Muhammad  1 , Mohd Hatta Abdul Mutalip  1 , Tania Gayle Robert Lourdes  1 , Halizah Mat Rifin  1 , Sarbhan Singh  3 , Ravindran Thayan  3
Affiliations

The seroprevalence of SARS-CoV-2 infection in Malaysia: 7 August to 11 October 2020

Zhuo-Lin Chong et al. Influenza Other Respir Viruses. .

Abstract

Background: From the beginning of the COVID-19 pandemic until mid-October 2020, Malaysia recorded ~15,000 confirmed cases. But there could be undiagnosed cases due mainly to asymptomatic infections. Seroprevalence studies can better quantify underlying infection from SARS-CoV-2 by identifying humoral antibodies against the virus. This study was the first to determine the prevalence of SARS-CoV-2 infection in Malaysia's general population, as well as the proportion of asymptomatic and undiagnosed infections.

Methods: This cross-sectional seroprevalence study with a two-stage stratified random cluster sampling design included 5,131 representative community dwellers in Malaysia aged ≥1 year. Data collection lasted from 7 August to 11 October 2020 involving venous blood sampling and interviews for history of COVID-19 symptoms and diagnosis. Previous SARS-CoV-2 infection was defined as screened positive using the Wantai SARS-CoV-2 Total Antibody enzyme-linked immunosorbent assay and confirmed positive using the GenScript SARS-CoV-2 surrogate Virus Neutralization Test. We performed a complex sampling design analysis, calculating sample weights considering probabilities of selection, non-response rate and post-stratification weight.

Results: The overall weighted prevalence of SARS-CoV-2 infection was 0.49% (95%CI 0.28-0.85) (N = 150,857). Among the estimated population with past infection, around 84.1% (95%CI 58.84-95.12) (N = 126 826) were asymptomatic, and 90.1% (95%CI 67.06-97.58) (N = 135 866) were undiagnosed.

Conclusions: Our study revealed a low pre-variant and pre-vaccination seroprevalence of SARS-CoV-2 infection in Malaysia up to mid-October 2020, with a considerable proportion of asymptomatic and undiagnosed cases. This led to subsequent adoption of SARS-CoV-2 antigen rapid test kits to increase case detection rate and to reduce time to results and infection control measures.

Keywords: COVID‐19; Malaysia; SARS‐CoV‐2; WHO‐UNITY studies; seroprevalence.

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Conflict of interest statement

All authors declared no conflict of interest.

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