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. 2023 Oct 9:7:101.
doi: 10.12688/gatesopenres.14684.2. eCollection 2023.

Heterogenous transmission and seroprevalence of SARS-CoV-2 in two demographically diverse populations with low vaccination uptake in Kenya, March and June 2021

Patrick K Munywoki  1 , Godfrey Bigogo  2 , Carolyne Nasimiyu  3   4 , Alice Ouma  2 , George Aol  2 , Clifford O Oduor  5 , Samuel Rono  5 , Joshua Auko  2 , George O Agogo  1 , Ruth Njoroge  3 , Dismas Oketch  3 , Dennis Odhiambo  2 , Victor W Odeyo  2 , Gilbert Kikwai  5 , Clayton Onyango  1 , Bonventure Juma  1 , Elizabeth Hunsperger  1 , Shirley Lidechi  2 , Caroline Apondi Ochieng  5 , Terrence Q Lo  1 , Peninah Munyua  1 , Amy Herman-Roloff  1
Affiliations

Heterogenous transmission and seroprevalence of SARS-CoV-2 in two demographically diverse populations with low vaccination uptake in Kenya, March and June 2021

Patrick K Munywoki et al. Gates Open Res. .

Abstract

Background: SARS-CoV-2 has extensively spread in cities and rural communities, and studies are needed to quantify exposure in the population. We report seroprevalence of SARS-CoV-2 in two well-characterized populations in Kenya at two time points. These data inform the design and delivery of public health mitigation measures.

Methods: Leveraging on existing population based infectious disease surveillance (PBIDS) in two demographically diverse settings, a rural site in western Kenya in Asembo, Siaya County, and an urban informal settlement in Kibera, Nairobi County, we set up a longitudinal cohort of randomly selected households with serial sampling of all consenting household members in March and June/July 2021. Both sites included 1,794 and 1,638 participants in the March and June/July 2021, respectively. Individual seroprevalence of SARS-CoV-2 antibodies was expressed as a percentage of the seropositive among the individuals tested, accounting for household clustering and weighted by the PBIDS age and sex distribution.

Results: Overall weighted individual seroprevalence increased from 56.2% (95%CI: 52.1, 60.2%) in March 2021 to 63.9% (95%CI: 59.5, 68.0%) in June 2021 in Kibera. For Asembo, the seroprevalence almost doubled from 26.0% (95%CI: 22.4, 30.0%) in March 2021 to 48.7% (95%CI: 44.3, 53.2%) in July 2021. Seroprevalence was highly heterogeneous by age and geography in these populations-higher seroprevalence was observed in the urban informal settlement (compared to the rural setting), and children aged <10 years had the lowest seroprevalence in both sites. Only 1.2% and 1.6% of the study participants reported receipt of at least one dose of the COVID-19 vaccine by the second round of serosurvey-none by the first round.

Conclusions: In these two populations, SARS-CoV-2 seroprevalence increased in the first 16 months of the COVID-19 pandemic in Kenya. It is important to prioritize additional mitigation measures, such as vaccine distribution, in crowded and low socioeconomic settings.

Keywords: COVID-19; Households; Kenya; Population-based; Rural; SARS-CoV-2; Serology; Serosurvey; seroprevalence; transmission; urban informal settlement.

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Conflict of interest statement

No competing interests were disclosed.

Figures

Figure 1.
Figure 1.. Kenyan map showing population-based infectious disease surveillance (PBIDS) sites (red) in Asembo, Siaya County in western Kenya and Kibera informal settlement, Nairobi County, Kenya.
Maps data: Google, ©2022.
Figure 2.
Figure 2.. Flow chart showing household (HH) enrolment, participant consenting and specimen collection in Asembo, Siaya County and Kibera, Nairobi County, Kenya.
Figure 3.
Figure 3.. Panel figure showing the probability (prob) of an individual being selected by age and sex in Asembo and Kibera population based infectious disease surveillance (PBIDS) for seroprevalence surveys for round one and two (R1 and R2).
Figure 4.
Figure 4.. Temporal trends of weekly PCR-positivity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detections in Asembo (top) and Kibera (bottom) population based infectious disease surveillance (PBIDS) from May 2020 to December 2021.
Included are the overall weighted individual seropositivity in the respective times of the serosurvey in Asembo and Kibera.
See this image and copyright information in PMC

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