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. 2024 Jun;18(6):e13332.
doi: 10.1111/irv.13332.

High SARS-CoV-2 Exposure in Rural Southern Mozambique After Four Waves of COVID-19: Community-Based Seroepidemiological Surveys

Áuria de Jesus  1 , Rita Ernesto  1 , Arsénia J Massinga  1 , Felizarda Nhacolo  1 , Khátia Munguambe  1   2 , Alcido Timana  1 , Arsénio Nhacolo  1 , Augusto Messa Jr  1 , Sérgio Massora  1 , Valdemiro Escola  1 , Sónia Enosse  3 , Rufino Gunjamo  3 , Carlos Funzamo  4 , Jason M Mwenda  5 , Joseph Okeibunor  5 , Alberto Garcia-Basteiro  1   6   7 , Caterina Guinovart  6 , Alfredo Mayor  1   6   8 , Inácio Mandomando  1   3   6
Affiliations

High SARS-CoV-2 Exposure in Rural Southern Mozambique After Four Waves of COVID-19: Community-Based Seroepidemiological Surveys

Áuria de Jesus et al. Influenza Other Respir Viruses. 2024 Jun.

Abstract

Background: Mozambique was one of many African countries with limited testing capacity for SARS-CoV-2. Serosurveys, an alternative to estimate the real exposure to understand the epidemiology and transmission dynamics, have been scarce in Mozambique. Herein, we aimed to estimate the age-specific seroprevalence of SARS-CoV-2 in the general population of the Manhiça District, at four time points, for evaluating dynamics of exposure and the impact of vaccination.

Methods: We conducted four community-based seroepidemiological surveys separated by 3 months between May 2021 and June 2022 to assess the prevalence of SARS-CoV-2 antibodies. An age-stratified (0-19, 20-39, 40-59, and ≥ 60 years) sample of 4810 individuals was randomly selected from demographic surveillance database, and their blood samples were analyzed using WANTAI SARS-CoV-2 IgG + IgM ELISA. Nasopharyngeal swabs from a subsample of 2209 participants were also assessed for active infection by RT-qPCR.

Results: SARS-CoV-2 seroprevalence increased from 27.6% in the first survey (May 2021) to 63.6%, 91.2%, and 91.1% in the second (October 2021), third (January 2022), and fourth (May 2022) surveys, respectively. Seroprevalence in individuals < 18 years, who were not eligible for vaccination, increased from 23.1% in the first survey to 87.1% in the fourth. The prevalence of active infection was below 10.1% in all surveys.

Conclusions: A high seroprevalence to SARS-CoV-2 was observed in the study population, including individuals not eligible for vaccination at that time, particularly after circulation of the highly transmissible Delta variant. These data are important to inform decision making on the vaccination strategies in the context of pandemic slowdown in Mozambique.

Keywords: COVID‐19; Mozambique; SARS‐CoV‐2; antibodies; seroprevalence; serosurvey; sub‐Saharan Africa.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Overall and age‐specific seroprevalence of SARS‐CoV‐2 antibodies in four community‐based seroepidemiological surveys conducted in the district of Manhiça between May 2021 and June 2022. % = prevalence of seropositives; n = absolute number of positives per age group; N = total sample size per age group.
FIGURE 2
FIGURE 2
Seroprevalence of SARS‐CoV‐2 antibodies in four community‐based seroepidemiological surveys in age groups not eligible for vaccination. % = prevalence of seropositives; n = absolute number of positives per age group; N = total sample size per age group.
FIGURE 3
FIGURE 3
Seroprevalences in Manhiça district by administrative post and serosurvey. (A) Serosurvey 1 (May–June 2021). (B) Serosurvey 2 (October–November 2021). (C) Serosurvey 3 (January–February 2022). (D) Serosurvey 4 (May–June 2022).
FIGURE 4
FIGURE 4
Comparison of the seroprevalence of SARS‐CoV‐2 antibodies between vaccinated and not vaccinated survey participants in Manhiça district.
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