TY - JOUR
T1 - Seroprevalence survey of anti-SARS-CoV-2 antibody and associated factors in South Africa
T2 - Findings of the 2020–2021 population-based household survey
AU - Moyo, Sizulu
AU - Simbayi, Leickness C.
AU - Zuma, Khangelani
AU - Zungu, Nompumelelo
AU - Marinda, Edmore
AU - Jooste, Sean
AU - Ramlagan, Shandir
AU - Fortuin, Mirriam
AU - Singh, Beverley
AU - Mabaso, Musawenkosi
AU - Reddy, Tarylee
AU - Parker, Whadi Ah
AU - Naidoo, Inbarani
AU - Manda, Samuel
AU - Goga, Ameena
AU - Ngandu, Nobubelo
AU - Cawood, Cherie
AU - Moore, Penny L.
AU - Puren, Adrian
N1 - Publisher Copyright:
© 2023 Moyo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2023/9
Y1 - 2023/9
N2 - Population-based serological testing is important to understand the epidemiology and estimate the true cumulative incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to inform public health interventions. This study reports findings of a national household population SARS-CoV-2 serosurvey in people 12 years and older in South Africa. This cross-sectional multi-stage random stratified cluster survey undertaken from November 2020 to June 2021 collected sociodemographic data, medical history, behavioural data, and blood samples from consenting participants. The samples were tested for SARS-CoV-2 antibodies using the Roche ElecsysAnti-SARS-CoV-2 chemiluminescence immunoassay (CLIA) Total Antibody Test. The survey data were weighted by age, race, sex, and province with final individual weights benchmarked against the 2020 mid-year population estimates and accounted for clustering. Descriptive statistics summarize the characteristics of participants and seroprevalence. Logistic regression analyses were used to identify factors associated with seropositivity. From 13290 survey participants (median age 33 years, interquartile range (IQR) 23–46 years), SARS-CoV-2 seroprevalence was 37.8% [95% Confidence Interval (CI) 35.4–40.4] and varied substantially across the country’s nine provinces, and by sex, age and locality type. In the final adjusted model, the odds of seropositivity were higher in women than in men [aOR = 1.3 (95% CI: 1.0–1.6), p = 0.027], and those living with HIV (self-report) [aOR = 1.6 (95% CI: 1.0–2.4), p = 0.031]. The odds were lower among those 50 years and older compared to adolescents 12–19 years old [aOR = 0.6 (95% CI: 0.5–0.8), p<0.001] and in those who did not attend events or gatherings [aOR = 0.7 (95% CI: 0.6–1.0), p = 0.020]. The findings help us understand the epidemiology of SARS-CoV-2 within different regions in a low-middle-income country. The survey highlights the higher risk of infection in women in South Africa likely driven by their home and workplace roles and also highlighted a need to actively target and include younger people in the COVID-19 response.
AB - Population-based serological testing is important to understand the epidemiology and estimate the true cumulative incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to inform public health interventions. This study reports findings of a national household population SARS-CoV-2 serosurvey in people 12 years and older in South Africa. This cross-sectional multi-stage random stratified cluster survey undertaken from November 2020 to June 2021 collected sociodemographic data, medical history, behavioural data, and blood samples from consenting participants. The samples were tested for SARS-CoV-2 antibodies using the Roche ElecsysAnti-SARS-CoV-2 chemiluminescence immunoassay (CLIA) Total Antibody Test. The survey data were weighted by age, race, sex, and province with final individual weights benchmarked against the 2020 mid-year population estimates and accounted for clustering. Descriptive statistics summarize the characteristics of participants and seroprevalence. Logistic regression analyses were used to identify factors associated with seropositivity. From 13290 survey participants (median age 33 years, interquartile range (IQR) 23–46 years), SARS-CoV-2 seroprevalence was 37.8% [95% Confidence Interval (CI) 35.4–40.4] and varied substantially across the country’s nine provinces, and by sex, age and locality type. In the final adjusted model, the odds of seropositivity were higher in women than in men [aOR = 1.3 (95% CI: 1.0–1.6), p = 0.027], and those living with HIV (self-report) [aOR = 1.6 (95% CI: 1.0–2.4), p = 0.031]. The odds were lower among those 50 years and older compared to adolescents 12–19 years old [aOR = 0.6 (95% CI: 0.5–0.8), p<0.001] and in those who did not attend events or gatherings [aOR = 0.7 (95% CI: 0.6–1.0), p = 0.020]. The findings help us understand the epidemiology of SARS-CoV-2 within different regions in a low-middle-income country. The survey highlights the higher risk of infection in women in South Africa likely driven by their home and workplace roles and also highlighted a need to actively target and include younger people in the COVID-19 response.
UR - https://www.scopus.com/pages/publications/85195679608
U2 - 10.1371/journal.pgph.0002358
DO - 10.1371/journal.pgph.0002358
M3 - Article
AN - SCOPUS:85195679608
SN - 2767-3375
VL - 3
JO - PLOS Global Public Health
JF - PLOS Global Public Health
IS - 9 September
M1 - e0002358
ER -
