SARS-CoV-2 seroprevalence in the city of Hyderabad, India in early 2021.

Background: COVID-19 emerged as a global pandemic in 2020, spreading rapidly to most parts of the world. The proportion of infected individuals in a population can be reliably estimated via serosurveillance, making it a valuable tool for planning control measures. Our serosurvey study aimed to investigate SARS-CoV-2 seroprevalence in the urban population of Hyderabad at the end of the first wave of infections. Methods: This cross-sectional survey, conducted in January 2021 and including males and females aged 10 years and above, used multi-stage random sampling. 9363 samples were collected from 30 wards distributed over six zones of Hyderabad, and tested for antibodies against SARS-CoV-2 nucleocapsid antigen. Results: Overall seropositivity was 54.2%, ranging from 50% to 60% in most wards. Highest exposure appeared to be among those aged 30-39 and 50-59 years, with women showing greater seropositivity. Seropositivity increased with family size, with only marginal differences among people with varying levels of education. Seroprevalence was significantly lower among smokers. Only 11% of the survey subjects reported any COVID-19 symptoms, while 17% had appeared for COVID-19 testing. Conclusion: Over half the city's population was infected within a year of onset of the pandemic. However, ∼ 46% of people remained susceptible, contributing to subsequent waves of infection.

Development and use of alternative nutrient-dense foods for management of acute malnutrition in India. (Special Issue: Child wasting in South Asia.)

A review was undertaken of locally available energy and nutrient-dense foods used in the management of undernourished children in India. Suitability of the 42 food products identified was examined in terms of nutrient profile, palatability, safety, cost-effectiveness, shelf life and feasibility for scale-up of production. Results showed that there is potential to supplement several existing products with additional foods, multivitamins and mineral mixes to enable their use as therapeutic foods in the management of uncomplicated severe acute malnutrition (SAM) in the community. Based on these findings, an existing locally produced product (Balamrutham) was adapted (Balamrutham+) to provide improved energy, protein and nutrient density to enable its use in SAM treatment. To test Balamrutham+, the product was given to uncomplicated moderate and severe malnutrition cases in children under five years old admitted to a government supplementary feeding programme in a district in Telangana state. Follow-up was only possible for two weeks due to the COVID-19 pandemic. After two weeks of supplementation, 22.3% of children with moderate acute malnutrition (MAM) reached discharge criteria and 17.7% of severe acute malnutrition (SAM) children reached MAM criteria. Production of Balamrutham+ has since been scaled up and is being used in treatment across Telangana state according to pre-existing plans as the food was found acceptable by the children in the community. COVID-19-related adaptations include use of mid-upper arm circumference (MUAC)-only protocols for treatment and a separate strategy for follow-up visits in designated containment zones for COVID.

SARS-CoV-2 seroprevalence in the city of Hyderabad, India in early 2021 (preprint)

BackgroundCOVID-19 emerged as a global pandemic in 2020, rapidly spreading to most parts of the world. The proportion of infected individuals in a population can be reliably estimated via sero-surveillance, making it a valuable tool for planning control measures. We conducted a serosurvey study to investigate SARS-CoV-2 seroprevalence in the urban population of Hyderabad at the end of the first wave of infections. MethodsThe cross-sectional survey conducted in January 2021 included males and females aged 10 years and above, selected by multi-stage random sampling. 9363 samples were collected from 30 wards distributed over 6 zones of Hyderabad and tested for antibodies against SARS-CoV-2 nucleocapsid antigen. ResultsOverall seropositivity was 54.2%, ranging from 50-60% in most wards. Highest exposure appeared to be among 30-39y and 50-59y olds, with women showing greater seropositivity. Seropositivity increased with family size, with only marginal differences among people with varying levels of education. Seroprevalence was significantly lower among smokers. Only 11% of the survey subjects reported any COVID-19 symptoms, while 17% had appeared for Covid testing. ConclusionOver half the citys population was infected within a year of onset of the pandemic. However, [~]46% people were still susceptible, contributing to subsequent waves of infection. Highlights National level serosurveys under-estimate localised prevalence in dense urban areas SARS-CoV-2 seroprevalence in Hyderabad city was 54.2% after the first wave A large proportion of the population remains at risk over a year into the pandemic