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Seroprevalence of Severe Acute Respiratory Syndrome Coronavirus 2 After the Second Wave in South Africa in Human Immunodeficiency Virus-Infected and Uninfected Persons: A Cross-Sectional Household Survey.
Wolter, Nicole; Tempia, Stefano; von Gottberg, Anne; Bhiman, Jinal N; Walaza, Sibongile; Kleynhans, Jackie; Moyes, Jocelyn; Buys, Amelia; McMorrow, Meredith L; Aitken, Sue; Magni, Sarah; Yun, Jessica; Fellows, Tamika; Maakamedi, Tetelo; Weiner, Renay; Cawood, Cherie; Martinson, Neil; Lebina, Limakatso; Jassat, Waasila; Brauer, Marieke; Cohen, Cheryl.
  • Wolter N; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
  • Tempia S; School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • von Gottberg A; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
  • Bhiman JN; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • Walaza S; Influenza Division, Centers for Disease Control and Prevention, Atlanta, GeorgiaUSA.
  • Kleynhans J; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
  • Moyes J; School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • Buys A; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
  • McMorrow ML; School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • Aitken S; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
  • Magni S; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • Yun J; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
  • Fellows T; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • Maakamedi T; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
  • Weiner R; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • Cawood C; Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
  • Martinson N; Influenza Division, Centers for Disease Control and Prevention, Atlanta, GeorgiaUSA.
  • Lebina L; Genesis Analytics, Johannesburg, South Africa.
  • Jassat W; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • Brauer M; Genesis Analytics, Johannesburg, South Africa.
  • Cohen C; Genesis Analytics, Johannesburg, South Africa.
Clin Infect Dis ; 75(1): e57-e68, 2022 08 24.
Article in English | MEDLINE | ID: covidwho-2008554
ABSTRACT

BACKGROUND:

Seroprevalence studies are important for quantifying the burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in resource-constrained countries.

METHODS:

We conducted a cross-sectional household survey spanning the second pandemic wave (November 2020 to April 2021) in 3 communities. Blood was collected for SARS-CoV-2 antibody (2 enzyme-linked immunosorbent assays targeting spike and nucleocapsid) and human immunodeficiency virus (HIV) testing. An individual was considered seropositive if testing positive on ≥1 assay. Factors associated with infection, and the age-standardized infection case detection rate, infection hospitalization rate, and infection fatality rate were calculated.

RESULTS:

Overall, 7959 participants were enrolled, with a median age of 34 years and an HIV prevalence of 22.7%. SARS-CoV-2 seroprevalence was 45.2% (95% confidence interval 43.7%-46.7%) and increased from 26.9% among individuals enrolled in December 2020 to 47.1% among those enrolled in April 2021. On multivariable analysis, seropositivity was associated with age, sex, race, being overweight/obese, having respiratory symptoms, and low socioeconomic status. Persons living with HIV with high viral load were less likely to be seropositive than HIV-uninfected individuals. The site-specific infection case detection rate, infection hospitalization rate, and infection fatality rate ranged across sites from 4.4% to 8.2%, 1.2% to 2.5%, and 0.3% to 0.6%, respectively.

CONCLUSIONS:

South Africa has experienced a large burden of SARS-CoV-2 infections, with <10% of infections diagnosed. Lower seroprevalence among persons living with HIV who are not virally suppressed, likely as a result of inadequate antibody production, highlights the need to prioritize this group for intervention.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / COVID-19 Type of study: Observational study / Randomized controlled trials Topics: Long Covid Limits: Adult / Humans Country/Region as subject: Africa Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / COVID-19 Type of study: Observational study / Randomized controlled trials Topics: Long Covid Limits: Adult / Humans Country/Region as subject: Africa Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid