High seroprevalence of SARS-CoV-2 but low infection fatality ratio eight months after introduction in Nairobi, Kenya

High seroprevalence of SARS-CoV-2 but low infection fatality ratio eight months after introduction in Nairobi, Kenya

ABSTRACT: Background: The lower than expected COVID-19 morbidity and mortality in Africa has been attributed to multiple factors, including weak surveillance. This study estimated the burden of SARS-CoV-2 infections eight months into the epidemic in Nairobi, Kenya. Methods: A population-based, cros...

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Autores principales: Isaac Ngere, Jeanette Dawa, Elizabeth Hunsperger, Nancy Otieno, Moses Masika, Patrick Amoth, Lyndah Makayotto, Carolyne Nasimiyu, Bronwyn M. Gunn, Bryan Nyawanda, Ouma Oluga, Carolyne Ngunu, Harriet Mirieri, John Gachohi, Doris Marwanga, Patrick K. Munywoki, Dennis Odhiambo, Moshe D. Alando, Robert F. Breiman, Omu Anzala, M. Kariuki Njenga, Marc Bulterys, Amy Herman-Roloff, Eric Osoro
Formato: article
Lenguaje:EN
Publicado: Elsevier 2021
Materias:
COVID-19 pandemic
SARS-CoV-2
Seroprevalence
Disease underreporting
Infection underestimation
Infectious and parasitic diseases
RC109-216
Acceso en línea:https://doaj.org/article/196fa2c1d22b497ba657e797d80a6686
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Sumario:ABSTRACT: Background: The lower than expected COVID-19 morbidity and mortality in Africa has been attributed to multiple factors, including weak surveillance. This study estimated the burden of SARS-CoV-2 infections eight months into the epidemic in Nairobi, Kenya. Methods: A population-based, cross-sectional survey was conducted using multi-stage random sampling to select households within Nairobi in November 2020. Sera from consenting household members were tested for antibodies to SARS-CoV-2. Seroprevalence was estimated after adjusting for population structure and test performance. Infection fatality ratios (IFRs) were calculated by comparing study estimates with reported cases and deaths. Results: Among 1,164 individuals, the adjusted seroprevalence was 34.7% (95% CI 31.8-37.6). Half of the enrolled households had at least one positive participant. Seropositivity increased in more densely populated areas (spearman's r=0.63; p=0.009). Individuals aged 20-59 years had at least two-fold higher seropositivity than those aged 0-9 years. The IFR was 40 per 100,000 infections, with individuals ≥60 years old having higher IFRs. Conclusion: Over one-third of Nairobi residents had been exposed to SARS-CoV-2 by November 2020, indicating extensive transmission. However, the IFR was >10-fold lower than that reported in Europe and the USA, supporting the perceived lower morbidity and mortality in sub-Saharan Africa.

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