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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2021
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oai:doaj.org-article:196fa2c1d22b497ba657e797d80a66862021-11-30T04:14:03ZHigh seroprevalence of SARS-CoV-2 but low infection fatality ratio eight months after introduction in Nairobi, Kenya1201-971210.1016/j.ijid.2021.08.062https://doaj.org/article/196fa2c1d22b497ba657e797d80a66862021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1201971221006962https://doaj.org/toc/1201-9712ABSTRACT: 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.Isaac NgereJeanette DawaElizabeth HunspergerNancy OtienoMoses MasikaPatrick AmothLyndah MakayottoCarolyne NasimiyuBronwyn M. GunnBryan NyawandaOuma OlugaCarolyne NgunuHarriet MirieriJohn GachohiDoris MarwangaPatrick K. MunywokiDennis OdhiamboMoshe D. AlandoRobert F. BreimanOmu AnzalaM. Kariuki NjengaMarc BulterysAmy Herman-RoloffEric OsoroElsevierarticleCOVID-19 pandemicSARS-CoV-2SeroprevalenceDisease underreportingInfection underestimationInfectious and parasitic diseasesRC109-216ENInternational Journal of Infectious Diseases, Vol 112, Iss , Pp 25-34 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
COVID-19 pandemic SARS-CoV-2 Seroprevalence Disease underreporting Infection underestimation Infectious and parasitic diseases RC109-216 |
| spellingShingle |
COVID-19 pandemic SARS-CoV-2 Seroprevalence Disease underreporting Infection underestimation Infectious and parasitic diseases RC109-216 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 High seroprevalence of SARS-CoV-2 but low infection fatality ratio eight months after introduction in Nairobi, Kenya |
| description |
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. |
| format |
article |
| author |
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 |
| author_facet |
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 |
| author_sort |
Isaac Ngere |
| title |
High seroprevalence of SARS-CoV-2 but low infection fatality ratio eight months after introduction in Nairobi, Kenya |
| title_short |
High seroprevalence of SARS-CoV-2 but low infection fatality ratio eight months after introduction in Nairobi, Kenya |
| title_full |
High seroprevalence of SARS-CoV-2 but low infection fatality ratio eight months after introduction in Nairobi, Kenya |
| title_fullStr |
High seroprevalence of SARS-CoV-2 but low infection fatality ratio eight months after introduction in Nairobi, Kenya |
| title_full_unstemmed |
High seroprevalence of SARS-CoV-2 but low infection fatality ratio eight months after introduction in Nairobi, Kenya |
| title_sort |
high seroprevalence of sars-cov-2 but low infection fatality ratio eight months after introduction in nairobi, kenya |
| publisher |
Elsevier |
| publishDate |
2021 |
| url |
https://doaj.org/article/196fa2c1d22b497ba657e797d80a6686 |
| work_keys_str_mv |
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