SARS-CoV-2 seroprevalence in three Kenyan health and demographic surveillance sites, December 2020-May 2021.

Etyang, Anthony OORCID logo; Adetifa, IfedayoORCID logo; Omore, RichardORCID logo; Misore, Thomas; Ziraba, Abdhalah KORCID logo; Ng'oda, Maurine AORCID logo; Gitau, EvelynORCID logo; Gitonga, John; Mugo, Daisy; Kutima, BernadetteORCID logo; +32 more...Karanja, HenryORCID logo; Toroitich, MonicaORCID logo; Nyagwange, JamesORCID logo; Tuju, JamesORCID logo; Wanjiku, Perpetual; Aman, Rashid; Amoth, Patrick; Mwangangi, Mercy; Kasera, KadondiORCID logo; Ng'ang'a, Wangari; Akech, Donald; Sigilai, Antipa; Karia, BonifaceORCID logo; Karani, AngelaORCID logo; Voller, ShirineORCID logo; Agoti, Charles NORCID logo; Ochola-Oyier, Lynette I; Otiende, MarkORCID logo; Bottomley, ChristianORCID logo; Nyaguara, AmekORCID logo; Uyoga, Sophie; Gallagher, KatherineORCID logo; Kagucia, Eunice WORCID logo; Onyango, DickensORCID logo; Tsofa, BenjaminORCID logo; Mwangangi, JosephORCID logo; Maitha, Eric; Barasa, EdwineORCID logo; Bejon, PhilipORCID logo; Warimwe, George M; Scott, J Anthony GORCID logo; and Agweyu, AmbroseORCID logo (2022) SARS-CoV-2 seroprevalence in three Kenyan health and demographic surveillance sites, December 2020-May 2021. PLOS Global Public Health, 2 (8). e0000883-. ISSN 2767-3375 DOI: 10.1371/journal.pgph.0000883
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BACKGROUND: Most of the studies that have informed the public health response to the COVID-19 pandemic in Kenya have relied on samples that are not representative of the general population. We conducted population-based serosurveys at three Health and Demographic Surveillance Systems (HDSSs) to determine the cumulative incidence of infection with SARS-CoV-2. METHODS: We selected random age-stratified population-based samples at HDSSs in Kisumu, Nairobi and Kilifi, in Kenya. Blood samples were collected from participants between 01 Dec 2020 and 27 May 2021. No participant had received a COVID-19 vaccine. We tested for IgG antibodies to SARS-CoV-2 spike protein using ELISA. Locally-validated assay sensitivity and specificity were 93% (95% CI 88-96%) and 99% (95% CI 98-99.5%), respectively. We adjusted prevalence estimates using classical methods and Bayesian modelling to account for the sampling scheme and assay performance. RESULTS: We recruited 2,559 individuals from the three HDSS sites, median age (IQR) 27 (10-78) years and 52% were female. Seroprevalence at all three sites rose steadily during the study period. In Kisumu, Nairobi and Kilifi, seroprevalences (95% CI) at the beginning of the study were 36.0% (28.2-44.4%), 32.4% (23.1-42.4%), and 14.5% (9.1-21%), and respectively; at the end they were 42.0% (34.7-50.0%), 50.2% (39.7-61.1%), and 24.7% (17.5-32.6%), respectively. Seroprevalence was substantially lower among children (<16 years) than among adults at all three sites (p≤0.001). CONCLUSION: By May 2021 in three broadly representative populations of unvaccinated individuals in Kenya, seroprevalence of anti-SARS-CoV-2 IgG was 25-50%. There was wide variation in cumulative incidence by location and age.


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