SARS-CoV-2 Prevalence in Malawi Based on Data from Survey of Communities and Health Workers in 5 High-Burden Districts, October 2020.
Theu, Joe Alex;
Kabaghe, Alinune Nathanael;
Bello, George;
Chitsa-Banda, Evelyn;
Kagoli, Matthews;
Auld, Andrew;
Mkungudza, Jonathan;
O'Malley, Gabrielle;
Bangara, Fred Fredrick;
Peacocke, Elizabeth F;
+13 more...Babaye, Yusuf;
Ng'ambi, Wingston;
Saussier, Christel;
MacLachlan, Ellen;
Chapotera, Gertrude;
Phiri, Mphatso Dennis;
Kim, Evelyn;
Chiwaula, Mabvuto;
Payne, Danielle;
Wadonda-Kabondo, Nellie;
Chauma-Mwale, Annie;
Divala, Titus Henry;
Public Health Institute of Malawi COVID-19 surveillance committe;
(2022)
SARS-CoV-2 Prevalence in Malawi Based on Data from Survey of Communities and Health Workers in 5 High-Burden Districts, October 2020.
Emerging infectious diseases, 28 (13).
S76-S84.
ISSN 1080-6040
DOI: https://doi.org/10.3201/eid2813.212348
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To determine early COVID-19 burden in Malawi, we conducted a multistage cluster survey in 5 districts. During October-December 2020, we recruited 5,010 community members (median age 32 years, interquartile range 21-43 years) and 1,021 health facility staff (HFS) (median age 35 years, interquartile range 28-43 years). Real-time PCR-confirmed SARS-CoV-2 infection prevalence was 0.3% (95% CI 0.2%-0.5%) among community and 0.5% (95% CI 0.1%-1.2%) among HFS participants; seroprevalence was 7.8% (95% CI 6.3%-9.6%) among community and 9.7% (95% CI 6.4%-14.5%) among HFS participants. Most seropositive community (84.7%) and HFS (76.0%) participants were asymptomatic. Seroprevalence was higher among urban community (12.6% vs. 3.1%) and HFS (14.5% vs. 7.4%) than among rural community participants. Cumulative infection findings 113-fold higher from this survey than national statistics (486,771 vs. 4,319) and predominantly asymptomatic infections highlight a need to identify alternative surveillance approaches and predictors of severe disease to inform national response.
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