sssHigh seroprevalence of SARS-CoV-2 but low infection fatality ratio eight months after introduction in Nairobi, Kenya.
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Date
2021Author
Masika, Moses
Ngere, Isaac
Dawa, Jeanette
Hunsperger, Elizabeth
Otieno, Nancy
Amoth, Patrick
Makayotto, Lyndah
Nasimiyu, Carolyne
Gunn, Bronwyn M
et al
Type
ArticleLanguage
enMetadata
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Background: The lower-than-expected COVID-19 morbidity and mortality in Africa has been attributed to multiple factors, including weak surveillance. We estimated the burden of SARS-CoV-2 infections eight months into the epidemic in Nairobi, Kenya.
Methods: We conducted a population-based cross-sectional survey 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 to reported cases and deaths.
Results: Among 1,164 individuals, the adjusted seroprevalence was 34.7% (95%CI 31.8-37.6). Half 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 2-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 United States, supporting the perceived lower morbidity and mortality in sub-Saharan Africa.
Citation
Ngere I, Dawa J, Hunsperger E, Otieno N, Masika M, Amoth P, Makayotto L, Nasimiyu C, Gunn BM, Nyawanda B, Oluga O, Ngunu C, Mirieri H, Gachohi J, Marwanga D, Munywoki PK, Odhiambo D, Alando MD, Breiman RF, Anzala O, Njenga MK, Bulterys M, Herman-Roloff A, Osoro E. sssHigh seroprevalence of SARS-CoV-2 but low infection fatality ratio eight months after introduction in Nairobi, Kenya. Int J Infect Dis. 2021 Sep 2:S1201-9712(21)00696-2. doi: 10.1016/j.ijid.2021.08.062. Epub ahead of print. PMID: 34481966; PMCID: PMC8411609.Publisher
Elsevier Ltd
Subject
COVID-19 pandemic; SARS-CoV-2; disease underreporting; infection underestimation; seroprevalence.Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
- Faculty of Health Sciences (FHS) [10387]
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