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


Journal

PLOS global public health
ISSN: 2767-3375
Titre abrégé: PLOS Glob Public Health
Pays: United States
ID NLM: 9918283779606676

Informations de publication

Date de publication:
2022
Historique:
received: 15 02 2022
accepted: 12 07 2022
entrez: 24 3 2023
pubmed: 25 3 2023
medline: 25 3 2023
Statut: epublish

Résumé

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. 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. 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). 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.

Sections du résumé

BACKGROUND 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 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 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 CONCLUSIONS
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.

Identifiants

pubmed: 36962821
doi: 10.1371/journal.pgph.0000883
pii: PGPH-D-22-00247
pmc: PMC10021917
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e0000883

Subventions

Organisme : Wellcome Trust
ID : 214320
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/S005293/1
Pays : United Kingdom

Informations de copyright

Copyright: © 2022 Etyang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Anthony O Etyang (AO)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Ifedayo Adetifa (I)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
London School of Hygiene and Tropical Medicine, London, United Kingdom.

Richard Omore (R)

Kenya Medical Research Institute Centre for Global Health Research, Kisumu, Kenya.

Thomas Misore (T)

Kenya Medical Research Institute Centre for Global Health Research, Kisumu, Kenya.

Abdhalah K Ziraba (AK)

African Population and Health Research Center, Nairobi, Kenya.

Maurine A Ng'oda (MA)

African Population and Health Research Center, Nairobi, Kenya.

Evelyn Gitau (E)

African Population and Health Research Center, Nairobi, Kenya.

John Gitonga (J)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Daisy Mugo (D)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Bernadette Kutima (B)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Henry Karanja (H)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Monica Toroitich (M)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

James Nyagwange (J)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

James Tuju (J)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Perpetual Wanjiku (P)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Rashid Aman (R)

Ministry of Health, Nairobi, Kenya.

Patrick Amoth (P)

Ministry of Health, Nairobi, Kenya.

Mercy Mwangangi (M)

Ministry of Health, Nairobi, Kenya.

Kadondi Kasera (K)

Ministry of Health, Nairobi, Kenya.

Wangari Ng'ang'a (W)

Presidential Policy and Strategy Unit, The Presidency, Government of Kenya, Nairobi, Kenya.

Donald Akech (D)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Antipa Sigilai (A)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Boniface Karia (B)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Angela Karani (A)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Shirine Voller (S)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
London School of Hygiene and Tropical Medicine, London, United Kingdom.

Charles N Agoti (CN)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Lynette I Ochola-Oyier (LI)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Mark Otiende (M)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Christian Bottomley (C)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Amek Nyaguara (A)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Sophie Uyoga (S)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Katherine Gallagher (K)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Eunice W Kagucia (EW)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Dickens Onyango (D)

Department of Health, Kisumu County, Kenya.

Benjamin Tsofa (B)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Joseph Mwangangi (J)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Eric Maitha (E)

Department of Health, Kilifi County, Kenya.

Edwine Barasa (E)

Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom.

Philip Bejon (P)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom.

George M Warimwe (GM)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom.

J Anthony G Scott (JAG)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
London School of Hygiene and Tropical Medicine, London, United Kingdom.

Ambrose Agweyu (A)

KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.

Classifications MeSH