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Cited by 110COVID-19 epidemiological studiesSARS-CoV-2 and COVID-19 ResearchSARS-CoV-2 detection and testing

The DOI matches its Crossref record; 14 of the 15 references it cites were found in a registry or an index.

High SARS-CoV-2 seroprevalence in health care workers but relatively low numbers of deaths in urban Malawi

Open access
Chibwana, Marah G., Jere, Khuzwayo C., Kamng'ona, Raphael, Mandolo, Jonathan, Katunga-Phiri, Vincent, Tembo, Dumizulu, Mitole, Ndaona, Musasa, Samantha, Sichone, Simon, Lakudzala, Agness, Sibale, Lusako, Matambo, Prisca, Kadwala, Innocent, Byrne, Rachel L., Mbewe, Alice, Henrion, Marc Y. R., Morton, Ben, Phiri, Chimota, Mallewa, Jane, Mwandumba, Henry C., Adams, Emily R., Gordon, Stephen B., Jambo, Kondwani C.·2020·Wellcome Open Research
DOI 10.12688/wellcomeopenres.16188.1PMC PMC7402052

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Abstract

Background : In low-income countries, like Malawi, important public health measures including social distancing or a lockdown have been challenging to implement owing to socioeconomic constraints, leading to predictions that the COVID-19 pandemic would progress rapidly. However, due to limited capacity to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of the true burden of infection and death. We, therefore, conducted a SARS-CoV-2 serosurvey amongst health care workers (HCWs) in Blantyre city to estimate the cumulative incidence of SARS-CoV-2 infection in urban Malawi. Methods : We recruited 500 otherwise asymptomatic HCWs from Blantyre City (Malawi) from 22 nd May 2020 to 19 th June 2020 and serum samples were collected from all participants. A commercial ELISA was used to measure SARS-CoV-2 IgG antibodies in serum. Results : A total of 84 participants tested positive for SARS-CoV-2 antibodies. The HCWs with positive SARS-CoV-2 antibody results came from different parts of the city. The adjusted seroprevalence of SARS-CoV-2 antibodies was 12.3% [CI 8.2 - 16.5]. Using age-stratified infection fatality estimates reported from elsewhere, we found that at the observed adjusted seroprevalence, the number of predicted deaths was eight times the number of reported deaths. Conclusions : The high seroprevalence of SARS-CoV-2 antibodies among HCWs and the discrepancy in the predicted versus reported deaths suggests that there was early exposure but slow progression of COVID-19 epidemic in urban Malawi. This highlights the urgent need for development of locally parameterised mathematical models to more accurately predict the trajectory of the epidemic in sub-Saharan Africa for better evidence-based policy decisions and public health response planning.

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Figure 1. SARS-CoV-2 serological results from asymptomatic health care workers. We used a commercial ELISA to measure SARS-CoV-2 antibodies against Spike (S2) and Nucleoprotein (N). OD, optical density.
Figure 1. SARS-CoV-2 serological results from asymptomatic health care workers. We used a commercial ELISA to measure SARS-CoV-2 antibodies against Spike (S2) and Nucleoprotein (N). OD, optical density.CC BY-NC-ND · PubMed Central
Figure 2. Map of Blantyre showing geospatial distribution of seropositive results. We collected geocoordinate data for the place of residence of all study participants at recruitment. The geocoordinates were combined with the ELISA assay results and plotted on the map of Blantyre using R. Black dot, seronegative; Orange dot, indeterminate; Red dot, seropositive.
Figure 2. Map of Blantyre showing geospatial distribution of seropositive results. We collected geocoordinate data for the place of residence of all study participants at recruitment. The geocoordinates were combined with the ELISA assay results and plotted on the map of Blantyre using R. Black dot, seronegative; Orange dot, indeterminate; Red dot, seropositive.CC BY-NC-ND · PubMed Central

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Authors
Chibwana, M. G., Jere, K. C., Kamng'ona, R., Mandolo, J., Katunga-Phiri, V., Tembo, D., Mitole, N., Musasa, S., Sichone, S., Lakudzala, A., Sibale, L., Matambo, P., Kadwala, I., Byrne, R. L., Mbewe, A., Henrion, M. Y. R., Morton, B., Phiri, C., Mallewa, J., Mwandumba, H. C., Adams, E. R., Gordon, S. B., & Jambo, K. C.
Affiliations
  • Malawi-Liverpool-Wellcome Trust Clinical Research Programme (MW)
  • University of Liverpool (GB)
  • University of Malawi (MW)
  • Liverpool School of Tropical Medicine (GB)
  • Ministry of Health (MW)
Corresponding author
Gordon, Stephen B.
ORCID
Venue
Wellcome Open Research
Publisher
F1000 Research Ltd
Published
2020-08-25
Volume
5
Pages
199
ISSN
2398-502X (ISSN-L)
DOI
10.12688/wellcomeopenres.16188.1
PMC
PMC7402052
OpenAlex
W3046449642
Cited by
110
References
15
Citations by year
2026: 3 · 2025: 2 · 2024: 13 · 2023: 9 · 2022: 24 · 2021: 44 · 2020: 15
FWCI
3.63
Type
journal article
Language
en
Update notices
new_version (2020-12-18)
Open access
Licence
Locations
  • Wellcome Open Research (publishedVersion, cc-by)
  • medRxiv (acceptedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • LSTM Online Archive (Liverpool School of Tropical Medicine) (acceptedVersion)
  • PubMed Central (submittedVersion, cc-by-nc-nd)
  • Figshare (submittedVersion, cc-by)
  • Figshare (cc-by)
Funders
  • Medical Research Council (MR/T008822/1)
  • National Institutes of Health (U01AI131348)
  • National Institute for Health Research (3477609, 200907)
  • Wellcome Trust (201945, 220764, 206545, 211433)
Topics
  • Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 detection and testing
Keywords
SARS-CoV-2, COVID-19 pandemic, seroprevalence, healthcare workers, IgG, underreporting of deaths, epidemic trajectory, epidemic modeling, Blantyre, sub-Saharan Africa

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