SARS-CoV-2 infection in Africa: a systematic review and meta-analysis of standardised seroprevalence studies, from January 2020 to December 2021. Issue 8 (23rd August 2022)

• Record Type: Journal Article
• Authors: Lewis, Hannah C; Ware, Harriet; Whelan, Mairead; Subissi, Lorenzo; Li, Zihan; Ma, Xiaomeng; Nardone, Anthony; Valenciano, Marta; Cheng, Brianna; Noel, Kim; Cao, Christian; Yanes-Lane, Mercedes; Herring, Belinda L; Talisuna, Ambrose; Ngoy, Nsenga; Balde, Thierno; Clifton, David; Van Kerkhove, Maria D; Buckeridge, David; Bobrovitz, Niklas; Okeibunor, Joseph; Arora, Rahul K; Bergeri, Isabel
• Other Names: author non-byline.; Adamou Rafiou author non-byline.; Adegnika Ayola A author non-byline.; Assoumou Samira Z author non-byline.; Audu Rosemary A author non-byline.; Barnor Jacob S author non-byline.; Birru Enyew author non-byline.; Bosa Henry K author non-byline.; Boucher Emily L author non-byline.; Chauma-Mwale Annie author non-byline.; Cheng Matthew P author non-byline.; Chen Judy author non-byline.; Cohen Cheryl author non-byline.; Dabakuyo-Yonli Tienhan S author non-byline.; Deveaux Gabriel author non-byline.; Diop Boly author non-byline.; Divala Titus H author non-byline.; Dokubo Emily K author non-byline.; Donkor Irene O author non-byline.; Donnici Claire author non-byline.; Duarte Nathan author non-byline.; Duarte Natalie A author non-byline.; Ekouevi Didier K author non-byline.; Essone Paulin N author non-byline.; Evans Timothy G author non-byline.; Fairlie Lee author non-byline.; Faye Ousmane author non-byline.; Gottberg Anne von author non-byline.; Harris Tiffany G author non-byline.; Ilincic Natasha author non-byline.; Ilori Elsie A author non-byline.; Kleynhans Jackie author non-byline.; Kim Dayoung author non-byline.; Kolawole Olatunji M author non-byline.; Kondwani Jambo C author non-byline.; Liu Michael author non-byline.; Loeschnik Emma author non-byline.; Makiala-Mandanda Sheila author non-byline.; Manirakiza Alexandre author non-byline.; Mawien Pinyi N author non-byline.; Mutevedzi Portia C author non-byline.; Mwenda Jason M author non-byline.; Essone Paulin N author non-byline.; Ngoungou Edgard B author non-byline.; Ntoumi Francine author non-byline.; Osoro Eric M author non-byline.; Ouedraogo Samiratou author non-byline.; Oyegue Sandrine L author non-byline.; Perlman-Arrow Sara author non-byline.; Papenburg Jesse author non-byline.; Quan Hude author non-byline.; Rahim Hannah P author non-byline.; Sachathep Karampreet author non-byline.; Sawry Shobna author non-byline.; Segal Mitchell author non-byline.; Selemon Anabel author non-byline.; Shang Judith author non-byline.; Siawaya Joel F Djoba author non-byline.; Stafford Kristen A author non-byline.; Steinhardt Laura author non-byline.; Talla Cheikh author non-byline.; Tinto Halidou author non-byline.; Traore Isidore T author non-byline.; Theu Joe A author non-byline.; Vigan-Womas Ines author non-byline.; Williamson Tyler author non-byline.; Yan Tingting author non-byline.; Yansouni Cedric P author non-byline.; Zhang Caseng author non-byline.;
• Is Part Of: BMJ global health. Volume 7:Issue 8(2022)
• Publication Date: 2022-08-23
• Subjects: COVID-19 -- systematic review -- epidemiology -- serology -- public health; World health -- Periodicals; 362.105
• DOI: 10.1136/bmjgh-2022-008793
• Languages: English
• ISSNs: 2059-7908

Abstract

Abstract : Introduction: Estimating COVID-19 cumulative incidence in Africa remains problematic due to challenges in contact tracing, routine surveillance systems and laboratory testing capacities and strategies. We undertook a meta-analysis of population-based seroprevalence studies to estimate SARS-CoV-2 seroprevalence in Africa to inform evidence-based decision making on public health and social measures (PHSM) and vaccine strategy. Methods: We searched for seroprevalence studies conducted in Africa published 1 January 2020–30 December 2021 in Medline, Embase, Web of Science and Europe PMC (preprints), grey literature, media releases and early results from WHO Unity studies. All studies were screened, extracted, assessed for risk of bias and evaluated for alignment with the WHO Unity seroprevalence protocol. We conducted descriptive analyses of seroprevalence and meta-analysed seroprevalence differences by demographic groups, place and time. We estimated the extent of undetected infections by comparing seroprevalence and cumulative incidence of confirmed cases reported to WHO.PROSPERO: CRD42020183634. Results: We identified 56 full texts or early results, reporting 153 distinct seroprevalence studies in Africa. Of these, 97 (63%) were low/moderate risk of bias studies. SARS-CoV-2 seroprevalence rose from 3.0% (95% CI 1.0% to 9.2%) in April–June 2020 to 65.1% (95% CI 56.3% to 73.0%) in July–September 2021. The ratios of seroprevalence from infection to cumulative incidence of confirmed cases was large (overall: 100:1, ranging from 18:1 to 954:1) and steady over time. Seroprevalence was highly heterogeneous both within countries—urban versus rural (lower seroprevalence for rural geographic areas), children versus adults (children aged 0–9 years had the lowest seroprevalence)—and between countries and African subregions. Conclusion: We report high seroprevalence in Africa suggesting greater population exposure to SARS-CoV-2 and potential protection against COVID-19 severe disease than indicated by surveillance data. As seroprevalence was heterogeneous, targeted PHSM and vaccination strategies need to be tailored to local epidemiological situations.