BACKGROUND: Relatively few COVID-19 cases and deaths have been reported through much of sub-Saharan Africa, including South Sudan, although the extent of SARS-CoV-2 spread remains unclear due to weak surveillance systems and few population-representative serosurveys. METHODS: We conducted a representative household-based cross-sectional serosurvey in Juba, South Sudan. We quantified IgG antibody responses to SARS-CoV-2 spike protein receptor-binding domain and estimated seroprevalence using a Bayesian regression model accounting for test performance. RESULTS: We recruited 2,214 participants from August 10 to September 11, 2020 and 22.3% had anti-SARS-CoV-2 IgG titers above levels in pre-pandemic samples. After accounting for waning antibody levels, age, and sex, we estimated that 38.5% (32.1 - 46.8) of the population had been infected with SARS-CoV-2. For each RT-PCR confirmed COVID-19 case, 104 (87-126) infections were unreported. Background antibody reactivity was higher in pre-pandemic samples from Juba compared to Boston, where the serological test was validated. The estimated proportion of the population infected ranged from 30.1% to 60.6% depending on assumptions about test performance and prevalence of clinically severe infections. CONCLUSIONS: SARS-CoV-2 has spread extensively within Juba. Validation of serological tests in sub-Saharan African populations is critical to improve our ability to use serosurveillance to understand and mitigate transmission.
BACKGROUND: Relatively few COVID-19 cases and deaths have been reported through much of sub-Saharan Africa, including South Sudan, although the extent of SARS-CoV-2 spread remains unclear due to weak surveillance systems and few population-representative serosurveys. METHODS: We conducted a representative household-based cross-sectional serosurvey in Juba, South Sudan. We quantified IgG antibody responses to SARS-CoV-2 spike protein receptor-binding domain and estimated seroprevalence using a Bayesian regression model accounting for test performance. RESULTS: We recruited 2,214 participants from August 10 to September 11, 2020 and 22.3% had anti-SARS-CoV-2 IgG titers above levels in pre-pandemic samples. After accounting for waning antibody levels, age, and sex, we estimated that 38.5% (32.1 - 46.8) of the population had been infected with SARS-CoV-2. For each RT-PCR confirmed COVID-19 case, 104 (87-126) infections were unreported. Background antibody reactivity was higher in pre-pandemic samples from Juba compared to Boston, where the serological test was validated. The estimated proportion of the population infected ranged from 30.1% to 60.6% depending on assumptions about test performance and prevalence of clinically severe infections. CONCLUSIONS: SARS-CoV-2 has spread extensively within Juba. Validation of serological tests in sub-Saharan African populations is critical to improve our ability to use serosurveillance to understand and mitigate transmission.
Authors: Russell M Viner; Oliver T Mytton; Chris Bonell; G J Melendez-Torres; Joseph Ward; Lee Hudson; Claire Waddington; James Thomas; Simon Russell; Fiona van der Klis; Archana Koirala; Shamez Ladhani; Jasmina Panovska-Griffiths; Nicholas G Davies; Robert Booy; Rosalind M Eggo Journal: JAMA Pediatr Date: 2021-02-01 Impact factor: 16.193
Authors: Kara L Lynch; Jeffrey D Whitman; Noreen P Lacanienta; Erica W Beckerdite; Shannon A Kastner; Brian R Shy; Gregory M Goldgof; Andrew G Levine; Sagar P Bapat; Susan L Stramer; Jonathan H Esensten; Allen W Hightower; Caryn Bern; Alan H B Wu Journal: Clin Infect Dis Date: 2021-01-27 Impact factor: 20.999
Authors: Petra Emmerich; Carolin Murawski; Christa Ehmen; Ronald von Possel; Neele Pekarek; Lisa Oestereich; Sophie Duraffour; Meike Pahlmann; Nicole Struck; Daniel Eibach; Ralf Krumkamp; John Amuasi; Oumou Maiga-Ascofaré; Raphael Rakotozandrindrainy; Danny Asogun; Yemisi Ighodalo; Simone Kann; Jürgen May; Egbert Tannich; Christina Deschermeier Journal: Trop Med Int Health Date: 2021-04-05 Impact factor: 3.918
Authors: Anita S Iyer; Andrew S Azman; Malika Bouhenia; Lul O Deng; Cole P Anderson; Michael Graves; Pavol Kováč; Peng Xu; Edward T Ryan; Jason B Harris; David A Sack; Francisco J Luquero; Daniel T Leung Journal: PLoS Negl Trop Dis Date: 2018-01-29
Authors: Silvia Stringhini; Ania Wisniak; Giovanni Piumatti; Andrew S Azman; Stephen A Lauer; Hélène Baysson; David De Ridder; Dusan Petrovic; Stephanie Schrempft; Kailing Marcus; Sabine Yerly; Isabelle Arm Vernez; Olivia Keiser; Samia Hurst; Klara M Posfay-Barbe; Didier Trono; Didier Pittet; Laurent Gétaz; François Chappuis; Isabella Eckerle; Nicolas Vuilleumier; Benjamin Meyer; Antoine Flahault; Laurent Kaiser; Idris Guessous Journal: Lancet Date: 2020-06-11 Impact factor: 79.321