Banda, L. et al. (2023) Characterising the evolving SARS-CoV-2 seroprevalence in urban and rural Malawi between February 2021 and April 2022: A population-based cohort study. International Journal of Infectious Diseases, 137, pp. 118-125. (doi: 10.1016/j.ijid.2023.10.020) (PMCID:PMC10695832)
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Abstract
Objectives This study aimed to investigate the changing SARS-CoV-2 seroprevalence and associated health and sociodemographic factors in Malawi between February 2021 and April 2022. Methods In total, four 3-monthly serosurveys were conducted within a longitudinal population-based cohort in rural Karonga District and urban Lilongwe, testing for SARS-CoV-2 S1 immunoglobulin (Ig)G antibodies using an enzyme-linked immunosorbent assay. Population seroprevalence was estimated in all and unvaccinated participants. Bayesian mixed-effects logistic models estimated the odds of seropositivity in the first survey, and of seroconversion between surveys, adjusting for age, sex, occupation, location, and assay sensitivity/specificity. Results Of the 2005 participants (Karonga, n = 1005; Lilongwe, n = 1000), 55.8% were female and median age was 22.7 years. Between Surveys (SVY) 1 and 4, population-weighted SARS-CoV-2 seroprevalence increased from 26.3% to 89.2% and 46.4% to 93.9% in Karonga and Lilongwe, respectively. At SVY4, seroprevalence did not differ by COVID-19 vaccination status in adults, except for those aged 30+ years in Karonga (unvaccinated: 87.4%, 95% credible interval 79.3-93.0%; two doses: 98.1%, 94.8-99.5%). Location and age were associated with seroconversion risk. Individuals with hybrid immunity had higher SARS-CoV-2 seropositivity and antibody titers, than those infected. Conclusion High SARS-CoV-2 seroprevalence combined with low morbidity and mortality indicate that universal vaccination is unnecessary at this stage of the pandemic, supporting change in national policy to target at-risk groups.
| Item Type: | Articles |
|---|---|
| Additional Information: | The study was supported by the Wellcome Trust (grant numbers 217073/Z/19/Z and 221989/Z/20/Z). |
| Keywords: | SARS-CoV-2, seroprevalence, longitudinal cohort, community, Malawi. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Hughes, Ms Ellen and Willett, Professor Brian and Crampin, Professor Mia and Ho, Dr Antonia |
| Creator Roles: | Ho, A.Conceptualization, Formal analysis, Investigation, Writing – original draft, Writing – review and editing, Visualization, Supervision, Funding acquisition Hughes, E.Resources Willett, B.Resources Crampin, M.Conceptualization, Supervision, Funding acquisition |
| Authors: | Banda, L., Ho, A., Kasenda, S., Read, J. M., Jewell, C., Price, A., McLean, E., Dube, A., Chaima, D., Samikwa, L., Nyirenda, T. S., Hughes, E. C., Willett, B. J., Chauma Mwale, A., Amoah, A. S., and Crampin, A. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Virus Research |
| Journal Name: | International Journal of Infectious Diseases |
| Publisher: | Elsevier |
| ISSN: | 1201-9712 |
| ISSN (Online): | 1878-3511 |
| Published Online: | 28 October 2023 |
| Copyright Holders: | Copyright: © 2023 The Author(s) |
| First Published: | First published in International Journal of Infectious Diseases 137: 118-125 |
| Publisher Policy: | Reproduced under a Creative Commons licence |
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