Prevalence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) among Health Care Workers—Zambia, July 2020

Fwoloshi, Sombo; Hines, Jonas Z; Barradas, Danielle T; Yingst, Samuel; Siwingwa, Mpanji; Chirwa, Lameck; Zulu, James E; Banda, Dabwitso; Wolkon, Adam; Nikoi, Kotey I; Chirwa, Bob; Kampamba, Davies; Shibemba, Aaron; Sivile, Suilanji; Zyambo, Khozya D; Chanda, Duncan; Mupeta, Francis; Kapina, Muzala; Sinyange, Nyambe; Kapata, Nathan; Zulu, Paul M; Makupe, Alex; Mweemba, Aggrey; Mbewe, Nyuma; Ziko, Luunga; Mukonka, Victor; Mulenga, Lloyd B; Malama, Kennedy; Agolory, Simon

INTRODUCTION: Healthcare workers (HCWs) in Zambia have become infected with SARS-CoV-2, the virus that causes coronavirus disease (COVID-19). However, SARS-CoV-2 prevalence among HCWs is not known in Zambia. METHODS: We conducted a cross-sectional SARS-CoV-2 prevalence survey among Zambian HCWs in twenty health facilities in six districts in July 2020. Participants were tested for SARS-CoV-2 infection using polymerase chain reaction (PCR) and for SARS-CoV-2 antibodies using enzyme-linked immunosorbent assay (ELISA). Prevalence estimates and 95% confidence intervals (CIs), adjusted for health facility clustering, were calculated for each test separately and a combined measure for those who had PCR and ELISA performed. RESULTS: In total, 660 HCWs participated in the study, with 450 (68.2%) providing nasopharyngeal swab for PCR and 575 (87.1%) providing a blood specimen for ELISA. Sixty-six percent of participants were females and the median age was 31.5 years (interquartile range 26.2–39.8 years). The overall prevalence of the combined measure was 9.3% (95% CI 3.8%–14.7%). PCR-positive prevalence of SARS-CoV-2 was 6.6% (95% CI 2.0%–11.1%) and ELISA-positive prevalence was 2.2% (95% CI 0.5%–3.9%). CONCLUSIONS: SARS-CoV-2 prevalence among HCWs was similar to a population-based estimate (10.6%) during a period of community transmission in Zambia. Public health measures such as establishing COVID-19 treatment centers before the first cases, screening for COVID-19 symptoms among patients accessing health facilities, infection prevention and control trainings, and targeted distribution of personal protective equipment based on exposure risk might have prevented increased SARS-CoV-2 transmission among Zambian HCWs.