Author: Wiens, Kirsten E.; Mawien, Pinyi Nyimol; Rumunu, John; Slater, Damien; Jones, Forrest K.; Moheed, Serina; Caflish, Andrea; Bior, Bior K.; Jacob, Iboyi Amanya; Lako, Richard Lino Loro; Guyo, Argata Guracha; Olu, Olushayo Oluseun; Maleghemi, Sylvester; Baguma, Andrew; Hassen, Juma John; Baya, Sheila K.; Deng, Lul; Lessler, Justin; Demby, Maya N.; Sanchez, Vanessa; Mills, Rachel; Fraser, Clare; Charles, Richelle C.; Harris, Jason B.; Azman, Andrew S.; Wamala, Joseph F.
Title: Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Juba, South Sudan: a population-based study Cord-id: bv2wbc5o Document date: 2021_3_12
ID: bv2wbc5o
Snippet: 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 Ba
Document: 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.
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