Seroprevalence of anti-SARS-CoV-2 antibodies in women attending antenatal care in eastern Ethiopia: a facility-based surveillance
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Abstract
We conducted serosurveillance of anti-SARS-CoV-2 antibodies among pregnant women attending their first antenatal care.
Setting
The surveillance was set in one referral hospital in Harar, one district hospital and one health centre located in Haramaya district in rural eastern Ethiopia.
Participants
We collected questionnaire data and a blood sample from 3312 pregnant women between 1 April 2020 and 31 March 2021. We selected 1447 blood samples at random and assayed these for anti-SARS-CoV-2 antibodies at Hararghe Health Research laboratory using WANTAI SARS-CoV-2 Rapid Test for total immunoglobulin.
Outcome
We assayed for anti-SARS-CoV-2 antibodies and temporal trends in seroprevalence were analysed with a χ 2 test for trend and multivariable binomial regression.
Results
Among 1447 sera tested, 83 were positive for anti-SARS-CoV-2 antibodies giving a crude seroprevalence of 5.7% (95% CI 4.6% to 7.0%). Of 160 samples tested in April–May 2020, none was seropositive; the first seropositive sample was identified in June and seroprevalence rose steadily thereafter (χ 2 test for trend, p=0.003) reaching a peak of 11.8% in February 2021. In the multivariable model, seroprevalence was approximately 3% higher in first-trimester mothers compared with later presentations, and rose by 0.75% (95% CI 0.31% to 1.20%) per month of calendar time.
Conclusions
This clinical convenience sample illustrates the dynamic of the SARS-CoV-2 epidemic in pregnant women in eastern Ethiopia; infection was rare before June 2020 but it spread in a linear fashion thereafter, rather than following intermittent waves, and reached 10% by the beginning of 2021. After 1 year of surveillance, most pregnant mothers remained susceptible.
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SciScore for 10.1101/2021.06.17.21257323: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable Haramaya Hospital was rapidly designated a COVID-19 treatment facility and women seeking ANC services were therefore referred to Aweday Health Centre after April 16, 2020. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Antibodies Sentences Resources Laboratory analyses: For the anti–SARS-CoV-2 antibodies test, residual blood samples from the routine ANC tests were transferred to a test-tube containing clot activator by trained medical laboratory technologists working in each health facility. anti–SARS-CoV-2suggested: NoneWe estimated unadjusted seroprevalence of SARS-CoV-2 IgG antibody with a 95% confidence … SciScore for 10.1101/2021.06.17.21257323: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable Haramaya Hospital was rapidly designated a COVID-19 treatment facility and women seeking ANC services were therefore referred to Aweday Health Centre after April 16, 2020. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Antibodies Sentences Resources Laboratory analyses: For the anti–SARS-CoV-2 antibodies test, residual blood samples from the routine ANC tests were transferred to a test-tube containing clot activator by trained medical laboratory technologists working in each health facility. anti–SARS-CoV-2suggested: NoneWe estimated unadjusted seroprevalence of SARS-CoV-2 IgG antibody with a 95% confidence interval (CI). SARS-CoV-2 IgGsuggested: NoneSoftware and Algorithms Sentences Resources Statistical analysis: We used STATA version 16.0 for statistical analysis. STATAsuggested: (Stata, RRID:SCR_012763)Results from OddPub: Thank you for sharing your data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:The principal limitations of the study are the potential generalisability of the population under surveillance and the validity of the serological assay employed. Pregnant women have been used as an indicator population in prior pandemics, including HIV [6], but also for SARS-CoV-2, both in high-income settings [4,5,7-11] and low- and middle-income settings, including in neighbouring Kenya [3]. The principal advantage of sampling pregnant women is that they remain one of the few patient groups for whom health services cannot be postponed until after the pandemic has passed. They are permitted and encouraged to attend even in the face of social and movement restrictions, and so provide a consistent and reliable sampling group. The principal limitation of this group is their restriction on age and sex, however, in most settings, including other East African countries, seroprevalence does not vary significantly by sex and the cumulative incidence in women is likely to represent the infection history of both sexes [12]. Similarly, in most settings young adults are the group most likely to be infected by SARS-CoV-2 and so the seroprevalence estimates here are likely to represent the highest risk in the whole population; other age groups, particularly children and the elderly, are likely to have lower seroprevalence [13,14]. The World Health Organization has deprecated the use of rapid tests for SARS-CoV-2 antibodies for individual diagnosis but recognises their potential value in ...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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