Prevalence of SARS-CoV-2: An age-stratified, population-based, sero-epidemiological survey in Islamabad, Pakistan

  1. Mirza Amir Baig
  2. Jamil Ahmed Ansari
  3. Aamer Ikram
  4. Mumtaz Ali Khan
  5. Muhammad Salman
  6. Zakir Hussain
  7. Mirza Zeeshan Iqbal Baig
  8. Ambreen Chaudhry
  9. Muhammad Wasif Malik
  10. Khurram Shahzad Akram
  11. Asim Saeed
  12. Muazzam Abbas Ranjha
  13. Faisal Sultan
  14. Sohail Sabir

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

Introduction

Serological surveys are valuable tools to evaluate the extent of disease transmission, measuring preventive effectiveness and proportion of asymptomatic individuals. This age-stratified, serological survey was aimed to measure the COVID-19 distribution and determinants in district Islamabad of Pakistan.

Methodology

Three-stage cluster sampling, using population proportionate to size technique, starting with a random number was used. A structured, pretested questionnaire was used after taking informed written consent, to gather demographic, risk factor information.

Results

Seroprevalence was found 16.5% (AR: 16.5%/100,000). The mean age was 35 (±16 Years). The majority were male (64%), self-employed (29%), and had primary level education (33%). The highest seroprevalence was found in the 21-30 years age group (24.8%) while the 41-50 years age group showed the highest attack rate (112.9/100,000 population). The proportion of the population tested that were asymptomatic was 69% (n=711) while the most frequently reported sign/symptom was cough (99%) followed by fever (20%). No known co-morbidity was reported in 86% (n=884) of respondents while hypertension remained the most reported condition (8%). High seroprevalence was observed in urban areas (12.3%) compared to rural union councils (6.4%). Visiting a house where COVID-19 case was isolated (OR 2, CI 1.38-2.84, P < 0.001), history of contact with a known case of COVID-19 (OR 1.42, CI 1.11-1.82, P =0.005), and attending a mass gathering (OR 1.21, CI: 1.02-1.42, p=0.02) were significant risk factors associated with contracting an infection. A Chi-Square test of independence showed significant protection while using regular hand hygiene practices (6.5; p<0.05) and regular usage of face masks (8.6; p<0.05).

Conclusion

Seroprevalence gives a direct estimation of population groups exposed to the virus. A remarkable difference in prevalence is found in urban and rural areas, extreme age groups, and socioeconomic statuses, suggesting targeted public health interventions. Sero-studies are affordable counterparts of molecular testing where quick estimation, prevention effectiveness, and data-driven public health policies are priorities.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2021.09.27.21264003: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: An institutional review board (IRB) approval was obtained from National Institute of Health (NIH).
    Consent: A consent form was developed and translated into local language for the purpose of enabling the respondents to understand their autonomous right to decide to participate in the study and announcing the beneficence and justice rendered in the study 15.
    Sex as a biological variablenot detected.
    Randomization” Using a systematic random sampling approach, a sampling interval was calculated by dividing the total number of households by number of households allocated per village/sector.
    Blindingnot detected.
    Power AnalysisThe sample size was equally divided between rural (n=31, 49%), and urban (n=13, 51%) union councils for equal representation of both populations where urban UCs contain sectors and rural UCs contain villages in them.
    Cell Line AuthenticationAuthentication: Data was coded to mask identities of respondents, double entered, validated and password protected at central office.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    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.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.09.27.21264003v1 on medRxiv