Measures for infection prevention and control of SARS-CoV-2 in Belgian schools between December 2020 and June 2021: a prospective cohort study
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Abstract
Introduction
As the role of school-aged children was unclear at the onset of the COVID-19 pandemic, public health authorities recommended to implement infection prevention and control (IPC) measures in school settings. Few studies evaluated the implementation of these measures and their effect on SARS-CoV-2 infection rates among pupils and staff.
Aim
To describe the implementation of IPC measures in Belgian primary and secondary schools and assess its relation to the prevalence of anti-SARS-CoV-2 antibodies among pupils and staff.
Methods
We conducted a prospective cohort study in a representative sample of primary and secondary schools in Belgium. Implementation of IPC measures in schools was assessed using an online questionnaire. Saliva samples were collected from pupils and staff to determine the SARS-CoV-2 seroprevalence.
Results
A variety of IPC measures (ventilation, hygiene and physical distancing) was implemented by more than 60% of primary and secondary schools with most attention for hygiene measures. Almost no differences in implementation coverage were observed between primary and secondary schools or the Dutch and French language network. Poor implementation of IPC measures was associated with an increased anti-SARS-CoV-2 antibody prevalence among pupils from 8.6% (95% CI: 4.5 - 16.6) to 16.7% (95% CI: 10.2 - 27.4) and staff from 11.5% (95% CI: 8.1 - 16.4) to 17.6% (95% CI: 11.5 - 27.0). This association was statistically significant for all IPC measures and pupils and staff combined.
Conclusion
Belgian schools were relatively compliant with recommended IPC measures at the school level. Poor implementation of IPC measures was associated with higher SARS-CoV-2 seroprevalence among pupils and staff.
Trial registration number
Trial registration number: NCT04613817
Article activity feed
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SciScore for 10.1101/2022.04.12.22273722: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Antibodies Sentences Resources During each data collection period, the prevalence of anti-SARS-CoV-2 antibodies among pupils and staff of participating schools was assessed using saliva samples. anti-SARS-CoV-2suggested: NoneSoftware and Algorithms Sentences Resources Data were analysed using SAS Enterprise Guide version 7.1 (SAS Institute Inc., Cary, NC, USA) and R version 4.0 (2021, R. SAS Institutesuggested: (Statistical Analysis System, RRID:SCR_008567)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 Limitat…SciScore for 10.1101/2022.04.12.22273722: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Antibodies Sentences Resources During each data collection period, the prevalence of anti-SARS-CoV-2 antibodies among pupils and staff of participating schools was assessed using saliva samples. anti-SARS-CoV-2suggested: NoneSoftware and Algorithms Sentences Resources Data were analysed using SAS Enterprise Guide version 7.1 (SAS Institute Inc., Cary, NC, USA) and R version 4.0 (2021, R. SAS Institutesuggested: (Statistical Analysis System, RRID:SCR_008567)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: We detected the following sentences addressing limitations in the study:There are also limitations. First, the data on the implementation of IPC measures were self-reported which is prone to confirmation bias and misinterpretation. Secondly, data collection started in December 2020 and covered the preceding months which could result in recollection bias. Moreover, the first testing period covered a rather heterogeneous phase of the pandemic including periods of in-person teaching and the summer holiday in July and August 2020. Thirdly, individual characteristics of the participants were not included in our analyses. Finally, while representative for Belgian schools, the sample sizes at the school level are small and do not allow to quantify the attributable impact of individual IPC measures. In conclusion, Belgian primary and secondary schools of both language networks complied relatively well with recommended IPC measures. A poor implementation of the IPC measures together and by ventilation, hygiene and physical distancing subcategory, showed an increase in the prevalence of anti-SARS-CoV-2 antibodies among pupils and staff in Belgian schools. This association was statistically significant for the IPC measures together for pupils and staff combined showing a decrease of being seropositive by 21% with thorough implementation. Despite observing comparable effect sizes in pupils and staff separately, these did not reach statistical significance, and neither were the trends for the three different IPC measures subcategories. This might be due to lo...
Results from TrialIdentifier: We found the following clinical trial numbers in your paper:
Identifier Status Title NCT04613817 Recruiting Sero-prevalence COVID-19 Among Belgian Children 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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