Seroprevalence, Knowledge, Attitudes, and Practices of People to COVID-19 in Chililabombwe and Lusaka Districts of Zambia

Coronavirus disease 2019 (COVID-19) is a respiratory disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first reported in Wuhan, China. Understanding seroprevalence and the knowledge, attitudes and practices (KAP) of individuals is a given context is crucial for effective public health interventions. This cross-sectional study assessed the seroprevalence of SARS-CoV-2 antibodies and KAP toward COVID-19 in Chililabombwe and Lusaka districts of Zambia. A total of 179 participants were enrolled in the study. These included individuals who visited a health facility, were 18 years of age or older, and were residents of the selected districts. Each participant was swabbed with one nasopharyngeal sample by the medical officer present and immediately subjected to a COVID-19 rapid diagnostic test using the Sure Status® kit (Premier Medical Corporation) targeting the nucleocapsid protein antigen from SARS-CoV-2. In addition, Samples were collected from these participants by drawing approximately 5 ml of venous blood, and the extracted sera was subjected to ELISA targeting the SARS-CoV-2 Nucleocapsid protein. A semi structured questionnaire was used to collect demographic and KAP data from the participants. Only one positive case was detected using the rapid diagnostic test (RDT) 0.5% (1/179). The overall seroprevalence of COVID-19 antibodies in the study areas was 9.5% (17/179). The seroprevalence in Chililabombwe (11.0%) was higher than that in Lusaka (8.0%). The study found variations in seroprevalence based on age, gender, and education level, with higher rates among individuals aged 40-49, females and those with no education. However, these differences were not statistically significant ( p > 0.05). Both seropositive and seronegative participants exhibited moderate knowledge and attitudes, alongside high levels of preventive practices, indicating a shared understanding of health risks and practices. Further analysis showed that low knowledge, attitudes and practices were strongly associated with higher seropositivity. This study recommends enhanced community engagement in future pandemics to close knowledge gaps, disseminate accurate information, and promote effective preventive behaviours. These efforts could help limit the spread of diseases and strengthen community resilience in response to pandemics.