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Abdella S, Riou S, Tessema M, et al. Prevalence of SARS-CoV-2 in urban and rural Ethiopia: Randomized household serosurveys reveal level of spread during the first wave of the pandemic. EClinicalMedicine. 2021;35:100880doi: 10.1016/j.eclinm.2021.100880.
Abdella, S., Riou, S., Tessema, M., Assefa, A., Seifu, A., Blachman, A., Abera, A., Moreno, N., Irarrazaval, F., Tollera, G., Browning, D., & Tasew, G. (2021). Prevalence of SARS-CoV-2 in urban and rural Ethiopia: Randomized household serosurveys reveal level of spread during the first wave of the pandemic. EClinicalMedicine, 35100880. https://doi.org/10.1016/j.eclinm.2021.100880
Abdella, Saro, et al. "Prevalence of SARS-CoV-2 in urban and rural Ethiopia: Randomized household serosurveys reveal level of spread during the first wave of the pandemic." EClinicalMedicine vol. 35 (2021): 100880. doi: https://doi.org/10.1016/j.eclinm.2021.100880
Abdella S, Riou S, Tessema M, Assefa A, Seifu A, Blachman A, Abera A, Moreno N, Irarrazaval F, Tollera G, Browning D, Tasew G. Prevalence of SARS-CoV-2 in urban and rural Ethiopia: Randomized household serosurveys reveal level of spread during the first wave of the pandemic. EClinicalMedicine. 2021 May 07;35:100880. doi: 10.1016/j.eclinm.2021.100880. eCollection 2021 May. PMID: 34124630; PMCID: PMC8176122.
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EClinicalMedicine. 2021 May 07;35:100880. doi: 10.1016/j.eclinm.2021.100880. eCollection 2021 May.

Prevalence of SARS-CoV-2 in urban and rural Ethiopia: Randomized household serosurveys reveal level of spread during the first wave of the pandemic.

EClinicalMedicine

Saro Abdella, Samuel Riou, Masresha Tessema, Ashenafi Assefa, Albab Seifu, Anna Blachman, Adugna Abera, Nicolas Moreno, Fernando Irarrazaval, Getachew Tollera, David Browning, Geremew Tasew

Affiliations

  1. HIV/TB Research Directorate, Ethiopian Public Health Institute, Gulelle Arbegnoch street, Addis Ababa, Ethiopia.
  2. Enveritas, 24 Innis Lane, Old Greenwich, CT, USA.
  3. Nutrition and Food Sciences Research Directorate, Ethiopian Public Health Institute, Gulelle Arbegnoch street, Addis Ababa, Ethiopia.
  4. Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Gulelle Arbegnoch street, Addis Ababa, Ethiopia.

PMID: 34124630 PMCID: PMC8176122 DOI: 10.1016/j.eclinm.2021.100880

Abstract

BACKGROUND: The spread of SARS-CoV-2 in Sub-Saharan Africa is poorly understood and to date has generally been characterised by a lower number of declared cases and deaths as compared to other regions of the world. Paucity of reliable information, with insights largely derived from limited RT-PCR testing in high-risk and urban populations, has been one of the biggest barriers to understanding the course of the pandemic and informed policy-making. Here we estimate seroprevalence of anti-SARS-CoV-2 antibodies in Ethiopia during the first wave of the pandemic.

METHODS: We undertook a population-based household seroprevalence serosurvey based on 1856 participants in Ethiopia, in the capital city Addis Ababa, and in Jimma, a middle-sized town in the Oromia region, and its rural surroundings (districts of Seka and Mana), between 22 July and 02 September 2020. We tested one random participant per household for anti-SARS-CoV-2 antibodies using a high specificity rapid diagnostic tests (RDTs) and evaluated population seroprevalence using a Bayesian logistic regression model taking into account test performance as well as age and sex of the participants.

FINDINGS: In total, 2304 random households were visited, with 1856 individuals consenting to participate. This produced a sample of 956 participants in Addis Ababa and 900 participants in Jimma. IgG prevalence was estimated at 1.9% (95% CI 0.4-3.7%), and combined IgM/IgG prevalence at 3.5% (95% CI 1.7-5.4%) for Addis Ababa in early August 2020, with higher prevalence in central sub-cities. Prevalence in Jimma town was lower at 0.5% (95% CI 0-1.8%) for IgG and 1.6% (95%CI 0-4.1%) for IgM/IgG, while in rural Jimma IgG prevalence was 0.2% and IgM/IgG 0.4% in early September.

INTERPRETATION: More than four months after the first cases were detected in Ethiopia, Addis Ababa displayed a prevalence under 5% and likely as low as 2%, while rural Jimma displayed a prevalence of 0.2%. A 2% seroprevalence figure for the capital translated to a number of cases at least five times larger than those reported for the country as a whole. At the same time, it contrasts with significantly higher seroprevalence figures in large cities in Europe and America only two to three months after the first cases. This population-based seroepidemiological study thus provides evidence of a slower spread of SARS-CoV-2 in the Ethiopian population during the first wave of the pandemic and does not appear to support the notion that lower case numbers were simply a reflection of limited testing and surveillance.

FUNDING: Schmidt Family Foundation, Joachim Hertz Foundation, Nespresso, Peet's and Smuckers.

© 2021 The Author(s).

Keywords: Africa; Ethiopia; Household surveys; Prevalence; SARS-CoV-2

Conflict of interest statement

We declare no competing interests.

References

  1. Infect Ecol Epidemiol. 2020 Aug 11;10(1):1806505 - PubMed
  2. Lancet. 2020 Aug 1;396(10247):313-319 - PubMed
  3. Lancet Glob Health. 2021 Jun;9(6):e773-e781 - PubMed
  4. Science. 2021 Jan 1;371(6524):79-82 - PubMed
  5. Annu Rev Virol. 2020 Sep 29;7(1):83-101 - PubMed
  6. Int J Infect Dis. 2021 Jan;102:577-583 - PubMed
  7. Lancet. 2020 Mar 14;395(10227):841-842 - PubMed
  8. Nat Med. 2020 Aug;26(8):1196-1199 - PubMed
  9. Lancet. 2020 Mar 14;395(10227):871-877 - PubMed
  10. Lancet Glob Health. 2020 Nov;8(11):e1390-e1398 - PubMed
  11. J Rural Health. 2020 Sep;36(4):591-601 - PubMed
  12. Lancet. 2020 Aug 22;396(10250):535-544 - PubMed
  13. Proc Natl Acad Sci U S A. 2020 Nov 3;117(44):27456-27464 - PubMed
  14. Euro Surveill. 2020 Dec;25(50): - PubMed
  15. Epidemiology. 2021 Jul 1;32(4):518-524 - PubMed
  16. Am J Trop Med Hyg. 2020 Aug;103(2):564-569 - PubMed
  17. Nat Biotechnol. 2020 Oct;38(10):1174-1183 - PubMed
  18. Science. 2021 Jan 1;371(6524):27-28 - PubMed
  19. S Afr Med J. 2020 Jul 27;110(9):837-841 - PubMed
  20. Nat Med. 2020 Nov;26(11):1714-1719 - PubMed
  21. Clin Infect Dis. 2020 Jul 28;71(15):875-878 - PubMed
  22. Clin Chem Lab Med. 2020 Jun 29;58(9):1595-1600 - PubMed
  23. Ann Epidemiol. 2020 Aug;48:23-29.e4 - PubMed
  24. Science. 2020 Aug 7;369(6504):624-626 - PubMed
  25. PLoS One. 2020 Sep 18;15(9):e0238339 - PubMed
  26. Bull World Health Organ. 2014 Sep 1;92(9):690-4 - PubMed
  27. Emerg Infect Dis. 2021 Mar;27(3):928-931 - PubMed
  28. Euro Surveill. 2020 Mar;25(10): - PubMed

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