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High SARS-CoV-2 Seroprevalence in Healthcare Workers in Bukavu, Eastern Democratic Republic of Congo

Our take —

Among healthcare workers at the Panzi General Referral Hospital in Bukavu, Democratic Republic of Congo, the prevalence of SARS-CoV-2 antibodies was 41.2% (148/359). Less than a quarter of those with positive antibodies were able to recall any symptoms suggestive of symptomatic COVID-19 disease, and none had prior severe disease (i.e. hospitalization or death). Further research is needed to understand levels of community transmission in this setting and the extent to which asymptomatic infections among healthcare workers contribute to community spread via nosocomial and household transmission how the burden of disease may compare between healthcare workers and non-healthcare workers.

Study design

Cross-Sectional

Study population and setting

Between July 2 and August 19, 2020, healthcare workers at the Panzi General Referral Hospital in Bukavu, Democratic Republic of Congo were asked to participate in a voluntary study. The study involved collection of a brief survey regarding medical history and current or past symptoms and serological testing. Serological testing was performed using a QuickZen COVID-19 IgM/IgG rapid point-of-care test kit and confirmed using Euroimmun Anti-SARS-CoV-2 ELISA IgG assay.

Summary of Main Findings

A total of 359 healthcare workers, or 91.4% of all working staff members (n=393), participated in the study. 41.2% (n=148) tested positive for SARS-CoV-2 IgG antibodies by the Euroimmun assay. Based on findings from the questionnaire, 22.3% (33/148) of healthcare workers who tested positive for SARS-CoV-2 antibodies reported prior symptoms suggestive of COVID-19 illness, with none suffered from severe COVID-19 (i.e. hospitalization or death).

Study Strengths

The level of participation was high, and so the numbers reported here likely represent a fairly good picture of seroprevalence for this population of healthcare workers. Confirmation testing using ELISA reduced misclassification of antibody status.

Limitations

This was a cross-sectional study, and therefore recall of prior symptoms may have been poor. This study was not able to establish the relative burden of prior infection among healthcare workers compared with the general community, because measurement of SARS-CoV-2 antibodies was only done among healthcare workers.

Value added

Serological testing in sub-Saharan Africa to date has been limited, and this study provides valuable insight into the levels of exposure to SARS-CoV-2 in a healthcare setting in the Democratic Republic of Congo.

This review was posted on: 3 April 2021