Seroprevalence and risk factors of SARS-CoV-2 infection in an urban informal settlement in Nairobi, Kenya, December 2020.
Seroprevalence and risk factors of SARS-CoV-2 infection in an urban informal settlement in Nairobi, Kenya, December 2020.
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DOI：
10.12688/f1000research.72914.2
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发表时间：
2021
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简介：由于过度拥挤和其他社会经济挑战，城市非正规住区可能受到COVID-19大流行的不成比例影响，难以采取和实施公共卫生缓解措施。我们在肯尼亚内罗毕的基贝拉非正式定居点进行了血清阳性率调查，以确定SARS-CoV-2感染的程度。 研究方法：从现有的以人口为基础的传染病监测（PBIDS）中随机选择的家庭成员在2020年11月27日至12月5日期间提供了血液样本。对样本进行了SARS-CoV-2刺突蛋白抗体检测。根据PBIDS人群的年龄和性别分布加权血清阳性率估计值，并考虑家庭聚集性。多变量逻辑回归用于确定个体血清阳性的危险因素。 结果：从175个家庭的523个个体获得了同意，产生了511份血清样本进行了检测。总体加权血清阳性率为43.3%（95% CI，37.4 - 49.5%），不因性别而异。在抽样家庭中，122户（69.7%）至少有一名血清反应阳性者。个体血清阳性率随年龄增长而增加，从7.6%（95% CI，2.4 - 21.3%）（5岁以下），32.7%（95% CI，22.9 - 44.4%），10-19岁为41.8%（95% CI，33.0 - 51.1%），成人（≥20岁）为54.9%（46.2 - 63.3%）。相对于中等规模家庭（3人和4人），来自大（≥5人）家庭的血清阳性几率显著增加，aOR为1.98（95%CI，1.17 - 1.58），而来自小规模家庭的（≤2例个体）的比值增加，但无统计学显著性，aOR，2.31（95% CI，0.93 - 5.74）。 结论：在人口稠密的城市环境中，在肯尼亚COVID-19大流行8个月后，近一半的人感染了SARS-CoV-2。这突出了在拥挤、低社会经济环境中优先采取缓解措施的重要性，包括COVID-19疫苗分发。
Introduction: Urban informal settlements may be disproportionately affected by the COVID-19 pandemic due to overcrowding and other socioeconomic challenges that make adoption and implementation of public health mitigation measures difficult. We conducted a seroprevalence survey in the Kibera informal settlement, Nairobi, Kenya, to determine the extent of SARS-CoV-2 infection. Methods: Members of randomly selected households from an existing population-based infectious disease surveillance (PBIDS) provided blood specimens between 27 th November and 5 th December 2020. The specimens were tested for antibodies to the SARS-CoV-2 spike protein. Seroprevalence estimates were weighted by age and sex distribution of the PBIDS population and accounted for household clustering. Multivariable logistic regression was used to identify risk factors for individual seropositivity. Results: Consent was obtained from 523 individuals in 175 households, yielding 511 serum specimens that were tested. The overall weighted seroprevalence was 43.3% (95% CI, 37.4 – 49.5%) and did not vary by sex. Of the sampled households, 122(69.7%) had at least one seropositive individual. The individual seroprevalence increased by age from 7.6% (95% CI, 2.4 – 21.3%) among children (<5 years), 32.7% (95% CI, 22.9 – 44.4%) among children 5 – 9 years, 41.8% (95% CI, 33.0 – 51.1%) for those 10-19 years, and 54.9%(46.2 – 63.3%) for adults (≥20 years). Relative to those from medium-sized households (3 and 4 individuals), participants from large (≥5 persons) households had significantly increased odds of being seropositive, aOR, 1.98(95% CI, 1.17 – 1.58), while those from small-sized households (≤2 individuals) had increased odds but not statistically significant, aOR, 2.31 (95% CI, 0.93 – 5.74). Conclusion: In densely populated urban settings, close to half of the individuals had an infection to SARS-CoV-2 after eight months of the COVID-19 pandemic in Kenya. This highlights the importance to prioritize mitigation measures, including COVID-19 vaccine distribution, in the crowded, low socioeconomic settings.