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Emerg Infect Dis . SARS-CoV-2 Prevalence in Malawi Based on Data from Survey of Communities and Health Workers in 5 High-Burden Districts, October 2

tetano

Editor, Senior Moderator
Emerg Infect Dis


. 2022 Oct;28(13):76-84.
doi: 10.3201/eid2813.212348.
SARS-CoV-2 Prevalence in Malawi Based on Data from Survey of Communities and Health Workers in 5 High-Burden Districts, October 2020

Joe Alex Theu, Alinune Nathanael Kabaghe, George Bello, Evelyn Chitsa-Banda, Matthews Kagoli, Andrew Auld, Jonathan Mkungudza, Gabrielle O'Malley, Fred Fredrick Bangara, Elizabeth F Peacocke, Yusuf Babaye, Wingston Ng'ambi, Christel Saussier, Ellen MacLachlan, Gertrude Chapotera, Mphatso Dennis Phiri, Evelyn Kim, Mabvuto Chiwaula, Danielle Payne, Nellie Wadonda-Kabondo, Annie Chauma-Mwale, Titus Henry Divala, Public Health Institute of Malawi COVID-19 surveillance committee3

Abstract

To determine early COVID-19 burden in Malawi, we conducted a multistage cluster survey in 5 districts. During October-December 2020, we recruited 5,010 community members (median age 32 years, interquartile range 21-43 years) and 1,021 health facility staff (HFS) (median age 35 years, interquartile range 28-43 years). Real-time PCR-confirmed SARS-CoV-2 infection prevalence was 0.3% (95% CI 0.2%-0.5%) among community and 0.5% (95% CI 0.1%-1.2%) among HFS participants; seroprevalence was 7.8% (95% CI 6.3%-9.6%) among community and 9.7% (95% CI 6.4%-14.5%) among HFS participants. Most seropositive community (84.7%) and HFS (76.0%) participants were asymptomatic. Seroprevalence was higher among urban community (12.6% vs. 3.1%) and HFS (14.5% vs. 7.4%) than among rural community participants. Cumulative infection findings 113-fold higher from this survey than national statistics (486,771 vs. 4,319) and predominantly asymptomatic infections highlight a need to identify alternative surveillance approaches and predictors of severe disease to inform national response.

Keywords: COVID-19; Malawi; SARS-CoV-2; community health workers; community surveillance; coronavirus disease; respiratory infections; serosurveillance; severe acute respiratory syndrome coronavirus 2; viruses; zoonoses.
 
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