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J Glob Health . Prevalence and risk factors of Severe Acute Respiratory Syndrome Coronavirus 2 infection in women and children in peri-urban communi

tetano

Editor, Senior Moderator
J Glob Health


. 2022 Dec 17;12:05055.
doi: 10.7189/jogh.12.95955.
Prevalence and risk factors of Severe Acute Respiratory Syndrome Coronavirus 2 infection in women and children in peri-urban communities in Pakistan: A prospective cohort study


Nadia Ansari[SUP] 1 [/SUP], Muhammad I Nisar[SUP] 1 [/SUP], Farah Khalid[SUP] 1 [/SUP], Usma Mehmood[SUP] 1 [/SUP], Asra A Usmani[SUP] 1 [/SUP], Fariha Shaheen[SUP] 1 [/SUP], Aneeta Hotwani[SUP] 1 [/SUP], Kehkashan Begum[SUP] 1 [/SUP], Amina Barkat[SUP] 1 [/SUP], Sachiyo Yoshida[SUP] 2 [/SUP], Alexander A Manu[SUP] 3 [/SUP], Sunil Sazawal[SUP] 4 5 [/SUP], Abdullah H Baqui[SUP] 6 [/SUP], Rajiv Bahl[SUP] 2 [/SUP], Fyezah Jehan[SUP] 1 [/SUP]



Affiliations
Free article

Abstract

Background: Population-based seroepidemiological surveys provide accurate estimates of disease burden. We compare the COVID-19 prevalence estimates from two serial serological surveys and the associated risk factors among women and children in a peri-urban area of Karachi, Pakistan.
Methods: The AMANHI-COVID-19 study enrolled women and children between November 2020 and March 2021. Blood samples were collected from March to June 2021 (baseline) and September to December 2021 (follow-up) to test for anti-SARS-CoV-2 antibodies using ROCHE Elecsys®. Participants were visited or called weekly during the study for recording symptoms of COVID-19. We report the proportion of participants with anti-SARS-CoV-2 antibodies and symptoms in each survey and describe infection risk factors using step-wise binomial regression analysis.
Results: The adjusted seroprevalence among women was 45.3% (95% confidence interval (CI) = 42.6-47.9) and 82.3% (95% CI = 79.9-84.4) at baseline and follow-up survey, respectively. Among children, it was 18.4% (95% CI = 16.1-20.7) and 57.4% (95% CI = 54.3-60.3) at baseline and follow-up, respectively. Of the women who were previously seronegative, 404 (74.4%) tested positive at the follow-up survey, as did 365 (50.4%) previously seronegative children. There was a high proportion of asymptomatic infection. At baseline, being poorest and lacking access to safe drinking water lowered the risk of infection for both women (risk ratio (RR) = 0.8, 95% CI = 0.7-0.9 and RR = 1.2, 95% CI = 1.1-1.4, respectively) and children (RR = 0.7, 95% CI = 0.5-1.0 and RR = 1.4, 95% CI = 1.0-1.8, respectively). At the follow-up survey, the risk of infection was lower for underweight women and children (RR = 0.4, 95% CI = 0.3-0.7 and RR = 0.7, 95% CI = 0.5-0.8, respectively) and for women in the 30-39 years age group and children who were 24-36 months of age (RR = 0.6, 95% CI = 0.4-0.9 and RR = 0.7, 95% CI = 0.5-0.9, respectively). In both surveys, paternal employment was an important predictor of seropositivity among children (RR = 0.7, 95% CI = 0.6-0.9 and RR = 0.8, 95% CI = 0.7-1.0, respectively).
Conclusion: There was a high rate of seroconversion among women and children. Infection was generally mild. Parental education plays an important role in protection of children from COVID-19.
 
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