Seroprevalence of anti-SARS-CoV-2 antibodies and risk of viral exposure among healthcare workers in the South Kivu province, eastern Democratic Republic of the Congo: a cross-sectional study

ObjectivesHealthcare workers (HCWs) are on the frontline of combating COVID-19, hence are at elevated risk of contracting an infection with SARS-CoV-2. The present study aims to measure the impact of SARS-CoV-2 on HCWs in central sub-Saharan Africa.SettingA cross-sectional serological study was cond...

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Published in:	BMJ open Vol. 14; no. 1; p. e072212
Main Authors:	Chasinga, Tshass B, Cikwanine, Jean-Paul Buhendwa, Kribi, Sarah, Yoyu, Jonathan Tunangoya, Hofmann, Natalie, Grossegesse, Marica, Nitsche, Andreas, Tomczyk, Sara, Vietor, Ann C, Leendertz, Fabian H, Eckmanns, Tim, Kusinza, Aline B, Munguakonkwa, Eric, Kalk, Andreas, Raha, Maroyi, Kambale, Nelson S, Ayagirwe, Rodrigue B, Schubert, Grit, Mukwege, Denis
Format:	Journal Article
Language:	English
Published:	England British Medical Journal Publishing Group 04-01-2024 BMJ Publishing Group LTD BMJ Publishing Group
Series:	Original research
Subjects:	Antibodies Antibodies, Viral Asymptomatic COVID-19 COVID-19 - epidemiology Cross-Sectional Studies Democratic Republic of the Congo - epidemiology Epidemiology Health Personnel Hospitals Hospitals, Rural Humans Infections Infectious Diseases Laboratories Medical personnel Medical research Pandemics Population Prime ministers Public health Questionnaires Rural areas Rural health care SARS-CoV-2 Seroepidemiologic Studies Serology Severe acute respiratory syndrome coronavirus 2 Sociodemographics Urban areas Democratic Republic of the Congo Beijing China China Germany COVID-19 Epidemiology Public health
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Summary:	ObjectivesHealthcare workers (HCWs) are on the frontline of combating COVID-19, hence are at elevated risk of contracting an infection with SARS-CoV-2. The present study aims to measure the impact of SARS-CoV-2 on HCWs in central sub-Saharan Africa.SettingA cross-sectional serological study was conducted at six urban and five rural hospitals during the first pandemic wave in the South Kivu province, Democratic Republic of the Congo (DRC).ParticipantsSerum specimens from 1029 HCWs employed during the first pandemic wave were collected between August and October 2020, and data on demographics and work-related factors were recorded during structured interviews.Primary and secondary outcome measuresThe presence of IgG antibodies against SARS-CoV-2 was examined by ELISA. Positive specimens were further tested using a micro-neutralisation assay. Factors driving SARS-CoV-2 seropositivity were assessed by multivariable analysis.ResultsOverall SARS-CoV-2 seroprevalence was high among HCWs (33.1%), and significantly higher in urban (41.5%) compared with rural (19.8%) hospitals. Having had presented with COVID-19-like symptoms before was a strong predictor of seropositivity (31.5%). Personal protective equipment (PPE, 88.1% and 11.9%) and alcohol-based hand sanitizer (71.1% and 28.9%) were more often available, and hand hygiene was more often reported after patient contact (63.0% and 37.0%) in urban compared with rural hospitals, respectively. This may suggest that higher exposure during non-work times in high incidence urban areas counteracts higher work protection levels of HCWs.ConclusionsHigh SARS-CoV-2 seropositivity indicates widespread transmission of the virus in this region of DRC. Given the absence of publicly reported cases during the same time period at the rural sites, serological studies are very relevant in revealing infection dynamics especially in regions with low diagnostic capacities. This, and discrepancies in the application of PPE between urban and rural sites, should be considered in future pandemic response programmes.
Bibliography:	Original research ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2044-6055 2044-6055
DOI:	10.1136/bmjopen-2023-072212