PMID- 37747851
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230928
IS  - 2767-3375 (Electronic)
IS  - 2767-3375 (Linking)
VI  - 3
IP  - 9
DP  - 2023
TI  - Seroprevalence survey of anti-SARS-CoV-2 antibody and associated factors in South 
      Africa: Findings of the 2020-2021 population-based household survey.
PG  - e0002358
LID - 10.1371/journal.pgph.0002358 [doi]
LID - e0002358
AB  - Population-based serological testing is important to understand the epidemiology 
      and estimate the true cumulative incidence of severe acute respiratory syndrome 
      coronavirus 2 (SARS-CoV-2) to inform public health interventions. This study 
      reports findings of a national household population SARS-CoV-2 serosurvey in 
      people 12 years and older in South Africa. This cross-sectional multi-stage 
      random stratified cluster survey undertaken from November 2020 to June 2021 
      collected sociodemographic data, medical history, behavioural data, and blood 
      samples from consenting participants. The samples were tested for SARS-CoV-2 
      antibodies using the Roche ElecsysAnti-SARS-CoV-2 chemiluminescence immunoassay 
      (CLIA) Total Antibody Test. The survey data were weighted by age, race, sex, and 
      province with final individual weights benchmarked against the 2020 mid-year 
      population estimates and accounted for clustering. Descriptive statistics 
      summarize the characteristics of participants and seroprevalence. Logistic 
      regression analyses were used to identify factors associated with seropositivity. 
      From 13290 survey participants (median age 33 years, interquartile range (IQR) 
      23-46 years), SARS-CoV-2 seroprevalence was 37.8% [95% Confidence Interval (CI) 
      35.4-40.4] and varied substantially across the country's nine provinces, and by 
      sex, age and locality type. In the final adjusted model, the odds of 
      seropositivity were higher in women than in men [aOR = 1.3 (95% CI: 1.0-1.6), p = 
      0.027], and those living with HIV (self-report) [aOR = 1.6 (95% CI: 1.0-2.4), p = 
      0.031]. The odds were lower among those 50 years and older compared to 
      adolescents 12-19 years old [aOR = 0.6 (95% CI: 0.5-0.8), p<0.001] and in those 
      who did not attend events or gatherings [aOR = 0.7 (95% CI: 0.6-1.0), p = 0.020]. 
      The findings help us understand the epidemiology of SARS-CoV-2 within different 
      regions in a low-middle-income country. The survey highlights the higher risk of 
      infection in women in South Africa likely driven by their home and workplace 
      roles and also highlighted a need to actively target and include younger people 
      in the COVID-19 response.
CI  - Copyright: (c) 2023 Moyo et al. This is an open access article distributed under 
      the terms of the Creative Commons Attribution License, which permits unrestricted 
      use, distribution, and reproduction in any medium, provided the original author 
      and source are credited.
FAU - Moyo, Sizulu
AU  - Moyo S
AUID- ORCID: 0000-0002-5296-3242
AD  - Human Sciences Research Council, Pretoria, South Africa.
AD  - School of Public Health and Family Medicine, University of Cape Town, Cape Town, 
      South Africa.
FAU - Simbayi, Leickness C
AU  - Simbayi LC
AD  - Human Sciences Research Council, Pretoria, South Africa.
AD  - Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, 
      South Africa.
FAU - Zuma, Khangelani
AU  - Zuma K
AD  - Human Sciences Research Council, Pretoria, South Africa.
AD  - School of Public Health, University of the Witwatersrand, Johannesburg, South 
      Africa.
FAU - Zungu, Nompumelelo
AU  - Zungu N
AD  - Human Sciences Research Council, Pretoria, South Africa.
AD  - Department of Psychology, University of Pretoria, Pretoria, South Africa.
FAU - Marinda, Edmore
AU  - Marinda E
AD  - Human Sciences Research Council, Pretoria, South Africa.
AD  - School of Public Health, University of the Witwatersrand, Johannesburg, South 
      Africa.
FAU - Jooste, Sean
AU  - Jooste S
AD  - Human Sciences Research Council, Pretoria, South Africa.
FAU - Ramlagan, Shandir
AU  - Ramlagan S
AD  - Human Sciences Research Council, Pretoria, South Africa.
FAU - Fortuin, Mirriam
AU  - Fortuin M
AD  - National Institute for Communicable Diseases of the National Health Laboratory 
      Service, Johannesburg, South Africa.
FAU - Singh, Beverley
AU  - Singh B
AD  - National Institute for Communicable Diseases of the National Health Laboratory 
      Service, Johannesburg, South Africa.
FAU - Mabaso, Musawenkosi
AU  - Mabaso M
AD  - Human Sciences Research Council, Pretoria, South Africa.
FAU - Reddy, Tarylee
AU  - Reddy T
AD  - Biostatistics Research Unit (TR and SMa)/ HIV and other Infectious Diseases 
      Research Unit (AG and NN), South African Medical Research Council, Cape Town, 
      South Africa.
FAU - Parker, Whadi-Ah
AU  - Parker WA
AD  - Human Sciences Research Council, Pretoria, South Africa.
FAU - Naidoo, Inbarani
AU  - Naidoo I
AD  - Human Sciences Research Council, Pretoria, South Africa.
FAU - Manda, Samuel
AU  - Manda S
AD  - Biostatistics Research Unit (TR and SMa)/ HIV and other Infectious Diseases 
      Research Unit (AG and NN), South African Medical Research Council, Cape Town, 
      South Africa.
FAU - Goga, Ameena
AU  - Goga A
AD  - Biostatistics Research Unit (TR and SMa)/ HIV and other Infectious Diseases 
      Research Unit (AG and NN), South African Medical Research Council, Cape Town, 
      South Africa.
AD  - Department of Paediatrics and Child Health, University of Pretoria, Pretoria, 
      South Africa.
FAU - Ngandu, Nobubelo
AU  - Ngandu N
AUID- ORCID: 0000-0001-8883-3821
AD  - Biostatistics Research Unit (TR and SMa)/ HIV and other Infectious Diseases 
      Research Unit (AG and NN), South African Medical Research Council, Cape Town, 
      South Africa.
FAU - Cawood, Cherie
AU  - Cawood C
AD  - Epicentre, Randburg, South Africa.
FAU - Moore, Penny L
AU  - Moore PL
AD  - National Institute for Communicable Diseases of the National Health Laboratory 
      Service, Johannesburg, South Africa.
AD  - SAMRC Antibody Immunity Research Unit, Division of Virology and Immunology, 
      University of the Witwatersrand, Johannesburg, South Africa.
FAU - Puren, Adrian
AU  - Puren A
AD  - National Institute for Communicable Diseases of the National Health Laboratory 
      Service, Johannesburg, South Africa.
AD  - Division of Virology, School of Pathology, University of the Witwatersrand 
      Medical School, Johannesburg, South Africa.
LA  - eng
PT  - Journal Article
DEP - 20230925
PL  - United States
TA  - PLOS Glob Public Health
JT  - PLOS global public health
JID - 9918283779606676
PMC - PMC10519586
COIS- I have read the journal's policy and the authors of this manuscript have the 
      following competing interests. All authors were Funded by the Solidarity Fund and 
      the Human Sciences Research Council. The National Institute for Communicable 
      Diseases, South Africa, funded testing with the Roche assay Sizulu Moyo, 
      Leickness C.S. Simbayi, Khangelani Zuma, Nompumelelo Zungu, Edmore Marinda E, 
      Sean Jooste, Whadi-ah Parker, Shandir Ramlagan, Inbarani Naidoo, Musawenkosi 
      Mabaso designed and led the study and were and are still employed by the Human 
      Sciences Research Council. Mirriam Fortuin Beverley Singh, Adrian Puren led and 
      conducted the laboratory testing and were and are still employed by the National 
      Institute for Communicable Diseases, South Africa.
EDAT- 2023/09/25 18:41
MHDA- 2023/09/25 18:42
PMCR- 2023/09/25
CRDT- 2023/09/25 13:23
PHST- 2022/12/20 00:00 [received]
PHST- 2023/08/13 00:00 [accepted]
PHST- 2023/09/25 18:42 [medline]
PHST- 2023/09/25 18:41 [pubmed]
PHST- 2023/09/25 13:23 [entrez]
PHST- 2023/09/25 00:00 [pmc-release]
AID - PGPH-D-22-02017 [pii]
AID - 10.1371/journal.pgph.0002358 [doi]
PST - epublish
SO  - PLOS Glob Public Health. 2023 Sep 25;3(9):e0002358. doi: 
      10.1371/journal.pgph.0002358. eCollection 2023.