SARS-CoV-2 Serological testing in frontline health workers in Zimbabwe

PLoS Negl Trop Dis. 2021 Mar 31;15(3):e0009254. doi: 10.1371/journal.pntd.0009254. eCollection 2021 Mar.

Abstract

Background: In order to protect health workers from SARS-CoV-2, there is need to characterise the different types of patient facing health workers. Our first aim was to determine both the infection status and seroprevalence of SARS-CoV-2 in health workers. Our second aim was to evaluate the occupational and demographic predictors of seropositivity to inform the country's infection prevention and control (IPC) strategy.

Methods and principal findings: We invited 713 staff members at 24 out of 35 health facilities in the City of Bulawayo in Zimbabwe. Compliance to testing was defined as the willingness to uptake COVID-19 testing by answering a questionnaire and providing samples for both antibody testing and PCR testing. SARS-COV-2 antibodies were detected using a rapid diagnostic test kit and SAR-COV-2 infection was determined by real-time (RT)-PCR. Of the 713 participants, 635(89%) consented to answering the questionnaire and providing blood sample for antibody testing while 560 (78.5%) agreed to provide nasopharyngeal swabs for the PCR SARS-CoV-2 testing. Of the 635 people (aged 18-73) providing a blood sample 39.1% reported a history of past COVID-19 symptoms while 14.2% reported having current symptoms of COVID-19. The most-prevalent co-morbidity among this group was hypertension (22.0%) followed by asthma (7.0%) and diabetes (6.0%). The SARS-CoV-2 sero-prevalence was 8.9%. Of the 560 participants tested for SARS-CoV-2 infection, 2 participants (0.36%) were positive for SAR-CoV-2 infection by PCR testing. None of the SARS-CoV-2 antibody positive people were positive for SAR-CoV-2 infection by PCR testing.

Conclusion and interpretation: In addition to clinical staff, several patient-facing health workers were characterised within Zimbabwe's health system and the seroprevalence data indicated that previous exposure to SAR-CoV-2 had occurred across the full spectrum of patient-facing staff with nurses and nurse aides having the highest seroprevalence. Our results highlight the need for including the various health workers in IPC strategies in health centres to ensure effective biosecurity and biosafety.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • COVID-19 / epidemiology*
  • COVID-19 / prevention & control
  • COVID-19 / transmission
  • COVID-19 Nucleic Acid Testing
  • COVID-19 Serological Testing*
  • Comorbidity
  • Female
  • Health Facilities
  • Health Personnel*
  • Humans
  • Male
  • Middle Aged
  • Occupational Diseases / epidemiology
  • Occupational Diseases / prevention & control
  • Occupational Health
  • Pandemics
  • Risk Factors
  • SARS-CoV-2
  • Seroepidemiologic Studies
  • Young Adult
  • Zimbabwe / epidemiology

Grants and funding

This research is supported through the Scottish Funding Council Global Challenges Research Fund Grant (to FM) at the University of Edinburgh. The research was also commissioned in part, by the National Institute for Health Research (NIHR) Global Health Research Program (16/136/33) using UK AID from the UK Government. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.