ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022
Seroprevalence of Severe Acute Respiratory Syndrome Coronavirus 2 After the Second Wave in South Africa in Human Immunodeficiency Virus-Infected and Uninfected Persons: A Cross-Sectional Household Survey.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 25 citations in OpenAlex.
- SARS-CoV-2 IgG seropositivity among people living with and without HIV in the first year of the COVID-19 pandemic in Haiti and Tanzania.IJID regions · 2026Article
- Seroprevalence and molecular detection of SARS-CoV-2 among apparently healthy healthcare workers and patients in a Nigerian tertiary hospital.BMC infectious diseases · 2025Article
- SARS-CoV-2 cross-sectional serosurvey across three HIV-1 therapeutic clinical trials in Africa.AIDS (London, England) · 2025Article
- Are children and adolescents living with HIV in Europe and South Africa at higher risk of SARS-CoV-2 and poor COVID-19 outcomes?Epidemiology and infection · 2025Article
- Population-based cross-sectional seroprevalence study of SARS-CoV-2 infection in urban residential areas in Ghana.BMJ public health · 2025Article
- Aggregating multiple test results to improve medical decision-making.PLoS computational biology · 2025Article
- Deciphering Factors Linked With Reduced Severe Acute Respiratory Syndrome Coronavirus 2 Susceptibility in the Swiss HIV Cohort Study.The Journal of infectious diseases · 2024Article
- SARS-CoV-2 seroepidemiology in Cape Town, South Africa, and implications for future outbreaks in low-income communities.PLOS global public health · 2024Article
- The Performance of Diagnostic Tests for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the South African Population: A Scoping Review.Tropical medicine and infectious disease · 2023Article
- SARS-CoV-2 seroprevalence and associated factors, based on HIV serostatus, in young people in Sofala province, Mozambique.BMC infectious diseases · 2023Article
- Seroprofiling of Antibodies Against Endemic Human Coronaviruses and Severe Acute Respiratory Syndrome Coronavirus 2 in a Human Immunodeficiency Virus Cohort in Lesotho: Correlates of Antibody Response and Seropositivity.The Journal of infectious diseases · 2023Article
- Knowledge, attitudes, practices and intention to get vaccinated against COVID-19: results from a cross-sectional survey in three peri-urban communities in South Africa.The Pan African medical journal · 2023Article
- T cell immunity ameliorates COVID-19 disease severity and provides post-exposure prophylaxis after peptide-vaccination, in Syrian hamsters.Frontiers in immunology · 2023Article
- Epidemiology and outcomes of SARS-CoV-2 infection associated with anti-nucleocapsid seropositivity in Cape Town, South Africa.medRxiv : the preprint server for health sciences · 2022Article
- Escape of SARS-CoV-2 Variant Omicron to Mucosal Immunity in Vaccinated Subjects.Open forum infectious diseases · 2022Article
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21 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundSeroprevalence studies are important for quantifying the burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in resource-constrained countries.
methodsWe conducted a cross-sectional household survey spanning the second pandemic wave (November 2020 to April 2021) in 3 communities. Blood was collected for SARS-CoV-2 antibody (2 enzyme-linked immunosorbent assays targeting spike and nucleocapsid) and human immunodeficiency virus (HIV) testing. An individual was considered seropositive if testing positive on ≥1 assay. Factors associated with infection, and the age-standardized infection case detection rate, infection hospitalization rate, and infection fatality rate were calculated.
resultsOverall, 7959 participants were enrolled, with a median age of 34 years and an HIV prevalence of 22.7%. SARS-CoV-2 seroprevalence was 45.2% (95% confidence interval 43.7%-46.7%) and increased from 26.9% among individuals enrolled in December 2020 to 47.1% among those enrolled in April 2021. On multivariable analysis, seropositivity was associated with age, sex, race, being overweight/obese, having respiratory symptoms, and low socioeconomic status. Persons living with HIV with high viral load were less likely to be seropositive than HIV-uninfected individuals. The site-specific infection case detection rate, infection hospitalization rate, and infection fatality rate ranged across sites from 4.4% to 8.2%, 1.2% to 2.5%, and 0.3% to 0.6%, respectively.
conclusionsSouth Africa has experienced a large burden of SARS-CoV-2 infections, with <10% of infections diagnosed. Lower seroprevalence among persons living with HIV who are not virally suppressed, likely as a result of inadequate antibody production, highlights the need to prioritize this group for intervention.
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