Evidence map›Paper›PMID 39106267›Full record

ArticlePLOS global public health2024

SARS-CoV-2 seroepidemiology in Cape Town, South Africa, and implications for future outbreaks in low-income communities.

Hannah Hussey, Helena Vreede, Mary-Ann Davies, Alexa Heekes, Emma Kalk, Diana Hardie, Gert van Zyl, Michelle Naidoo, Erna Morden, Jamy-Lee Bam and 14 more

Erratum issuedAbstract read
In one paragraph

Article in PLOS global public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

24 authors.

Hannah HusseyHealth Intelligence Directorate, Western Cape Government: Health, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-6199-0904
Helena VreedeDivision of Chemical Pathology, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-6644-6027
Mary-Ann DaviesHealth Intelligence Directorate, Western Cape Government: Health, Cape Town, South Africa.
Alexa HeekesHealth Intelligence Directorate, Western Cape Government: Health, Cape Town, South Africa.
Emma KalkSchool of Public Health, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0001-7706-6866
Diana HardieNational Health Laboratory Service, Cape Town, South Africa.
Gert van ZylNational Health Laboratory Service, Cape Town, South Africa.
Michelle NaidooNational Health Laboratory Service, Cape Town, South Africa.ORCID https://orcid.org/0000-0001-7880-8868
Erna MordenHealth Intelligence Directorate, Western Cape Government: Health, Cape Town, South Africa.ORCID https://orcid.org/0000-0003-0148-5065
Jamy-Lee BamHealth Intelligence Directorate, Western Cape Government: Health, Cape Town, South Africa.
Nesbert ZinyakatiraHealth Intelligence Directorate, Western Cape Government: Health, Cape Town, South Africa.
Chad M CentnerNational Health Laboratory Service, Cape Town, South Africa.
Jean MaritzDivision of Medical Virology, Stellenbosch University, Cape Town, South Africa.
Jessica OpieNational Health Laboratory Service, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-1408-2604
Zivanai ChapandukaNational Health Laboratory Service, Cape Town, South Africa.
Hassan MahomedMetro Health Services, Western Cape Government: Health, Cape Town, South Africa.
Mariette SmithHealth Intelligence Directorate, Western Cape Government: Health, Cape Town, South Africa.
Annibale CoisSchool of Public Health, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-7014-6510
David PienaarRural Health Services, Western Cape Government: Health, Cape Town, South Africa.
Andrew D ReddDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.ORCID https://orcid.org/0000-0003-4651-1423
Wolfgang PreiserNational Health Laboratory Service, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-0254-7910
Robert WilkinsonWellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-2753-1800
Andrew BoulleHealth Intelligence Directorate, Western Cape Government: Health, Cape Town, South Africa.
Nei-Yuan HsiaoNational Health Laboratory Service, Cape Town, South Africa.ORCID https://orcid.org/0000-0003-4926-6216

Funding

International Studies of the Acquired Immune Deficiency Syndrome (AIDS)ZIAAI000361 · NIAID · NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES · PI REDD, ANDREW · 2009 to 2025
$15.8M
6 · The paper itself

Abstract

In low- and middle-income countries where SARS-CoV-2 testing is limited, seroprevalence studies can help describe and characterise the extent of the pandemic, as well as elucidate protection conferred by prior exposure. We conducted repeated cross-sectional serosurveys (July 2020 -November 2021) using residual samples from patients from Cape Town, South Africa, sent for routine laboratory studies for non-COVID-19 conditions. SARS-CoV-2 anti-nucleocapsid antibodies and linked clinical information were used to investigate: (1) seroprevalence over time and risk factors associated with seropositivity, (2) ecological comparison of seroprevalence between subdistricts, (3) case ascertainment rates, and (4) the relative protection against COVID-19 associated with seropositivity and vaccination statuses. Among the subset sampled, seroprevalence of SARS-CoV-2 in Cape Town increased from 39.19% (95% confidence interval [CI] 37.23-41.19) in July 2020 to 67.8% (95%CI 66.31-69.25) in November 2021. Poorer communities had both higher seroprevalence and COVID-19 mortality. Only 10% of seropositive individuals had a recorded positive SARS-CoV-2 test. Using COVID-19 hospital admission and death data at the Provincial Health Data Centre, antibody positivity before the start of the Omicron BA.1 wave (28 November 2021) was strongly protective for severe disease (adjusted odds ratio [aOR] 0.15; 95%CI 0.05-0.46), with additional benefit in those who were also vaccinated (aOR 0.07, 95%CI 0.01-0.35). The high population seroprevalence in Cape Town was attained at the cost of substantial COVID-19 mortality. At the individual level, seropositivity was highly protective against subsequent infections and severe COVID-19 disease. In low-income communities, where diagnostic testing capacity is often limited, surveillance systems dependent on them will underestimate the true extent of an outbreak. Rapidly conducted seroprevalence studies can play an important role in addressing this.

Identifiers

PMID39106267
PMCPMC11302865

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.