Population-based sero-epidemiological investigation of the dynamics of SARS-CoV-2 infections in the Greater Accra Region of Ghana
Benedicta Ayiedu Mensah, Ignatius Cheng Ndong, Peter K. Quashie, Emilande Guichet, Benjamin Abuaku, Yaw Effah-Baafi, Kesego Tapela, Kwame Asiedu, Sekyibea Nana Ama Appiedu-Addo, Louisa Baaba Obbeng, Jones A. Amponsah, Kwadwo Asamoah Kusi, Michael F. Ofori, Ahidjo Ayouba, David Courtin, Rachida Tahar, Éric Delaporte, Gordon A. Awandare, Nicaise Tuikue Ndam
Abstract
The coronavirus disease 2019 (COVID-19) pandemic devastated countries worldwide, and resulted in a global shutdown. Not all infections are symptomatic and hence the extent of SARS-CoV-2 infection in the community is unknown. The paper presents the dynamics of the SARS-CoV-2 epidemic in the Greater Accra Metropolis, describing the evolution of seroprevalence through time and by age group. Three repeated independent population-based surveys at 6-week intervals were conducted in from November 2020 to July 2021. The global and by age-groups weighted seroprevalences were estimated and the risk factors for SARS-CoV-2 antibody seropositivity were assessed using logistic regression. The overall age-standardized SARS-CoV-2 antibody seroprevalence for both spike and nucleocapsid increased from 13.8% (95% CI 11.9, 16.1) in November 2020 to 39.6% (95% CI 34.8, 44.6) in July 2021. After controlling for gender, marital status, education level, and occupation, the older age group over 40 years had a higher odds of seropositivity than the younger age group (OR 3.0 [95% CI 1.1-8.5]) in the final survey. Pupils or students had 3.3-fold increased odds of seropositivity (OR 3.2 [95% CI 1.1-8.5]) compared to the unemployed. This study reinforces that, SARS-CoV-2 infections have been significantly higher than reported.