A multi-site cross-sectional study on the burden of SARS-CoV-2 in healthcare workers in Madagascar

• Published in: PloS one 2024-10, Vol.19 (10), p.e0309977
• Main Authors: Abrokwa, Seth Kofi, Ravaoarisoa, Lantonirina, Briesemeister, Veronica, Andrianasolo, Radonirina Lazasoa, Andrianarivelo, Andry Maharo, Müller, Sophie Alice, Randriamanantany, Zely Arivelo, Bernasconi, Andrea, Weiss, Sabrina
• Format: Article
• Language: English
• Subjects: Adult; Antibodies, Viral - blood; Biology and life sciences; Control equipment; Coronaviruses; COVID-19; COVID-19 - epidemiology; Cross-Sectional Studies; Disease control; Engineering and Technology; Enzyme-linked immunosorbent assay; Epidemiology; Fatalities; Female; Health aspects; Health care; Health care facilities; Health Personnel - statistics & numerical data; Hospital facilities; Hospitals; Humans; IgG antibody; Immunoglobulin G; Immunoglobulin G - blood; Infections; Madagascar - epidemiology; Male; Medical personnel; Medical research; Medicine and health sciences; Medicine, Experimental; Middle Aged; Occupational exposure; Pandemics; Patients; People and Places; Personal protective equipment; Polymerase chain reaction; Population; Population studies; Prevalence; Prevention; Profession; Protective equipment; Real time; Respiration; Respiratory diseases; Reverse transcription; Risk Factors; Risk groups; Sample size; SARS-CoV-2 - immunology; SARS-CoV-2 - isolation & purification; Seroepidemiologic Studies; Serology; Severe acute respiratory syndrome coronavirus 2; Spike protein; Statistical analysis; Surveys; Vaccination; Viral diseases; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0309977

The prevalence of infections and risk factors that go along with them give insights into the burden of disease and effectiveness of infection prevention and control strategies. In this study we investigated the burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and associated epidemiological factors in three regions of Madagascar among healthcare workers. Between May and June 2021, we conducted a multi-site cross-sectional study among healthcare workers in eight University Hospital Centers, during the local second wave and before the coronavirus disease 2019 vaccination campaign in three regional capitals of Madagascar. We collected demographic information and relevant SARS-CoV-2 exposure history and tested for both immunoglobulin G antibodies to SARS-CoV-2 spike protein, using enzyme-linked immunosorbent assay and active SARS-CoV-2 infection using real-time reverse transcription-polymerase chain reaction. A total of 1006 healthcare workers enrolled in the study out of which 53.8% tested positive for either acute infection or SARS-CoV-2 antibodies. Approximately 50% of the participants reported receiving inadequate training on SARS-CoV-2 and associated infection prevention and control measures, inadequate supply of Personal Protective Equipment (PPE) and discomfort when using available PPE. Prevalence of acute infection was 3.4% without statistically significant variation in the different regions or health facilities as well as the different profession groups and units of work. Average seroprevalence of SARS-CoV-2 IgG antibodies was 52.0%, varying between 47.8% and 53.3% across the different regions. No significant difference was observed for region, gender, profession, and different risk groups. Predictive multivariable model showed significant association between seropositivity and healthcare facility and age (p