Global seroprevalence of SARS-CoV-2 antibodies: A systematic review and meta-analysis

Background Many studies report the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies. We aimed to synthesize seroprevalence data to better estimate the level and distribution of SARS-CoV-2 infection, identify high-risk groups, and inform public health decision making. Methods In this systematic review and meta-analysis, we searched publication databases, preprint servers, and grey literature sources for seroepidemiological study reports, from January 1, 2020 to December 31, 2020. We included studies that reported a sample size, study date, location, and seroprevalence estimate. We corrected estimates for imperfect test accuracy with Bayesian measurement error models, conducted meta-analysis to identify demographic differences in the prevalence of SARS-CoV-2 antibodies, and meta-regression to identify study-level factors associated with seroprevalence. We compared region-specific seroprevalence data to confirmed cumulative incidence. PROSPERO: CRD42020183634. Results We identified 968 seroprevalence studies including 9.3 million participants in 74 countries. There were 472 studies (49%) at low or moderate risk of bias. Seroprevalence was low in the general population (median 4.5%, IQR 2.4–8.4%); however, it varied widely in specific populations from low (0.6% perinatal) to high (59% persons in assisted living and long-term care facilities). Median seroprevalence also varied by Global Burden of Disease region, from 0.6% in Southeast Asia, East Asia and Oceania to 19.5% in Sub-Saharan Africa (p<0.001). National studies had lower seroprevalence estimates than regional and local studies (p<0.001). Compared to Caucasian persons, Black persons (prevalence ratio [RR] 3.37, 95% CI 2.64–4.29), Asian persons (RR 2.47, 95% CI 1.96–3.11), Indigenous persons (RR 5.47, 95% CI 1.01–32.6), and multi-racial persons (RR 1.89, 95% CI 1.60–2.24) were more likely to be seropositive. Seroprevalence was higher among people ages 18–64 compared to 65 and over (RR 1.27, 95% CI 1.11–1.45). Health care workers in contact with infected persons had a 2.10 times (95% CI 1.28–3.44) higher risk compared to health care workers without known contact. There was no difference in seroprevalence between sex groups. Seroprevalence estimates from national studies were a median 18.1 times (IQR 5.9–38.7) higher than the corresponding SARS-CoV-2 cumulative incidence, but there was large variation between Global Burden of Disease regions from 6.7 in South Asia to 602.5 in Sub-Saharan Africa. Notable methodological limitations of serosurveys included absent reporting of test information, no statistical correction for demographics or test sensitivity and specificity, use of non-probability sampling and use of non-representative sample frames. Discussion Most of the population remains susceptible to SARS-CoV-2 infection. Public health measures must be improved to protect disproportionately affected groups, including racial and ethnic minorities, until vaccine-derived herd immunity is achieved. Improvements in serosurvey design and reporting are needed for ongoing monitoring of infection prevalence and the pandemic response.

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Epidemiology of ebolavirus disease (EVD) and occupational EVD in health care workers in Sub-Saharan Africa: Need for strengthened public health preparedness

Journal of Epidemiology ◽

10.1016/j.je.2016.09.010 ◽

2017 ◽

Vol 27 (10) ◽

pp. 455-461 ◽

Cited By ~ 13

Author(s):

Nlandu Roger Ngatu ◽

Ntumba Jean-Marie Kayembe ◽

Elayne Kornblatt Phillips ◽

Joa Okech-Ojony ◽

Masika Patou-Musumari ◽

...

Keyword(s):

Public Health ◽

Health Care ◽

Health Care Workers ◽

Sub Saharan Africa ◽

Public Health Preparedness ◽

Care Workers ◽

Sub Saharan

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Effectiveness of N95 respirators versus surgical masks in protecting health care workers from acute respiratory infection: a systematic review and meta-analysis

Canadian Medical Association Journal ◽

10.1503/cmaj.150835 ◽

2016 ◽

Vol 188 (8) ◽

pp. 567-574 ◽

Cited By ~ 118

Author(s):

Jeffrey D. Smith ◽

Colin C. MacDougall ◽

Jennie Johnstone ◽

Ray A. Copes ◽

Brian Schwartz ◽

...

Keyword(s):

Systematic Review ◽

Health Care ◽

Respiratory Infection ◽

Health Care Workers ◽

Acute Respiratory Infection ◽

Meta Analysis ◽

Care Workers ◽

Surgical Masks ◽

N95 Respirators

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Prevalence and causes of unreported needle stick injuries among health care workers: a systematic review and meta-analysis

Reviews on Environmental Health ◽

10.1515/reveh-2021-0148 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Razieh Behzadmehr ◽

Abbas Balouchi ◽

Mehran Hesaraki ◽

Farshid Alazmani Noodeh ◽

Hosein Rafiemanesh ◽

...

Keyword(s):

Systematic Review ◽

Health Care ◽

Health Care Workers ◽

Health Workers ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Needle Stick ◽

Care Workers ◽

Needle Stick Injuries

Abstract Objectives Health care workers (HCWs) are exposed to needle needles daily. Despite individual studies, there is no statistics on the prevalence of unreported needle stick injuries (NSIs) have been reported. This study was performed to determine the prevalence and causes of unreported NSIs among HCWs. Content In present systematic review and meta-analysis study, three international databases (Web of Science, Scopus, PubMed) were searched from January 1, 2000 to December 31, 2018. The random model was used to determine the prevalence of unreported needle stick among HCWs. Summary and outlook Forty-one studies performed on 19,635 health care workers entered the final stage. Based-on random effect model, pooled prevalence of unreported needle stick injuries was 59.9% (95% CI: 52.0, 67.7; I2=98.9%). The most common cause of unreported NSIs was: They were not worried about NSIs (n=12). The high prevalence of unreported needle sticks injuries indicates the urgency and necessity of paying attention to strategies to improve reporting among health workers.

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Will Universal Access to Antiretroviral Therapy Ever be Possible? The Health Care Worker Challenge

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2010/432306 ◽

2010 ◽

Vol 21 (1) ◽

pp. e64-e69 ◽

Cited By ~ 23

Author(s):

André R Maddison ◽

Walter F Schlech

Keyword(s):

Health Care ◽

Antiretroviral Therapy ◽

Health Care Worker ◽

Health Care Workers ◽

Universal Access ◽

Sub Saharan Africa ◽

Development Goal ◽

Care Workers ◽

Sub Saharan ◽

Care Worker

The United Nations millennium development goal of providing universal access to antiretroviral therapy (ART) for patients living with HIV/AIDS by 2010 is unachievable. Currently, four million people are receiving ART, of an estimated 13.7 million who need it. A major challenge to achieving this goal is the shortage of health care workers in low-income and low-resource areas of the world. Sub-Saharan African countries have 68% of the world’s burden of illness from AIDS, yet have only 3% of health care workers worldwide. The shortage of health care providers is primarily caused by a national and international ‘brain drain,’ poor distribution of health care workers within countries, and health care worker burnout.Even though the millennium development goal to provide universal access to ART will not be met by 2010, it is imperative to continue to build on the momentum created by these humanitarian goals. The present literature review was written with the purpose of attracting research and policy attention toward evidence from small-scale projects in sub-Saharan Africa, which have been successful at increasing access to ART. Specifically, a primary-care model of ART delivery, which focuses on decentralization of services, task shifting and community involvement will be discussed. To improve the health care worker shortage in sub-Saharan Africa, the conventional model of health care delivery must be replaced with an innovative model that utilizes doctors, nurses and community members more effectively.

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Consideration for the asymptomatic transmission of COVID-19: Systematic Review and Meta-Analysis

10.1101/2020.10.06.20207597 ◽

2020 ◽

Author(s):

Khaiwal Ravindra ◽

Vivek Singh Malik ◽

Bijaya K Padhi ◽

Sonu Goel ◽

Madhu Gupta

Keyword(s):

Systematic Review ◽

Health Care ◽

Health Care Workers ◽

Meta Analysis ◽

Chest Ct ◽

Nucleic Acid Testing ◽

Social Distancing ◽

Care Workers ◽

Children Health ◽

Chest Ct Scan

AbstractObjectiveWorldwide countries are experiencing viral load in their population, leading to potential infectivity of asymptomatic COVID-19. Current systematic review and meta-analysis aimed to investigate the role of asymptomatic infection worldwide reported in family-cluster, adults, children, health care workers, and travelers.DesignOnline literature search (PubMed, Google Scholar, medRixv, and BioRixv) was accomplished using standard Boolean operators, studies published till 07th June 2020.SettingStudies were included from case reports, short communication, and retrospective to cover sufficient asymptomatic COVID-19 transmission reported.ParticipantsFamilial-clusters, adults, children, health care workers, and travelers.ResultsWe observed asymptomatic transmission among familial-cluster, adults, children, health care workers, and travelers with a proportion of 32% 37%, 26%, 6%, and 32%, respectively. This study observed an overall proportion of 31% (95%CI: 0.19-0.44) with heterogeneity of I2 (97.28%, p=<0.001) among all asymptomatic populations mentioned in this study. Among children and healthcare workers, this study showed no heterogeneity; to overcome the interpretation from a fixed model, the random effect model was also applied to estimate the average distribution across studies included in the meta-analysis.ConclusionWe found and suggest the rigorous epidemiological history, early isolation, social distancing, and increased quarantine period (at least 28 days) after screening asymptomatic cases as well as their close contacts for chest CT scan even after their negative nucleic acid testing to minimize the spread among the community. This systematic review and meta-analysis support asymptomatic COVID-19 transmission between person to person depending on the variation of virus incubation period among individuals. Children especially, school-going aged <18 years, need to be monitored and prevention strategy, e.g., chest CT and social distancing required to prevent the community transmission of COVID-19 in asymptomatic mode.Strengths and limitations of this studyExamine the possibility of asymptomatic COVID-19 transmission in the community at different levels.Supports contact tracing, social distancing, early isolation, and increased quarantine period to minimize the risk of virus spread.Supports chest CT scan and viral nucleic acid testing to identify the asymptomatic cases in the community.Supports rigorous epidemiological history with multiple detection methods.A higher proportion of asymptomatic incidence was seen, suggests monitoring, and maintaining social distancing.

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Reliability of HIV rapid diagnostic tests for self-testing compared with testing by health-care workers: a systematic review and meta-analysis

The Lancet HIV ◽

10.1016/s2352-3018(18)30044-4 ◽

2018 ◽

Vol 5 (6) ◽

pp. e277-e290 ◽

Cited By ~ 55

Author(s):

Carmen Figueroa ◽

Cheryl Johnson ◽

Nathan Ford ◽

Anita Sands ◽

Shona Dalal ◽

...

Keyword(s):

Systematic Review ◽

Health Care ◽

Health Care Workers ◽

Diagnostic Tests ◽

Meta Analysis ◽

Rapid Diagnostic Tests ◽

Self Testing ◽

Care Workers

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The Prevalence of Generalized Anxiety Disorder Among Health Care Workers During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.658846 ◽

2021 ◽

Vol 12 ◽

Author(s):

Amir Adibi ◽

Mohamad Golitaleb ◽

Iman Farrahi-Ashtiani ◽

Davoud Pirani ◽

Kosar Yousefi ◽

...

Keyword(s):

Systematic Review ◽

Health Care ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Health Care Workers ◽

Meta Analysis ◽

Psychological Problems ◽

Health Staff ◽

Generalized Anxiety ◽

Care Workers

Introduction: Health care workers, due to be involved in caring for COVID-19 patients may experience various psychological problems including anxiety disorders. This study aimed to investigate the prevalence of Generalized Anxiety Disorder (GAD) among health care workers during the COVID-19 pandemic by systematic review and meta-analysis.Methods: The PRISMA guideline was used for conducting this study. Related keywords were searched in credited resources including ISC, Magiran, PubMed, Scopus, Web of Science, Cochrane, ProQuest, Science Direct, Google Scholar, and Embase to find the articles published on the prevalence of GAD among health care workers during the COVID-19 pandemic from the first of January to the end of June 2020. Meta-analysis was conducted by the random effects model.Results: In this study, 553 articles were initially identified, from which 19 studies were finally included in the meta-analysis. The results showed that the prevalence of GAD in health care workers based on the GAD-7 and GAD-2 instruments were 32.04% (95% CI: 26.89–37.19, I2 = 98.2%, p < 0.001) and 22.62% (95% CI: 9.01–36.24, I2 = 97.7%, p < 0.001). The overall prevalence of GAD was obtained 30.5% (95% CI: 25.58–35.42, I2 = 98.4%, p < 0.001).Conclusion: This study showed a relatively high GAD prevalence, as one of the fundamental psychological problems, among health care workers during the COVID-19 pandemic. Therefore, health system managers should implement preventive strategies to protect health staff from contracting the virus and monitor them for psychological problems and provide them with supportive measures if necessary.

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High SARS-CoV-2 seroprevalence in health care workers but relatively low numbers of deaths in urban Malawi

Wellcome Open Research ◽

10.12688/wellcomeopenres.16188.2 ◽

2020 ◽

Vol 5 ◽

pp. 199

Author(s):

Marah G. Chibwana ◽

Khuzwayo C. Jere ◽

Raphael Kamng'ona ◽

Jonathan Mandolo ◽

Vincent Katunga-Phiri ◽

...

Keyword(s):

Public Health ◽

Health Care ◽

Health Care Workers ◽

Low Income ◽

Sub Saharan Africa ◽

Low Income Countries ◽

Serum Samples ◽

Public Health Response ◽

Response Planning ◽

Care Workers

Background: In low-income countries, like Malawi, important public health measures including social distancing or a lockdown have been challenging to implement owing to socioeconomic constraints, leading to predictions that the COVID-19 pandemic would progress rapidly. However, due to limited capacity to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of the true burden of infection and death. We, therefore, conducted a SARS-CoV-2 serosurvey amongst health care workers (HCWs) in Blantyre city to estimate the cumulative incidence of SARS-CoV-2 infection in urban Malawi. Methods: We recruited 500 otherwise asymptomatic HCWs from Blantyre City (Malawi) from 22nd May 2020 to 19th June 2020 and serum samples were collected from all participants. A commercial ELISA was used to measure SARS-CoV-2 IgG antibodies in serum. Results: A total of 84 participants tested positive for SARS-CoV-2 antibodies. The HCWs with positive SARS-CoV-2 antibody results came from different parts of the city. The adjusted seroprevalence of SARS-CoV-2 antibodies was 12.3% [CI 8.2 - 16.5]. Using age-stratified infection fatality estimates reported from elsewhere, we found that at the observed adjusted seroprevalence, the number of predicted deaths was eight times the number of reported deaths. Conclusions: The high seroprevalence of SARS-CoV-2 antibodies among HCWs and the discrepancy in the predicted versus reported deaths suggests that there was early exposure but slow progression of COVID-19 epidemic in urban Malawi. This highlights the urgent need for development of locally parameterised mathematical models to more accurately predict the trajectory of the epidemic in sub-Saharan Africa for better evidence-based policy decisions and public health response planning.

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Roles and Expectations of Male Partners from PMTCT services in Chiradzulu Malawi: A Qualitative Study

10.21203/rs.2.13825/v1 ◽

2019 ◽

Author(s):

Beatrice M'baya Kansinjiro ◽

Alinane Linda Nyondo-Mipando

Keyword(s):

Health Care ◽

Qualitative Study ◽

Health Facility ◽

Health Care Workers ◽

Health Assessment ◽

Male Involvement ◽

Sub Saharan Africa ◽

Male Partners ◽

Care Workers ◽

Sub Saharan

Abstract Background: Prevention of mother to child transmission of HIV (PMTCT) is the main measure for curbing HIV infection in children. Male involvement (MI) greatly influences uptake and adherence to PMTCT services yet the level remain low in Sub Saharan Africa. Lack of well stipulated roles for men in PMTCT is one of the main barriers to MI. Studies on MI have focused on women and Health care workers (HCW), thereby making men silent partners. The main aim of the study was to explore the roles and expectations of male partners in PMTCT services in Malawi. Methods: This was a descriptive qualitative study that involved men whose partners were either pregnant or breastfeeding a child, health care workers working in PMTCT services for over six months and traditional leaders. We conducted 9 in-depth interviews and 12 key informant interviews from January to March 2018. All interviews were audio-recorded, transcribed and translated. Thematic analysis was employed to analyze data. Results: Male partners play supportive, HIV prevention behaviour change and decision-making roles in PMTCT services. Health assessment and health promotion activities are the male specific services required in PMTCT services and these should be delivered at both health facility and community levels. Conclusion : Male partners in PMTCT have expectations that need to be met at both health facility and community levels. There is need to have male-tailored package of health services that are directly provided to men along with PMTCT services at different levels in order to promote MI. The services should be provided in an atmosphere that allows and accepts male partners to exercise their roles in PMTCT services.

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