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Peer reviewedOpen accessCOVID-19SARS

SARS-CoV-2 infection in Africa: a systematic review and meta-analysis of standardised seroprevalence studies, from January 2020 to December 2021

BMJ Global Health·

Hannah C Lewis, Harriet Ware, Mairead Whelan, Lorenzo Subissi, Zihan Li, Xiaomeng Ma, Anthony Nardone, Marta Valenciano, Brianna Cheng, Kim Noel, Christian Cao, Mercedes Yanes-Lane, Belinda L Herring, Ambrose Talisuna, Nsenga Ngoy, Thierno Balde, David Clifton, Maria D Van Kerkhove, David Buckeridge, Niklas Bobrovitz, Joseph Okeibunor, Rahul K Arora, Isabel Bergeri

DOI
10.1136/bmjgh-2022-008793
PMID
35998978
PMCID
PMC9402450
OpenAlex
W4292774342
Study type
Systematic review
Publisher
BMJ
Article type
journal-article
Integrity
current

Why this research matters now

The findings suggest greater population exposure to SARS-CoV-2 in Africa than indicated by routine surveillance data, implying potential protection against severe COVID-19 disease; the heterogeneity of seroprevalence supports the need for targeted public health measures and vaccination strategies tailored to local epidemiological situations.

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Structured evidence summary

Research question

This systematic review and meta-analysis estimated COVID-19 cumulative incidence in Africa by analyzing population-based seroprevalence studies to inform public health and social measures and vaccination strategies.

Study design

A systematic review and meta-analysis of population-based seroprevalence studies conducted in Africa from January 2020 to December 2021, with studies assessed for risk of bias and evaluated for alignment with WHO Unity seroprevalence protocol.

Population and setting

Seroprevalence studies across African countries and subregions, including both urban and rural geographic areas, with analysis by age groups spanning children aged 0-9 years through adults.

Main findings

SARS-CoV-2 seroprevalence increased from 3.0% in April-June 2020 to 65.1% in July-September 2021; the ratio of seroprevalence to reported confirmed cases was approximately 100:1 overall, ranging from 18:1 to 954:1; seroprevalence showed substantial heterogeneity by geography, age, and subregion, with rural areas and children aged 0-9 years exhibiting lower seroprevalence.

Public-health relevance

The findings suggest greater population exposure to SARS-CoV-2 in Africa than indicated by routine surveillance data, implying potential protection against severe COVID-19 disease; the heterogeneity of seroprevalence supports the need for targeted public health measures and vaccination strategies tailored to local epidemiological situations.

Important limitations

This summary is limited to the supplied single-article abstract and metadata; the original paper would be required for decision-grade interpretation including full assessment of study quality, heterogeneity analysis methods, and potential publication bias.

GIDS interpretation

This systematic review and meta-analysis provides standardized seroprevalence data across multiple African studies and time periods; the documented infection-to-case ratios and subregional heterogeneity could support contextualization of seroepidemiological surveillance findings in the region.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 10 auditable classifier relationships to diseases, places, topics, and study design.

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