Prevalence and risk factors of Severe Acute Respiratory Syndrome Coronavirus 2 infection in women and children in peri-urban communities in Pakistan: A prospective cohort study
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Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of Global Health
Abstract
Background Population-based seroepidemiological surveys provide ac curate estimates of disease burden. We compare the COVID-19 prevalence estimates from two serial serological surveys and the associated risk factors among women and children in a peri-urban area of Karachi, Pakistan. Methods The AMANHI-COVID-19 study enrolled women and children between November 2020 and March 2021. Blood samples were collected from March to June 2021 (baseline) and September to December 2021 (follow-up) to test for anti-SARS-CoV-2 antibodies using ROCHE Elecsys®. Participants were visited or called weekly during the study for recording symptoms of COVID-19. We report the proportion of participants with anti-SARS-CoV-2 antibodies and symptoms in each survey and describe infection risk factors using step-wise binomial regression analysis. Results The adjusted seroprevalence among women was 45.3% (95% confidence interval (CI)=42.6-47.9) and 82.3% (95% CI=79.9-84.4) at baseline and follow-up survey, respectively. Among children, it was 18.4% (95% CI=16.1-20.7) and 57.4% (95% CI=54.3-60.3) at base line and follow-up, respectively. Of the women who were previously seronegative, 404 (74.4%) tested positive at the follow-up survey, as did 365 (50.4%) previously seronegative children. There was a high proportion of asymptomatic infection. At baseline, being poorest and lacking access to safe drinking water lowered the risk of infection for both women (risk ratio (RR)=0.8, 95% CI=0.7-0.9 and RR=1.2, 95% CI=1.1- 1.4, respectively) and children (RR=0.7, 95% CI=0.5-1.0 and RR=1.4, 95% CI=1.0-1.8, respectively). At the follow-up survey, the risk of infection was lower for underweight women and children (RR=0.4, 95% CI=0.3-0.7 and RR=0.7, 95% CI=0.5-0.8, respectively) and for women in the 30-39 years age group and children who were 24-36 months of age (RR=0.6, 95% CI=0.4-0.9 and RR=0.7, 95% CI=0.5-0.9, respective ly). In both surveys, paternal employment was an important predictor of seropositivity among children (RR=0.7, 95% CI=0.6-0.9 and RR=0.8, 95% CI=0.7-1.0, respectively). Conclusion There was a high rate of seroconversion among women and children. Infection was generally mild. Parental education plays an important role in protection of children from COVID-19.
Description
Research Article
Keywords
women, Acute Respiratory Syndrome Coronavirus 2 infection
Citation
Cite as: Ansari N, Nisar MI, Khalid F, Mehmood U, Usmani AA, Shaheen F, Hotwani A, Begum K, Barkat A, Yoshida S, Manu AA, Sazwal S, Baqui AH, Bahl R, Jehan F. Prevalence and risk factors of Severe Acute Respiratory Syndrome Coronavirus 2 infection in women and children in peri-urban communities in Pakistan: A prospective cohort study. J Glob Health 2022;12:05055.