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Background <p>Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection is an emerging viral disease that became a global pandemic in March 2020. Despite the protracted pandemic, population-based local data on the burden and exposure risks of SARS-CoV-2 infection remain limited in most parts of sub-Saharan Africa, where the pandemic surprisingly defied early public health predictions.</p> Methods <p>A community-based cross-sectional study of 252 consenting unvaccinated adults was conducted from March 11 to June 12, 2022, in Enugu State, southeastern Nigeria. A two-stage cluster sampling design was used, with a validated, interviewer-administered questionnaire adapted from the World Health Organization Unity Study Protocol, to collect demographic, socio-behavioural, and clinical data. Each participant was tested for SARS-CoV-2 IgM and IgG antibodies by the enzyme-linked immunosorbent assay. Multivariate analysis was used to determine factors independently associated with SARS-CoV-2 seropositivity. A <i>P-value</i> of &lt; 0.05 was considered statistically significant.</p> Results <p>The mean age was 47.72 ± 17.92 years, with 57.14% (144) female. The seroprevalence of SARS-CoV-2 (IgG or IgM) was 67.90%. Thirty-nine (15.48%) out of 252 participants had both SARS-CoV-2 IgG and IgM antibodies. Multivariable logistic regression analysis showed that healthcare workers had significantly higher odds of SARS-CoV-2 seropositivity than non-healthcare workers (adjusted odds ratio [aOR] = 3.83, 95% confidence interval [CI]: 1.52–9.66; <i>P</i> = 0.004).</p> Conclusion <p>Serological evidence of SARS-CoV-2 infection was observed in approximately two out of every three unvaccinated adults, indicating widespread previous exposure through natural infection in the study population by the first half of 2022. The predominance of SARS-CoV-2 IgG over IgM antibodies suggests that most infections occurred before sample collection and is consistent with declining community transmission during the study period. Healthcare worker status was independently associated with SARS-CoV-2 seropositivity, reinforcing the importance of strengthening infection prevention and control measures to protect frontline healthcare workers during future emerging infectious disease outbreaks.</p>

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Seroprevalence and risk factors for SARS-CoV-2 infection among unvaccinated adults in a rural community in South-East Nigeria during the Omicron era: a community-based cross-sectional study

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  • 出版模式：

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  • 发表日期：

    2026年7月31日

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  • Chizaram Onyeaghala,
  • Uche Unigwe,
  • Nneka Chika-Igwenyi,
  • Michael Iroezindu

摘要

Background

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection is an emerging viral disease that became a global pandemic in March 2020. Despite the protracted pandemic, population-based local data on the burden and exposure risks of SARS-CoV-2 infection remain limited in most parts of sub-Saharan Africa, where the pandemic surprisingly defied early public health predictions.

Methods

A community-based cross-sectional study of 252 consenting unvaccinated adults was conducted from March 11 to June 12, 2022, in Enugu State, southeastern Nigeria. A two-stage cluster sampling design was used, with a validated, interviewer-administered questionnaire adapted from the World Health Organization Unity Study Protocol, to collect demographic, socio-behavioural, and clinical data. Each participant was tested for SARS-CoV-2 IgM and IgG antibodies by the enzyme-linked immunosorbent assay. Multivariate analysis was used to determine factors independently associated with SARS-CoV-2 seropositivity. A P-value of < 0.05 was considered statistically significant.

Results

The mean age was 47.72 ± 17.92 years, with 57.14% (144) female. The seroprevalence of SARS-CoV-2 (IgG or IgM) was 67.90%. Thirty-nine (15.48%) out of 252 participants had both SARS-CoV-2 IgG and IgM antibodies. Multivariable logistic regression analysis showed that healthcare workers had significantly higher odds of SARS-CoV-2 seropositivity than non-healthcare workers (adjusted odds ratio [aOR] = 3.83, 95% confidence interval [CI]: 1.52–9.66; P = 0.004).

Conclusion

Serological evidence of SARS-CoV-2 infection was observed in approximately two out of every three unvaccinated adults, indicating widespread previous exposure through natural infection in the study population by the first half of 2022. The predominance of SARS-CoV-2 IgG over IgM antibodies suggests that most infections occurred before sample collection and is consistent with declining community transmission during the study period. Healthcare worker status was independently associated with SARS-CoV-2 seropositivity, reinforcing the importance of strengthening infection prevention and control measures to protect frontline healthcare workers during future emerging infectious disease outbreaks.