Seroprevalence of SARS-CoV-2 and risk factors for infection among children in Uganda: A serial cross-sectional study.

<h4>Background</h4>Understanding COVID-19's impact on children is vital for public health policy, yet age-specific data is scarce, especially in Uganda. This study examines SARS-CoV-2 seroprevalence and risk factors among Ugandan children at two timepoints, along with COVID-19-relat...

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Main Authors: Irene Bagala, Jane Frances Namuganga, Patience Nayebare, Gloria Cuu, Thomas Katairo, Isaiah Nabende, Samuel Gonahasa, Martha Nassali, Stephen Tukwasibwe, Grant Dorsey, Joaniter I Nankabirwa, Sabrina Bakeera-Kitaka, Sarah Kiguli, Bryan Greenhouse, Isaac Ssewanyana, Moses R Kamya, Jessica Briggs
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0312554
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author Irene Bagala
Jane Frances Namuganga
Patience Nayebare
Gloria Cuu
Thomas Katairo
Isaiah Nabende
Samuel Gonahasa
Martha Nassali
Stephen Tukwasibwe
Grant Dorsey
Joaniter I Nankabirwa
Sabrina Bakeera-Kitaka
Sarah Kiguli
Bryan Greenhouse
Isaac Ssewanyana
Moses R Kamya
Jessica Briggs
author_facet Irene Bagala
Jane Frances Namuganga
Patience Nayebare
Gloria Cuu
Thomas Katairo
Isaiah Nabende
Samuel Gonahasa
Martha Nassali
Stephen Tukwasibwe
Grant Dorsey
Joaniter I Nankabirwa
Sabrina Bakeera-Kitaka
Sarah Kiguli
Bryan Greenhouse
Isaac Ssewanyana
Moses R Kamya
Jessica Briggs
author_sort Irene Bagala
collection DOAJ
description <h4>Background</h4>Understanding COVID-19's impact on children is vital for public health policy, yet age-specific data is scarce, especially in Uganda. This study examines SARS-CoV-2 seroprevalence and risk factors among Ugandan children at two timepoints, along with COVID-19-related knowledge and practices in households, including adult vaccination status.<h4>Methods</h4>Baseline surveys were conducted in 12 communities from April to May 2021 (post-Alpha wave) and follow-up surveys in 32 communities from November 2021 to March 2022 (Omicron wave). Household questionnaires and blood samples were collected to test for malaria by microscopy and for SARS-CoV-2 using a Luminex assay. Seroprevalence was estimated at both the survey and community level. Mixed-effects logistic regression models assessed the association between individual and household factors and SARS-CoV-2 seropositivity in children, adjusting for household clustering.<h4>Results</h4>More households reported disruptions in daily life at baseline compared to follow-up, though economic impacts lingered. By the follow-up survey, 52.7% of adults had received at least one COVID-19 vaccine dose. Overall seroprevalence in children was higher at follow-up compared to baseline (71.6% versus 19.2%, p < 0.001). Seroprevalence in children ranged across communities from 6-37% at baseline and 50-90% at follow-up. At baseline, children from the poorest households were more likely to be infected. Increasing age remained the only consistent risk factor for SARS-CoV-2 seroconversion at both timepoints.<h4>Conclusions</h4>Results indicate that a larger number of children were infected during the Delta and Omicron waves of COVID-19 compared to the Alpha wave. This study is the largest seroprevalence survey in children in Uganda, providing evidence that most children were infected with SARS-CoV-2 before the vaccine was widely available to pediatric populations. Pediatric infections were vastly underreported by case counts, highlighting the importance of seroprevalence surveys in assessing disease burden when testing and reporting rates are limited and many cases are mild or asymptomatic.
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spelling doaj-art-3d5943a8a1764fb7a6109458fcef0f182025-01-08T05:32:39ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011912e031255410.1371/journal.pone.0312554Seroprevalence of SARS-CoV-2 and risk factors for infection among children in Uganda: A serial cross-sectional study.Irene BagalaJane Frances NamugangaPatience NayebareGloria CuuThomas KatairoIsaiah NabendeSamuel GonahasaMartha NassaliStephen TukwasibweGrant DorseyJoaniter I NankabirwaSabrina Bakeera-KitakaSarah KiguliBryan GreenhouseIsaac SsewanyanaMoses R KamyaJessica Briggs<h4>Background</h4>Understanding COVID-19's impact on children is vital for public health policy, yet age-specific data is scarce, especially in Uganda. This study examines SARS-CoV-2 seroprevalence and risk factors among Ugandan children at two timepoints, along with COVID-19-related knowledge and practices in households, including adult vaccination status.<h4>Methods</h4>Baseline surveys were conducted in 12 communities from April to May 2021 (post-Alpha wave) and follow-up surveys in 32 communities from November 2021 to March 2022 (Omicron wave). Household questionnaires and blood samples were collected to test for malaria by microscopy and for SARS-CoV-2 using a Luminex assay. Seroprevalence was estimated at both the survey and community level. Mixed-effects logistic regression models assessed the association between individual and household factors and SARS-CoV-2 seropositivity in children, adjusting for household clustering.<h4>Results</h4>More households reported disruptions in daily life at baseline compared to follow-up, though economic impacts lingered. By the follow-up survey, 52.7% of adults had received at least one COVID-19 vaccine dose. Overall seroprevalence in children was higher at follow-up compared to baseline (71.6% versus 19.2%, p < 0.001). Seroprevalence in children ranged across communities from 6-37% at baseline and 50-90% at follow-up. At baseline, children from the poorest households were more likely to be infected. Increasing age remained the only consistent risk factor for SARS-CoV-2 seroconversion at both timepoints.<h4>Conclusions</h4>Results indicate that a larger number of children were infected during the Delta and Omicron waves of COVID-19 compared to the Alpha wave. This study is the largest seroprevalence survey in children in Uganda, providing evidence that most children were infected with SARS-CoV-2 before the vaccine was widely available to pediatric populations. Pediatric infections were vastly underreported by case counts, highlighting the importance of seroprevalence surveys in assessing disease burden when testing and reporting rates are limited and many cases are mild or asymptomatic.https://doi.org/10.1371/journal.pone.0312554
spellingShingle Irene Bagala
Jane Frances Namuganga
Patience Nayebare
Gloria Cuu
Thomas Katairo
Isaiah Nabende
Samuel Gonahasa
Martha Nassali
Stephen Tukwasibwe
Grant Dorsey
Joaniter I Nankabirwa
Sabrina Bakeera-Kitaka
Sarah Kiguli
Bryan Greenhouse
Isaac Ssewanyana
Moses R Kamya
Jessica Briggs
Seroprevalence of SARS-CoV-2 and risk factors for infection among children in Uganda: A serial cross-sectional study.
PLoS ONE
title Seroprevalence of SARS-CoV-2 and risk factors for infection among children in Uganda: A serial cross-sectional study.
title_full Seroprevalence of SARS-CoV-2 and risk factors for infection among children in Uganda: A serial cross-sectional study.
title_fullStr Seroprevalence of SARS-CoV-2 and risk factors for infection among children in Uganda: A serial cross-sectional study.
title_full_unstemmed Seroprevalence of SARS-CoV-2 and risk factors for infection among children in Uganda: A serial cross-sectional study.
title_short Seroprevalence of SARS-CoV-2 and risk factors for infection among children in Uganda: A serial cross-sectional study.
title_sort seroprevalence of sars cov 2 and risk factors for infection among children in uganda a serial cross sectional study
url https://doi.org/10.1371/journal.pone.0312554
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