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Volume 27, Number 12—December 2021
Research

SARS-CoV-2 Seroprevalence in a Rural and Urban Household Cohort during First and Second Waves of Infections, South Africa, July 2020–March 2021

Jackie KleynhansComments to Author , Stefano Tempia, Nicole Wolter, Anne von Gottberg, Jinal N. Bhiman, Amelia Buys, Jocelyn Moyes, Meredith L. McMorrow, Kathleen Kahn, F. Xavier Gómez-Olivé, Stephen Tollman, Neil A. Martinson, Floidy Wafawanaka, Limakatso Lebina, Jacques du Toit, Waasila Jassat, Mzimasi Neti, Marieke Brauer, Cheryl Cohen, and for the PHIRST-C Group1
Author affiliations: National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa (J. Kleynhans, S. Tempia, N. Wolter, A. von Gottberg, J.N. Bhiman, A. Buys, J. Moyes, W. Jassat, M. Neti, C. Cohen); University of the Witwatersrand, Johannesburg (J. Kleynhans, S. Tempia, N. Wolter, A. von Gottberg, J.N. Bhiman, J. Moyes, C. Cohen); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Tempia, M.L. McMorrow); Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa (M.L. McMorrow); MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg (K. Kahn, F.X. Gómez-Olivé, S. Tollman, F. Wafawanaka, J. du Toit); Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg (N.A. Martinson, L. Lebina); Johns Hopkins University Center for TB Research, Baltimore, Maryland, USA (N.A. Martinson); Ampath Pathology, Pretoria (M. Brauer)

Main Article

Table

Comparison of participants with detectable SARS-CoV-2 antibodies after the first wave (blood draw 3) and second wave (blood draw 5), South Africa, July 2020–April 2021*

Characteristic Infected in wave 1, no. (%) Infected in wave 2, no. (%) Univariate OR 
(95% CI) Multivariable aOR (95% CI)
Site
Rural 40/140 (29) 100/140 (71) 4.9 (3.1–7.8) 4.7 (2.9–7.6)
Urban
139/210 (66)
71/210 (34)
Referent
Referent
Sex
M 65/123 (53) 58/123 (47) Referent
F
114/227 (50)
113/227 (50)
1.1 (0.7–1.7)

Age group, y
<5 9/25 (36) 16/25 (64) 3.2 (1.3–8.0) 2.7 (1.0–7.2)
5–12 30/74 (41) 44/74 (59) 2.6 (1.4–4.9) 2.1 (1.1–4.2)
13–18 36/64 (56) 28/64 (44) 1.4 (0.7–2.7) 1.3 (0.6–2.6)
19–34 34/67 (51) 33/67 (49) 1.7 (0.9–3.3) 1.3 (0.7–2.6)
35–59 59/92 (64) 33/92 (36) Referent Referent
>60
11/28 (39)
17/28 (61)
2.8 (1.2–6.6)
2.8 (1.1–7.0)
HIV status
Negative 139/271 (51) 132/271 (49) 1.0 (0.6–1.7)
Positive
35/68 (51)
33/68 (49)
Referent

CD4 count, cells/μL
>200 28/54 (52) 26/54 (48) 1.9 (0.2–21.7)
<200
2/3 (67)
1/3 (33)
Referent

Viral load, copies/mL
<1,000 28/51 (55) 23/51 (45) Referent
>1,000
2/7 (29)
5/7 (71)
3.0 (0.5–17.2)

Other underlying illness‡
No 161/316 (51) 155/316 (49) 1.1 (0.5–2.2)
Yes
18/34 (53)
16/34 (47)
Referent

Body mass index category
Underweight 10/22 (45) 12/22 (55) 1.5 (0.6–3.9)
Normal weight 65/141 (46) 76/141 (54) 1.5 (0.9–2.5)
Overweight 46/84 (55) 38/84 (45) 1.1 (0.6–1.9)
Obese
58/103 (56)
45/103 (44)
Referent

Currently smoking‡
No 109/190 (57) 81/190 (43) Referent
Yes
20/36 (56)
16/36 (44)
1.1 (0.5–2.2)

Alcohol use‡
No 88/167 (53) 79/167 (47) 2.0 (1.1–3.8)
Yes
41/59 (69)
18/59 (31)
Referent

Employment status§
Unemployed 70/128 (55) 58/128 (45) 1.9 (0.5–6.4)
Student 9/13 (69) 4/13 (31) Referent
Employed 25/41 (61) 16/41 (39) 1.4 (0.4–5.5)

*Includes all participants with blood draw 3 and 5 serum pairs and who showed seroconversion at either draw. Bold indicates a statistically significant difference. aOR, adjusted odds ratio; OR, odds ratio; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2. †Self-reported history of asthma, lung disease, heart disease, stroke, spinal cord injury, epilepsy, organ transplant, immunosuppressive therapy, organ transplantation, cancer, liver disease, renal disease, or diabetes. ‡Among persons >15 years of age. §Among persons >18 years of age.

Main Article

1Additional members of the PHIRST-C group who contributed to this manuscript are listed at the end of this article.

Page created: August 30, 2021
Page updated: November 19, 2021
Page reviewed: November 19, 2021
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