Escalating spread of SARS-CoV-2 infection after school reopening among students in hotspot districts of Oromia Region in Ethiopia: Longitudinal study

PLoS One. 2023 Feb 3;18(2):e0280801. doi: 10.1371/journal.pone.0280801. eCollection 2023.

Abstract

Background: COVID-19 pandemic caused by extended variants of SARS-CoV-2 has infected more than 350 million people, resulting in over 5.5 million deaths globally. However, the actual burden of the pandemic in Africa, particularly among children, remains largely unknown. We aimed to assess the seroepidemiological changes of SARS-CoV-2 infection after school reopening among school children in Oromia, Ethiopia.

Methods: A prospective cohort study involving students aged 10 years and older were used. A serological survey was performed twice, at school reopening in December 2020 and four months later in April 2021. Participants were selected from 60 schools located in 15 COVID-19 hotspot districts in Oromia Region. Serology tests were performed by Elecsys anti-SARS-CoV-2 nucleocapsid assay. Data were collected using CSentry CSProData Entry 7.2.1 and exported to STATA version 14.2 for data cleaning and analysis.

Results: A total of 1884 students were recruited at baseline, and 1271 completed the follow-up. SARS-CoV-2 seroprevalence almost doubled in four months from 25.7% at baseline to 46.3% in the second round, with a corresponding seroincidence of 1910 per 100,000 person-week. Seroincidence was found to be higher among secondary school students (grade 9-12) compared to primary school students (grade 4-8) (RR = 1.6, 95% CI 1.21-2.22) and among those with large family size (> = 5) than those with a family size of <3 (RR = 2.1, 95% CI 1.09-4.17). The increase in SARS-CoV-2 seroprevalence among the students corresponded with Ethiopia's second wave of the COVID-19 outbreak.

Conclusion: SARS-CoV-2 seroprevalence among students in hotspot districts of the Oromia Region was high even at baseline and almost doubled within four months of school recommencement. The high seroincidence coincided with the second wave of the COVID-19 outbreak in Ethiopia, indicating a possible contribution to school opening for the new outbreak wave.

MeSH terms

  • COVID-19* / epidemiology
  • Child
  • Ethiopia / epidemiology
  • Humans
  • Longitudinal Studies
  • Pandemics
  • Prospective Studies
  • SARS-CoV-2
  • Schools
  • Seroepidemiologic Studies
  • Students

Grants and funding

There is no specific funding for this study. In collaboration with different universities in the region and a partner (Fenot project) team, Oromia Health Bureau initiated this work to strengthen COVID-19 surveillance and innovative approach to COVID-19. The collaborative team develops the proposal as voluntary work and resources pulled from different organizations as part of evidence generation for the routine activity of fighting COVID-19. The team organized the workshop during data analysis and arranged the transport for the research team to supervise the testing procedures at the Adama reference laboratory (this laboratory is under the management of the Oromia Health Bureau). A platform was established to bring programmers (Oromia Health bureau) and researchers from Jimma University and Armauer Hansen Research Institute. It is to provide continuous technical support on serological testing, and Jimma University provides Elecsys Anti-SARS-CoV-2 immunoassay test kits). Overall, this study is an effort from different sectors to generate evidence to support decision-making in fighting COVID-19 in the Oromia region, Ethiopia. Hence, no specific funding was allocated for this study. The funders had no role in the study design, data collection, analysis, publication decision, or manuscript preparation.