Division of Community Health and Family Medicine, Bangalore Baptist Hospital, Bangalore560024, Karnataka, India.
Department of Microbiology, Bangalore Baptist Hospital, Bangalore560024, Karnataka, India.
Epidemiol Infect. 2021 Feb 4;149:e39. doi: 10.1017/S0950268821000273.
People living in urban slums or informal settlements are among the most vulnerable communities, highly susceptible to coronavirus disease 2019 (COVID-19) infection and vulnerable to the consequences of the measures taken to control the spread of the virus. Fear and stigma related to infection, mistrust between officials and the population, the often-asymptomatic nature of the disease is likely to lead to under-reporting. We conducted a cross-sectional study to determine the seroprevalence of COVID-19 infection in a large slum in South India 3 months after the index case and recruited 499 adults (age >18 years). The majority (74.3%) were females and about one-third of the population reported comorbidities. The overall seroprevalence of IgG antibody for COVID-19 was 57.9% (95% CI 53.4-62.3). Age, education, occupation and the presence of reported comorbidities were not associated with seroprevalence (P-value >0.05). Case-to-undetected-infections ratio was 1:195 and infection fatality rate was calculated as 2.94 per 10 000 infections. We estimated seroprevalence of COVID-19 was very high in our study population. The focus in this slum should shift from infection prevention to managing the indirect consequences of the pandemic. We recommend seroprevalence studies in such settings before vaccination to identify the vulnerability of COVID-19 infection to optimise the use of insufficient resources. It is a wake-up call to societies and nations, to dedicate paramount attention to slums into recovery and beyond - to build, restore and maintain health equity for the 'Health and wellbeing of all'.
生活在城市贫民窟或非正规住区的人属于最脆弱的群体，极易感染 2019 年冠状病毒病（COVID-19），并且容易受到为控制病毒传播而采取的措施的影响。与感染相关的恐惧和耻辱、官员与民众之间的不信任、疾病通常无症状，这些都可能导致漏报。我们进行了一项横断面研究，以确定印度南部一个大型贫民窟在首例病例发生后 3 个月 COVID-19 感染的血清流行率，共招募了 499 名成年人（年龄> 18 岁）。大多数（74.3%）为女性，约三分之一的人口报告有合并症。COVID-19 感染 IgG 抗体的总体血清流行率为 57.9%（95%CI 53.4-62.3）。年龄、教育程度、职业以及报告合并症的存在与血清流行率无关（P 值> 0.05）。病例与未检出感染的比例为 1:195，感染病死率为每 10 000 例感染 2.94 例。我们估计，我们研究人群中的 COVID-19 血清流行率非常高。在这个贫民窟，重点应从感染预防转移到管理大流行的间接后果。我们建议在接种疫苗之前在这些环境中进行血清流行率研究，以确定 COVID-19 感染的脆弱性，从而优化对有限资源的利用。这是对社会和国家的一个警醒，需要高度关注贫民窟的复苏和未来发展，为所有人的“健康和福祉”建设、恢复和维护健康公平。
