Seroprevalence and risk factors of COVID-19 in healthcare workers from 11 African countries: a scoping review and appraisal of existing evidence.

A better understanding of serological data and risk factors for coronavirus disease 2019 (COVID-19) infection in healthcare workers (HCWs) is especially important in African countries where human resources and health services are more constrained. We reviewed and appraised the evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence and its risk factors in HCWs in Africa to inform response and preparedness strategies during the SARS-CoV-2 pandemic. We followed the Preferred Reporting Items for systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines in this scoping review. Databases including PubMed, Embase and preprint servers were searched accordingly from the start of the COVID-19 pandemic to 19 April 2021. Our search yielded 12 peer-reviewed and four pre-print articles comprising data on 9223 HCWs from 11 countries in Africa. Seroprevalence varied widely and ranged from 0% to 45.1%. Seropositivity was associated with older age, lower education, working as a nurse/non-clinical HCW or in gynaecology, emergency, outpatient or surgery departments. Asymptomatic rates were high and half of the studies recommended routine testing of HCWs. This scoping review found a varying but often high SARS-CoV-2 seroprevalence in HCWs in 11 African countries and identified certain risk factors. COVID-19 public health strategies for policy and planning should consider these risk factors and the potential for high seroprevalence among HCWs when prioritizing infection prevention and control measures and vaccine deployment.