Emerg Infect Dis. 2022 Dec;28(13):S76-S84. doi: 10.3201/eid2813.212348.
To determine early COVID-19 burden in Malawi, we conducted a multistage cluster survey in 5 districts. During October-December 2020, we recruited 5,010 community members (median age 32 years, interquartile range 21-43 years) and 1,021 health facility staff (HFS) (median age 35 years, interquartile range 28-43 years). Real-time PCR-confirmed SARS-CoV-2 infection prevalence was 0.3% (95% CI 0.2%-0.5%) among community and 0.5% (95% CI 0.1%-1.2%) among HFS participants; seroprevalence was 7.8% (95% CI 6.3%-9.6%) among community and 9.7% (95% CI 6.4%-14.5%) among HFS participants. Most seropositive community (84.7%) and HFS (76.0%) participants were asymptomatic. Seroprevalence was higher among urban community (12.6% vs. 3.1%) and HFS (14.5% vs. 7.4%) than among rural community participants. Cumulative infection findings 113-fold higher from this survey than national statistics (486,771 vs. 4,319) and predominantly asymptomatic infections highlight a need to identify alternative surveillance approaches and predictors of severe disease to inform national response.
为了确定马拉维的早期 COVID-19 负担，我们在 5 个地区进行了多阶段聚类调查。2020 年 10 月至 12 月期间，我们招募了 5010 名社区成员（中位数年龄为 32 岁，四分位间距为 21-43 岁）和 1021 名卫生机构工作人员（HFS）（中位数年龄为 35 岁，四分位间距为 28-43 岁）。实时 PCR 确认的 SARS-CoV-2 感染患病率在社区参与者中为 0.3%（95%CI 0.2%-0.5%），在 HFS 参与者中为 0.5%（95%CI 0.1%-1.2%）；在社区参与者中的血清阳性率为 7.8%（95%CI 6.3%-9.6%），在 HFS 参与者中为 9.7%（95%CI 6.4%-14.5%）。大多数血清阳性的社区（84.7%）和 HFS（76.0%）参与者无症状。与农村社区参与者相比，城市社区（12.6%比 3.1%）和 HFS（14.5%比 7.4%）的血清阳性率更高。与全国统计数据（486771 例比 4319 例）相比，该调查的累积感染发现高出 113 倍，且主要为无症状感染，这突显了需要确定替代监测方法和严重疾病预测因素，以为国家应对提供信息。
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