Center for International Health Protection, Robert Koch Institute, Berlin, Germany.
Laboratoire d'Analyses Médicales Malagasy, Antananarivo, Madagascar.
PLoS One. 2024 Oct 24;19(10):e0309977. doi: 10.1371/journal.pone.0309977. eCollection 2024.
The prevalence of infections and risk factors that go along with them give insights into the burden of disease and effectiveness of infection prevention and control strategies. In this study we investigated the burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and associated epidemiological factors in three regions of Madagascar among healthcare workers. Between May and June 2021, we conducted a multi-site cross-sectional study among healthcare workers in eight University Hospital Centers, during the local second wave and before the coronavirus disease 2019 vaccination campaign in three regional capitals of Madagascar. We collected demographic information and relevant SARS-CoV-2 exposure history and tested for both immunoglobulin G antibodies to SARS-CoV-2 spike protein, using enzyme-linked immunosorbent assay and active SARS-CoV-2 infection using real-time reverse transcription-polymerase chain reaction. A total of 1006 healthcare workers enrolled in the study out of which 53.8% tested positive for either acute infection or SARS-CoV-2 antibodies. Approximately 50% of the participants reported receiving inadequate training on SARS-CoV-2 and associated infection prevention and control measures, inadequate supply of Personal Protective Equipment (PPE) and discomfort when using available PPE. Prevalence of acute infection was 3.4% without statistically significant variation in the different regions or health facilities as well as the different profession groups and units of work. Average seroprevalence of SARS-CoV-2 IgG antibodies was 52.0%, varying between 47.8% and 53.3% across the different regions. No significant difference was observed for region, gender, profession, and different risk groups. Predictive multivariable model showed significant association between seropositivity and healthcare facility and age (p<0.05). Our results revealed high infection rate of SARS-CoV-2 in HCWs in all three selected regions of Madagascar. The high disease burden identified in the study population might characterize the extent of high undocumented infection rates in HCWs in other regions of Madagascar.
感染的流行情况和相关危险因素为疾病负担以及感染预防和控制策略的效果提供了深入了解。在这项研究中，我们调查了马达加斯加三个地区医护人员中严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的负担及其相关流行病学因素。2021 年 5 月至 6 月，我们在马达加斯加三个地区首府的当地第二波疫情期间和 2019 年冠状病毒病疫苗接种运动之前，在八家大学医院中心进行了一项多地点横断面研究。我们收集了人口统计学信息和 SARS-CoV-2 暴露史，并使用酶联免疫吸附试验检测了 SARS-CoV-2 刺突蛋白的免疫球蛋白 G 抗体，使用实时逆转录聚合酶链反应检测了 SARS-CoV-2 急性感染。共有 1006 名医护人员参加了这项研究，其中 53.8%的人急性感染或 SARS-CoV-2 抗体检测呈阳性。大约 50%的参与者报告称，他们接受了关于 SARS-CoV-2 及其相关感染预防和控制措施的培训不足，个人防护设备（PPE）供应不足，以及使用现有 PPE 时感到不适。急性感染的流行率为 3.4%，不同地区或卫生机构以及不同职业群体和工作单位之间没有统计学显著差异。SARS-CoV-2 IgG 抗体的平均血清阳性率为 52.0%，不同地区的血清阳性率在 47.8%至 53.3%之间。地区、性别、职业和不同风险组之间未观察到显著差异。预测多变量模型显示，血清阳性与医疗机构和年龄显著相关（p<0.05）。我们的结果表明，马达加斯加三个选定地区的医护人员中 SARS-CoV-2 的感染率很高。研究人群中发现的高疾病负担可能反映了马达加斯加其他地区医护人员中未记录的高感染率的程度。
