COVID-19 morbidity in Afghanistan: a nationwide, population-based seroepidemiological study
Objective The primary objectives were to determine the magnitude of COVID-19 infections in the general population and age-specific cumulative incidence, as determined by seropositivity and clinical symptoms of COVID-19, and to determine the magnitude of asymptomatic or subclinical infections.Design,...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e060739.full |
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| author | Siyu Chen Fatima Arifi Mohammad Nadir Sahak Sayed Ataullah Saeedzai Lisa J White Amal Barakat Eman Abdelkreem Aly Margo van Gurp Giti Azim Bahara Rasoly Soraya Safi Jennifer A Flegg Nasar Ahmed Mohmmad Jamaluddin Ahadi Niaz M Achakzai Alaa AbouZeid |
| author_facet | Siyu Chen Fatima Arifi Mohammad Nadir Sahak Sayed Ataullah Saeedzai Lisa J White Amal Barakat Eman Abdelkreem Aly Margo van Gurp Giti Azim Bahara Rasoly Soraya Safi Jennifer A Flegg Nasar Ahmed Mohmmad Jamaluddin Ahadi Niaz M Achakzai Alaa AbouZeid |
| author_sort | Siyu Chen |
| collection | DOAJ |
| description | Objective The primary objectives were to determine the magnitude of COVID-19 infections in the general population and age-specific cumulative incidence, as determined by seropositivity and clinical symptoms of COVID-19, and to determine the magnitude of asymptomatic or subclinical infections.Design, setting and participants We describe a population-based, cross-sectional, age-stratified seroepidemiological study conducted throughout Afghanistan during June/July 2020. Participants were interviewed to complete a questionnaire, and rapid diagnostic tests were used to test for SARS-CoV-2 antibodies. This national study was conducted in eight regions of Afghanistan plus Kabul province, considered a separate region. The total sample size was 9514, and the number of participants required in each region was estimated proportionally to the population size of each region. For each region, 31–44 enumeration areas (EAs) were randomly selected, and a total of 360 clusters and 16 households per EA were selected using random sampling. To adjust the seroprevalence for test sensitivity and specificity, and seroreversion, Bernoulli’s model methodology was used to infer the population exposure in Afghanistan.Outcome measures The main outcome was to determine the prevalence of current or past COVID-19 infection.Results The survey revealed that, to July 2020, around 10 million people in Afghanistan (31.5% of the population) had either current or previous COVID-19 infection. By age group, COVID-19 seroprevalence was reported to be 35.1% and 25.3% among participants aged ≥18 and 5–17 years, respectively. This implies that most of the population remained at risk of infection. However, a large proportion of the population had been infected in some localities, for example, Kabul province, where more than half of the population had been infected with COVID-19.Conclusion As most of the population remained at risk of infection at the time of the study, any lifting of public health and social measures needed to be considered gradually. |
| format | Article |
| id | doaj-art-7a563994a540408393ca1fb583538563 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-7a563994a540408393ca1fb5835385632025-01-31T09:10:09ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2021-060739COVID-19 morbidity in Afghanistan: a nationwide, population-based seroepidemiological studySiyu Chen0Fatima Arifi1Mohammad Nadir Sahak2Sayed Ataullah Saeedzai3Lisa J White4Amal Barakat5Eman Abdelkreem Aly6Margo van Gurp7Giti Azim8Bahara Rasoly9Soraya Safi10Jennifer A Flegg11Nasar Ahmed12Mohmmad Jamaluddin Ahadi13Niaz M Achakzai14Alaa AbouZeid15Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, Universiry of Oxford, Oxford, UKWHE, World Health Organization, Kabul, AfghanistanWHE, World Health Organization, Kabul, AfghanistanMonitoring, Evaluation and Health Information System, Ministry of Public Health, Kabul, AfghanistanNuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UKInfectious Hazard Preparedness Unit, WHO Eastern Mediterranean Regional Office, Cairo, EgyptInformation Systems for Health Unit, WHO Eastern Mediterranean Regional Office, Cairo, EgyptKIT Royal Tropical Institute, Amsterdam, NetherlandsMonitoring, Evaluation and Health Information System, Ministry of Public Health, Kabul, AfghanistanMonitoring, Evaluation and Health Information System, Ministry of Public Health, Kabul, AfghanistanMonitoring, Evaluation and Health Information System, Ministry of Public Health, Kabul, AfghanistanSchool of Mathematics and Statistics, University of Melbourne, Melbourne, Victoria, AustraliaDepartment of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida, USAMonitoring, Evaluation and Health Information System, Ministry of Public Health, Kabul, AfghanistanDepartment of Molecular Biology, Forensic Medicine Directorate, Ministry of Public Health, Kabul, AfghanistanDepartment of Public Health, Cairo University Kasr Alainy Faculty of Medicine, Cairo, EgyptObjective The primary objectives were to determine the magnitude of COVID-19 infections in the general population and age-specific cumulative incidence, as determined by seropositivity and clinical symptoms of COVID-19, and to determine the magnitude of asymptomatic or subclinical infections.Design, setting and participants We describe a population-based, cross-sectional, age-stratified seroepidemiological study conducted throughout Afghanistan during June/July 2020. Participants were interviewed to complete a questionnaire, and rapid diagnostic tests were used to test for SARS-CoV-2 antibodies. This national study was conducted in eight regions of Afghanistan plus Kabul province, considered a separate region. The total sample size was 9514, and the number of participants required in each region was estimated proportionally to the population size of each region. For each region, 31–44 enumeration areas (EAs) were randomly selected, and a total of 360 clusters and 16 households per EA were selected using random sampling. To adjust the seroprevalence for test sensitivity and specificity, and seroreversion, Bernoulli’s model methodology was used to infer the population exposure in Afghanistan.Outcome measures The main outcome was to determine the prevalence of current or past COVID-19 infection.Results The survey revealed that, to July 2020, around 10 million people in Afghanistan (31.5% of the population) had either current or previous COVID-19 infection. By age group, COVID-19 seroprevalence was reported to be 35.1% and 25.3% among participants aged ≥18 and 5–17 years, respectively. This implies that most of the population remained at risk of infection. However, a large proportion of the population had been infected in some localities, for example, Kabul province, where more than half of the population had been infected with COVID-19.Conclusion As most of the population remained at risk of infection at the time of the study, any lifting of public health and social measures needed to be considered gradually.https://bmjopen.bmj.com/content/12/7/e060739.full |
| spellingShingle | Siyu Chen Fatima Arifi Mohammad Nadir Sahak Sayed Ataullah Saeedzai Lisa J White Amal Barakat Eman Abdelkreem Aly Margo van Gurp Giti Azim Bahara Rasoly Soraya Safi Jennifer A Flegg Nasar Ahmed Mohmmad Jamaluddin Ahadi Niaz M Achakzai Alaa AbouZeid COVID-19 morbidity in Afghanistan: a nationwide, population-based seroepidemiological study BMJ Open |
| title | COVID-19 morbidity in Afghanistan: a nationwide, population-based seroepidemiological study |
| title_full | COVID-19 morbidity in Afghanistan: a nationwide, population-based seroepidemiological study |
| title_fullStr | COVID-19 morbidity in Afghanistan: a nationwide, population-based seroepidemiological study |
| title_full_unstemmed | COVID-19 morbidity in Afghanistan: a nationwide, population-based seroepidemiological study |
| title_short | COVID-19 morbidity in Afghanistan: a nationwide, population-based seroepidemiological study |
| title_sort | covid 19 morbidity in afghanistan a nationwide population based seroepidemiological study |
| url | https://bmjopen.bmj.com/content/12/7/e060739.full |
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