Widespread SARS-CoV-2 exposure in West Africa: findings from a 20,748-participant multi-country seroepidemiology study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Africa seemed to have had low SARS-CoV-2 infection and COVID-19 morbidity and mortality. While several studies reported high SARS-CoV-2 seropositivity among healthy Africans, others hypothesized that this could have resulted from pre-existing cross-reactive antibodies. Our study tracks trends in seropositivity across three West African countries during the Delta- and Omicron-dominant pandemic periods using validated SARS-CoV-2 IgG/IgM rapid diagnostic tests (Prestige Diagnostics in Ghana and Burkina Faso; SD Biosensor in Nigeria). Methods Cross-sectional studies were conducted in three West African countries (Burkina Faso, Ghana, and Nigeria), with study sites conveniently selected within each country. Using validated immunoassay kits with published validation procedures, SARS-CoV-2 antibodies were detected in peripheral blood during the Delta- and Omicron-dominant periods. Because we did not perform widespread viral sequencing on participant samples, we could not attribute seropositivity to a specific variant; instead, we classified sampling periods by the variant reported as dominant nationally/globally at the time of sample collection. Participants’ demographic and clinical data were obtained using a semi-structured questionnaire, and the primary outcome was the proportion of each population with SARS-CoV-2 antibodies. Results Across the 3 countries, 20,748 participants were recruited, and SARS-CoV-2 IgG seropositivity ranged from 24.1 to 76.4%, with higher rates during the Omicron-dominant period. All sites showed low self-reported vaccination rates, suggesting that seropositivity may be primarily driven by natural infection rather than vaccination. While there was a significant positive association between seropositivity and age across all sites, the association with other demographic factors was country-dependent, and most participants expressed positive opinions of vaccination. Conclusion This is one of the largest multi-country community-based SARS-CoV-2 seroepidemiology studies in Africa, showing widespread exposure to SARS-CoV-2 infection among our study population across three West African countries. These findings are consistent with a marked disconnect between high population exposure and low reported clinical burden, underscoring the need for strengthened community surveillance.
Source: Frontiers in Public Health
Authors: Aniefiok John Udoakang, Daniel Oduro-Mensah, Gloria Amegatcher, Onikepe Folarin, Isah Abubakar Aliyu, Irene Amoakoh Owusu, Francis Dzabeng, Alphonse Ouedraogo, Reuben Ayivor-Djanie, Jones Gyamfi, Moumouni Armel Sanou, Kesego Tapela, Manfreddy Binyet, Kyerewaa Akuamoah Boateng, Taiwo Gboluwaga Amole, Johnson Okolie, Baba Maiyaki Musa, Jamilu Abubakar Bala, Kazeem Akano, Ajibade Olufunke Olayemi, Olivia Achonduh-Atijegbe, Ajayi Nnennaya, Okoro Sylvanus Ihere, Azuogu Benedict, Okechukwu Ukpabi, Ojide Chiedozie Kingsley, Augustine Abu, Moyosoore Osoba, Nicholas Oyejide, Evans Agyapong Owusu, Bismark Adade, James Ekow Sampah, Samed Ishaq, George Agyei, Boateng Benjamin, William Oduro-Obeng, Janet Ogoe-Anderson, Nicholas Aloba Amekpordi, Safiatu Alhassan, David Afrifa, Bismark Akwasi Opoku, Oladele Oluwafemi Ayodeji, Chukwuyem Abejegah, Akinola Nelson Adedosu, Liasu Adeagbo Ahmed, Samuel S. Serme, Maurice Ouattara, Denise Hien, Nebié Issa, Rachael O. Boateng, Precious C. Opurum, Fatima O. Oyawoye, Dzidzor Yawa Ayeke, Michael Ofori, Nikiema Sindimbasba Achille, Bazoumana Sow, Lea Pare-Toe, Charles Guissou, Bismark Minna, Gifty Amponsah, Sylvester Donne Dassah, Sharif Alhassan Abdullahi, Nura Garba, Khadija Muhammad Bala, Rufai Umar Zubair, Mahfuz Muhammad Haddad, Lucas Amenga-Etego, Dominic S. Y. Amuzu, Collins M. Morang’a, Kwabena A. N. Sarpong, Patrick Williams Narkwa, William K Ampofo, Franklin Asiedu-Bekoe, Patrick Kuma-Aboagye, Kwabena O. Duedu, James Abugri, Mohamed Mutocheluh, Gideon Kofi Helegbe, Paul Armah Aryee, James Duah, Peter Yeboah, Yaw Bediako, Abdulai Diabate, Hadiza Shehu Galadanci, Sodiomon B. Sirima, Christian Happi, Gordon A. Awandare, Peter Kojo Quashie
Institutions: University of Ghana, West African Centre for Cell Biology of Infectious Pathogens, Redeemer's University, Bayero University Kano, University of Health and Allied Sciences, Institut de Recherche en Sciences de la Santé, Aminu Kano Teaching Hospital, St. Elizabeth Hospital in Enumclaw, St. Patrick Hospital, St. Patrick's Hospital, St. Peter's Hospital, Noguchi Memorial Institute for Medical Research, Nazi Boni University, University of Technology and Applied Sciences, Kwame Nkrumah University of Science and Technology, Ghana Health Service, University for Development Studies, Christian Health Association of Nigeria, Christian Health Association of Malawi, The Francis Crick Institute
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7162131560