Severe Acute Respiratory Syndrome Coronavirus-2 seroprevalence in South-Central Uganda, during 2019–2021

Charles Ssuuna, Ronald Moses Galiwango, Edward Nelson Kankaka, Joseph Kagaayi, Anthony Ndyanabo, Godfrey Kigozi, Gertrude Nakigozi, Tom Lutalo, Robert Ssekubugu, John Bosco Wasswa, Anthony Mayinja, Martina Cathy Nakibuuka, Samiri Jamiru, John Baptist Oketch, Edward Muwanga, Larry William Chang, Mary Kate Grabowski, Maria Wawer, Ronald Gray, Mark AndersonMichael Stec, Gavin Cloherty, Oliver Laeyendecker, Steven James Reynolds, Thomas C. Quinn, David Serwadda

Research output: Contribution to journalArticlepeer-review


Background: Globally, key subpopulations such as healthcare workers (HCW) may have a higher risk of contracting SARS-CoV-2. In Uganda, limited access to Personal Protective Equipment and lack of clarity on the extent/pattern of community spread may exacerbate this situation. The country established infection prevention/control measures such as lockdowns and proper hand hygiene. However, due to resource limitations and fatigue, compliance is low, posing continued onward transmission risk. This study aimed to describe extent of SARS-CoV-2 seroprevalence in selected populations within the Rakai region of Uganda. Methods: From 30th November 2020 to 8th January 2021, we collected venous blood from 753 HCW at twenty-six health facilities in South-Central Uganda and from 227 population-cohort participants who reported specific COVID-19 like symptoms (fever, cough, loss of taste and appetite) in a prior phone-based survey conducted (between May and August 2020) during the first national lockdown. 636 plasma specimens collected from individuals considered high risk for SARS-CoV-2 infection, prior to the first confirmed COVID-19 case in Uganda were also retrieved. Specimens were tested for antibodies to SARS-CoV-2 using the CoronaChek™ rapid COVID-19 IgM/IgG lateral flow test assay. IgM only positive samples were confirmed using a chemiluminescent microparticle immunoassay (CMIA) (Architect AdviseDx SARS-CoV-2 IgM) which targets the spike protein. SARS-CoV-2 exposure was defined as either confirmed IgM, both IgM and IgG or sole IgG positivity. Overall seroprevalence in each participant group was estimated, adjusting for test performance. Results: The seroprevalence of antibodies to SARS-CoV-2 in HCW was 26.7% [95%CI: 23.5, 29.8] with no difference by sex, age, or cadre. We observed no association between PPE use and seropositivity among exposed healthcare workers. Of the phone-based survey participants, 15.6% [95%CI: 10.9, 20.3] had antibodies to SARS-CoV-2, with no difference by HIV status, sex, age, or occupation. Among 636 plasma specimens collected prior to the first confirmed COVID-19 case, 2.3% [95%CI: 1.2, 3.5] were reactive. Conclusions: Findings suggest high seroprevalence of antibodies to SARS-CoV-2 among HCW and substantial exposure in persons presenting with specific COVID-19 like symptoms in the general population of South-Central Uganda. Based on current limitations in serological test confirmation, it remains unclear whether seroprevalence among plasma specimens collected prior to confirmation of the first COVID-19 case implies prior SARS-CoV-2 exposure in Uganda.

Original languageEnglish (US)
Article number174
JournalBMC infectious diseases
Issue number1
StatePublished - Dec 2022


  • COVID-19
  • Healthcare workers
  • SARS-CoV-2 seroprevalence
  • South-Central Uganda

ASJC Scopus subject areas

  • Infectious Diseases


Dive into the research topics of 'Severe Acute Respiratory Syndrome Coronavirus-2 seroprevalence in South-Central Uganda, during 2019–2021'. Together they form a unique fingerprint.

Cite this