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Updated: Aug 28, 2025
Dynamic Monitoring of Seroconversion using a Multianalyte Immunobead Assay for Covid-19
Published on: February 16, 2022
Dynamics of SARS-CoV-2 exposure in Malawian infants between February 2020 and May 2021
Silvia Baroncelli1, Clementina Maria Galluzzo1, Stefano Orlando2
1National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
Insights
SARS-CoV-2 infection is widespread in Malawian infants, with a 31% seroprevalence. This study highlights the need for improved serosurveillance and tailored diagnostic tests for pediatric populations in sub-Saharan Africa.
Area of Science:
- Epidemiology
- Infectious Diseases
- Pediatrics
Background:
- Limited data exists on SARS-CoV-2 seroprevalence in infants across sub-Saharan Africa.
- Understanding pediatric infection dynamics is crucial for public health strategies.
Purpose of the Study:
- To determine the seroprevalence and temporal trends of SARS-CoV-2 (the virus that causes COVID-19) in breastfed infants in Malawi.
- To compare seropositivity rates between infants exposed and unexposed to HIV.
Main Methods:
- Blood samples from 158 infants (born to HIV-negative and HIV-positive mothers) were collected between February 2020 and May 2021.
- Samples were tested using ELISA assays for anti-SARS-CoV-2 antibodies (IgG/IgA/IgM) against the spike protein and Receptor Binding Domain.
Main Results:
- A confirmed seroprevalence of 31.0% for anti-SARS-CoV-2 antibodies was observed.
- No significant difference in seropositivity was found between HIV-exposed (29.3%) and HIV-unexposed (37.1%) infants.
- Antibody presence was not linked to maternal socioeconomic or demographic factors.
Conclusions:
- The findings indicate a broad circulation of SARS-CoV-2 within the pediatric population in sub-Saharan Africa.
- There is a critical need for developing more specific serological tests for African populations and enhancing serosurveillance programs to monitor SARS-CoV-2 infection dynamics effectively.
Background:
Very limited information is available on SARS-CoV-2 seroprevalence in infants in sub-Saharan countries.
Objective:
In this study, we aimed to determine the rate and the temporal evolution of SARS CoV-2 seropositivity in breastfed Malawian infants.
Study Design:
Blood samples (n = 250) from 158 infants, born to HIV-negative women and women living with HIV, collected from February 2020 to May 2021, were first tested using an Anti-IgG/A/M SARS CoV 2 ELISA assay against trimeric spike protein, and then, if positive, confirmed using a second ELISA assay detecting IgG against Receptor Binding Domain.
Results:
The confirmed prevalence of anti-SARS CoV-2 antibodies was 31.0% (95% CI: 23.7%-38.3%) with no significant difference between HIV-exposed and HIV-unexposed infants (29.3% and 37.1% respectively, P = 0.410). The presence of anti-SARS-CoV-2 IgG was not associated with maternal socioeconomic or demographic indices.
Conclusions:
Our data underline the wide spread of the SARS-CoV-2 infection in the pediatric population in sub-Saharan Africa. Design of more specific serological tests for African samples and improvements in serosurveillance programs are needed for more rigorous monitoring of the dynamics of SARS-CoV-2 infection in Africa.
