Prevalence and characterization of post-acute sequelae of SARS-CoV-2 infection (PASC) in Rwanda

Reliable, population-level estimates of post-acute sequelae of SARS-CoV-2 infection (PASC) remain scarce for sub-Saharan Africa. We aimed to quantify PASC prevalence and identify associated factors among adult COVID-19 survivors in Rwanda.

A nationally representative cross-sectional telephone survey (August-October 2024) sampled 3143 adults from the national COVID-19 registry. PASC was defined as new or persisting symptoms ≥3 months after acute illness and lasting ≥2 months. The prevalence was calculated, and multivariable logistic regression identified factors independently associated with PASC.

Overall, PASC prevalence was 34%. Leading symptoms were back pain, headache, dizziness, fatigue, and reduced sexual desire. Higher odds of PASC occurred in women, adults ≥35 years, individuals with ≥2 COVID-19 infections, and those screening positive for anxiety. Current alcohol use was linked to lower odds. COVID-19 vaccination showed no association with PASC.

Approximately one-third of adult Rwandan COVID-19 survivors continue to experience persistent symptoms. This burden signals that post-COVID care must become an integral part of routine health services, especially as new variants periodically drive fresh waves of infection. Preventing repeat infections and integrating mental health support emerge as actionable priorities. Harmonized longitudinal studies are needed to clarify PASC causality.