Volume 27, Number 6—June 2021
Research
Seroprevalence of Severe Acute Respiratory Syndrome Coronavirus 2 IgG in Juba, South Sudan, 20201
Figure 1

Figure 1. Number of weekly SARS-CoV-2 tests and infections reported in Juba, South Sudan, May 3–October 30, 2020. The survey of seroprevalence of SARS-CoV-2 IgG was conducted August 10–September 11. First coronavirus disease case in South Sudan was identified on April 2 and confirmed on April 4, 2020 (23). SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.
References
- World Health Organization. Weekly epidemiological update: 16 March 2021 [cited 2021 Mar 18]. https://www.who.int/publications/m/item/weekly-epidemiological-update---16-march-2021
- Rice BL, Annapragada A, Baker RE, Bruijning M, Dotse-Gborgbortsi W, Mensah K, et al. Variation in SARS-CoV-2 outbreaks across sub-Saharan Africa. Nat Med. 2021;27:447–53. DOIPubMedGoogle Scholar
- Mbow M, Lell B, Jochems SP, Cisse B, Mboup S, Dewals BG, et al. COVID-19 in Africa: Dampening the storm? Science. 2020;369:624–6. DOIPubMedGoogle Scholar
- Chitungo I, Dzobo M, Hlongwa M, Dzinamarira T. COVID-19: unpacking the low number of cases in Africa. Public Health in Practice. 2020;1:
100038 . DOIGoogle Scholar - World Health Organization. Population-based age-stratified seroepidemiological investigation protocol for coronavirus 2019 (COVID-19) infection [cited 2021 Feb 11]. https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-Seroepidemiology-2020.2
- Chen X, Chen Z, Azman AS, Deng X, Sun R, Zhao Z, et al. Serological evidence of human infection with SARS-CoV-2: a systematic review and meta-analysis. Lancet Glob Health. 2021;9:e598–609; Epub ahead of print. DOIPubMedGoogle Scholar
- Uyoga S, Adetifa IMO, Karanja HK, Nyagwange J, Tuju J, Wanjiku P, et al. Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Kenyan blood donors. Science. 2021;371:79–82. DOIPubMedGoogle Scholar
- Olayanju O, Bamidele O, Edem F, Eseile B, Amoo A, Nwaokenye J, et al. SARS-CoV-2 seropositivity in asymptomatic frontline health workers in Ibadan, Nigeria. Am J Trop Med Hyg. 2021;104:91–4. DOIPubMedGoogle Scholar
- Halatoko WA, Konu YR, Gbeasor-Komlanvi FA, Sadio AJ, Tchankoni MK, Komlanvi KS, et al. Prevalence of SARS-CoV-2 among high-risk populations in Lomé (Togo) in 2020. PLoS One. 2020;15:
e0242124 . DOIPubMedGoogle Scholar - Asuquo MI, Effa E, Otu A, Ita O, Udoh U, Umoh V, et al. Prevalence of IgG and IgM antibodies to SARS-CoV-2 among clinic staff and patients. Eur J Immunol. 2020;50:2025–40.
- Yadouleton A, Sander A-L, Moreira-Soto A, Tchibozo C, Hounkanrin G, Badou Y, et al. Limited specificity of serologic tests for SARS-CoV-2 antibody detection, Benin. Emerg Infect Dis. 2021;27:233–7. DOIPubMedGoogle Scholar
- Chibwana MG, Jere KC, Kamng’ona R, Mandolo J, Katunga-Phiri V, Tembo D, et al. High SARS-CoV-2 seroprevalence in Health Care Workers but relatively low numbers of deaths in urban Malawi. medRxiv. 2020;5:199. DOIPubMedGoogle Scholar
- Nkuba Ndaye A, Hoxha A, Madinga J, Mariën J, Peeters M, Leendertz FH, et al. Challenges in interpreting SARS-CoV-2 serological results in African countries. Lancet Glob Health. 2021;9:e588–9. DOIPubMedGoogle Scholar
- Hsiao M, Davies M-A, Kalk E, Hardie D, Naidoo M, Centner C, et al. SARS-CoV-2 seroprevalence in the Cape Town metropolitan sub-districts after the peak of infections. COVID-19 Special Public Health Surveillance Bulletin. 2020;18(Suppl 5):1–9. Johannesburg (South Africa): National Institute for Communicable Diseases; 2021 [cited 2021 Mar 2]. https://www.nicd.ac.za/wp-content/uploads/2020/09/COVID-19-Special-Public-Health-Surveillance-Bulletin_Issue-5.pdf
- Milleliri JM, Coulibaly D, Nyobe B, Rey J-L, Lamontagne F, Hocqueloux L, et al. SARS-CoV-2 infection in Ivory Coast: a serosurveillance survey among gold mine workers. Am J Trop Med Hyg. 2021;
tpmd210081 ; [Epub ahead of print].PubMedGoogle Scholar - Mulenga LB, Hines JZ, Fwoloshi S, Chirwa L, Siwingwa M, Yingst S, et al. Prevalence of SARS-CoV-2 in six districts in Zambia in July, 2020: a cross-sectional cluster sample survey. Lancet Glob Health. 2021;
S2214-109X(21)00053-X ; [Epub ahead of print].PubMedGoogle Scholar - World Health Organization. South Sudan. South Sudan confirms first case of COVID-19 [cited 2021 Feb 23]. https://www.afro.who.int/news/south-sudan-confirms-first-case-covid-19
- Integrated Food Security Phase Classification. South Sudan: IPC results October 2020–July 2021 [cited 2021 Mar 4]. http://www.ipcinfo.org/ipcinfo-website/alerts-archive/issue-31
- International Organization for Migration Data Tracking Matrix. South Sudan—mobility tracking round 9 initial findings [cited 2021 Mar 4]. https://displacement.iom.int/reports/south-sudan-%E2%80%94-mobility-tracking-round-9-initial-findings
- International Organization for Migration, World Food Programme. Urban multi-sector needs, vulnerabilities and COVID-19 impact survey (FSNMS+): Juba Town [cited 2021 Mar 4]. https://migration.iom.int/reports/south-sudan-%E2%80%94-urban-multi-sector-needs-vulnerabilities-and-covid-19-impact-survey-fsnms-%E2%80%94
- Iyer AS, Jones FK, Nodoushani A, Kelly M, Becker M, Slater D, et al. Persistence and decay of human antibody responses to the receptor binding domain of SARS-CoV-2 spike protein in COVID-19 patients. Sci Immunol. 2020;5:
eabe0367 . DOIPubMedGoogle Scholar - Slater DM. Preparation of elutions from dried blood spots for ELISAs [cited 2021 Mar 2]. https://www.protocols.io/view/preparation-of-elutions-from-dried-blood-spots-for-bsrnnd5e
- Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. DOIPubMedGoogle Scholar
- Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8:420–2. DOIPubMedGoogle Scholar
- Republic of South Sudan Ministry of Health. Malaria indicator survey 2017: final report. 2019 [cited 2021 Feb 22]. https://www.malariasurveys.org/documents/SSMIS%202017%20final%20report%202019%2005%2020_signed%20(1).pdf
- Stringhini S, Wisniak A, Piumatti G, Azman AS, Lauer SA, Baysson H, et al. Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Geneva, Switzerland (SEROCoV-POP): a population-based study. Lancet. 2020;396:313–9. DOIPubMedGoogle Scholar
- Carpenter B, Gelman A, Hoffman MD, Lee D, Goodrich B, Betancourt M, et al. Stan: a probabilistic programming language. J Stat Softw. 2017;76:1–32. DOIGoogle Scholar
- United Nations Office for the Coordination of Humanitarian Affairs, Integrated Food Security Phase Classification Technical Working Group, South Sudan National Bureau of Standards. South Sudan total population by county. 2020 [cited 2021 Mar 2]. https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/ss_total_population_by_county_map_a4_20201116.pdf
- Tso FY, Lidenge SJ, Peña PB, Clegg AA, Ngowi JR, Mwaiselage J, et al. High prevalence of pre-existing serological cross-reactivity against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in sub-Saharan Africa. Int J Infect Dis. 2021;102:577–83. DOIPubMedGoogle Scholar
- Emmerich P, Murawski C, Ehmen C, von Possel R, Pekarek N, Oestereich L, et al. Limited specificity of commercially available SARS-CoV-2 IgG ELISAs in serum samples of African origin. Trop Med Int Health. 2021;•••:
tmi.13569 ; Epub ahead of print. DOIPubMedGoogle Scholar - World Health Organization. South Sudan. South Sudan launches a nationwide campaign to protect 2.5 million children against measles [cited 2021 Mar 2]. https://www.afro.who.int/news/south-sudan-launches-nationwide-campaign-protect-25-million-children-against-measles
- Takahashi S, Greenhouse B, Rodríguez-Barraquer I. Are seroprevalence estimates for severe acute respiratory syndrome coronavirus 2 biased? J Infect Dis. 2020;222:1772–5. DOIPubMedGoogle Scholar
- Kutsuna S, Asai Y, Matsunaga A. Loss of anti–SARS-CoV-2 antibodies in mild COVID-19. N Engl J Med. 2020;383:1695–6.PubMedGoogle Scholar
- Shirin T, Bhuiyan TR, Charles RC, Amin S, Bhuiyan I, Kawser Z, et al. Antibody responses after COVID-19 infection in patients who are mildly symptomatic or asymptomatic in Bangladesh. Int J Infect Dis. 2020;101:220–5. DOIPubMedGoogle Scholar
- Choe PG, Kim K-H, Kang CK, Suh HJ, Kang E, Lee SY, et al. Antibody responses 8 months after asymptomatic or mild SARS-CoV-2 infection. Emerg Infect Dis. 2021;27:928–31. DOIPubMedGoogle Scholar
- Cervia C, Nilsson J, Zurbuchen Y, Valaperti A, Schreiner J, Wolfensberger A, et al. Systemic and mucosal antibody responses specific to SARS-CoV-2 during mild versus severe COVID-19. J Allergy Clin Immunol. 2021;147:545–557.e9. DOIPubMedGoogle Scholar
- Long Q-X, Tang X-J, Shi Q-L, Li Q, Deng H-J, Yuan J, et al. Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections. Nat Med. 2020;26:1200–4. DOIPubMedGoogle Scholar
- Lynch KL, Whitman JD, Lacanienta NP, Beckerdite EW, Kastner SA, Shy BR, et al. Magnitude and kinetics of anti-SARS-CoV-2 antibody responses and their relationship to disease severity. Clin Infect Dis. 2020;72:301–8. DOIPubMedGoogle Scholar
- Mwananyanda L, Gill CJ, MacLeod W, Kwenda G, Pieciak R, Mupila Z, et al. Covid-19 deaths in Africa: prospective systematic postmortem surveillance study. BMJ. 2021;372:n334. DOIPubMedGoogle Scholar
- Oved K, Olmer L, Shemer-Avni Y, Wolf T, Supino-Rosin L, Prajgrod G, et al. Multi-center nationwide comparison of seven serology assays reveals a SARS-CoV-2 non-responding seronegative subpopulation. EClinicalMedicine. 2020;29:
100651 . DOIPubMedGoogle Scholar - International Organization for Migration Data Tracking Matrix. Biometric registration. 2021 [cited 2021 Mar 4]. https://displacement.iom.int/component/biometric-registration
1A portion of this research was presented at the United States–Japan Cooperative Medical Sciences Program—Virtual Workshop on COVID-19, February 24–26, 2021.
2These authors contributed equally to this article.
3These authors contributed equally to this article.