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Volume 28, Supplement—December 2022
SUPPLEMENT ISSUE
Surveillance

SARS-CoV-2 Prevalence in Malawi Based on Data from Survey of Communities and Health Workers in 5 High-Burden Districts, October 2020

Joe Alex Theu1, Alinune Nathanael Kabaghe1Comments to Author , George Bello, Evelyn Chitsa-Banda, Matthews Kagoli, Andrew Auld, Jonathan Mkungudza, Gabrielle O’Malley, Fred Fredrick Bangara, Elizabeth F. Peacocke, Yusuf Babaye, Wingston Ng’ambi, Christel Saussier, Ellen MacLachlan, Gertrude Chapotera, Mphatso Dennis Phiri, Evelyn Kim, Mabvuto Chiwaula, Danielle Payne, Nellie Wadonda-Kabondo2, Annie Chauma-Mwale2, Titus Henry Divala2, and Public Health Institute of Malawi COVID-19 surveillance committee3
Author affiliations: University of Washington Malawi International Training and Education Center for Health, Lilongwe, Malawi (J.A. Theu, G. Bello, J. Mkungudza, F.F. Bangara, Y. Babaye, C. Saussier); US Centers for Disease Control and Prevention, Malawi, Lilongwe (A.N. Kabaghe, A. Auld, E. Kim, D. Payne, N. Wadonda-Kabondo); Public Health Institute of Malawi, Lilongwe (E. Chitsa-Banda, M. Kagoli, M. Chiwaula, A. Chauma-Mwale); University of Washington International Training and Education Center for Health, Seattle, Washington, USA (G. O’Malley, E. MacLachlan); Norwegian Institute of Public Health, Lilongwe (E.F. Peacocke); Kamuzu University of Health Sciences, Blantyre, Malawi (G. Chapotera, M.D. Phiri, T.H. Divala)

Main Article

Table 2

Prevalence of and risk factors associated with SARS-CoV-2 positive test result among participants in survey of SARS-CoV-2 prevalence in Malawi in October 2020*

Characteristic Community, N = 4,261
 Health facility staff, N = 970
Pos Weighted prevalence (95% CI) Crude OR 
(95% CI) Adjusted OR (95% CI)† Pos Weighted prevalence (95% CI) Crude OR 
(95% CI) Adjusted OR (95% CI)†
Overall
 423
 7.8 (6.3–9.6)
 NA
 NA
124
 9.7 (6.4–14.5)
 NA
 NA
Sex
M 170 8.3 (6.5–10.4) Referent Referent 58 9.7 (5.6–15.6) Referent Referent
F
 253
 7.5 (6.0–9.4)
 0.9 (0.7–1.1)
 0.9 (0.6–1.2)
66
 9.7 (6.1–15.1)
 1.0 (0.6–1.6)
 0.7 (0.4–1.0)
Age, y
10–19 71 5.3 (3.7–7.5) Referent Ref 5 57.4 (4.4–97.5) Ref Referent
20–29 104 6.9 (5.3–9.0) 1.3 (0.9–1.9) 1.3 (0.8–2.4) 38 7.6 (4.4–12.9) 0.06 (0.01–0.3)§ 0.1 (0.01–0.5)¶
30–39 105 9.7 (7.4–12.6) 1.9 (1.3–3.0)§ 2.6 (1.3–5.2)§ 41 12.6 (6.4–23.4) 0.1 (0.02–0.4)§ 0.2 (0.03–0.9)¶
40–49 61 6.2 (4.0–9.5) 1.2 (0.8–1.8) 1.8 (0.9–3.6) 32 6.6 (3.3–13.0) 0.1 (0.01–0.3)§ 0.1 (0.01–0.7)¶
≥50
 82
 11.0 (7.6–15.8)
 2.2 (1.4–3.4)¶
 2.8 (1.4–5.4)§
8
 8.7 (2.6–25.4)
 0.1 (0.01–0.4)§
 0.2 (0.02–1.2)
District
Karonga 103 9.4 (7.3–12.2) Referent Referent 13 8.9 (2.2–29.4) Referent Referent
Blantyre 67 13.1 (9.0–18.7) 1.4 (0.9–2.2) 1.3 (0.9–2.1) 25 4.7 (1.1–18.0) 3.5 (0.8–15.2) 3.6 (0.6–21.4)
Lilongwe 47 6.1 (3.5–10.2) 0.6 (0.3–1.1) 0.9 (0.6–1.6) 23 10 (6.7–14.7) 2.3 (0.6–8.6) 2.1 (0.4–10.2)
Mangochi 38 4.1 (2.6–6.2) 0.4 (0.2–0.6)§ 0.5 (0.3–0.8)§ 6 2.6 (1.0–6.6) 0.5 (0.1–2.5) 0.7 (0.1–3.5)
Mzimba North
 168
 12.1 (8.7–16.6)
 1.3 (0.8–2.1)
 1.5 (1.0–2.2)
57
 14.5 (6.7–28.5)
 2.0 (0.3–12.0)
 2.0 (0.4–11.3)
Location type
Rural 59 3.1 (1.8–5.5) Referent Referent 27 7.4 (3.6–14.7) Referent Referent
Urban
 364
 12.6 (11.2–14.1)
 4.4 (2.5–7.9)¶
 4.2 (2.6–6.7)¶
97
 14.5 (9.7–21.1)
 2.1 (0.9–4.9)
 1.8 (0.7–4.9)
Household size
1–2 47 8.4 (5.9–11.8) Referent – 33 8.3 (3.6–17.9) Referent NA
3–4 167 7.4 (5.7–9.4) 0.9 (0.6–1.3) NA 35 8.3 (3.9–16.9) 1.0 (0.3–3.9) NA
≥5
 209
 8.0 (6.1–10.4)
 1.0 (0.6–1.5)
 NA
56
 11.6 (7.3–17.9)
 1.4 (0.6–3.5)
 NA
Education#
No education 22 7.6 (4.2–13.2) Referent Referent NA NA NA
Primary 151 5.2 (3.8–7.1) 0.7 (0.4–1.3) 0.4 (0.2–0.9)¶ 3 5.1 (1.7–14.3) Referent NA
Secondary 211 11.9 (9.7–14.4) 1.6 (0.9–3.1) 0.8 (0.4–1.7) 53 8.6 (5.6–13.0) 1.7 (0.6–5.5) NA
Tertiary/postsecondary
 39
 14.4 (10.6–19.3)
 2.1 (1.0–4.1)¶
 0.8 (0.4–1.8)
68
 12.0 (7.1–19.7)
 2.5 (0.7–8.9)
 NA
Occupation
Student 81 6.7 (4.6–9.8) Referent Referent NA NA NA
Unemployed 160 7.7 (6.1–9.7) 1.2 (0.8–1.7) 0.7 (0.4–1.4) NA NA NA
Employed, HFS 13 4.9 (1.1–18.6) 0.7 (0.2.3.3) 0.2 (0.05–1.1) NA NA NA
Employed, non-HFS 3 10.0 (6.4–15.2) 1.5 (0.9–2.7) 0.6 (0.2–1.2) NA NA NA
Retired 36 25.7 (14.5–41.3) 4.8 (2.1–10.9)¶ 1.4 (0.5–4.0) NA NA NA
Other
 130
 7.6 (5.5–10.4)
 1.1 (0.7–1.8)
 0.6 (0.3–1.2)
NA
 NA
 NA
Contact with confirmed case
No 422 7.8 (6.3–9.6) Referent NA 117 9.5 (6.1–14.4) Referent NA
Yes
 1
 14.5 (0.14–95.3)
 2.0 (0.3–14.9)
 NA
7
 26.1 (8.5–57.3)
 3.4 (0.9–12.7)
 NA
Attended gatherings**
No 90 6.9 (4.8–9.8) Referent NA 19 9.8 (6.3–15.0) Referent NA
Yes
 333
 8.3 (6.7–10.3)
 1.2 (0.8–1.8)
 NA
105
 9.7 (6.0–15.3)
 1.0 (0.5–2.0)
 NA
Any medical condition
No 367 7.7 (6.2–9.5) Referent NA 103 10.1 (6.8–14.7) Referent NA
Yes
 56
 8.7 (5.8–13.0)
 1.1 (0.8–1.7)
 NA
21
 8.3 (3.3–19.4)
 0.8 (0.3–2.0)
 NA
Diabetes mellitus
No 401 7.5 (6.0–9.3) Referent Referent 120 9.8 (6.2–15.3) Referent Referent
Yes
 10
 27.3 (12.9–48.9)
 4.6 (1.7–12.5)§
 2.4 (0.9–6.3)
2
 17.6 (0.9–84.2)
 2.0 (0.2–16.2)
 1.9 (0.3–11.6)
CVD, including hypertension
No 383 7.6 (6.1–9.4) Referent NA 113 10.6 (6.8–16.2) Referent NA
Yes
 30
 8.4 (4.6–14.9)
 1.1 (0.6–2.0)
 NA
9
 3.3 (0.65–15.5)
 0.3 (0.6–1.4)
 NA
Immunosuppressive condition††
No 398 7.5 (6.1–9.3) Referent NA 116 9.0 (5.7–13.9) Referent NA
Yes
 9
 12.0 (5.8–22.9)
 1.7 (0.7–3.8)
 NA
5
 23.1 (8.1–50.7)
 3.1 (1.7–8.7)¶
 NA
Obesity
No 407 7.6 (6.1–9.3) Referent NA 122 10.0 (6.3–15.5) NA NA
Yes
 2
 19.2 (3.3–6.2)
 2.9 (0.5–15.9)
 NA
0
 0
 NA
 NA
Asthma
No 407 7.6 (6.1–9.3) Referent NA 119 10.5 (6.6–16.3) Referent NA
Yes
 2
 9.5 (4.6–18.5)
 1.3 (0.6–2.7)
 NA
3
 1.9 (0.34–9.7)
 0.2 (0.03–0.8)¶
 NA
Chronic lung disease, including COPD NA
No 411 7.7 (6.2–9.4) Referent NA 121 9.9 (6.2–15.4) Referent NA
Yes
 1
 9.7 (0.05–69.6)
 1.3 (0.1–12.2)
 NA
1
 59.1 (–)
 13.1 (0.7–246.7)
 NA
Pregnant
No 88 7.6 (6.0–9.6) Referent NA 66 10.0 (6.3–15.7) NA NA
Yes
 9
 6.3 (2.8–13.4)
 0.8 (0.3–1.9)
 NA
0
 0
 NA
 NA
Smoking
No 400 7.9 (6.4–9.7) Referent NA 120 10.1 (6.6–15.1) NA NA
Yes, current 4 5.5 (0.9–26.5) 0.7 (0.1–3.7) NA 0 0 NA NA
Yes, past
 19
 6.0 (3.3–10.5)
 0.7 (0.4–1.3)
 NA
4
 4.2 (0.61–24.3)
 0.4 (0.05–2.9)
 NA
International travel‡‡
No 417 7.8 (6.3–9.6) Referent NA 13 9.6 (6.2–14.5) Referent NA
Yes 5 12.4 (3.0–39.8) 1.7 (0.4–6.5) NA 3 18.0 (3.7–55.7) 2.1 (0.6–7.7) NA

*COPD, chronic obstructive pulmonary disease; CVD, cardiovascular disease; HFS, health facility staff; NA, not available; OR, odds ratio; pos, positive. †Adjusted for age, sex, district and residence. ‡p value <0.05. §p value <0.01. ¶p value <0.001. #Education: primary education = 8 y; secondary education = 4 y; tertiary/postsecondary = college/university education. **Gathering included any of prayers, sporting events or market, family celebrations, weddings, funerals and bars. ††From cancer, chemotherapy, radiation therapy, immunosuppressive medications, self-reported HIV, organ transplant, or inherited immunodeficiency. ‡‡International travel includes both road and air travel.

Main Article

1These first authors contributed equally to this article.

2These senior authors contributed equally to this article.

3Members are listed at the end of this article.

Page created: July 01, 2022
Page updated: December 11, 2022
Page reviewed: December 11, 2022
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