Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Kenyan blood donors

By the end of July 2020, Kenya h ad reported only 341 deaths and ∼20,000 cases of COVID-19. This is in marked contrast to the tens of thousands of deaths reported in many higher-income countries. The true extent of COVID-19 in the community was unknown and likely to be higher than reports indicated. Uyoga et al. found an overall seroprevalence among blood donors of 4.3%, peaking in 35- to 44-year-old individuals (see the Perspective by Maeda and Nkengasong). The low mortality can be partly explained by the steep demographics in Kenya, where less than 4% of the population is 65 or older. These circumstances combine to result in Kenyan hospitals not currently being overwhelmed by patients with respiratory distress. However, the imposition of a strict lockdown in this country has shifted the disease burden to maternal and child deaths as a result of disruption to essential medical services. Science , this issue p. [79][1]; see also p. [27][2] The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Africa is poorly described. The first case of SARS-CoV-2 in Kenya was reported on 12 March 2020, and an overwhelming number of cases and deaths were expected, but by 31 July 2020, there were only 20,636 cases and 341 deaths. However, the extent of SARS-CoV-2 exposure in the community remains unknown. We determined the prevalence of anti–SARS-CoV-2 immunoglobulin G among blood donors in Kenya in April–June 2020. Crude seroprevalence was 5.6% (174 of 3098). Population-weighted, test-performance-adjusted national seroprevalence was 4.3% (95% confidence interval, 2.9 to 5.8%) and was highest in urban counties Mombasa (8.0%), Nairobi (7.3%), and Kisumu (5.5%). SARS-CoV-2 exposure is more extensive than indicated by case-based surveillance, and these results will help guide the pandemic response in Kenya and across Africa. [1]: /lookup/doi/10.1126/science.abe1916 [2]: /lookup/doi/10.1126/science.abf8832