Epidemiology of COVID-19 in Misrata, Libya: A Population-Based Surveillance Study

Anas Zarmouh,Hussien Elaswdi,Khalid Abufalgha,Essam Elakhtel,Mohamed Taraina

doi:10.4236/ojepi.2021.111010

Abstract

Background: The prevalence of SARS-COV2 in Libya is unclear; PCR is still under-performed. Although lockdown measures have been in place for weeks, there is no prevalence data to support the gradual lifting of such lockdowns. SARS-COV2 IgM/IgG is emerging as potential alternatives to PCR testing, and many counties and towns have undertaken such seroprevalence studies. Objective: Prevalence of SARS-COV2 in Misrata, Libya amongst the population as a whole. Materials and Methods: The study was prospective, cross-sectional, population-based, and age-stratified, to assess SARS-COV2 IgM/IgG in the population of Misrata. It was carried out between the 18th and 21st of April, 2020. Results: A representative sample of 897 participants was tested for SARS-COV2 IgM/IgG antibodies. 30 participants were positive for IgM or IgG indicating a prevalence of 3.4% (95% CI, 2.8% - 5.2%), with eight (0.9%) IgM positive and 22 (2.4%) IgG positive. Accordingly, 9075 (95% CI, 6586 - 14,170) people are estimated to have had a current or recent COVID-19 infection, symptomatic or asymptomatic. Conclusion and Recommendations: Serological testing as a diagnostic or surveillance tool may uncover a large proportion of asymptomatic individuals in the community, far outnumbering PCR. The authors highly recommend further precautionary public measures, as well as an ongoing surveillance programme to monitor the epidemiological trends of the disease in the city of Misrata and Libya in general.

Highlights

A representative sample of 897 participants was tested for SARS-COV2 IgM/IgG antibodies. 30 participants were positive for IgM or IgG indicating a prevalence of 3.4%, with eight (0.9%) IgM positive and 22 (2.4%) IgG positive
Whilst attempting to contrast the seroprevalence rate of 3.34% to the presumed PCR -based infection rate in Misrata of 0.002% is a serious task, this outcome is well supported in the literature, as these results of outnumbering PCR -based statistics have been reproduced in several studies with varying degrees of seroprevalence at 2.81% (Santa Clara County, US), 4.1% (Southern Los Angeles County, US), 14% (Gangelt, Germany), 11% (Robbio, Italy), 3% (Vo, Italy), 22% (Guilan province, Iran) and 33% (Kobe, Japan) respectively [17]-[23]
This study reports unanticipated prevalence rates at 3.34%, it is likely that acceptance to the public and uptake by decision-makers will be weak

Summary

Introduction

The local knowledge deficit of COVID-19 epidemiology is huge; the weak government is unable to lead on large-scale mass screening programmes, which other countries have embarked on It is, essential to establish an epidemiological landmark study in Libya to underpin further central efforts to tackle the pandemic and inform any future decisions easing up lockdowns in the cities. As PCR testing is scarce in Libya, an alternative is to measure serological markers for COVID-19 (SARS-COV2 IgM/IgG). These have become commercially available only in February 2020, and available only in February 2020. Materials and Methods: The study was prospective, cross-sectional, population-based, and age-stratified, to assess SARS-COV2 IgM/IgG in the population of Misrata. The authors highly recommend further precautionary public measures, as well as an ongoing surveillance programme to monitor the epidemiological trends of the disease in the city of Misrata and Libya in general

Objectives

Methods

Results

Conclusion