Abstract
In Mali, a country in West Africa, cumulative confirmed COVID-19 cases and deaths among healthcare workers (HCWs) remain enigmatically low, despite a series of waves, circulation of SARS-CoV-2 variants, the country’s weak healthcare system, and a general lack of adherence to public health mitigation measures. The goal of the study was to determine whether exposure is important by assessing the seroprevalence of anti-SARS-CoV-2 IgG antibodies in HCWs. The study was conducted between November 2020 and June 2021. HCWs in the major hospitals where COVID-19 cases were being cared for in the capital city, Bamako, Mali, were recruited. During the study period, vaccinations were not yet available. The ELISA of the IgG against the spike protein was optimized and quantitatively measured. A total of 240 HCWs were enrolled in the study, of which seropositivity was observed in 147 cases (61.8%). A continuous increase in the seropositivity was observed, over time, during the study period, from 50% at the beginning to 70% at the end of the study. HCWs who provided direct care to COVID-19 patients and were potentially highly exposed did not have the highest seropositivity rate. Vulnerable HCWs with comorbidities such as obesity, diabetes, and asthma had even higher seropositivity rates at 77.8%, 75.0%, and 66.7%, respectively. Overall, HCWs had high SARS-CoV-2 seroprevalence, likely reflecting a “herd” immunity level, which could be protective at some degrees. These data suggest that the low number of cases and deaths among HCWs in Mali is not due to a lack of occupational exposure to the virus but rather related to other factors that need to be investigated.
Highlights
The coronavirus disease of 2019 (COVID-19), due to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is believed to have emerged in Wuhan, HubeiProvince in China at the end of December 2019 [1]
A total of 240 healthcare workers (HCWs) participants were enrolled in the study, but data for 238 participants were included in the final analysis, as 2 participants had missing information
Among the HCWs, there were those with comorbidities, and the seropositive participants accounted for more comorbidities than seronegative participants, including obesity (87.5% vs. 22.2%), asthma (75.0% vs. 25.0%), and diabetes (66.7% vs. 33.3%)
Summary
The coronavirus disease of 2019 (COVID-19), due to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is believed to have emerged in Wuhan, HubeiProvince in China at the end of December 2019 [1]. The coronavirus disease of 2019 (COVID-19), due to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is believed to have emerged in Wuhan, Hubei. The disease spread rapidly all over the world, with millions of deaths reported [2]. The World Health Organization (WHO), on 30 January 2020, declared the outbreak a “public health emergency of international concern” and on 11 March 2020, defined it as a pandemic disease. 2021, WHO reported nearly 277 million confirmed cases and more than 5.3 million deaths worldwide from COVID-19 [2]. Mali, located in West Africa with an estimated population of 21 million people, recorded its first case of COVID-19 on 25 March 2020, and, as of 24 December 2021, less than 20 thousand confirmed cases and 648 deaths related to COVID-19 had been reported [2] The epicenter of the disease outbreak was first in Asia, in Europe, and later in the United States of America and South America, the WHO predicted and warned that the African continent could become the epicenter, with dire consequences due to the weakness of the healthcare systems and limited resources and organization.
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