Prevalence of SARS-CoV-2 and Associated Factors Among Individuals During the Second Wave of Infection in Yaounde, Cameroon

Abstract

Background: The first case of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported in Cameroon on March 5, 2020, in Yaounde. Since then, viral propagation occurred nationwide with a higher burden in urban settings and limited evidence on transmission patterns. Our objective was to determine the prevalence of SARS-CoV-2 and associated factors among individuals in urban settings of Cameroon during the second wave of the pandemic. Methods: a population-based cross-sectional survey was conducted from January 18 to April 26, 2021, among 807 consenting individuals living in four major districts of the city of Yaoundé. Out of 711 nasopharyngeal swabs collected, 671 tests were performed by SARS-CoV-2 ribonucleic acid (RNA) extraction and real time-polymerase chain reaction (RT-PCR) at the National Public Health Laboratory (NPHL). Data were analysed using SPSS v21.0, with p < 0.05 considered statistically significant. Results: overall SARS-CoV-2 RNA positivity rate was 11.62% (78/671), without any significant difference between males and females with 10.9% versus 12.20% respectively (OR = 0.87, p = 0.5). However, clinical status was associated with SARS-CoV-2 RNA positivity rate in symptomatic (26.3%) vs. asymptomatic (9.7%) individuals (Odds Ratio [OR] = 3.30, p = 0.0001). Other factors associated with SARS-CoV-2 RNA positivity include exposure to more than 15min with confirmed cases, wearing a non-conventional facemask (p ˂ 0.05), the practice of occasional hand hygiene before and after contact with patients (OR = 3.60, p < 0.0001) or always as recommended (OR = 0.28, p = 0.0001), hand hygiene before and after occasional contact with objects (OR = 2.05, p = 0.0043) or always as recommended (OR = 0.48, p = 0.0027), surgical mask (OR = 0.17, p = 0.013) and standard mask (p = 0.026). Conclusion: From this urban setting of Cameroon, coronavirus disease 2019 (COVID-19) reached an alert burden (10-20%) during the second wave of the pandemic at the district level. Interestingly, SARS-CoV-2 infection was driven by the presence of symptoms, close contact with confirmed cases, limited adherence to recommended barrier measures, and the use of non-conventional facemasks.