Abstract
Background: Few studies have prospectively evaluated SARS-CoV-2 infections in households. We assessed the prevalence and incidence of SARS-CoV-2 infections in a prospective study of households in Lima, Peru.Methods: We conducted a prospective cohort study in a peri-urban district of Lima, Peru. Households with at least a child, a young adult (age 18 to 50 years) and an older adult age >50 years, were followed with twice-a-week household visits during a two-month period for health surveillance. Nasal swabs and saliva specimens were collected twice weekly, and nasopharyngeal swabs were collected weekly from each participant, regardless of symptoms. Laboratory-confirmed SARS-CoV-2 infection was defined by two RT-PCR tests from any of the collected specimens within a week. Blood samples collected at enrolment and end of follow-up were tested with rapid serological tests. We calculated the prevalence and incidence of laboratory-confirmed SARS-CoV-2 infections during the study period.Findings: We enrolled 132 participants from 44 households, including 44 children, 44 young adults and 44 older adults. A total of 13 SARS-CoV-2 infections were detected in 9 households, for an overall period prevalence of 9·85% (95% confidence interval [CI]:5·35-16·25). Most (66·67%) infections were symptomatic. Eight of 11 (72·73%) SARS-CoV-2 detections corresponded to the Lambda variant. During 218·79 person-months at risk of follow-up there were six new SARS-CoV-2 infections detected (2·74 per 100 person-month, 95% CI: 1·25– 6·04). At enrollment, 59 of 128 participants tested had positive SARS-CoV-2 IgG serology (46·09%, 95% CI: 37·25-55·12). Five of six new infections occurred among participants with negative baseline serology.Interpretation: We demonstrated high incidence of SARS-CoV-2 infections in households during periods of active circulation of the Lambda variant, especially among subjects without evidence of prior infection, most of them not detected by the Ministry of Health system.Funding Information: Consejo Nacional de Ciencia y Tecnología – CONCYTEC-PROCIENCIA, Lima, Peru (contract No. 082-2020); Vanderbilt University Medical Center, Nashville TN, USA; and Instituto de Investigación Nutricional, Lima, Peru. Declaration of Interests: None to declare. Ethics Approval Statement: The study was approved by the ethics review boards (ERBs) of the Instituto de Investigacion Nutricional and Vanderbilt University. All adults signed their own ERB approved written informed consent form (ICF). For individuals under 18 years of age, either the mother or the father signed an ICF. Additionally, children 8 years and older signed a written informed assent form.
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