Assessing SARS-CoV-2 transmission in African households from the reanalysis of serosurveys
Household transmission studies provided key insights on SARS-CoV-2 transmission in high-income countries but were rarely implemented in Africa. To help fill this gap, we analyzed SARS-CoV-2 seroprevalence studies with a household-based recruitment, focussing on households with ≤7 members, in four Sub-Saharan African cities: Kinshasa (82 households, 370 individuals), Lubumbashi (225 households, 970 individuals), Conakry (149 households, 649 individuals), and Yaoundé (311 households, 1,183 individuals), between late 2020 and mid-2021. Using an extended chain-binomial model accounting for missing serology, we estimated both the probability of community-acquired infection and within-household transmission. The proportion infected in the community rose sharply over time, reaching up to 73% by June 2021. Household transmission varied by location, with secondary attack rates (SAR) ranging from 8.9% to 26.7%, and households accounting for 9% to 28% of infections. Simulations showed that including households with missing serology improved the precision of estimates without introducing bias. SAR estimates were consistent with findings from South Africa and slightly lower than global pooled estimates, mostly from high-income settings, suggesting different transmission dynamics in African contexts. Our approach for handling missing serology can improve transmission estimates accuracy.
Authors
- Jean-François Étard (ORCID: https://orcid.org/0000-0002-4873-0788)
- Nathanaël Hozé (ORCID: https://orcid.org/0000-0002-3977-8966)
- Benjamín Roche (ORCID: https://orcid.org/0000-0001-7975-4232)
- Simon Cauchemez (ORCID: https://orcid.org/0000-0001-9186-4549)
- Abdoulaye Touré (ORCID: https://orcid.org/0000-0003-2269-6611)
- Emilande Guichet (ORCID: https://orcid.org/0000-0003-0380-2044)
- Francis Atéba Ndongo (ORCID: https://orcid.org/0000-0002-0745-1715)
- Lina Cristancho Fajardo (ORCID: https://orcid.org/0000-0001-7216-4037)
- Yves Asuni Izia
- Jacques Muzinga (ORCID: https://orcid.org/0000-0002-4483-116X)
- Antoine Nkuba-Ndaye
- Sheila Makiala‐Mandanda (ORCID: https://orcid.org/0000-0002-4261-4399)
- Placide Mbala‐Kingebeni (ORCID: https://orcid.org/0000-0003-1556-3570)
- Éric Delaporte (ORCID: https://orcid.org/0000-0002-1822-9853)
- Martine Peeters (ORCID: https://orcid.org/0000-0001-6738-8730)
- Steve Ahuka‐Mundeke (ORCID: https://orcid.org/0009-0009-5210-864X)
- Ahidjo Ayouba (ORCID: https://orcid.org/0000-0002-5081-1632)
- Paul Tshiminyi-Munkamba
- Mamadou Saliou Kalifa Diallo (ORCID: https://orcid.org/0000-0002-9742-8702)
- Abou Aissata Soumah (ORCID: https://orcid.org/0009-0009-1027-2302)
- Birgit Nikolay (ORCID: https://orcid.org/0000-0003-1291-7599)
- Erica Simons
- Anne‐Cécile Zoung‐Kanyi Bissek
Institutions
- Centre National de la Recherche Scientifique (FR)
- University of Lubumbashi (CD)
- Inserm (FR)
- Institut Pasteur (FR)
- Université de Montpellier (FR)
- Université Paris Cité (FR)
- University of Kinshasa (CD)
- Sorbonne Université (FR)
- Maladies Infectieuses et Vecteurs: Écologie, Génétique, Évolution et Contrôle (FR)
- Université Sorbonne Paris Nord (FR)
- Sorbonne Paris Cité (FR)
- Gamal Abdel Nasser University of Conakry (GN)
- Central Hospital of Yaoundé (CM)
- Epicentre (South Africa) (ZA)
- Médecins Sans Frontières (GB)
- Epigénétique et Destin Cellulaire (FR)
- National Institute of Biomedical Research (CD)
- National Radiation Protection Agency of Cameroon (CM)
- Ministry of Public Health (CM)
- Médecins Sans Frontières (FR)
- Institut de Recherche pour le Développement (FR)
Publication Details
- Journal
- American Journal of Epidemiology
- Published
- 2025-12-04
- DOI
- https://doi.org/10.1093/aje/kwaf269
- Primary Topic
- COVID-19 epidemiological studies
- Type
- article
- Field-Weighted Citation Impact
- 0.00