Widespread SARS-CoV-2 exposure in West Africa: findings from a 20,748-participant multi-country seroepidemiology study

Background Africa seemed to have had low SARS-CoV-2 infection and COVID-19 morbidity and mortality. While several studies reported high SARS-CoV-2 seropositivity among healthy Africans, others hypothesized that this could have resulted from pre-existing cross-reactive antibodies. Our study tracks trends in seropositivity across three West African countries during the Delta- and Omicron-dominant pandemic periods using validated SARS-CoV-2 IgG/IgM rapid diagnostic tests (Prestige Diagnostics in Ghana and Burkina Faso; SD Biosensor in Nigeria). Methods Cross-sectional studies were conducted in three West African countries (Burkina Faso, Ghana, and Nigeria), with study sites conveniently selected within each country. Using validated immunoassay kits with published validation procedures, SARS-CoV-2 antibodies were detected in peripheral blood during the Delta- and Omicron-dominant periods. Because we did not perform widespread viral sequencing on participant samples, we could not attribute seropositivity to a specific variant; instead, we classified sampling periods by the variant reported as dominant nationally/globally at the time of sample collection. Participants’ demographic and clinical data were obtained using a semi-structured questionnaire, and the primary outcome was the proportion of each population with SARS-CoV-2 antibodies. Results Across the 3 countries, 20,748 participants were recruited, and SARS-CoV-2 IgG seropositivity ranged from 24.1 to 76.4%, with higher rates during the Omicron-dominant period. All sites showed low self-reported vaccination rates, suggesting that seropositivity may be primarily driven by natural infection rather than vaccination. While there was a significant positive association between seropositivity and age across all sites, the association with other demographic factors was country-dependent, and most participants expressed positive opinions of vaccination. Conclusion This is one of the largest multi-country community-based SARS-CoV-2 seroepidemiology studies in Africa, showing widespread exposure to SARS-CoV-2 infection among our study population across three West African countries. These findings are consistent with a marked disconnect between high population exposure and low reported clinical burden, underscoring the need for strengthened community surveillance.

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Journal
Frontiers in Public Health
Published
2026-10-26
DOI
https://doi.org/10.3389/fpubh.2026.1945355
Primary Topic
SARS-CoV-2 and COVID-19 Research
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article
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article

Widespread SARS-CoV-2 exposure in West Africa: findings from a 20,748-participant multi-country seroepidemiology study

Daniel Oduro‐Mensah, Patrick Kuma‐Aboagye, Okechukwu Ukpabi, Ojide Chiedozie Kingsley et al.
Frontiers in Public Health
SARS-CoV-2 and COVID-19 Research
article

Widespread SARS-CoV-2 exposure in West Africa: findings from a 20,748-participant multi-country seroepidemiology study

Daniel Oduro‐Mensah, Patrick Kuma‐Aboagye, Okechukwu Ukpabi, Ojide Chiedozie Kingsley, Aniefiok John Udoakang, Reuben Ayivor-Djanie, Alphonse Ouédraogo, Kesego Tapela, Collins Misita Morang’a, Paul Armah Aryee, Sylvester Dassah, Kwabena Amofa Nketia Sarpong, Gordon A. Awandare, Precious Chinonyerem Opurum, Kyerewaa Akuamoah Boateng, Oladele Oluwafemi Ayodeji, Charles Guissou, Jamilu Abubakar Bala, Hadiza Shehu Galadanci, Olivia A. Achonduh-Atijegbe, Francis Dzabeng, Kazeem O. Akano, Peter K. Quashie, Rufai Umar Zubair, Denise Hien, Akinola Nelson Adedosu, Sharif Alhassan Abdullahi, Mahfuz Muhammad Haddad, James Duah, Johnson C. Okolie, Onikepe A. Folarin, George Agyei, Chukwuyem Abejegah, Franklin Asiedu‐Bekoe, William Ampofo, Dominic S. Y. Amuzu, Lucas Naam-Kayagre Amenga-Etego, Maurice S. Ouattara, Patrick Williams Narkwa, Augustine M. Abu, Nicholas E. Oyejide, Yaw Bediako, Irene Amoakoh Owusu, Isah Abubakar Aliyu, Mohamed Mutocheluh, Christian Tientcha Happi, Gideon Kofi Helegbe, Taiwo Gboluwaga Amole, Michael Fokuo Ofori, Jones Gyamfi, Fatima O. Oyawoye, James Abugri, Samuel Sindié Sermé, Gloria Amegatcher, Moyosoore Osoba, David Amoah Afrifa, Dzidzor Yawa Ayeke, Ajibade Olufunke Olayemi, Ajayi Nnennaya, Okoro Sylvanus Ihere, Bismark Adade, James Ekow Sampah, William Oduro-Obeng, Janet Ogoe-Anderson, Nicholas Aloba Amekpordi, Bismark Akwasi Opoku, Rachael Boateng Obeng, Khadija Muhammad Bala, Gifty Amponsah, Léa Paré-Toé, Liasu Adeagbo Ahmed, Bazoumana B. D. Sow, Nura Garba, Peter Yeboah, Sodiomon B. Sirima, Safiatu Alhassan, Samed Ishaq, Baba Maiyaki Musa, Kwabena Obeng Duedu, Evans Agyapong Owusu, Manfreddy Binyet, Nebié Issa, Nikiema Sindimbasba Achille, Abdulai Diabate, Moumouni Armel Sanou, Boateng Benjamin, Azuogu Benedict, Bismark Minna
article en

Abstract

Background Africa seemed to have had low SARS-CoV-2 infection and COVID-19 morbidity and mortality. While several studies reported high SARS-CoV-2 seropositivity among healthy Africans, others hypothesized that this could have resulted from pre-existing cross-reactive antibodies. Our study tracks trends in seropositivity across three West African countries during the Delta- and Omicron-dominant pandemic periods using validated SARS-CoV-2 IgG/IgM rapid diagnostic tests (Prestige Diagnostics in Ghana and Burkina Faso; SD Biosensor in Nigeria). Methods Cross-sectional studies were conducted in three West African countries (Burkina Faso, Ghana, and Nigeria), with study sites conveniently selected within each country. Using validated immunoassay kits with published validation procedures, SARS-CoV-2 antibodies were detected in peripheral blood during the Delta- and Omicron-dominant periods. Because we did not perform widespread viral sequencing on participant samples, we could not attribute seropositivity to a specific variant; instead, we classified sampling periods by the variant reported as dominant nationally/globally at the time of sample collection. Participants’ demographic and clinical data were obtained using a semi-structured questionnaire, and the primary outcome was the proportion of each population with SARS-CoV-2 antibodies. Results Across the 3 countries, 20,748 participants were recruited, and SARS-CoV-2 IgG seropositivity ranged from 24.1 to 76.4%, with higher rates during the Omicron-dominant period. All sites showed low self-reported vaccination rates, suggesting that seropositivity may be primarily driven by natural infection rather than vaccination. While there was a significant positive association between seropositivity and age across all sites, the association with other demographic factors was country-dependent, and most participants expressed positive opinions of vaccination. Conclusion This is one of the largest multi-country community-based SARS-CoV-2 seroepidemiology studies in Africa, showing widespread exposure to SARS-CoV-2 infection among our study population across three West African countries. These findings are consistent with a marked disconnect between high population exposure and low reported clinical burden, underscoring the need for strengthened community surveillance.

Frontiers in Public HealthVol. 14
University of Ghana (GH), University of Health and Allied Sciences (GH), Redeemer's University (NG), St. Elizabeth Hospital in Enumclaw (US), St. Patrick Hospital (US), The Francis Crick Institute (GB), Kwame Nkrumah University of Science and Technology (GH), Nazi Boni University (BF), Noguchi Memorial Institute for Medical Research (GH), St. Peter's Hospital (CA), Christian Health Association of Nigeria (NG), St. Patrick's Hospital (IE), Kwame Nkrumah University (ZM), Christian Health Association of Malawi (MW), Aminu Kano Teaching Hospital (NG), Ghana Health Service (GH), Institut de Recherche en Sciences de la Santé (BF), C.K. Tedam University of Technology and Applied Sciences (GH), West African Centre for Cell Biology of Infectious Pathogens (GH), University for Development Studies (GH), Bayero University Kano (NG)
Openalex Percentile: Top 12%
SARS-CoV-2 and COVID-19 Research
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