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

@article{udoakang2026widespread,
  title = {{Widespread SARS-CoV-2 exposure in West Africa: findings from a 20,748-participant multi-country seroepidemiology study}},
  author = {Aniefiok John Udoakang and Daniel Oduro-Mensah and Gloria Amegatcher and Onikepe Folarin and Isah Abubakar Aliyu and Irene Amoakoh Owusu and Francis Dzabeng and Alphonse Ouedraogo and Reuben Ayivor-Djanie and Jones Gyamfi and Moumouni Armel Sanou and Kesego Tapela and Manfreddy Binyet and Kyerewaa Akuamoah Boateng and Taiwo Gboluwaga Amole and Johnson Okolie and Baba Maiyaki Musa and Jamilu Abubakar Bala and Kazeem Akano and Ajibade Olufunke Olayemi and Olivia Achonduh-Atijegbe and Ajayi Nnennaya and Okoro Sylvanus Ihere and Azuogu Benedict and Okechukwu Ukpabi and Ojide Chiedozie Kingsley and Augustine Abu and Moyosoore Osoba and Nicholas Oyejide and Evans Agyapong Owusu and Bismark Adade and James Ekow Sampah and Samed Ishaq and George Agyei and Boateng Benjamin and William Oduro-Obeng and Janet Ogoe-Anderson and Nicholas Aloba Amekpordi and Safiatu Alhassan and David Afrifa and Bismark Akwasi Opoku and Oladele Oluwafemi Ayodeji and Chukwuyem Abejegah and Akinola Nelson Adedosu and Liasu Adeagbo Ahmed and Samuel S. Serme and Maurice Ouattara and Denise Hien and Nebié Issa and Rachael O. Boateng and Precious C. Opurum and Fatima O. Oyawoye and Dzidzor Yawa Ayeke and Michael Ofori and Nikiema Sindimbasba Achille and Bazoumana Sow and Lea Pare-Toe and Charles Guissou and Bismark Minna and Gifty Amponsah},
  journal = {Frontiers in Public Health},
  year = {2026},
  month = oct,
  doi = {10.3389/fpubh.2026.1945355},
  url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1945355/full},
  note = {CC BY 4.0},
}

TY  - JOUR
TI  - Widespread SARS-CoV-2 exposure in West Africa: findings from a 20,748-participant multi-country seroepidemiology study
AU  - Aniefiok John Udoakang
AU  - Daniel Oduro-Mensah
AU  - Gloria Amegatcher
AU  - Onikepe Folarin
AU  - Isah Abubakar Aliyu
AU  - Irene Amoakoh Owusu
AU  - Francis Dzabeng
AU  - Alphonse Ouedraogo
AU  - Reuben Ayivor-Djanie
AU  - Jones Gyamfi
AU  - Moumouni Armel Sanou
AU  - Kesego Tapela
AU  - Manfreddy Binyet
AU  - Kyerewaa Akuamoah Boateng
AU  - Taiwo Gboluwaga Amole
AU  - Johnson Okolie
AU  - Baba Maiyaki Musa
AU  - Jamilu Abubakar Bala
AU  - Kazeem Akano
AU  - Ajibade Olufunke Olayemi
AU  - Olivia Achonduh-Atijegbe
AU  - Ajayi Nnennaya
AU  - Okoro Sylvanus Ihere
AU  - Azuogu Benedict
AU  - Okechukwu Ukpabi
AU  - Ojide Chiedozie Kingsley
AU  - Augustine Abu
AU  - Moyosoore Osoba
AU  - Nicholas Oyejide
AU  - Evans Agyapong Owusu
AU  - Bismark Adade
AU  - James Ekow Sampah
AU  - Samed Ishaq
AU  - George Agyei
AU  - Boateng Benjamin
AU  - William Oduro-Obeng
AU  - Janet Ogoe-Anderson
AU  - Nicholas Aloba Amekpordi
AU  - Safiatu Alhassan
AU  - David Afrifa
AU  - Bismark Akwasi Opoku
AU  - Oladele Oluwafemi Ayodeji
AU  - Chukwuyem Abejegah
AU  - Akinola Nelson Adedosu
AU  - Liasu Adeagbo Ahmed
AU  - Samuel S. Serme
AU  - Maurice Ouattara
AU  - Denise Hien
AU  - Nebié Issa
AU  - Rachael O. Boateng
AU  - Precious C. Opurum
AU  - Fatima O. Oyawoye
AU  - Dzidzor Yawa Ayeke
AU  - Michael Ofori
AU  - Nikiema Sindimbasba Achille
AU  - Bazoumana Sow
AU  - Lea Pare-Toe
AU  - Charles Guissou
AU  - Bismark Minna
AU  - Gifty Amponsah
PY  - 2026
DA  - 2026/10/26
JO  - Frontiers in Public Health
DO  - 10.3389/fpubh.2026.1945355
UR  - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1945355/full
AB  - 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.
SN  - 2296-2565
ER  -