Eastern Cape Healthcare Workers Acquisition of SARS-CoV-2 (ECHAS): Cross-Sectional (Nested Cohort) Study Protocol

Oladele Vincent Adeniyi, David Stead, Mandisa Singata-Madliki, Joanne Batting, Leo Hyera, Eloise Jelliman, Shareef Abrahams and Andrew Parrish
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Oladele Vincent Adeniyi: Department of Family Medicine, Cecilia Makiwane Hospital, East London 5219, South Africa
David Stead: Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa
Mandisa Singata-Madliki: Effective Care Research Unit, Department of Obstetrics & Gynaecology, Frere Hospital, East London 5247, South Africa
Joanne Batting: Effective Care Research Unit, Department of Obstetrics & Gynaecology, Frere Hospital, East London 5247, South Africa
Leo Hyera: Department of Obstetrics & Gynaecology, Cecilia Makiwane Hospital, East London 5219, South Africa
Eloise Jelliman: Department of Radiology, Frere Hospital, East London 5247, South Africa
Shareef Abrahams: Department of Pathology, Division of Medical Microbiology, National Health Laboratory Service, Port Elizabeth 6020, South Africa
Andrew Parrish: Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa

IJERPH, 2021, vol. 18, issue 1, 1-9

Abstract: Healthcare workers (HCWs) are at increased risk of infection by the virulent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Though data exist on the positivity rate of the SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) test as well as COVID-19-related deaths amongst HCWs in South Africa, the overall infection rate remains underestimated by these indicators. It is also unclear whether the humoral immune response after SARS-CoV-2 infection offers durable protection against reinfection. This study will assess the SARS-CoV-2 seroprevalence amongst HCWs in the Eastern Cape (EC) and examine the longitudinal changes (rate of decay) in the antibody levels after infection in this cohort. Using a multi-stage cluster sampling of healthcare workers in selected health facilities in the EC, a cross-sectional study of 2250 participants will be recruited. In order to assess the community infection rate, 750 antenatal women in the same settings will be recruited. Relevant demographic and clinical characteristics will be obtained by a self-administered questionnaire. A chemiluminescent microparticle immunoassay (CMIA) will be used for the qualitative detection of IgG antibodies against SARS-CoV-2 nucleocapsid protein. A nested cohort study will be conducted by performing eight-weekly antibody assays (X2) from 201 participants who tested positive for both SARS-CoV-2 RT-PCR and serology. Logistic regression models will be fitted to identify the independent risk factors for SARS-CoV-2 infection. The cumulative SARS-CoV-2 infection rate and infection fatality rate among the frontline HCWs will be estimated. In addition, the study will highlight the overall effectiveness of infection prevention and control measures (IPC) per exposure sites/wards at the selected health facilities. Findings will inform the South African Department of Health’s policies on how to protect HCWs better as the country prepares for the second wave of the SARS-CoV pandemic.

Keywords: Eastern Cape; healthcare workers; SARS-CoV-2 RT-PCR; SARS-CoV-2 serology; South Africa (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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