{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T23:50:52Z","timestamp":1784245852384,"version":"3.55.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"name":"United Kingdom Foreign"},{"name":"Commonwealth and Development Office","award":["221003\/Z\/20\/Z"],"award-info":[{"award-number":["221003\/Z\/20\/Z"]}]},{"DOI":"10.13039\/100000030","name":"US Centers for Disease Control and Prevention","doi-asserted-by":"crossref","award":["5U01IP001048-05-00"],"award-info":[{"award-number":["5U01IP001048-05-00"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Seroprevalence studies are important for quantifying the burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in resource-constrained countries.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a cross-sectional household survey spanning the second pandemic wave (November 2020 to April 2021) in 3 communities. Blood was collected for SARS-CoV-2 antibody (2 enzyme-linked immunosorbent assays targeting spike and nucleocapsid) and human immunodeficiency virus (HIV) testing. An individual was considered seropositive if testing positive on \u22651 assay. Factors associated with infection, and the age-standardized infection case detection rate, infection hospitalization rate, and infection fatality rate were calculated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 7959 participants were enrolled, with a median age of 34 years and an HIV prevalence of 22.7%. SARS-CoV-2 seroprevalence was 45.2% (95% confidence interval 43.7%\u201346.7%) and increased from 26.9% among individuals enrolled in December 2020 to 47.1% among those enrolled in April 2021. On multivariable analysis, seropositivity was associated with age, sex, race, being overweight\/obese, having respiratory symptoms, and low socioeconomic status. Persons living with HIV with high viral load were less likely to be seropositive than HIV-uninfected individuals. The site-specific infection case detection rate, infection hospitalization rate, and infection fatality rate ranged across sites from 4.4% to 8.2%, 1.2% to 2.5%, and 0.3% to 0.6%, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>South Africa has experienced a large burden of SARS-CoV-2 infections, with &amp;lt;10% of infections diagnosed. Lower seroprevalence among persons living with HIV who are not virally suppressed, likely as a result of inadequate antibody production, highlights the need to prioritize this group for intervention.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciac198","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T12:21:40Z","timestamp":1646828500000},"page":"e57-e68","source":"Crossref","is-referenced-by-count":18,"title":["Seroprevalence of Severe Acute Respiratory Syndrome Coronavirus 2 After the Second Wave in South Africa in Human Immunodeficiency Virus\u2013Infected and Uninfected Persons: A Cross-Sectional Household Survey"],"prefix":"10.1093","volume":"75","author":[{"given":"Nicole","family":"Wolter","sequence":"first","affiliation":[{"name":"Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service , Johannesburg , South Africa"},{"name":"School of Pathology, 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the Witwatersrand , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinal N","family":"Bhiman","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service , Johannesburg , South Africa"},{"name":"School of Pathology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sibongile","family":"Walaza","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service , Johannesburg , South Africa"},{"name":"School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackie","family":"Kleynhans","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service , Johannesburg , South Africa"},{"name":"School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocelyn","family":"Moyes","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service , Johannesburg , South Africa"},{"name":"School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Buys","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith L","family":"McMorrow","sequence":"additional","affiliation":[{"name":"Influenza Division, Centers for Disease Control and Prevention , Atlanta , Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Aitken","sequence":"additional","affiliation":[{"name":"Genesis Analytics , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Magni","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa"},{"name":"Genesis Analytics , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Yun","sequence":"additional","affiliation":[{"name":"Genesis Analytics , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamika","family":"Fellows","sequence":"additional","affiliation":[{"name":"Genesis Analytics , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetelo","family":"Maakamedi","sequence":"additional","affiliation":[{"name":"Genesis Analytics , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renay","family":"Weiner","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South 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