{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,22]],"date-time":"2025-02-22T00:41:20Z","timestamp":1740184880382,"version":"3.37.3"},"reference-count":18,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T00:00:00Z","timestamp":1722816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership","doi-asserted-by":"publisher","award":["RIA2020EF-3031"],"award-info":[{"award-number":["RIA2020EF-3031"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>In sub-Saharan Africa, reported COVID-19 numbers have been lower than anticipated, even when considering populations\u2019 younger age. The extent to which risk factors, established in industrialised countries, impact the risk of infection and of disease in populations in sub-Saharan Africa, remains unclear. We estimated the incidence of mild and moderate COVID-19 in urban Mozambique and analysed factors associated with infection and disease in a population-based surveillance study. During December 2020-March 2022, 1,561 households (6,049 participants, median 21 years, 54.8% female, 7.3% disclosed HIV positive) of Polana Cani\u00e7o, Maputo, Mozambique, were visited biweekly to report respiratory symptoms, anosmia, or ageusia, and self-administer a nasal swab for SARS-CoV-2 testing. Every three months, dried blood spots of a subset of participants (1,412) were collected for detection of antibodies against SARS-CoV-2 spike glycoprotein and nucleocapsid protein. Per 1000 person-years, 364.5 (95%CI 352.8\u2013376.1) respiratory illness episodes were reported, of which 72.2 (95%CI 60.6\u201383.9) were COVID-19. SARS-CoV-2 seroprevalence rose from 4.8% (95%CI 1.1\u20138.6%) in December 2020 to 34.7% (95%CI 20.2\u201349.3%) in June 2021, when 3.0% were vaccinated. Increasing age, chronic lung disease, hypertension, and overweight increased risk of COVID-19. Older age increased the risk of SARS-CoV-2 seroconversion. We observed no association between socio-economic status, behaviour and COVID-19 or SARS-CoV-2 seroconversion. Active surveillance in an urban population confirmed frequent COVID-19 underreporting, yet indicated that the large majority of cases were mild and non-febrile. In contrast to reports from industrialised countries, social deprivation did not increase the risk of infection nor disease.<\/jats:p>","DOI":"10.1371\/journal.pgph.0003550","type":"journal-article","created":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T17:33:46Z","timestamp":1722879226000},"page":"e0003550","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mild and moderate COVID-19 during Alpha, Delta and Omicron pandemic waves in urban Maputo, Mozambique, December 2020-March 2022: A population-based surveillance study"],"prefix":"10.1371","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2214-6858","authenticated-orcid":true,"given":"Brecht","family":"Ingelbeen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vict\u00f3ria","family":"Cumbane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4893-6576","authenticated-orcid":true,"given":"Fer\u00e3o","family":"Mandlate","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Barb\u00e9","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheila Mercedes","family":"Nhachungue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nilzio","family":"Cavele","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cremildo","family":"Manhica","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6607-9554","authenticated-orcid":true,"given":"Catildo","family":"Cubai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neusa Maimuna Carlos","family":"Nguenha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Audrey","family":"Lacroix","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7023-445X","authenticated-orcid":true,"given":"Joachim","family":"Mari\u00ebn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anja","family":"de Weggheleire","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"van Kleef","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Selhorst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne A. B.","family":"van der Sande","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martine","family":"Peeters","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc-Alain","family":"Widdowson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1793-9471","authenticated-orcid":true,"given":"Nalia","family":"Ismael","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivalda","family":"Macicame","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,8,5]]},"reference":[{"key":"pgph.0003550.ref001","first-page":"1","article-title":"SARS-CoV-2 infection in Africa: A systematic review and meta-analysis of standardised seroprevalence studies, from January 2020 to December 2021.","volume":"7","author":"HC Lewis","year":"2022","journal-title":"BMJ Glob Heal."},{"key":"pgph.0003550.ref002","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1038\/s41586-020-2918-0","article-title":"Age-specific mortality and immunity patterns of SARS-CoV-2","volume":"590","author":"M O\u2019Driscoll","year":"2020","journal-title":"Nature"},{"key":"pgph.0003550.ref003","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1038\/s41586-020-2521-4","article-title":"Factors associated with COVID-19-related death using OpenSAFELY","volume":"584","author":"EJ Williamson","year":"2020","journal-title":"Nature"},{"key":"pgph.0003550.ref004","doi-asserted-by":"crossref","first-page":"e240","DOI":"10.1016\/S2468-2667(22)00007-X","article-title":"The effect of social deprivation on the dynamic of SARS-CoV-2 infection in France: a population-based analysis","volume":"7","author":"S Vandentorren","year":"2022","journal-title":"Lancet Public Heal"},{"key":"pgph.0003550.ref005","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1016\/S0140-6736(21)00634-6","article-title":"Ethnic differences in SARS-CoV-2 infection and COVID-19-related hospitalisation, intensive care unit admission, and death in 17 million adults in England: an observational cohort study using the OpenSAFELY platform","volume":"397","author":"R Mathur","year":"2021","journal-title":"Lancet"},{"key":"pgph.0003550.ref006","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1038\/s41591-020-0962-9","article-title":"Age-dependent effects in the transmission and control of COVID-19 epidemics","volume":"26","author":"NG Davies","year":"2020","journal-title":"Nat Med"},{"key":"pgph.0003550.ref007","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004107","article-title":"Global SARS-CoV-2 seroprevalence from January 2020 to April 2022: A systematic review and meta-analysis of standardized population-based studies.","volume":"19","author":"I Bergeri","year":"2022","journal-title":"PLoS Med."},{"key":"pgph.0003550.ref008","doi-asserted-by":"crossref","first-page":"e2005","DOI":"10.1093\/cid\/ciaa1198","article-title":"Risk Factors for Coronavirus Disease 2019 (COVID-19) Death in a Population Cohort Study from the Western Cape Province, South Africa.","volume":"73","author":"A Boulle","year":"2021","journal-title":"Clin Infect Dis"},{"key":"pgph.0003550.ref009","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-022-11706-7","article-title":"Understanding how socioeconomic inequalities drive inequalities in COVID-19 infections.","volume":"12","author":"R Laajaj","year":"2022","journal-title":"Sci Rep."},{"key":"pgph.0003550.ref010","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41467-023-42615-6","article-title":"Impact of COVID-19 on mortality in coastal Kenya: a longitudinal open cohort study.","volume":"14","author":"M Otiende","year":"2023","journal-title":"Nat Commun."},{"key":"pgph.0003550.ref011","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1016\/S0140-6736(21)02796-3","article-title":"Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020\u201321","volume":"399","author":"H Wang","year":"2022","journal-title":"Lancet"},{"key":"pgph.0003550.ref012","first-page":"288","article-title":"Evaluating SARS-CoV-2 spike and nucleocapsid proteins as targets for antibody detection in severe and mild COVID-19 cases using a Luminex bead-based assay","author":"J Mari\u00ebn","year":"2021","journal-title":"J Virol Methods"},{"journal-title":"England. Science","article-title":"Estimated transmissibility and impact of SARS-CoV-2 lineage B.1.1.7","author":"NG Davies","key":"pgph.0003550.ref013"},{"key":"pgph.0003550.ref014","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1038\/s41562-021-01079-8","article-title":"A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker).","volume":"5","author":"T Hale","year":"2021","journal-title":"Nat Hum Behav"},{"key":"pgph.0003550.ref015","article-title":"Prospective SARS-CoV-2 cohort study among primary health care providers during the second COVID-19 wave in Flanders, Belgium.","author":"J Mari\u00ebn","year":"2021","journal-title":"Fam Pract"},{"key":"pgph.0003550.ref016","doi-asserted-by":"crossref","first-page":"m1985","DOI":"10.1136\/bmj.m1985","article-title":"Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study","volume":"369","author":"AB Docherty","year":"2020","journal-title":"Br Med J"},{"key":"pgph.0003550.ref017","first-page":"372","article-title":"Socioeconomic status determines COVID-19 incidence and related mortality in Santiago","author":"GE Mena","year":"2021","journal-title":"Chile. Science"},{"key":"pgph.0003550.ref018","first-page":"369","article-title":"Prediction models for diagnosis and prognosis of covid-19: systematic review and critical appraisal","author":"L Wynants","year":"2020","journal-title":"BMJ"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0003550","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T17:34:19Z","timestamp":1722879259000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0003550"}},"subtitle":[],"editor":[{"given":"Nei-yuan","family":"Hsiao","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,8,5]]},"references-count":18,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8,5]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0003550","relation":{},"ISSN":["2767-3375"],"issn-type":[{"type":"electronic","value":"2767-3375"}],"subject":[],"published":{"date-parts":[[2024,8,5]]}}}