{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T16:19:01Z","timestamp":1781885941690,"version":"3.54.5"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>There is limited information on SARS-CoV-2 seroprevalence among children and adolescents in LMIC school settings. We aimed to assess (1) the seroprevalence of SARS-CoV-2 antibodies, (2) prevalence of self-reported or confirmed SARS-CoV-2 prior infections and, (3) COVID-19 symptoms (including long-COVID) among a cohort of primary school learners, their parents and teachers in a semi-rural school setting approximately 3-years into the COVID-19 pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Learners in grades 1\u20137 attending two pre-selected schools in close proximity in the Ndwedwe area, iLembe district, KwaZulu-Natal, South Africa, their parents and teachers were invited to enroll into the COVID Kids Schools Study (CoKiDSS) \u2013 a cross-sectional survey conducted between May\u2013August 2023. All participants provided informed consent, completed a questionnaire and provided a fingerprick of blood for SARS-CoV-2 antibody testing using the COVID-19 IgG\/IgM Rapid Test. Statistical methods included descriptive analysis, jackknife-estimated seroprevalence and incidence (unadjusted and sensitivity-adjusted), and logistic regression using generalized linear models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 645 participants (i.e., 456 learners, 147 parents and 42 teachers) were enrolled into the survey. Overall SARS-CoV-2 IgG seroprevalence was 78% unadjusted to 81% adjusted with an increasing seropositivity trend, from learners to teachers (76% unadjusted to 79% adjusted in learners, 79% unadjusted to 82% adjusted in parents and 93% unadjusted to 97% adjusted in teachers). About 2.6% of learners tested IgM seropositive. Interestingly, 17% of the participants, including 20% learners, tested negative for SARS-CoV-2 antibodies. While only 16 participants (2.5% - 2 learners, 10 parents, and four teachers) self-reported a prior confirmed SARS-CoV-2 infection. Of these 2 learners (100%), eight parents (80%) and 4 teachers (100%) reported COVID-19 like symptoms that persisted for \u226528-days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We reported high SARS-CoV-2 IgG seroprevalence among learners in grades 1\u20137, their parents and teacher approximately 3\u202fyears into the COVID-19 pandemic which may be attributed to the snowball effect of multiple waves of infection in South Africa. However, only a small proportion of participants self-reported prior COVID-19 infection. This may be due to (1) recall bias and participants\u2019 perception of low susceptibility to and severity of COVID-19, (2) limited access to SARS-CoV-2 testing, and\/or (3) a high prevalence of asymptomatic infections.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1548945","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T13:37:39Z","timestamp":1746452259000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["SARS-CoV-2 seroprevalence among learners in grades 1\u20137, their parents and teachers in KwaZulu-Natal, South Africa: a cross-sectional study"],"prefix":"10.3389","volume":"13","author":[{"given":"Reshmi","family":"Dassaye","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terusha","family":"Chetty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brodie","family":"Daniels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trisha","family":"Ramraj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zakir","family":"Gaffoor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Spooner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ncengani","family":"Mthethwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duduzile 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