Seroprevalence of SARS-CoV-2 in slums and non-slums of Mumbai, India, during June 29-July 19, 2020

  1. Anup Malani
  2. Daksha Shah
  3. Gagandeep Kang
  4. Gayatri Nair Lobo
  5. Jayanthi Shastri
  6. Manoj Mohanan
  7. Rajesh Jain
  8. Sachee Agrawal
  9. Sandeep Juneja
  10. Sofia Imad
  11. Ullas Kolthur
2 evaluations Published on
Read the full article Related papers
This article on Sciety

Abstract

Objective

Estimate seroprevalence in representative samples from slum and non-slum communities in Mumbai, India, a mega-city in a low or middle-income country and test if prevalence is different in slums.

Design

After geographically-spaced community sampling of households, one individual per household was tested for IgG antibodies to SARS-CoV-2 N-protein in a two-week interval.

Setting

Slum and non-slum communities in three wards, one each from the three main zones of Mumbai.

Participants

Individuals over age 12 who consent to and have no contraindications to venipuncture were eligible. 6,904 participants (4,202 from slums and 2,702 from non-slums) were tested.

Main outcome measures

The primary outcomes were the positive test rate for IgG antibodies to the SARS-CoV-2 N-protein by demographic group (age and gender) and location (slums and non-slums). The secondary outcome is seroprevalence at slum and non-slum levels. Sera was tested via chemiluminescence (CLIA) using Abbott Diagnostics ArchitectTM N-protein based test. Seroprevalence was calculated using weights to match the population distribution by age and gender and accounting for imperfect sensitivity and specificity of the test.

Results

The positive test rate was 54.1% (95% CI: 52.7 to 55.6) and 16.1% (95% CI: 14.9 to 17.4) in slums and non-slums, respectively, a difference of 38 percentage points (P < 0.001). Accounting for imperfect accuracy of tests (e.g., sensitivity, 0.90; specificity 1.00), seroprevalence was as high as 58.4% (95% CI: 56.8 to 59.9) and 17.3% (95% CI: 16 to 18.7) in slums and non-slums, respectively.

Conclusions

The high seroprevalence in slums implies a moderate infection fatality rate. The stark difference in seroprevalence across slums and non-slums has implications for the efficacy of social distancing, the level of herd immunity, and equity. It underlines the importance of geographic specificity and urban structure in modeling SARS-CoV-2.

Related articles

Related articles are currently not available for this article.