학술논문
SARS CoV-2 seroprevalence and diagnostic accuracy during a COVID-19 outbreak in a major penitentiary complex in Brazil, June to July 2020
Document Type
JOURNAL
Author
Gouvea-Reis, Fernando Augusto; Soares da Silva, Danniely Carolinne; Borja, Lairton Souza; Dias, Patrícia de Oliveira; Percio, Jadher; Peterka, Cassio; de Oliveira, Janaína; Sodré, Giselle; Feres, Claudia Mendes; Dos Santos, Wallace; Souza, Fábio; Passarella Teixeira, Ana Izabel; Cilião-Alves, Daiani Cristina; Romero, Gustavo Adolfo Sierra; Ferreira Noronha, Elza; Croda, Julio; Haddad, Rodrigo; Ramalho, Walter Massa; de Moraes, Camile; Araújo, Wildo Navegantes de
Source
International Journal of Prisoner Health, 2022, Vol. 19, Issue 2, pp. 143-156.
Subject
Language
English
ISSN
1744-9200
Abstract
Purpose This study aims to estimate the overall SARS-CoV-2 seroprevalence and evaluate the accuracy of an antibody rapid test compared to a reference serological assay during a COVID-19 outbreak in a prison complex housing over 13,000 prisoners in Brasília. Design/methodology/approach The authors obtained a randomized, stratified representative sample of each prison unit and conducted a repeated serosurvey among prisoners between June and July 2020, using a lateral-flow immunochromatographic assay (LFIA). Samples were also retested using a chemiluminescence enzyme immunoassay (CLIA) to compare SARS-CoV-2 seroprevalence and 21-days incidence, as well as to estimate the overall infection fatality rate (IFR) and determine the diagnostic accuracy of the LFIA test. Findings This study identified 485 eligible individuals and enrolled 460 participants. Baseline and 21-days follow-up seroprevalence were estimated at 52.0% (95% CI 44.9–59.0) and 56.7% (95% CI 48.2–65.3) with LFIA; and 80.7% (95% CI 74.1–87.3) and 81.1% (95% CI 74.4–87.8) with CLIA, with an overall IFR of 0.02%. There were 78.2% (95% CI 66.7–89.7) symptomatic individuals among the positive cases. Sensitivity and specificity of LFIA were estimated at 43.4% and 83.3% for IgM; 46.5% and 91.5% for IgG; and 59.1% and 77.3% for combined tests. Originality/value The authors found high seroprevalence of anti-SARS-CoV-2 antibodies within the prison complex. The occurrence of asymptomatic infection highlights the importance of periodic mass testing in addition to case-finding of symptomatic individuals; however, the field performance of LFIA tests should be validated. This study recommends that vaccination strategies consider the inclusion of prisoners and prison staff in priority groups.