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SARS-CoV-2 Antibody Prevalence in India: Findings from the Second Nationwide Household Serosurvey, August - September 2020
Background: The first round of national serosurvey in India was conducted in May-June 2020 among adults from 21 States. The second serosurvey was conducted in August-September 2020 to estimate the nationwide seroprevalence for SARS-CoV-2 infection in the general population aged ten years and above.
Methods: The household serosurvey was conducted among individuals aged ten years and above in the same 700 villages and wards from 70 districts selected during the first serosurvey. Blood samples were tested using the Abbott SARS-CoV-2 IgG assay. Seroprevalence was estimated after applying the sampling weights and adjusting for clustering and assay characteristics. In order to compare the adult seroprevalence between the two surveys, we randomly selected one adult serum sample from each household.
Findings: The weighted and adjusted prevalence of infection among 29,082 individuals aged ten years and above was 6·6% (95% CI: 5·8% - 7·4%). The seroprevalence among adults was 7·1% (95% CI: 6·2% – 8·2%). Seroprevalence was similar across age groups, sex, and occupation. Seroprevalence was highest in urban slum areas followed by urban non-slum and rural areas. We estimated a cumulative 74·3 million infections in the country, with 26 – 32 infections for every reported COVID-19 case by August 2020.
Interpretation: Nearly one in 15 individuals aged ten years and above had SARS-CoV-2 infection by August 2020. The adult seroprevalence increased ten times between May and August 2020. Lower infection to case ratio in August compared to May reflects a substantial increase in testing across the country.
Funding: The study was funded by the Indian Council of Medical Research, New Delhi, India. The study sponsor was involved in reviewing the study design, writing of the manuscript and the decision to submit the paper for publication.
Declaration of Interests: The authors declare no competing interests.
Ethics Approval Statement: The authors obtained written informed consent from individuals aged 18 years and older. We obtained assent from children aged between 10–17 years, and written informed consent from their parents or guardians prior to the survey. The Central Ethics Committee of Health Research of Indian Council of Medical Research and the Institutional Human Ethics Committee of ICMR-National Institute of Epidemiology, Chennai approved the study protocol.
Murhekar, Manoj V. and Bhatnagar, Tarun and Selvaraju, Sriram and Saravanakumar, V. and Thangaraj, Jeromie Wesley Vivian and Shah, Naman and Kumar, Muthusamy Santhosh and Rade, Kiran and Sabarinathan, R. and Asthana, Smita and Balachandar, Rakesh and Bangar, Sampada Dipak and Bansal, Avi Kumar and Bhat, Jyothi and Chopra, Vishal and Das, Dasarathi and Deb, Alok Kumar and Devi, Kangjam Rekha and Dwivedi, Gaurav Raj and Khan, S. Muhammad Salim and Kumar, C.P. Girish and Kumar, M. Sunil and Laxmaiah, Avula and Madhukar, Major and Mahapatra, Amarendra and Mohanty, Suman Sundar and Rangaraju, Chethana and Turuk, Alka and Baradwaj, Dinesh Kumar and Chahal, Ashrafjit S. and Debnath, Falguni and Haq, Inaamul and Kalliath, Arshad and Kanungo, Srikanta and Kanungo, Srikanta and Kshatri, Jaya Singh and Kshatri, Jaya Singh and Naga Lakshmi, Gangeti Gandhi Jayanthi and Naga Lakshmi, Gangeti Gandhi Jayanthi and Mitra, Anindya and Nirmala, A.R. and Prasad, Ganta Venkata and Prasad, Ganta Venkata and Qurieshi, Mariya Amin and Sahay, Seema and Sangwan, Ramesh Kumar and Sekar, Krithikaa and Shukla, Vijay Kumar and Singh, Prashant Kumar and Singh, Pushpendra and Singh, Rajeev and Varma, Dantuluri Sheethal and Varma, Dantuluri Sheethal and Viramgami, Ankit and Panda, Samiran and Reddy, D.C.S. and Bhargava, Balram and Group, ICMR Serosurveillance, SARS-CoV-2 Antibody Prevalence in India: Findings from the Second Nationwide Household Serosurvey, August - September 2020. Available at SSRN: https://ssrn.com/abstract=3715460 or http://dx.doi.org/10.2139/ssrn.3715460
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