COVID-19 SEROPREVALENCE STUDY AMONG MALAYSIA'S GENERAL POPULATION UP TO EARLY OCTOBER 2020
Intro: Coronavirus disease 2019 (COVID-19) began spreading in Malaysia since February 2020. Within months, the epidemic curve was flattened through strict public health measures and the number of confirmed cases remained low. But actual disease burden may be higher due to asymptomatic and undiagnose...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | International Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971223005830 |
| _version_ | 1797745280929497088 |
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| author | Z.L. Chong W.S. Rodzlan Hasani R. Thayan M.H. Abdul Mutalip |
| author_facet | Z.L. Chong W.S. Rodzlan Hasani R. Thayan M.H. Abdul Mutalip |
| author_sort | Z.L. Chong |
| collection | DOAJ |
| description | Intro: Coronavirus disease 2019 (COVID-19) began spreading in Malaysia since February 2020. Within months, the epidemic curve was flattened through strict public health measures and the number of confirmed cases remained low. But actual disease burden may be higher due to asymptomatic and undiagnosed COVID-19. This study aimed to determine the seroprevalence of COVID-19 and the proportion of asymptomatic and undiagnosed infections among Malaysia's general population. Methods: This cross-sectional seroprevalence study was conducted nationwide from 7 August to 11 October 2020. A two-stage stratified random cluster sampling design was used to select representative general populations aged ≥1 year-old. Participants provided their history of COVID-19 symptoms and diagnosis. Their blood specimens were tested with Wantai SARS-CoV-2 Total Antibody enzyme-linked immunosorbent assay first, and then GenScript SARSCoV-2 Surrogate Virus Neutralization Test. Participants with positive results on both tests were defined as having past COVID-19. Prevalence estimates and proportions were computed using complex sampling design analysis with weightage. Findings: A total of 5131 people participated, representing 30,763,427 of Malaysia's general population. The estimated population with past COVID-19 was 150,857, translating to an overall weighted COVID-19 seroprevalence of 0.49% (95%CI 0.28-0.85). Adults aged ≥18 year-old were significantly more likely to be infected (p=0.003), with 142,593 estimated past COVID-19 and 0.63% (95%CI 0.36-1.11) weighted prevalence. Among those with past COVID-19, the proportion of asymptomatic and undiagnosed infections was 84.1% (95%CI 58.9-95.1) and 90.1% (95%CI: 67.1-97.6), respectively. Discussion: COVID-19 seroprevalence in Malaysia up to early October 2020 was low, but higher among adults possibly due to higher mobility. High proportion of asymptomatic and undiagnosed infections pointed to underreporting and justified mass testing strategy using more cost-efficient SARS-CoV-2 antigen rapid test kits. Conclusion: The actual burden of COVID-19 was low but underreported in Malaysia during the first year of the pandemic. Repeated COVID-19 seroprevalence studies would be required as pandemic progresses. |
| first_indexed | 2024-03-12T15:22:08Z |
| format | Article |
| id | doaj.art-baeb3a652f284d6e9cdca8b2ca433513 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-03-12T15:22:08Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-baeb3a652f284d6e9cdca8b2ca4335132023-08-11T05:32:14ZengElsevierInternational Journal of Infectious Diseases1201-97122023-08-01134S5COVID-19 SEROPREVALENCE STUDY AMONG MALAYSIA'S GENERAL POPULATION UP TO EARLY OCTOBER 2020Z.L. Chong0W.S. Rodzlan Hasani1R. Thayan2M.H. Abdul Mutalip3Institute for Public Health, Centre for Communicable Disease Epidemiology Research, Shah Alam, MalaysiaInstitute for Public Health, Centre for Noncommunicable Disease Research, Shah Alam, MalaysiaInstitute for Medical Research, Infectious Disease Research Centre, Shah Alam, MalaysiaInstitute for Public Health, Centre for Communicable Disease Epidemiology Research, Shah Alam, MalaysiaIntro: Coronavirus disease 2019 (COVID-19) began spreading in Malaysia since February 2020. Within months, the epidemic curve was flattened through strict public health measures and the number of confirmed cases remained low. But actual disease burden may be higher due to asymptomatic and undiagnosed COVID-19. This study aimed to determine the seroprevalence of COVID-19 and the proportion of asymptomatic and undiagnosed infections among Malaysia's general population. Methods: This cross-sectional seroprevalence study was conducted nationwide from 7 August to 11 October 2020. A two-stage stratified random cluster sampling design was used to select representative general populations aged ≥1 year-old. Participants provided their history of COVID-19 symptoms and diagnosis. Their blood specimens were tested with Wantai SARS-CoV-2 Total Antibody enzyme-linked immunosorbent assay first, and then GenScript SARSCoV-2 Surrogate Virus Neutralization Test. Participants with positive results on both tests were defined as having past COVID-19. Prevalence estimates and proportions were computed using complex sampling design analysis with weightage. Findings: A total of 5131 people participated, representing 30,763,427 of Malaysia's general population. The estimated population with past COVID-19 was 150,857, translating to an overall weighted COVID-19 seroprevalence of 0.49% (95%CI 0.28-0.85). Adults aged ≥18 year-old were significantly more likely to be infected (p=0.003), with 142,593 estimated past COVID-19 and 0.63% (95%CI 0.36-1.11) weighted prevalence. Among those with past COVID-19, the proportion of asymptomatic and undiagnosed infections was 84.1% (95%CI 58.9-95.1) and 90.1% (95%CI: 67.1-97.6), respectively. Discussion: COVID-19 seroprevalence in Malaysia up to early October 2020 was low, but higher among adults possibly due to higher mobility. High proportion of asymptomatic and undiagnosed infections pointed to underreporting and justified mass testing strategy using more cost-efficient SARS-CoV-2 antigen rapid test kits. Conclusion: The actual burden of COVID-19 was low but underreported in Malaysia during the first year of the pandemic. Repeated COVID-19 seroprevalence studies would be required as pandemic progresses.http://www.sciencedirect.com/science/article/pii/S1201971223005830 |
| spellingShingle | Z.L. Chong W.S. Rodzlan Hasani R. Thayan M.H. Abdul Mutalip COVID-19 SEROPREVALENCE STUDY AMONG MALAYSIA'S GENERAL POPULATION UP TO EARLY OCTOBER 2020 International Journal of Infectious Diseases |
| title | COVID-19 SEROPREVALENCE STUDY AMONG MALAYSIA'S GENERAL POPULATION UP TO EARLY OCTOBER 2020 |
| title_full | COVID-19 SEROPREVALENCE STUDY AMONG MALAYSIA'S GENERAL POPULATION UP TO EARLY OCTOBER 2020 |
| title_fullStr | COVID-19 SEROPREVALENCE STUDY AMONG MALAYSIA'S GENERAL POPULATION UP TO EARLY OCTOBER 2020 |
| title_full_unstemmed | COVID-19 SEROPREVALENCE STUDY AMONG MALAYSIA'S GENERAL POPULATION UP TO EARLY OCTOBER 2020 |
| title_short | COVID-19 SEROPREVALENCE STUDY AMONG MALAYSIA'S GENERAL POPULATION UP TO EARLY OCTOBER 2020 |
| title_sort | covid 19 seroprevalence study among malaysia s general population up to early october 2020 |
| url | http://www.sciencedirect.com/science/article/pii/S1201971223005830 |
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