SARS-CoV-2 serological testing in front line health workers in Zimbabwe

Simbarashe Rusakaniko, Elopy Nemele Sibanda, Takafira Mduluza, Paradzayi Tagwireyi, Zephaniah Dlamini, Chiratidzo Ellen Ndhlovu, Precious Chandiwana, Shingirai Chiwambutsa, Rivka Lim, Fiona Scott, Lindiwe Majele Sibanda, Francisca Mutapi

Research output: Contribution to journalArticlepeer-review


In order to protect health workers from SARS-CoV-2, there is need to characteriset he different types of patient facing health workers. Our first aim was to determine both the infection and seroprevalence of SARS-COV-2 in health workers. Our second aim was to evaluate the occupational and demographic predictors of seropositivity to inform the country’s infection prevention and control (IPC) strategy.

Methods and Principal Findings
We invited 713 staff members at 24 out of 35 health facilities in the City of Bulawayo in Zimbabwe. Compliance to testing was defined as the willingness to uptake COVID-19 testing by answering a questionnaire and providing samples for both antibody testing and PCR testing. SARS-COV-2 antibodies were detected using a rapid diagnostic test kit and SAR-COV-2 infection was determined by real-time (RT)-PCR. Of the 713 participants, 635(89%) consented answering the questionnaire and providing blood sample for antibody testing while 560 (78.5%) agreed to provide nasopharyngeal swabs for the PCR COVID-19 testing. Of the 635 people (aged 18-51 73) providing a blood sample 39.1% reported a history of past COVID-19 symptoms while 14.2% reported having current symptoms of COVID-19. The most-prevalent co-morbidity among this group was hypertension (22.0%) followed by asthma (7.0%) and diabetes (6.0%). The SARS-CoV-2 sero-prevalence was 8.9%. Of the 560 participants tested for SARS-CoV-2 infection, 2 participants (0.36%) were positive for SAR-CoV-2 infection by PCR testing. None of the SARS-CoV-2 antibody positive people were positive for SAR-CoV-2 infection by PCR testing.

Conclusion and Interpretation
In addition to clinical staff, several patient-facing health workers were characterised within Zimbabwe’s health system and the seroprevalence data indicated that previous exposure to SAR-CoV-2 had occurred across the full spectrum of patient facing staff with nurses and nurse aides having the highest seroprevalence. Our results highlight the need for including the various health workers in IPC strategies in health centres to ensure effective biosecurity and biosafety.
Original languageEnglish
Article numbere0009254
Number of pages16
JournalPLoS Neglected Tropical Diseases
Issue number3
Publication statusPublished - 31 Mar 2021


  • COVID-19
  • serology
  • SARS-CoV-2
  • IgM
  • IgG
  • RT-PCR
  • health workers


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