International Journal of Infectious Diseases (Jul 2021)
The burden of active infection and anti-SARS-CoV-2 IgG antibodies in the general population: Results from a statewide sentinel-based population survey in Karnataka, India
- Giridhara R. Babu,
- Rajesh Sundaresan,
- Siva Athreya,
- Jawaid Akhtar,
- Pankaj Kumar Pandey,
- Parimala S. Maroor,
- M. Rajagopal Padma,
- R. Lalitha,
- Mohammed Shariff,
- Lalitha Krishnappa,
- C.N. Manjunath,
- Mysore Kalappa Sudarshan,
- Gopalkrishna Gururaj,
- Timmanahalli Sobagaiah Ranganath,
- Kumar D.E. Vasanth,
- Pradeep Banandur,
- Deepa Ravi,
- Shilpa Shiju,
- Eunice Lobo,
- Asish Satapathy,
- Lokesh Alahari,
- Prameela Dinesh,
- Vinitha Thakar,
- Anita Desai,
- Ambica Rangaiah,
- Ashok Munivenkatappa,
- Krishna S,
- Shantala Gowdara Basawarajappa,
- H.G. Sreedhara,
- Siddesh KC,
- Amrutha Kumari B,
- Nawaz Umar,
- Mythri BA,
- Ravi Vasanthapuram
Affiliations
- Giridhara R. Babu
- Indian Institute of Public Health – Bengaluru, Public Health Foundation of India, Magadi Rd 1st Cross, Next to Leprosy Hospital, SIHFW Premises, Bengaluru, Karnataka, India; Corresponding author at: Indian Institute of Public Health – Bengaluru, Public Health Foundation of India, Magadi Rd 1st Cross, Next to Leprosy Hospital, SIHFW Premises, Bengaluru, Karnataka, 560023, India.
- Rajesh Sundaresan
- Indian Institute of Science, CV Raman Rd, Bengaluru, Karnataka, India
- Siva Athreya
- Indian Statistical Institute – Bangalore Centre, 8th Mile, Mysore Rd, RVCE Post, Bengaluru, Karnataka, India
- Jawaid Akhtar
- Department of Health and Family Welfare Services, Government of Karnataka, Vikasa Soudha, Bengaluru, Karnataka, India
- Pankaj Kumar Pandey
- Department of Health and Family Welfare Services, Aarogya Soudha, 1st cross, Magadi Road, Bengaluru, Karnataka, India
- Parimala S. Maroor
- Department of Health and Family Welfare Services, Aarogya Soudha, 1st cross, Magadi Road, Bengaluru, Karnataka, India
- M. Rajagopal Padma
- Department of Health and Family Welfare Services, Aarogya Soudha, 1st cross, Magadi Road, Bengaluru, Karnataka, India
- R. Lalitha
- State Maternal and PPTCT Consultant, UNICEF, Bengaluru, India
- Mohammed Shariff
- Department of Health and Family Welfare Services, Aarogya Soudha, 1st cross, Magadi Road, Bengaluru, Karnataka, India
- Lalitha Krishnappa
- MS Ramaiah Medical College, MS Ramaiah Nagar, Mathikere, Bengaluru, Karnataka, India
- C.N. Manjunath
- Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bannerghatta Main Rd, Phase 3, Jayanagara 9th Block, Jayanagar, Bengaluru, Karnataka, India
- Mysore Kalappa Sudarshan
- Department of Health and Family Welfare Services, Aarogya Soudha, 1st cross, Magadi Road, Bengaluru, Karnataka, India
- Gopalkrishna Gururaj
- National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru, Karnataka, India
- Timmanahalli Sobagaiah Ranganath
- Bangalore Medical College and Research Institute, Fort, K.R. Road, Bengaluru, India
- Kumar D.E. Vasanth
- Department of Health and Family Welfare Services, Aarogya Soudha, 1st cross, Magadi Road, Bengaluru, Karnataka, India
- Pradeep Banandur
- National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru, Karnataka, India
- Deepa Ravi
- Indian Institute of Public Health – Bengaluru, Public Health Foundation of India, Magadi Rd 1st Cross, Next to Leprosy Hospital, SIHFW Premises, Bengaluru, Karnataka, India
- Shilpa Shiju
- Department of Health and Family Welfare Services, Aarogya Soudha, 1st cross, Magadi Road, Bengaluru, Karnataka, India
- Eunice Lobo
- Indian Institute of Public Health – Bengaluru, Public Health Foundation of India, Magadi Rd 1st Cross, Next to Leprosy Hospital, SIHFW Premises, Bengaluru, Karnataka, India
- Asish Satapathy
- Member Technical Advisory Committee on COVID19, Bengaluru, India
- Lokesh Alahari
- Member Technical Advisory Committee on COVID19, Bengaluru, India
- Prameela Dinesh
- Department of Health and Family Welfare Services, Aarogya Soudha, 1st cross, Magadi Road, Bengaluru, Karnataka, India
- Vinitha Thakar
- Department of Health and Family Welfare Services, Aarogya Soudha, 1st cross, Magadi Road, Bengaluru, Karnataka, India
- Anita Desai
- National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru, Karnataka, India
- Ambica Rangaiah
- Bangalore Medical College and Research Institute, Fort, K.R. Road, Bengaluru, India
- Ashok Munivenkatappa
- National Institute of Virology, Bangalore Unit, Someshwaranagar, 1st Main, Dharmaram College Post, Bengaluru, India
- Krishna S
- Vijayanagar Institute of Medical Sciences, Ballari, Karnataka, India
- Shantala Gowdara Basawarajappa
- Bangalore Medical College and Research Institute, Fort, K.R. Road, Bengaluru, India
- H.G. Sreedhara
- Hassan Institute of Medical Sciences, Sri Chamarajendra Hospital Campus, Krishnaraja Pura, Hassan, Karnataka, India
- Siddesh KC
- Shimoga Institute of Medical Sciences, Sagar Road, Shimoga, Karnataka, India
- Amrutha Kumari B
- Mysore Medical College and Research Institute, Irwin Road, Mysuru, Karnataka, India
- Nawaz Umar
- Gulbarga Institute of Medical Sciences, Veeresh Nagar, Sedam Road Kalaburagi, Karnataka, India
- Mythri BA
- Karnataka Institute of Medical Sciences, PB Rd, Vidya Nagar, Hubli, Karnataka, India
- Ravi Vasanthapuram
- National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru, Karnataka, India
- Journal volume & issue
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Vol. 108
pp. 27 – 36
Abstract
Objective: To estimate the burden of active infection and anti-SARS-CoV-2 IgG antibodies in Karnataka, India, and to assess variation across geographical regions and risk groups. Methods: A cross-sectional survey of 16,416 people covering three risk groups was conducted between 3–16 September 2020 using the state of Karnataka’s infrastructure of 290 healthcare facilities across all 30 districts. Participants were further classified into risk subgroups and sampled using stratified sampling. All participants were subjected to simultaneous detection of SARS-CoV-2 IgG using a commercial ELISA kit, SARS-CoV-2 antigen using a rapid antigen detection test (RAT) and reverse transcription-polymerase chain reaction (RT-PCR) for RNA detection. Maximum-likelihood estimation was used for joint estimation of the adjusted IgG, active and total prevalence (either IgG or active or both), while multinomial regression identified predictors. Results: The overall adjusted total prevalence of COVID-19 in Karnataka was 27.7% (95% CI 26.1–29.3), IgG 16.8% (15.5–18.1) and active infection fraction 12.6% (11.5–13.8). The case-to-infection ratio was 1:40 and the infection fatality rate was 0.05%. Influenza-like symptoms or contact with a COVID-19-positive patient were good predictors of active infection. RAT kits had higher sensitivity (68%) in symptomatic people compared with 47% in asymptomatic people. Conclusion: This sentinel-based population survey was the first comprehensive survey in India to provide accurate estimates of the COVID-19 burden. The findings provide a reasonable approximation of the population immunity threshold levels. Using existing surveillance platforms coupled with a syndromic approach and sampling framework enabled this model to be replicable.