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The seroprevalence of SARS-CoV-2 infection in Malaysia: 7 August to 11 October 2020 |
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| Authors: | Zhuo-Lin Chong Wan Shakira Rodzlan Hasani Filza Noor Asari Eida Nurhadzira Muhammad Mohd Hatta Abdul Mutalip Tania Gayle Robert Lourdes Halizah Mat Rifin Sarbhan Singh Ravindran Thayan |
| Affiliation: | 1. Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia;2. Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia Contribution: Data curation (lead), Formal analysis (equal), Methodology (supporting), Visualization (supporting), Writing - review & editing (supporting);3. Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia Contribution: Validation (equal), Writing - original draft (supporting);4. Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia Contribution: Project administration (equal), Validation (equal);5. Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia Contribution: Conceptualization (supporting), Funding acquisition (equal), Methodology (equal), Project administration (equal), Writing - review & editing (equal);6. Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia Contribution: Investigation (equal), Visualization (supporting);7. Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia Contribution: Validation (supporting), Writing - review & editing (equal);8. Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia Contribution: Methodology (equal), Validation (supporting) |
| Abstract: | BackgroundFrom the beginning of the COVID-19 pandemic until mid-October 2020, Malaysia recorded ~15,000 confirmed cases. But there could be undiagnosed cases due mainly to asymptomatic infections. Seroprevalence studies can better quantify underlying infection from SARS-CoV-2 by identifying humoral antibodies against the virus. This study was the first to determine the prevalence of SARS-CoV-2 infection in Malaysia's general population, as well as the proportion of asymptomatic and undiagnosed infections.MethodsThis cross-sectional seroprevalence study with a two-stage stratified random cluster sampling design included 5,131 representative community dwellers in Malaysia aged ≥1 year. Data collection lasted from 7 August to 11 October 2020 involving venous blood sampling and interviews for history of COVID-19 symptoms and diagnosis. Previous SARS-CoV-2 infection was defined as screened positive using the Wantai SARS-CoV-2 Total Antibody enzyme-linked immunosorbent assay and confirmed positive using the GenScript SARS-CoV-2 surrogate Virus Neutralization Test. We performed a complex sampling design analysis, calculating sample weights considering probabilities of selection, non-response rate and post-stratification weight.ResultsThe overall weighted prevalence of SARS-CoV-2 infection was 0.49% (95%CI 0.28–0.85) (N = 150,857). Among the estimated population with past infection, around 84.1% (95%CI 58.84–95.12) (N = 126 826) were asymptomatic, and 90.1% (95%CI 67.06–97.58) (N = 135 866) were undiagnosed.ConclusionsOur study revealed a low pre-variant and pre-vaccination seroprevalence of SARS-CoV-2 infection in Malaysia up to mid-October 2020, with a considerable proportion of asymptomatic and undiagnosed cases. This led to subsequent adoption of SARS-CoV-2 antigen rapid test kits to increase case detection rate and to reduce time to results and infection control measures. |
| Keywords: | COVID-19 Malaysia SARS-CoV-2 seroprevalence WHO-UNITY studies |