SARS-CoV-2 Antibody Prevalence Across Unvaccinated Health Care Workers During the COVID-19 Pandemic in Yemen: Cross-Sectional Study

JMIR Public Health and Surveillance, vol. 11, pp. e67296

Abstract

Background: The COVID-19 pandemic presented significant challenges to health care centers across Yemen. The lack of access to COVID-19 vaccines and limited availability of personal protective equipment greatly increased the risk of SARS-CoV-2 exposure among health care workers (HCWs). Only a few studies have examined the seroprevalence and burden of SARS-CoV-2 among Yemeni HCWs. Objective: This study aimed to assess the seroprevalence of SARS-CoV-2 and associated risk factors among a cohort of unvaccinated HCWs in Ibb City, the capital of Ibb Governorate, located in the highlands of southwestern Yemen between July 2022 and January 2023. Methods: Unvaccinated HCWs employed in public and private hospitals, dispensaries, pharmacies, and laboratories in Ibb City during the past 6 months were eligible. Blood samples, occupational information, and structured interviews using a questionnaire were collected from a convenience sample of 396 unvaccinated HCWs actively providing health care services between July 2022 and January 2023. SARS-CoV-2 antibody presence was determined using a lateral flow immunoassay. Results: Of the 396 HCWs tested, 268 (67.7%) were positive for SARS-CoV-2 antibodies, with no significant difference in seropositivity between sex (P=.29). Key factors associated with seropositivity included occupation and workplace. Compared to laboratory technicians (76/124, 61%), nurses (93/124, 75%; odds ratio [OR] 1.89, 95% CI 1.10-3.26; P=.02) and physician assistants (13/14, 92.9%; OR 8.21, 95% CI 1.04-64.79; P=.046) had significantly higher odds of seropositivity. Similarly, working in hospitals was associated with significantly higher odds of seropositivity compared to working in laboratories (OR 2.77, 95% CI 1.59-4.81; P<.001). Overall, 82% (219/268) of seropositive HCWs reported COVID-19-related symptoms within the last 6 months (OR 3.82, 95% CI 2.40-6.09; P<.001), the majority being fever (191/256, 74.6%; OR 2.40, 95% CI 1.56-3.72; P<.001), headache (175/230, 76.1%; OR 2.50, 95% CI 1.62-3.84; P<.001), cough (162/205, 79%; OR 3.02, 95% CI 1.94-4.70; P<.001), or loss of taste (155/202, 76.7%; OR 2.36, 95% CI 1.53-3.65; P<.001) or smell (146/191, 76.4%; OR 2.21, 95% CI 1.43-3.41; P<.001). Conclusions: This study reveals a high prevalence of SARS-CoV-2 antibodies among HCWs in Ibb City, Yemen, underscoring the impact of limited vaccination and personal protective equipment availability in 2022 and 2023. These findings highlight the urgent need for improved protective measures and vaccination efforts in conflict-affected regions.

Authors 14

1. Eihab Al‐Herwi

   Ibb University

   Affiliation as printed

   Medical Laboratories Department, Faculty of Medicine and Health Sciences, Ibb University, University Street, Ibb, 22017, Yemen, 967 0778811234

2. Maryam Baras
   Affiliation as printed

   National Centre of Public Health Laboratories, Al-Mukalla, Yemen

3. Khadega Alhetar

   Ibb University

   Affiliation as printed

   Medical Laboratories Department, Faculty of Medicine and Health Sciences, Ibb University, University Street, Ibb, 22017, Yemen, 967 0778811234

4. Mohammed Farhan

   Ibb University

   Affiliation as printed

   Medical Laboratories Department, Faculty of Medicine and Health Sciences, Ibb University, University Street, Ibb, 22017, Yemen, 967 0778811234

5. R.A. Saleh

   Ibb University

   Affiliation as printed

   Medical Laboratories Department, Faculty of Medicine and Health Sciences, Ibb University, University Street, Ibb, 22017, Yemen, 967 0778811234

6. Amani As-suhbani

   Ibb University

   Affiliation as printed

   Medical Laboratories Department, Faculty of Medicine and Health Sciences, Ibb University, University Street, Ibb, 22017, Yemen, 967 0778811234

7. Manal Alshoaibi
   Affiliation as printed

   National Centre of Public Health Laboratories, Ibb, Yemen

8. Mansour Mohammed

   Ibb University

   Affiliation as printed

   Medical Microbiology, Ibb University, Ibb, Yemen

9. Zainab Morshed

   Ibb University

   Affiliation as printed

   Medical Microbiology, Ibb University, Ibb, Yemen

10. Asia Shujaa-Aldeen
    Affiliation as printed

    Medical Laboratories, International Malaysian University, Ibb, Yemen

11. Fatima Ghanem
    Affiliation as printed

    Medical Laboratories, International Malaysian University, Ibb, Yemen

12. Bra’ah AlQisi
    Affiliation as printed

    Medical Laboratories, International Malaysian University, Ibb, Yemen

13. Mohammed Alherwi

    University of Science and Technology

    Affiliation as printed

    Pharmacy Department, University of Science and Technology, Ibb, Yemen

14. Tony Bruns Aachen Department of Internal Medicine III

    RWTH Aachen University · Universitätsklinikum Aachen

    Affiliation as printed

    Department of Internal Medicine III, University Hospital Rheinisch-Westfälische Technische Hochschule, Aachen, Germany