Seroprevalence of SARS-COV-2 infection in the general population of
Nepal during the first and second generalized waves of the COVID-19
pandemic -2020-2021
Abstract
Few seroprevalence studies were performed on coronavirus disease
(COVID-19) in Nepal. Here, we aimed to estimate seroprevalence and
assess risk factors for infection in the general population of Nepal by
conducting two rounds of sampling. The first round in October 2020 at
the peak of the first generalized wave of COVID-19 and the second round
in July-August 2021 following the peak of the wave caused by the delta
variant of SARS-COV-2. We used cross-sectional probability-to-size
(PPS)-based multistage cluster sampling to estimate the seroprevalence
in the general population of Nepal at the national and provincial
levels. We tested for the presence of anti-SARS-CoV-2 total antibody
using the WANTAI SARS-CoV-2 Ab ELISA kit. In Round 1, the overall
national seroprevalence was 14.4%, with provincial estimates ranging
from 5.3% in Sudurpaschim to 27.3% in Madesh province. In Round 2, the
estimated national seroprevalence was 70.7%, with the highest estimated
seroprevalence in Madesh Province (84.8%) and the lowest in the Gandaki
Province (62.9%). Seroprevalence was comparable between males and
females (Round 1, 15.8% vs 12.2% and Round 2, 72.3% vs. 68.7%). The
seroprevalence in the ecozones—terai, hills, and mountains—was
76.3%, 65.3%, and 60.5% in Round 2 and 17.7%, 11.7%, and 4.6% in
Round 1, respectively. In Nepal, COVID-19 vaccination was introduced in
January, 2021. At the peak of the first generalized wave of COVID-19,
most of the population of Nepal remained unexposed to SARS-COV-2 and
towards the end of the second generalized wave in April 2021, two-thirds
of the population was exposed.