Prevalence of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Nigeria: A Systematic Review and Meta Analysis of Seroprevalence Studies

Abstract

Abstract Background: In early 2020, Nigeria recorded its first case of COVID-19. The disease later became a pandemic with devastating consequences on the health and population globally. The exact incidence of the disease in Nigeria has not been reported. Aim: We determined pooled estimates, clinical characteristics, outcomes, and disease severity for COVID-19 patients in Nigeria. Materials and Methods: The search for relevant literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across multiple databases, including PUBMED, Web of Science, AJOL, BIOLINE, Hinari, and Cochrane Library. The search was done from November 1, 2021, to February 2, 2022. Studies of laboratory-confirmed COVID-19 cases with relevant data were included. Two reviewers independently performed study selection, article screening, and data extraction. Studies that did not differentiate between confirmed pathogenic isolates and specimen contamination or colonization were excluded. Of 58 articles, 14 studies were included in qualitative analysis, 77,419 total tested population. Results: The study found the prevalence of COVID 19 to be 20.2%; 95% confidence interval (CI): 13.2–27.4. Of these 16.2% 95% CI: (5.1–26.2) were symptomatic, while 21.3% 95% CI: (12.4–30.2) were asymptomatic. The prevalence based on diagnostic modality was 39.3%; 95% CI (30.2–48.1) using enzyme linked immunosorbent assay based rapid diagnostic test, 25.1% 95% CI (19.3–31.1) using polymerase chain reaction based test. Based on study design, the Prevalence was 10.3% 95% CI (4.1–24.2) in cross sectional studies; with 25.1% 95% CI (19.2–31.1) in retrospective study. The regional difference ranges from 11.1%; 95% CI (6.3–28.2) in North Central Nigeria to 42.4%; 95% CI (41.2–44.3) in North Western Nigeria. Conclusion: In conclusion, this meta-analysis reported an estimated prevalence of COVID-19 in Nigeria, indicating a moderate community transmission. It also demonstrates a tendency to decline in severe acute respiratory syndrome coronavirus 2 positivity. This finding provides a window of opportunity for strengthening existing preventive intervention measures, enhancing serologic and genomic surveillance, improving clinical management, and improving mobilization towards vaccination, particularly among susceptible populations.