SARS CoV-2 seroprevalence and diagnostic accuracy during a COVID-19 outbreak in a major penitentiary complex in Brazil, June to July 2020

• DOI: https://doi.org/10.1108/IJPH-08-2021-0083
• Published date: 22 February 2022
• Date: 22 February 2022
• Pages: 143-156
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice
• Author: Fernando Augusto Gouvea-Reis,Danniely Carolinne Soares da Silva,Lairton Souza Borja,Patrícia de Oliveira Dias,Jadher Percio,Cassio Peterka,Janaína de Oliveira,Giselle Sodré,Claudia Mendes Feres,Wallace Dos Santos,Fábio Souza,Ana Izabel Passarella Teixeira,Daiani Cristina Cilião-Alves,Gustavo Adolfo Sierra Romero,Elza Ferreira Noronha,Julio Croda,Rodrigo Haddad,Walter Massa Ramalho,Camile de Moraes,Wildo Navegantes de Araújo

SARS CoV-2 seroprevalence and

diagnostic accuracy during a COVID-19

outbreak in a major penitentiary complex

in Brazil, June to July 2020

Fernando Augusto Gouvea-Reis, Danniely Carolinne Soares da Silva, Lairton Souza Borja,

Patrícia de Oliveira Dias, Jadher Percio, Cassio Peterka, Janaína de Oliveira, Giselle Sodré,

Claudia Mendes Feres, Wallace Dos Santos, F

abio Souza, Ana Izabel Passarella Teixeira,

Daiani Cristina Cilião-Alves, Gustavo Adolfo Sierra Romero, Elza Ferreira Noronha,

Julio Croda, Rodrigo Haddad, Walter Massa Ramalho, Camile de Moraes and

Wildo Navegantes de Ara

ujo

Abstract

Purpose –This study aims to estimate the overall SARS-CoV-2 seroprevalence and evaluate the

accuracy of an antibody rapid test compared to a reference serological assay during a COVID-19

outbreakin a prison complex housing over 13,000prisoners in Brası

´

lia.

Design/methodology/approach –The authors obtaineda randomized, stratified representativesample

of each prison unit and conducteda repeated serosurvey among prisonersbetween June and July 2020,

using a lateral-flow immunochromatographic assay (LFIA). Samples were also retested using a

chemiluminescence enzyme immunoassay (CLIA) to compare SARS-CoV-2 seroprevalence and

21-days incidence, as well as to estimate the overall infection fatality rate (IFR) and determine the

diagnostic accuracy of the LFIA test.

Findings –This study identified 485 eligible individuals and enr olled 460 participants. Baseline and

21-days follow-up seroprevalence were estimated at 52.0% ( 95% CI 44.9–59.0) and 56.7% (95% CI

48.2–65.3) with LFIA; and 80.7% (95% CI 74.1–87.3) and 81.1% (95% CI 74.4–87.8) with CLIA, with

an overall IFR of 0.02%. There were 78.2% (95% CI 66.7–89.7) symptom atic individuals among the

positive cases. Sensitivity and specificity of LFIA wer e estimated at 43.4% and 83.3% for IgM; 46.5%

and 91.5% for IgG; and 59.1% and 77.3% for combined tes ts.

Originality/value –The authors found high seroprevalence of anti-SARS-CoV-2 antibodies within the

prison complex. The occurrence of asymptomatic infection highlights theimportance of periodic mass

testing in addition to case-finding of symptomatic individuals; however, the field performance of LFIA

tests should be validated. Thisstudy recommends that vaccination strategies consider the inclusion of

prisonersand prison staff in priority groups.

Keywords Public health, Brazil, Prisons, COVID-19, Outbreak, COVID-19 serological testing

Paper type Research paper

Introduction

The public health emergency related to the spread of SARS-CoV-2, the causative agent of

COVID-19, has presented as a threat to prisoners worldwide. Factors such as limited

sanitary conditions, overcrowding, barriers for implementing social distancing and other

non-pharmacological interventions increase the vulnerability of the incarcerated population

(Informationabout the

authorscan be found at the

end of this article.)

Received 18 August 2021

Revised 13 December 2021

15 December 2021

Accepted 15 December 2021

DOI 10.1108/IJPH-08-2021-0083 VOL. 19 NO. 2 2023, pp. 143-156, ©Emerald Publishing Limited, ISSN 1744-9200 jINTERNATIONAL JOURNAL OF PRISONER HEALTH jPAGE 143