AUTHOR=Vallejo-Janeta Alexander Paolo , Morales-Jadan Diana , Paredes-Espinosa Maria Belen , Coronel Barbara , Galvis Heberson , Bone-Guano Hugo Renato , Amador Rodriguez Belen , Gomez Abeledo Guadalupe , Freire-Paspuel Byron , Ortiz-Prado Esteban , Rivera-Olivero Ismar , Henriquez-Trujillo Aquiles Rodrigo , Lozada Tannya , Bereguiain Miguel Angel Garcia , the UDLA COVID-19 Team , Jaramillo Tatiana , Gordon Daniela Santander , Iturralde Gabriel Alfredo , Teran Julio Alejandro , Vasquez Karen Marcela , Rondal Jonathan Dario , Granda Genoveva , Santamaria Ana Cecilia , Pino Cynthia Lorena , Espinosa Oscar Lenin , Buitron Angie , Grisales David Sanchez , Jimenez Karina Beatriz , Bastidas Vanessa , Aguilar Dayana Marcela , Paredes Ines Maria , Bilvao Christian David , Pazmiño Sebastian Rodriguez , Laglaguano Juan Carlos , Herrera Henry , Espinosa Pablo Marcelo , Galarraga Edison Andres , Zambrano-Mila Marlon Steven , Tito Ana Maria , Zapata Nelson David TITLE=Sustained COVID-19 community transmission and potential super spreading events at neglected afro-ecuadorian communities assessed by massive RT-qPCR and serological testing of community dwelling population JOURNAL=Frontiers in Medicine VOLUME=9 YEAR=2022 URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.933260 DOI=10.3389/fmed.2022.933260 ISSN=2296-858X ABSTRACT=Background

Neglected ethnic minorities from underserved rural populations in Latin America are highly vulnerable to coronavirus disease 2019 (COVID-19) due to poor health infrastructure and limited access to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis. Esmeraldas is a mainly rural province of the Coastal Region of Ecuador characterized by a high presence of Afro-Ecuadorian population living under poverty conditions.

Objective

We herein present a retrospective analysis of the surveillance SARS-CoV-2 testing in community-dwelling population from Esmeraldas carried out by our university laboratory in collaboration with regional health authorities during the first week of October 2020, in a region where no public SARS-CoV-2 detection laboratory was available at that time.

Results

A total number of 1,259 people were tested for SARS-CoV-2 by Reverse Transcription quantitative Polimerasa Chain Reaction (RT-qPCR), resulting in an overall infection rate of 7.7% (97/1259, 95% CI: [6.32–9.35%]) for SARS-CoV-2, up to 12.1% in some communities. Interestingly, community-dwelling super spreaders with viral loads over 108 copies/ml represented 6.2% of the SARS-CoV-2-infected population. Furthermore, anti-SARS-CoV-2 IgG serological tests were applied to the same study group, yielding an overall seroprevalence of 11.68% (95% CI: [9.98–13.62%]) but as high as 24.47% at some communities.

Conclusion

These results support active COVID-19 community transmission in Esmeraldas province during the first semester of the COVID-19 pandemic as it has been shown for other rural communities in the Ecuadorian Coastal Region.