https://imcjms.com Ibrahim Medical College Journal of Medical Science https://imcjms.com/registration/journal_full_text/543 Thu, 11 Jul 2024 10:38:32 +0000 Abstract Background and objectives: Children comprised a significant part of the population during the second and third waves of the COVID-19 pandemic. The objectives of this study were to estimate the seroprevalence of COVID-19 IgG antibody among the children aged 6 to 14 years and to determine, if any, the factors associated with seropositivity. Methods: This cross-sectional study was conducted in a selected block of West Bengal, India over a period of 1 year (April 2022-March 2023) among children. Thirty villages in the block were selected by cluster sampling technique. COVID-19 IgM/IgG Rapid Antibody Test Kit (ICMR approved) was used for the detection of SARS-CoV-2 IgG antibodies.  Data were analyzed by appropriate statistical tests. Results: Total 600 children were enrolled in the study.SARS-CoV-2 IgG antibody was positive in 57.2% children. The seropositivity rate (91.8%) was significantly (p<0.001) high among children of age group 12 to 14 years. Seropositivity rate was not significantly different between male and female children (46.4% vs. 53.6%; p>0.05). Conclusion: SARS-COV-2 IgG antibody was positive in a high proportion of children residing in rural areas indicating asymptomatic coronavirus infections among rural population. Socio-demographic factors such as higher age group and father’s education were significantly associated with seropositivity. July 2024; Vol. 18(2):010.  DOI:https://doi.org/10.55010/imcjms.18.022 *Correspondence: Vineeta Shukla, Department of Community Medicine, Infectious Diseases and Beliaghata General Hospital, Kolkata, India. Email: vineeta1992@gmail.com   Introduction Children are the foundation of any nation, and the health and welfare of its child population determines the progress of any country. The COVID-19 pandemic, which hasn't been formally declared over yet, has led to some significant advancement in the worldwide health care industry. Since children constituted a significant portion of the unprotected population during the second and third waves of the COVID-19 pandemic, their vulnerability was an important consideration. Children and adolescents are also susceptible to the infection and thus form a part of the transmission chain. In late 2021, different nations had reported COVID-19 outbreaks in schools and child care facilities. What is more striking is that children were often reported to have asymptomatic infections than adults in case of COVID-19 [1]. Even though SARS-CoV-2 was thought to impact children and adolescents more mildly than adults, it nonetheless affects a variety of systems, with the cardiovascular signs being most noticeable [2]. In addition to being extremely unwell and necessitating Intensive Care Unit (ICU) admissions, child death rate, particularly in those with Multisystem Inflammatory Syndrome in Children (MIS-C), have been reported as high as 9% [3]. According to the World Health Organization (WHO), children under five years of age represented 2% of reported global COVID-19 cases during January 2020 to October 2021 and older children (5 to 14 years) accounted for 7% of the cases [4]. There was limited seroprevalence data among children in late 2021. Also, the antibody response to SARS-CoV-2 among children was poorly characterized. Very few studies related to SARS-CoV-2 antibody detection among children were carried out in India in the years 2020 and 2021 and literature from West Bengal was scarce [5]. Following the second wave of COVID-19 cases in 2021, George et al. conducted a study in a rural area of Karnataka, India, and found that children's seroprevalence of antibodies to SARS CoV-2 was 45.9% [6]. In 2021, a multicenter study conducted by Misra et al. [7] found the prevalence of SARS-CoV-2 antibody among under-18-year-olds in both urban and rural areas as 55.7%, with a higher seropositivity rate among females. In another study, about 48.3% of children aged 5 to 17 in both urban and rural Kerala were found positive for COVID-19 antibody [8]. But there was no significant association with gender. In Delhi, India, seroprevalence of immunoglobulin G antibodies against SARS-CoV-2 among children aged 5 to 17 rose from 52.8% in January 2021 to 81.8% in September and October 2021, according to a repeated cross-sectional study [9]. Age and seropositivity correlated positively, but not with gender. There was a dearth of information about the status of seroprevalence of SARS-COV-2 IgG antibody among people of rural Bengal, especially among children. Therefore,, the present study was conducted in a block of West Bengal, India with objectives to estimate the seroprevalence of SARS-CoV-2 IgG antibody among rural children aged 6 to 14 years and to find the factors associated (if any) with seropositivity among them.   Materials and methods This descriptive cross-sectional study was carried out in Budge-Budge II block, West Bengal over a period of 12 months from April 2022 to March 2023. The study was approved by Institutional Ethics Committee (IPGME&R/IEC/2022/006, dated 21.01.2022). For children 7-11 years, informed oral assent in presence of parents and for children 12 - 14 years old, informed written assent was taken. Informed written consent was taken from all parents. Study population: Children aged 7 to 14 years who had been residing with their families in the block for last one year or more were included.Those who had a laboratory confirmed COVID-19 infection in the past or who had any symptoms of COVID-19 infection during the time of data collection were excluded. Sample size and sampling method: Considering 61.1%  seroprevalence of anti- SARS-CoV-2 IgG antibody rate [10]  and at 95% confidence interval (CI) and with 10% margin of error, the total sample size was calculated as  591 (after multiplying by 2 for design effect for cluster sampling and adding 20% as inconclusive). A total of 30 clusters were selected. Therefore, from each cluster (village) 591/30=19.7≈20 children were enrolled. Thirty villages were selected from a total of 61 villages using probability proportional to size method. Data collection: Before commencing data collection, an orientation cum training session was conducted involving the Block Medical Officer, Accredited Social Health Activists (ASHA), Auxiliary Nurse Midwives (ANMs) and other health workers followed by pretesting among 20 children of the same age group who were not included in the final sample. Information on socio-demographic, clinical, COVID-19 exposure related questions and vaccination details were collected in a predesigned, pretested, and structured questionnaire. Socio-demographic variables included: age, gender, type of family, socio-economic status, as per Modified BG Prasad Scale 2022 [11], parents’ education, and occupation. Information on COVID-19 related infection included: history of COVID-19 infection in family, vaccination status of family members, and number of doses of vaccine received. Collection of blood and test: About 30µL of whole blood was collected aseptically by finger prick and tested immediately for SARS-CoV-2 IgM or IgG antibodies by Oscar Covid-19 Rapid Antibody Test Kit (ICMR approved).The measurement range of the assay was from 0.40 U/ml to 250 U/ml. Levels of <0.80 and ≥0.80 U/ml were considered as negative and positive respectively according to the manufacturer’s recommendations. Blood sample was placed in the specimen well of the test kit. Two drops (100µL) of buffer solution (provided with the kit) were added to the specimen. The results were read after 15 minutes. If a coloured line appeared at the IgG level along with the control line, the results were interpreted as positive. Data analysis: Descriptive statistical measures such as frequencies, mean, standard deviation and confidence interval (CI) were determined. Z test for proportion was applied to test for significant difference between age groups and gender. Multivariable binary logistic regression was performed to find predictors of IgG positive test among the study population.    Results Out of 600 children, about 40.5% belonged to age group of 12-14 years and their mean age was 10.36 ± 2.53 years. A little more than half were females (54.7%) and more than 80% followed Hinduism by faith. About 86.3% resided in joint households and half of the families belonged to upper middle class (50.2%).There was a health care worker in only 1.2% of the families (Table-1). None of the children had undergone any kind of COVID-19 detection test prior to the study. A small proportion (64, 10.7%) of the families had a laboratory confirmed history of COVID-19 infection within last one year in at least one of the members. Out of those who tested positive, 4 required hospitalizations and 1 of them died (Table-2).   Table-1: Distribution of the study participants according to the socio-demographic profile (N=600)   2026 Ibrahim Medical College. 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