@article{fdi:010095024,
  title = {{D}istribution and determinants of {COVID}-19 seroprevalence in a hard-to-access health district in {M}ali},
  author = {{T}hera, {S}. {O}. and {C}issoko, {M}. and {L}andier, {J}ordi and {D}oumbia, {Z}. and {D}olo, {A}. {M}. and {T}raore, {S}. and {S}angare, {A}. {K}. and {B}erthe, {I}. and {T}hera, {I}. and {B}erthe, {H}. and {S}ogodogo, {E}. and {C}oulibaly, {K}. and {G}uindo, {A}bdoulaye and {B}alique, {H}. and {S}anogo, {S}. and {D}ara, {C}. and {R}oy, {F}. {A}. and {S}agara, {I}. and {K}ouriba, {B}. and {D}jimde, {A}. {A}. and {S}agaon {T}eyssier, {L}uis and {V}idal, {L}aurent and {B}endiane, {M}. {K}. and {G}audart, {J}.},
  editor = {},
  language = {{ENG}},
  abstract = {{I}n {N}ovember 2023, three years after the onset of the pandemic, {M}ali officially recorded 33,160 confirmed {COVID}-19 cases and 743 related deaths. {T}ombouctou health district, following {B}amako, the capital city, emerged as the second major hotspot with over 532 confirmed cases. {H}owever, these figures likely underestimate the true scale of the epidemic due to limited healthcare access and diagnostic capacity. {T}his study aimed to describe the early trajectory of the epidemic, estimate seroprevalence, and identify factors associated with {COVID}-19 in the {T}ombouctou health district. {A} multi-level study was conducted in {J}anuary 2021. {F}irst, the epidemic dynamics in {T}ombouctou were analyzed, estimating the basic reproduction number ({R}0) using daily case time series. {A}dditionally, a cross-sectional survey was conducted, involving 419 households and 1102 participants, allowing for seroprevalence estimation by age and gender. {A} face-to-face questionnaire collected information on living conditions and knowledge, attitudes, behaviors and practices, regarding the epidemic. {F}actors associated with {SARS}-{C}o{V}-2 seropositivity were determined using generalized additive mixed models ({GAMM}s), adjusted to the variable under study and the level of analysis. {W}e estimated an {R}0 of 2.08 [1.46-2.93]. {T}he crude seroprevalence of {SARS}-{C}o{V}-2 was 33.5% (309/923, 95% {CI}: 30.4% to 36.6%). {L}iving in a household where someone had been diagnosed with {COVID}-19 [{I}ncidence {R}ate {R}atio ({IRR})=5.47; 95% {CI} (4.51 to 6.64)], traditionally wealth households [{IRR} = 2.02; 95% {CI} (1.23-3.33)], modernly wealth households [{IRR} = 1.33; 95% {CI} (1.02 - 1.72)], and older age (per year) [{A}djusted {O}dds {R}atio ({AOR})=1.02 (1.00 to 1.03)] were significantly associated with seropositivity. {O}ur analysis highlighted the active circulation of {SARS}-{C}o{V}-2 in {T}ombouctou, with higher seroprevalence observed among people from wealth households, as well as older age groups. {T}he findings underscore the need for tailored and targeted approach focusing on specific households, demographics and settings.},
  keywords = {{MALI}},
  booktitle = {},
  journal = {{PL}o{S} {G}lobal {P}ublic {H}ealth},
  volume = {5},
  numero = {7},
  pages = {e0004842 [21 p.]},
  year = {2025},
  DOI = {10.1371/journal.pgph.0004842},
  URL = {https://www.documentation.ird.fr/hor/fdi:010095024},
}