Seroprevalence of SARS-CoV-2 infection in the general population of Nepal during the first and second generalized waves of the COVID-19 pandemic-2020-2021.
Krishna Prasad Paudel: Epidemiology and Disease Control Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal.
Reuben Samuel: WHO Country Office for Nepal, Kathmandu, Nepal.
Runa Jha: National Public Health Laboratory, Ministry of Health and Population, Kathmandu, Nepal.
Basu Dev Pandey: Epidemiology and Disease Control Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal. ORCID
Chathura Edirisuriya: WHO Country Office for Nepal, Kathmandu, Nepal.
Nebin Lal Shrestha: Central Bureau of Statistics, National Planning Commission, Kathmandu, Nepal.
Pradip Gyawali: National Health Research Council, Kathmandu, Nepal.
Amrit Pokhrel: Epidemiology and Disease Control Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal.
Lilee Shrestha: National Public Health Laboratory, Ministry of Health and Population, Kathmandu, Nepal.
Ram Kumar Mahato: Epidemiology and Disease Control Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal.
Shaikh Shah Hossain: WHO Country Office for Nepal, Kathmandu, Nepal. ORCID
Govindakarnavar Arunkumar: WHO Country Office for Nepal, Kathmandu, Nepal. ORCID
Anindya Sekhar Bose: WHO Country Office for Nepal, Kathmandu, Nepal. ORCID
Meghnath Dhimal: National Health Research Council, Kathmandu, Nepal.
Dipendra Gautam: WHO Country Office for Nepal, Kathmandu, Nepal.
Subash Neupane: WHO Country Office for Nepal, Kathmandu, Nepal.
Nishant Thakur: Epidemiology and Disease Control Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal.
Saugat Shrestha: WHO Country Office for Nepal, Kathmandu, Nepal.
Nirajan Bhusal: WHO Country Office for Nepal, Kathmandu, Nepal.
Priya Jha: WHO Country Office for Nepal, Kathmandu, Nepal.
Binod Prasad Gupta: WHO Country Office for Nepal, Kathmandu, Nepal.
Rajan Bikram Rayamajhi: WHO Country Office for Nepal, Kathmandu, Nepal.
Koshal Chandra Subedi: Epidemiology and Disease Control Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal.
Shashi Kandel: Epidemiology and Disease Control Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal. ORCID
Mukesh Poudel: Epidemiology and Disease Control Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal.
Lila Bikram Thapa: Epidemiology and Disease Control Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal.
Guna Nidhi Sharma: Ministry of Health and Population, Kathmandu, Nepal.
Allison Eugenio Gocotano: WHO Country Office for Nepal, Kathmandu, Nepal.
Avinash K Sunny: WHO Country Office for Nepal, Kathmandu, Nepal.
Rabin Gautam: WHO Country Office for Nepal, Kathmandu, Nepal.
Deepak Raj Bhatta: Ministry of Health and Population, Kathmandu, Nepal.
Bal Krishna Awale: National Public Health Laboratory, Ministry of Health and Population, Kathmandu, Nepal.
Bhola Roka: Epidemiology and Disease Control Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal.
Hemant Chandra Ojha: Epidemiology and Disease Control Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal.
Phanindra Baral: Epidemiology and Disease Control Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal.
Mahendra Dhose Adhikari: Epidemiology and Disease Control Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal.
Guna Raj Lohani: Ministry of Health and Population, Kathmandu, Nepal.
Mahendra Shrestha: Ministry of Health and Population, Kathmandu, Nepal.
Dipendra Raman Singh: Ministry of Health and Population, Kathmandu, Nepal.
Laxman Aryal: Ministry of Health and Population, Kathmandu, Nepal.
Rajesh Sambhajirao Pandav: WHO Country Office for Nepal, Kathmandu, Nepal.
Roshan Pokhrel: Ministry of Health and Population, Kathmandu, Nepal.
Few seroprevalence studies have been conducted on coronavirus disease (COVID-19) in Nepal. Here, we aimed to estimate seroprevalence and assess risk factors for infection in the general population of Nepal by conducting two rounds of sampling. The first round was in October 2020, at the peak of the first generalized wave of COVID-19, and the second round in July-August 2021, following the peak of the wave caused by the delta variant of SARS-CoV-2. We used cross-sectional probability-to-size (PPS)-based multistage cluster sampling to estimate the seroprevalence in the general population of Nepal at the national and provincial levels. We tested for anti-SARS-CoV-2 total antibody using the WANTAI SARS-CoV-2 Ab ELISA kit. In Round 1, the overall national seroprevalence was 14.4%, with provincial estimates ranging from 5.3% in Sudurpaschim to 27.3% in Madhesh Province. In Round 2, the estimated national seroprevalence was 70.7%, with the highest in the Madhesh Province (84.8%) and the lowest in the Gandaki Province (62.9%). Seroprevalence was comparable between males and females (Round 1, 15.8% vs. 12.2% and Round 2, 72.3% vs. 68.7%). The seroprevalence in the ecozones-Terai, hills, and mountains-was 76.3%, 65.3%, and 60.5% in Round 2 and 17.7%, 11.7%, and 4.6% in Round 1, respectively. In Nepal, COVID-19 vaccination was introduced in January 2021. At the peak of the first generalized wave of COVID-19, most of the population of Nepal remained unexposed to SARS-CoV-2. Towards the end of the second generalized wave in April 2021, two thirds of the population was exposed.
