Journal Article

SARS-CoV-2 Antibody Prevalence Across Unvaccinated Health Care Workers During the COVID-19 Pandemic in Yemen: Cross-Sectional Study

Morshed, Zainab, Ghanem, Fatima, Al-Herwi, Eihab, Saleh, Rashad M, Mohammed, Mansour, Alherwi, Mohammed, Baras, Maryam, AlQisi, Bra’ah, Alhetar, Khadega, Shujaa-Aldeen, Asia, As-suhbani, Amani, Alshoaibi, Manal, Farhan, Mohammed A, Bruns, Tony

2025

Overview

The COVID-19 pandemic presented significant challenges to health care centers across Yemen. The lack of access to COVID-19 vaccines and limited availability of personal protective equipment greatly increased the risk of SARS-CoV-2 exposure among health care workers (HCWs). Only a few studies have examined the seroprevalence and burden of SARS-CoV-2 among Yemeni HCWs. This study aimed to assess the seroprevalence of SARS-CoV-2 and associated risk factors among a cohort of unvaccinated HCWs in Ibb City, the capital of Ibb Governorate, located in the highlands of southwestern Yemen between July 2022 and January 2023. Unvaccinated HCWs employed in public and private hospitals, dispensaries, pharmacies, and laboratories in Ibb City during the past 6 months were eligible. Blood samples, occupational information, and structured interviews using a questionnaire were collected from a convenience sample of 396 unvaccinated HCWs actively providing health care services between July 2022 and January 2023. SARS-CoV-2 antibody presence was determined using a lateral flow immunoassay. Of the 396 HCWs tested, 268 (67.7%) were positive for SARS-CoV-2 antibodies, with no significant difference in seropositivity between sex (P=.29). Key factors associated with seropositivity included occupation and workplace. Compared to laboratory technicians (76/124, 61%), nurses (93/124, 75%; odds ratio [OR] 1.89, 95% CI 1.10-3.26; P=.02) and physician assistants (13/14, 92.9%; OR 8.21, 95% CI 1.04-64.79; P=.046) had significantly higher odds of seropositivity. Similarly, working in hospitals was associated with significantly higher odds of seropositivity compared to working in laboratories (OR 2.77, 95% CI 1.59-4.81; P<.001). Overall, 82% (219/268) of seropositive HCWs reported COVID-19-related symptoms within the last 6 months (OR 3.82, 95% CI 2.40-6.09; P<.001), the majority being fever (191/256, 74.6%; OR 2.40, 95% CI 1.56-3.72; P<.001), headache (175/230, 76.1%; OR 2.50, 95% CI 1.62-3.84; P<.001), cough (162/205, 79%; OR 3.02, 95% CI 1.94-4.70; P<.001), or loss of taste (155/202, 76.7%; OR 2.36, 95% CI 1.53-3.65; P<.001) or smell (146/191, 76.4%; OR 2.21, 95% CI 1.43-3.41; P<.001). This study reveals a high prevalence of SARS-CoV-2 antibodies among HCWs in Ibb City, Yemen, underscoring the impact of limited vaccination and personal protective equipment availability in 2022 and 2023. These findings highlight the urgent need for improved protective measures and vaccination efforts in conflict-affected regions.

• Publisher: JMIR Publications
• Subject: Adult / Age groups / Antibodies / Antibodies, Viral - blood / Chi-square test / COVID-19 / COVID-19 - epidemiology / COVID-19 vaccines / Cross-Sectional Studies / Dentists / Diarrhea / Disease prevention / Disease transmission / Drug stores / Female / Fever / Headaches / Health care / Health Personnel - statistics & numerical data / Health services / Health Services in Resource-Poor Settings and LMICs / Hospitals / Humans / Impact of War and Conflict on Public Health / Infectious Diseases (non-STD/STI) / JMIR Theme Issue: COVID-19 Special Issue / Laboratories / Male / Medical personnel / Medical research / Middle Aged / Nurses / Occupational exposure / Olfaction disorders / Original Paper / Pandemics / Personal protective equipment / Physician assistants / Prevalence / Protective equipment / Questionnaires / Risk Factors / SARS-CoV-2 - immunology / Seroepidemiologic Studies / Serology / Severe acute respiratory syndrome coronavirus 2 / Taste disorders / Technicians / Vaccination and Immunization in the Digital Age / Working hours / Yemen - epidemiology