# Determinants of SARS-CoV-2 infection across three sentinels sites in Benin during 2021: A multicentric surveillance study

## TL;DR

This study in Benin identified factors influencing SARS-CoV-2 infection rates across three sites, highlighting the importance of active surveillance during the pandemic.

## Contribution

The study provides new insights into local determinants of SARS-CoV-2 infection in Benin through a multicenter surveillance approach.

## Key findings

- The Allada site and phase 3 of the national strategy were associated with higher SARS-CoV-2 infection risk.
- Respiratory symptoms and anosmia/ageusia were significant risk factors for infection.
- Natitingou site and group living were linked to reduced infection risk.

## Abstract

In the context of the COVID-19 pandemic, Benin, like other regions in sub-Saharan Africa and around the world, has been grappling with a public health crisis since march 2020. The country responded to this crisis by implementing adaptive response measures. The STREESCO project is part of this dynamic effort, strengthening epidemiological surveillance at three sentinel sites. This study thoroughly examines the determinants of SARS-CoV-2 infection. This involved strategic support based in Cotonou, Allada, and Natitingou. Data collection took place from march 1 to november 30, with individuals voluntarily undergoing COVID-19 screening at dedicated health units. Before participation, free and informed consent was obtained. The collected data included sociodemographic information, clinical details, and the results of COVID-19 tests. A multivariate logistic regression model was used to identify factors associated with SARS-CoV-2 infection. Surveillance included 4178 participants, with a male/female ratio of 0.98 and a median age of 33 (IQR: 25-45). Across all sites, 13.12% of participants tested positive for SARS-CoV-2, and 85.40% of them had a SARS-CoV-2 infection.of participants were symptomatic at baseline. The proportion of positivity was 6%, 11% and 28% respectively during phases 1, 2 and 3 of the national strategy. Identified risk factors included the Allada site (aOR 2.04, 95%CI 1.59-2.62), phase 3 (aOR 3.16, 95%CI 2.34-4.27), phase 2 (aOR 1.67, 95%CI 1.12-2.51), secondary (aOR 1.67, 95%CI 1.12-2.51) and higher level of education (aOR 1.83, 95%CI 1.22-2.74), respiratory symptoms (aOR 1.88, 95%CI 1.40-2.53), and/or anosmia/ageusia (aOR 1.88, 95%CI 1.48-2.38). Conversely, the Natitingou site (aOR = 0.29, 95%CI: 0.20-0.42), group living (aOR = 0.75, 95%CI: 0.60-0.94), and digestive symptoms (aOR = 0.70, 95%CI: 0.54-0.91) were associated with a reduced risk of infection. These results underscore the importance of active surveillance during crisis situations, ensuring the acquisition of reliable and persuasive data to enhance individual care and guide health policies.

NCT06170320 (retrospectively registered on December 21, 2023).