Seroprevalence of Anti–SARS-CoV-2 Antibodies among Healthcare Workers in Africa: A Systematic Review and Meta-Analysis

Background: Healthcare workers (HCWs) have been at the frontline of the COVID-19 pandemic, particularly in low-resource settings such as Africa, where protective measures were often limited. Understanding the extent of SARS-CoV-2 exposure among HCWs is crucial for guiding future infection control and vaccination strategies.

Objective: This systematic review and meta-analysis aimed to estimate the overall seroprevalence of anti–SARS-CoV-2 antibodies among HCWs in Africa and to explore variations by age, sex, geographic region, study design, and study period.

Methods: Following PRISMA guidelines, we searched PubMed and Cochrane databases for studies published between January 2020 and May 2025. Thirty-three eligible studies were included. Data were extracted on study characteristics, serological methods, and prevalence estimates. Pooled prevalence was calculated using random-effects models.

Results: The overall pooled seroprevalence of anti–SARS-CoV-2 antibodies among African HCWs was 23% (95% CI: 16–31%), indicating a high level of exposure. Considerable heterogeneity was observed (I² = 99.3%, p < 0.0001), with substantial variation across countries. The highest prevalence rates were reported in Mali (63%), Ethiopia (56%), and Cameroon (54%), whereas lower rates were found in South Africa (4%) and Mauritania (2%). Most studies used rapid antibody tests (IgG/IgM), and sampling was predominantly convenience-based. A non-significant trend toward higher seroprevalence among HCWs under 40 years of age and among women was observed.

Conclusions: African healthcare workers exhibited a high seroprevalence of SARS-CoV-2 antibodies, more than twice that reported in other global regions during the same period. This reflects increased occupational vulnerability due to limited personal protective equipment, weak infection prevention systems, and high community transmission in the absence of vaccination. Strengthening longitudinal research capacity, standardizing serological protocols, and enhancing HCW protection are essential to mitigate future infectious disease crises.