SAPRIN Sub-Study

South African Population Research Infrastructure Network (SAPRIN): A GRT-INSPIRED Sub Study of COVID-19 Perceptions, Impacts and Seroprevalence Among Residents of Atteridgeville, Melusi and Hillbrow in Gauteng, South Africa


The global COVID-19 pandemic is an exceptional emergency, and presents a serious risk to human health and livelihoods, especially in countries with complex economic and political problems, such as South Africa. While the pandemic in sub-Saharan Africa began later than in Asia, Europe and the United States, the number of cases in the sub-continent continues to escalate. Factors prevalent in South Africa such as malnutrition, HIV, tuberculosis and limited access to healthcare, among others, may worsen both transmission dynamics and disease progression of SARS-CoV-2 compared to other countries, as well as the burden on the healthcare system. The United Nations Department of Economic and Social Affairs describes the pandemic as ‘… a tragedy, killing more than half a million people and bringing the economy and life to a standstill in many parts of the world. The containment measures have had profound impacts on people and their livelihood. Economic growth has slowed, unemployment increased, and poverty and hunger raised. The World Bank noted that ‘In addition to its immediate impact on health outcomes and, tragically, on lives, it is now clear that the coronavirus (COVID-19) outbreak is likely to have long-lasting economic and social impacts of global proportions stemming from the direct and indirect effects of illness, the preventive behaviours of people and the transmission control policies of governments. Several individual-level risk factors for severe COVID-19 disease and death have been identified especially within the major metropolitan areas. The pandemic is disproportionately affecting the poor, less educated and other vulnerable groups, and has aggravated existing social, economic, and health inequities, and long-standing systemic inequalities. Transmission of SARS-CoV-2 appears heightened in certain types of urban areas, for example areas with high-rise apartment buildings, such as Hillbrow. Residents of informal settlements are also particularly vulnerable because of ‘lack of basic needs such as water, toilets, sewers, drainage, waste collection, and secure and adequate housing’ and because of ‘… space constraints, violence, and overcrowding in slums (that) make physical distancing and self-quarantine impractical, and the rapid spread of an infection highly likely

Primary Objectives

1. Describe knowledge, attitudes, perceptions and practices related to COVID-19, including around prevention and the potential uptake of the COVID-19 vaccine

2. Explore the economic, social and health impacts of mitigation measures, and changes in health care seeking during the first wave of the COVID-19 pandemic

3. Determine the percentage of the population previously infected with SARS-CoV-2 following the first wave of the pandemic, by type of urban setting, age group and gender

Secondary Objectives

1. Identify individual-level risk factors for SARS-CoV-2 infection, including age, gender and underlying illnesses or comorbidities, as well as knowledge and behaviours related to COVID-19

2. Explore household-level risk factors for SARS-CoV-2 infection, including household size and water source

3. Estimate the extent of intra-household transmission (percent of household who are SARS-CoV-2 seropositive)

Primary Endpoint/Outcome

Knowledge, attitudes, perceptions and behaviours on COVID-19 as well as perceptions towards a future COVID-19 vaccine

Study Design

Cross-sectional questionnaire-based and sero survey among residents in randomly selected dwellings in three urban sites in Gauteng Province

Study Population

Households residents in dwellings within the study area


Wits RHI

  • Dr. Thesla Palanee-Phillips, Principal Investigator
  • Ms. Krishnaveni Reddy, Sub-Investigator


  • Dr Abraham Jacobus Herbst, Co-Principal Investigator
  • Associate Professor Mark Collinson, Co-Principal Investigator
  • Mr Tinofa Mutevedzi, Co Investigator


Department of Science and Innovation

South African Medical Research Council

Latest Update: 20 August 2021

For more about SAPRIN Sub-Study please email