Dynamics of factors associated with rates of COVID-19 cases and deaths in African countries

BACKGROUND: African countries have not had the high case and death rates from COVID-19 as was predicted early in the pandemic. It is not well understood what factors modulated the rate of COVID-19 cases and death on the continent. METHODS: We collated data from the World Bank data site, Our World in Data and Freedom House for African for 54 African countries who are members of the African Union. We used them as explanatory variables in two general linear model regression analyses. COVID cases and deaths per 100,000 obtained from WHO COVID-19 dashboard on August 12, 2021, as outcome variables in two prediction models. RESULTS: GDP, percentage of population under 14 years of age, Maternal Mortality Ratio, number of international tourists visiting per year and public transportation closures were not significant in predicting COVID-19 cases. Higher percentage of unemployed adults in the population, lower percentage of the population over 25 years of age with secondary education, internal travel restrictions increased spread of COVID-19 while international travel restrictions were associated with lower COVID-19 cases per 100,000 population. Higher levels of democratization results in higher cases of COVID-19. Unemployment, education and democratization were still significant for COVID-19 death in the same direction as they were for COVID-19 cases. Number of tourism visitors per year was also associated with higher COVID-19 death rates but not with case rates. CONCLUSION: In African countries, internal movement restrictions enacted to inhibit COVID-19, had the opposite effect and enabled COVID-19 spread. Low Education levels and high unemployment were associated with having higher death rates from COVID-19. More studies are needed to understand the impact of tourism on COVID-19 and other infectious diseases arising from other regions on African countries, in order to put in place adequate control protocols.