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One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in Rwanda

The African region was predicted to have worse COVID-19 infection and death rates due to challenging health systems and social determinants of health. However, in the 10 months after its first case, Rwanda recorded 10316 cases and 133 COVID-19-related deaths translating to a case fatality rate (CFR)...

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Autores principales: Musanabaganwa, Clarisse, Cubaka, Vincent, Mpabuka, Etienne, Semakula, Muhammed, Nahayo, Ernest, Hedt-Gauthier, Bethany L, Ng, Kamela C S, Murray, Megan B, Kateera, Fredrick, Mutesa, Leon, Nsanzimana, Sabin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7907833/
https://www.ncbi.nlm.nih.gov/pubmed/33627363
http://dx.doi.org/10.1136/bmjgh-2020-004547
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author Musanabaganwa, Clarisse
Cubaka, Vincent
Mpabuka, Etienne
Semakula, Muhammed
Nahayo, Ernest
Hedt-Gauthier, Bethany L
Ng, Kamela C S
Murray, Megan B
Kateera, Fredrick
Mutesa, Leon
Nsanzimana, Sabin
author_facet Musanabaganwa, Clarisse
Cubaka, Vincent
Mpabuka, Etienne
Semakula, Muhammed
Nahayo, Ernest
Hedt-Gauthier, Bethany L
Ng, Kamela C S
Murray, Megan B
Kateera, Fredrick
Mutesa, Leon
Nsanzimana, Sabin
author_sort Musanabaganwa, Clarisse
collection PubMed
description The African region was predicted to have worse COVID-19 infection and death rates due to challenging health systems and social determinants of health. However, in the 10 months after its first case, Rwanda recorded 10316 cases and 133 COVID-19-related deaths translating to a case fatality rate (CFR) of 1.3%, which raised the question: why does Rwanda have a low COVID-19 CFR? Here we analysed COVID-19 data and explored possible explanations to better understand the disease burden in the context of Rwanda’s infection control strategies. We investigated whether the age distribution plays a role in the observed low CFR in Rwanda by comparing the expected number of deaths for 10-year age bands based on the CFR reported in other countries with the observed number of deaths for each age group. We found that the age-specific CFRs in Rwanda are similar to or, in some older age groups, slightly higher than those in other countries, suggesting that the lower population level CFR reflects the younger age structure in Rwanda, rather than a lower risk of death conditional on age. We also accounted for Rwanda’s comprehensive SARS-CoV-2 testing strategies and reliable documentation of COVID-19-related deaths and deduced that these measures may have allowed them to likely identify more asymptomatic or mild cases than other countries and reduced their reported CFR. Overall, the observed low COVID-19 deaths in Rwanda is likely influenced by the combination of effective infection control strategies, reliable identification of cases and reporting of deaths, and the population’s young age structure.
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spelling pubmed-79078332021-02-26 One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in Rwanda Musanabaganwa, Clarisse Cubaka, Vincent Mpabuka, Etienne Semakula, Muhammed Nahayo, Ernest Hedt-Gauthier, Bethany L Ng, Kamela C S Murray, Megan B Kateera, Fredrick Mutesa, Leon Nsanzimana, Sabin BMJ Glob Health Analysis The African region was predicted to have worse COVID-19 infection and death rates due to challenging health systems and social determinants of health. However, in the 10 months after its first case, Rwanda recorded 10316 cases and 133 COVID-19-related deaths translating to a case fatality rate (CFR) of 1.3%, which raised the question: why does Rwanda have a low COVID-19 CFR? Here we analysed COVID-19 data and explored possible explanations to better understand the disease burden in the context of Rwanda’s infection control strategies. We investigated whether the age distribution plays a role in the observed low CFR in Rwanda by comparing the expected number of deaths for 10-year age bands based on the CFR reported in other countries with the observed number of deaths for each age group. We found that the age-specific CFRs in Rwanda are similar to or, in some older age groups, slightly higher than those in other countries, suggesting that the lower population level CFR reflects the younger age structure in Rwanda, rather than a lower risk of death conditional on age. We also accounted for Rwanda’s comprehensive SARS-CoV-2 testing strategies and reliable documentation of COVID-19-related deaths and deduced that these measures may have allowed them to likely identify more asymptomatic or mild cases than other countries and reduced their reported CFR. Overall, the observed low COVID-19 deaths in Rwanda is likely influenced by the combination of effective infection control strategies, reliable identification of cases and reporting of deaths, and the population’s young age structure. BMJ Publishing Group 2021-02-24 /pmc/articles/PMC7907833/ /pubmed/33627363 http://dx.doi.org/10.1136/bmjgh-2020-004547 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Analysis
Musanabaganwa, Clarisse
Cubaka, Vincent
Mpabuka, Etienne
Semakula, Muhammed
Nahayo, Ernest
Hedt-Gauthier, Bethany L
Ng, Kamela C S
Murray, Megan B
Kateera, Fredrick
Mutesa, Leon
Nsanzimana, Sabin
One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in Rwanda
title One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in Rwanda
title_full One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in Rwanda
title_fullStr One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in Rwanda
title_full_unstemmed One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in Rwanda
title_short One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in Rwanda
title_sort one hundred thirty-three observed covid-19 deaths in 10 months: unpacking lower than predicted mortality in rwanda
topic Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7907833/
https://www.ncbi.nlm.nih.gov/pubmed/33627363
http://dx.doi.org/10.1136/bmjgh-2020-004547
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