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An in-depth statistical analysis of the COVID-19 pandemic’s initial spread in the WHO African region

During the first wave of the COVID-19 pandemic, sub-Saharan African countries experienced comparatively lower rates of SARS-CoV-2 infections and related deaths than in other parts of the world, the reasons for which remain unclear. Yet, there was also considerable variation between countries. Here,...

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Autores principales: James, Ananthu, Dalal, Jyoti, Kousi, Timokleia, Vivacqua, Daniela, Câmara, Daniel Cardoso Portela, Dos Reis, Izabel Cristina, Botero Mesa, Sara, Ng’ambi, Wignston, Ansobi, Papy, Bianchi, Lucas M, Lee, Theresa M, Ogundiran, Opeayo, Stoll, Beat, Chimbetete, Cleophas, Mboussou, Franck, Impouma, Benido, Hofer, Cristina Barroso, Coelho, Flávio Codeço, Keiser, Olivia, Abbate, Jessica Lee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9013786/
https://www.ncbi.nlm.nih.gov/pubmed/35418411
http://dx.doi.org/10.1136/bmjgh-2021-007295
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author James, Ananthu
Dalal, Jyoti
Kousi, Timokleia
Vivacqua, Daniela
Câmara, Daniel Cardoso Portela
Dos Reis, Izabel Cristina
Botero Mesa, Sara
Ng’ambi, Wignston
Ansobi, Papy
Bianchi, Lucas M
Lee, Theresa M
Ogundiran, Opeayo
Stoll, Beat
Chimbetete, Cleophas
Mboussou, Franck
Impouma, Benido
Hofer, Cristina Barroso
Coelho, Flávio Codeço
Keiser, Olivia
Abbate, Jessica Lee
author_facet James, Ananthu
Dalal, Jyoti
Kousi, Timokleia
Vivacqua, Daniela
Câmara, Daniel Cardoso Portela
Dos Reis, Izabel Cristina
Botero Mesa, Sara
Ng’ambi, Wignston
Ansobi, Papy
Bianchi, Lucas M
Lee, Theresa M
Ogundiran, Opeayo
Stoll, Beat
Chimbetete, Cleophas
Mboussou, Franck
Impouma, Benido
Hofer, Cristina Barroso
Coelho, Flávio Codeço
Keiser, Olivia
Abbate, Jessica Lee
author_sort James, Ananthu
collection PubMed
description During the first wave of the COVID-19 pandemic, sub-Saharan African countries experienced comparatively lower rates of SARS-CoV-2 infections and related deaths than in other parts of the world, the reasons for which remain unclear. Yet, there was also considerable variation between countries. Here, we explored potential drivers of this variation among 46 of the 47 WHO African region Member States in a cross-sectional study. We described five indicators of early COVID-19 spread and severity for each country as of 29 November 2020: delay in detection of the first case, length of the early epidemic growth period, cumulative and peak attack rates and crude case fatality ratio (CFR). We tested the influence of 13 pre-pandemic and pandemic response predictor variables on the country-level variation in the spread and severity indicators using multivariate statistics and regression analysis. We found that wealthier African countries, with larger tourism industries and older populations, had higher peak (p<0.001) and cumulative (p<0.001) attack rates, and lower CFRs (p=0.021). More urbanised countries also had higher attack rates (p<0.001 for both indicators). Countries applying more stringent early control policies experienced greater delay in detection of the first case (p<0.001), but the initial propagation of the virus was slower in relatively wealthy, touristic African countries (p=0.023). Careful and early implementation of strict government policies were likely pivotal to delaying the initial phase of the pandemic, but did not have much impact on other indicators of spread and severity. An over-reliance on disruptive containment measures in more resource-limited contexts is neither effective nor sustainable. We thus urge decision-makers to prioritise the reduction of resource-based health disparities, and surveillance and response capacities in particular, to ensure global resilience against future threats to public health and economic stability.
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spelling pubmed-90137862022-04-20 An in-depth statistical analysis of the COVID-19 pandemic’s initial spread in the WHO African region James, Ananthu Dalal, Jyoti Kousi, Timokleia Vivacqua, Daniela Câmara, Daniel Cardoso Portela Dos Reis, Izabel Cristina Botero Mesa, Sara Ng’ambi, Wignston Ansobi, Papy Bianchi, Lucas M Lee, Theresa M Ogundiran, Opeayo Stoll, Beat Chimbetete, Cleophas Mboussou, Franck Impouma, Benido Hofer, Cristina Barroso Coelho, Flávio Codeço Keiser, Olivia Abbate, Jessica Lee BMJ Glob Health Original Research During the first wave of the COVID-19 pandemic, sub-Saharan African countries experienced comparatively lower rates of SARS-CoV-2 infections and related deaths than in other parts of the world, the reasons for which remain unclear. Yet, there was also considerable variation between countries. Here, we explored potential drivers of this variation among 46 of the 47 WHO African region Member States in a cross-sectional study. We described five indicators of early COVID-19 spread and severity for each country as of 29 November 2020: delay in detection of the first case, length of the early epidemic growth period, cumulative and peak attack rates and crude case fatality ratio (CFR). We tested the influence of 13 pre-pandemic and pandemic response predictor variables on the country-level variation in the spread and severity indicators using multivariate statistics and regression analysis. We found that wealthier African countries, with larger tourism industries and older populations, had higher peak (p<0.001) and cumulative (p<0.001) attack rates, and lower CFRs (p=0.021). More urbanised countries also had higher attack rates (p<0.001 for both indicators). Countries applying more stringent early control policies experienced greater delay in detection of the first case (p<0.001), but the initial propagation of the virus was slower in relatively wealthy, touristic African countries (p=0.023). Careful and early implementation of strict government policies were likely pivotal to delaying the initial phase of the pandemic, but did not have much impact on other indicators of spread and severity. An over-reliance on disruptive containment measures in more resource-limited contexts is neither effective nor sustainable. We thus urge decision-makers to prioritise the reduction of resource-based health disparities, and surveillance and response capacities in particular, to ensure global resilience against future threats to public health and economic stability. BMJ Publishing Group 2022-04-12 /pmc/articles/PMC9013786/ /pubmed/35418411 http://dx.doi.org/10.1136/bmjgh-2021-007295 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://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/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
James, Ananthu
Dalal, Jyoti
Kousi, Timokleia
Vivacqua, Daniela
Câmara, Daniel Cardoso Portela
Dos Reis, Izabel Cristina
Botero Mesa, Sara
Ng’ambi, Wignston
Ansobi, Papy
Bianchi, Lucas M
Lee, Theresa M
Ogundiran, Opeayo
Stoll, Beat
Chimbetete, Cleophas
Mboussou, Franck
Impouma, Benido
Hofer, Cristina Barroso
Coelho, Flávio Codeço
Keiser, Olivia
Abbate, Jessica Lee
An in-depth statistical analysis of the COVID-19 pandemic’s initial spread in the WHO African region
title An in-depth statistical analysis of the COVID-19 pandemic’s initial spread in the WHO African region
title_full An in-depth statistical analysis of the COVID-19 pandemic’s initial spread in the WHO African region
title_fullStr An in-depth statistical analysis of the COVID-19 pandemic’s initial spread in the WHO African region
title_full_unstemmed An in-depth statistical analysis of the COVID-19 pandemic’s initial spread in the WHO African region
title_short An in-depth statistical analysis of the COVID-19 pandemic’s initial spread in the WHO African region
title_sort in-depth statistical analysis of the covid-19 pandemic’s initial spread in the who african region
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9013786/
https://www.ncbi.nlm.nih.gov/pubmed/35418411
http://dx.doi.org/10.1136/bmjgh-2021-007295
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