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COVID-19 in the 47 countries of the WHO African region: a modelling analysis of past trends and future patterns

BACKGROUND: COVID-19 has affected the African region in many ways. We aimed to generate robust information on the transmission dynamics of COVID-19 in this region since the beginning of the pandemic and throughout 2022. METHODS: For each of the 47 countries of the WHO African region, we consolidated...

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Autores principales: Cabore, Joseph Waogodo, Karamagi, Humphrey Cyprian, Kipruto, Hillary Kipchumba, Mungatu, Joseph Kyalo, Asamani, James Avoka, Droti, Benson, Titi-ofei, Regina, Seydi, Aminata Binetou Wahebine, Kidane, Solyana Ngusbrhan, Balde, Thierno, Gueye, Abdou Salam, Makubalo, Lindiwe, Moeti, Matshidiso R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9159735/
https://www.ncbi.nlm.nih.gov/pubmed/35659911
http://dx.doi.org/10.1016/S2214-109X(22)00233-9
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author Cabore, Joseph Waogodo
Karamagi, Humphrey Cyprian
Kipruto, Hillary Kipchumba
Mungatu, Joseph Kyalo
Asamani, James Avoka
Droti, Benson
Titi-ofei, Regina
Seydi, Aminata Binetou Wahebine
Kidane, Solyana Ngusbrhan
Balde, Thierno
Gueye, Abdou Salam
Makubalo, Lindiwe
Moeti, Matshidiso R
author_facet Cabore, Joseph Waogodo
Karamagi, Humphrey Cyprian
Kipruto, Hillary Kipchumba
Mungatu, Joseph Kyalo
Asamani, James Avoka
Droti, Benson
Titi-ofei, Regina
Seydi, Aminata Binetou Wahebine
Kidane, Solyana Ngusbrhan
Balde, Thierno
Gueye, Abdou Salam
Makubalo, Lindiwe
Moeti, Matshidiso R
author_sort Cabore, Joseph Waogodo
collection PubMed
description BACKGROUND: COVID-19 has affected the African region in many ways. We aimed to generate robust information on the transmission dynamics of COVID-19 in this region since the beginning of the pandemic and throughout 2022. METHODS: For each of the 47 countries of the WHO African region, we consolidated COVID-19 data from reported infections and deaths (from WHO statistics); published literature on socioecological, biophysical, and public health interventions; and immunity status and variants of concern, to build a dynamic and comprehensive picture of COVID-19 burden. The model is consolidated through a partially observed Markov decision process, with a Fourier series to produce observed patterns over time based on the SEIRD (denoting susceptible, exposed, infected, recovered, and dead) modelling framework. The model was set up to run weekly, by country, from the date the first infection was reported in each country until Dec 31, 2021. New variants were introduced into the model based on sequenced data reported by countries. The models were then extrapolated until the end of 2022 and included three scenarios based on possible new variants with varying transmissibility, severity, or immunogenicity. FINDINGS: Between Jan 1, 2020, and Dec 31, 2021, our model estimates the number of SARS-CoV-2 infections in the African region to be 505·6 million (95% CI 476·0–536·2), inferring that only 1·4% (one in 71) of SARS-CoV-2 infections in the region were reported. Deaths are estimated at 439 500 (95% CI 344 374–574 785), with 35·3% (one in three) of these reported as COVID-19-related deaths. Although the number of infections were similar between 2020 and 2021, 81% of the deaths were in 2021. 52·3% (95% CI 43·5–95·2) of the region's population is estimated to have some SARS-CoV-2 immunity, given vaccination coverage of 14·7% as of Dec 31, 2021. By the end of 2022, we estimate that infections will remain high, at around 166·2 million (95% CI 157·5–174·9) infections, but deaths will substantially reduce to 22 563 (14 970–38 831). INTERPRETATION: The African region is estimated to have had a similar number of COVID-19 infections to that of the rest of the world, but with fewer deaths. Our model suggests that the current approach to SARS-CoV-2 testing is missing most infections. These results are consistent with findings from representative seroprevalence studies. There is, therefore, a need for surveillance of hospitalisations, comorbidities, and the emergence of new variants of concern, and scale-up of representative seroprevalence studies, as core response strategies. FUNDING: None.
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spelling pubmed-91597352022-06-02 COVID-19 in the 47 countries of the WHO African region: a modelling analysis of past trends and future patterns Cabore, Joseph Waogodo Karamagi, Humphrey Cyprian Kipruto, Hillary Kipchumba Mungatu, Joseph Kyalo Asamani, James Avoka Droti, Benson Titi-ofei, Regina Seydi, Aminata Binetou Wahebine Kidane, Solyana Ngusbrhan Balde, Thierno Gueye, Abdou Salam Makubalo, Lindiwe Moeti, Matshidiso R Lancet Glob Health Articles BACKGROUND: COVID-19 has affected the African region in many ways. We aimed to generate robust information on the transmission dynamics of COVID-19 in this region since the beginning of the pandemic and throughout 2022. METHODS: For each of the 47 countries of the WHO African region, we consolidated COVID-19 data from reported infections and deaths (from WHO statistics); published literature on socioecological, biophysical, and public health interventions; and immunity status and variants of concern, to build a dynamic and comprehensive picture of COVID-19 burden. The model is consolidated through a partially observed Markov decision process, with a Fourier series to produce observed patterns over time based on the SEIRD (denoting susceptible, exposed, infected, recovered, and dead) modelling framework. The model was set up to run weekly, by country, from the date the first infection was reported in each country until Dec 31, 2021. New variants were introduced into the model based on sequenced data reported by countries. The models were then extrapolated until the end of 2022 and included three scenarios based on possible new variants with varying transmissibility, severity, or immunogenicity. FINDINGS: Between Jan 1, 2020, and Dec 31, 2021, our model estimates the number of SARS-CoV-2 infections in the African region to be 505·6 million (95% CI 476·0–536·2), inferring that only 1·4% (one in 71) of SARS-CoV-2 infections in the region were reported. Deaths are estimated at 439 500 (95% CI 344 374–574 785), with 35·3% (one in three) of these reported as COVID-19-related deaths. Although the number of infections were similar between 2020 and 2021, 81% of the deaths were in 2021. 52·3% (95% CI 43·5–95·2) of the region's population is estimated to have some SARS-CoV-2 immunity, given vaccination coverage of 14·7% as of Dec 31, 2021. By the end of 2022, we estimate that infections will remain high, at around 166·2 million (95% CI 157·5–174·9) infections, but deaths will substantially reduce to 22 563 (14 970–38 831). INTERPRETATION: The African region is estimated to have had a similar number of COVID-19 infections to that of the rest of the world, but with fewer deaths. Our model suggests that the current approach to SARS-CoV-2 testing is missing most infections. These results are consistent with findings from representative seroprevalence studies. There is, therefore, a need for surveillance of hospitalisations, comorbidities, and the emergence of new variants of concern, and scale-up of representative seroprevalence studies, as core response strategies. FUNDING: None. Elsevier Ltd 2022-06-01 /pmc/articles/PMC9159735/ /pubmed/35659911 http://dx.doi.org/10.1016/S2214-109X(22)00233-9 Text en © 2022 World Health Organization https://creativecommons.org/licenses/by-nc-nd/3.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
spellingShingle Articles
Cabore, Joseph Waogodo
Karamagi, Humphrey Cyprian
Kipruto, Hillary Kipchumba
Mungatu, Joseph Kyalo
Asamani, James Avoka
Droti, Benson
Titi-ofei, Regina
Seydi, Aminata Binetou Wahebine
Kidane, Solyana Ngusbrhan
Balde, Thierno
Gueye, Abdou Salam
Makubalo, Lindiwe
Moeti, Matshidiso R
COVID-19 in the 47 countries of the WHO African region: a modelling analysis of past trends and future patterns
title COVID-19 in the 47 countries of the WHO African region: a modelling analysis of past trends and future patterns
title_full COVID-19 in the 47 countries of the WHO African region: a modelling analysis of past trends and future patterns
title_fullStr COVID-19 in the 47 countries of the WHO African region: a modelling analysis of past trends and future patterns
title_full_unstemmed COVID-19 in the 47 countries of the WHO African region: a modelling analysis of past trends and future patterns
title_short COVID-19 in the 47 countries of the WHO African region: a modelling analysis of past trends and future patterns
title_sort covid-19 in the 47 countries of the who african region: a modelling analysis of past trends and future patterns
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9159735/
https://www.ncbi.nlm.nih.gov/pubmed/35659911
http://dx.doi.org/10.1016/S2214-109X(22)00233-9
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