Author | James, Ananthu | |
Author | Dalal, Jyoti | |
Author | Kousi, Timokleia | |
Author | Vivacqua, Daniela | |
Author | Câmara, Daniel Cardoso Portela | |
Author | Reis, Izabel Cristina Dos | |
Author | Mesa, Sara Botero | |
Author | Ng’ambi, Wignston | |
Author | Ansobi, Papy | |
Author | Bianchi, Lucas M | |
Author | Lee, Theresa M | |
Author | Ogundiran, Opeayo | |
Author | Stoll, Beat | |
Author | Chimbetete, Cleophas | |
Author | Mboussou, Franck | |
Author | Impouma, Benido | |
Author | Hofer, Cristina Barroso | |
Author | Coelho, Flávio Codeço | |
Author | Keiser, Olivia | |
Author | Abbate, Jessica Lee | |
Access date | 2023-02-06T13:20:52Z | |
Available date | 2023-02-06T13:20:52Z | |
Document date | 2022 | |
Citation | JAMES, Ananthu et al. An in-depth statistical analysis of the COVID-19 pandemic’s initial spread in the WHO African region. BMJ Global Health v. 7, e007295, p. 1-10, Feb. 2022. | en_US |
ISSN | 2059-7908 | en_US |
URI | https://www.arca.fiocruz.br/handle/icict/56878 | |
Language | eng | en_US |
Publisher | BMJ Open | en_US |
Rights | open access | |
Subject in Portuguese | COVID-19 | en_US |
Subject in Portuguese | Análise estatística | en_US |
Subject in Portuguese | Propagação inicial da pandemia | en_US |
Subject in Portuguese | Região africana da OMS | en_US |
Title | An in-depth statistical analysis of the COVID-19 pandemic’s initial spread in the WHO African region | en_US |
Type | Article | |
DOI | 10.1136/ bmjgh-2021-007295 | |
Abstract | 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. | en_US |
Affilliation | Department of Chemical Engineering, Indian Institute of Science, Bangalore, Karnataka, India /The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland. | en_US |
Affilliation | The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland. | en_US |
Affilliation | The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland / Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland. | en_US |
Affilliation | The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland / Universidade Federal do Rio de Janeiro. Instituto de Puericultura e Pediatria Martagão Gesteira. Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Mosquitos Transmissores de Hematozoários. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Núcleo Operacional Sentinela de Mosquitos Vetores (NOSMOVE). Rio de Janeiro, RJ, Brasil / World Health Organization Regional Office for Africa, Brazzaville, Congo. | en_US |
Affilliation | The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laborat[orio de Mosquitos Transmissores de Hematozoários. Rio de Janeiro, RJ, Brasil. Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Núcleo Operacional Sentinela de Mosquitos Vetores (NOSMOVE). Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland / Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland. | en_US |
Affilliation | The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland / Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland / Health Economics Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences, Lilongwe, Malawi. | en_US |
Affilliation | The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland / Research and Training Unit in Ecology and Control of Infectious Diseases (URF-ECMI), Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo. | en_US |
Affilliation | The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland / World Health Organization Regional Office for Africa, Brazzaville, Congo / Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | World Health Organization Regional Office for Africa, Brazzaville, Congo. | en_US |
Affilliation | World Health Organization Regional Office for Africa, Brazzaville, Congo. | en_US |
Affilliation | Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland. | en_US |
Affilliation | The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland / Newlands Clinic, Harare, Zimbabwe. | en_US |
Affilliation | World Health Organization Regional Office for Africa, Brazzaville, Congo. | en_US |
Affilliation | World Health Organization Regional Office for Africa, Brazzaville, Congo. | en_US |
Affilliation | The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland / Universidade Federal do Rio de Janeiro. Instituto de Puericultura e Pediatria Martagão Gesteira. Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland / School of Applied Mathematics, Getulio Vargas Foundation, Rio de Janeiro, Brazil. | en_US |
Affilliation | The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland / Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland. | en_US |
Affilliation | The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland / World Health Organization Regional Office for Africa, Brazzaville, Congo / UMI TransVIHMI (Institut de Recherche pour le Développement Institut National de la Santé et de la Recherche Médicale Université de Montpellier), Montpellier, France / Geomatys, Montpellier, France. | en_US |
Subject | COVID-19 | en_US |
Subject | Statistical analysis | en_US |
Subject | Pandemic’s initial spread | en_US |
Subject | WHO African region | en_US |