New study questions understanding of pandemic preparedness and resilience in Africa – world

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African countries assessed as the least vulnerable to an epidemic have been the most affected by COVID-19, according to a new study.

Countries with more urban populations and strong international travel links have been hit hardest by the pandemic, according to the study.

Death rates and levels of restrictions – such as roadblocks and travel bans – have been found to be lowest in countries previously thought to be most at risk of COVID-19.

A team of researchers from the NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA) at the University of Edinburgh worked with the African Region of the World Health Organization (WHO) to identify the factors affecting death rates during the first two waves of COVID-19 in Africa and the timing of the first reported cases.

Professor Mark Woolhouse, Director of TIBA, who co-led the study, said: “Our study shows very clearly that multiple factors influence the extent to which African countries are affected by COVID-19. These results challenge our understanding of vulnerability to pandemics.

“Our results show that we should not equate high levels of preparedness and resilience with low vulnerability.

“The fact that apparently well prepared and resilient countries suffered the worst tests during the pandemic is not only true in Africa; the result is consistent with a global trend that more developed countries have often been particularly hard hit by COVID-19. “

Among the 44 countries in the WHO African Region for which data are available, South Africa recorded the highest death rate in the first wave between May and August 2020, with 33.3 deaths recorded per 100,000 people. Cape Verde and Eswatini had the next highest rates with 17.5 and 8.6 deaths per 100,000, respectively. With 0.26 registered deaths per 100,000, the lowest death rate was in Uganda.

South Africa also recorded the highest death rate during the second wave between December 2020 and February 2021, with 55.4 deaths per 100,000. Eswatini and Botswana recorded rates of 39.8 and 17.7 deaths per 100,000, respectively. The lowest rate was in Mauritius, which recorded no deaths during the second wave.

“The first models that predicted how COVID-19 would lead to massive numbers of cases in Africa were largely the work of institutions outside of our continent. This collaboration between researchers from Africa and Europe underlines the importance of anchoring the analysis firmly on African epidemics here, ”said Dr Matshidiso Moeti, WHO Regional Director for Africa and co- author. “We can no longer focus our understanding of disease transmission solely on the characteristics of a virus – COVID-19 operates in a social context that has a major impact on its spread.”

In addition to those with large urban populations and strong international travel links, countries with high rates of HIV were also more likely to have higher death rates. This may be because people living with HIV often have other health conditions that put them at increased risk for COVID-19, the team suggests.

The weak link between the death rate and the timing or severity of government-imposed restrictions on day-to-day activities shows the impact of the wide range of applications and enforcement of these restrictions in the region, making it difficult to discern a consistent impact pattern. . It is well documented that restrictions during peak infection have interrupted transmission in the region.

The results show that the first recorded cases of COVID-19 were in counties where most people live in urban areas, with strong international travel links and greater testing capacity. Algeria was the first of 47 African countries to report a case, on February 25, 2020. Most countries had registered cases by the end of March 2020, with Lesotho being the last to report one, on May 14, 2020.

Researchers document higher deaths during the second wave, compared to the first. The peak of infections during the second wave was also higher, with 675 deaths across the continent on January 18, 2021 compared to 323 during the peak of the first wave on August 5, 2020. The potential underreporting was taken into account. counts in the analysis.

Dr Sarah Puddicombe, NIHR Deputy Director for Global Health Research, said: “This study offers compelling results that challenge conventional wisdom about epidemic preparedness and resilience in Africa. It is one in a series of important contributions that the TIBA partnership, in collaboration with governments and the WHO Regional Office has made to inform local, national and pan-African responses to the COVID-19 pandemic. “

The study, published in the journal Nature Medicine, is available in open access: https://www.nature.com/articles/s41591-021-01491-7

The research was supported by the National Institute for Health Research in the United Kingdom and the Darwin Trust of Edinburgh. It also involved researchers from the universities of Nairobi, Ghana and Hong Kong.

For more information, please contact: Rhona Crawford, Press and Public Relations Office, Tel. : +44 131 650 2246 M: 07876391498 e-mail: [email protected] and Collins Boakye-Agyemang WHO Regional Office for Africa boakyeagyemangc @ who. Phone: + 242 06 520 65 65


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