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

Autor: Cabore JW; Senior Management, WHO Regional Office for Africa, Brazzaville, Republic of the Congo., Karamagi HC; Data Analytics and Knowledge Management, WHO Regional Office for Africa, Brazzaville, Republic of the Congo. Electronic address: karamagih@gmail.com., Kipruto HK; Universal Health Coverage-Life Course, WHO Regional Office for Africa, Brazzaville, Republic of the Congo., Mungatu JK; Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya., Asamani JA; Universal Health Coverage-Life Course, WHO Regional Office for Africa, Brazzaville, Republic of the Congo., Droti B; Universal Health Coverage-Life Course, WHO Regional Office for Africa, Brazzaville, Republic of the Congo., Titi-Ofei R; Data Analytics and Knowledge Management, WHO Regional Office for Africa, Brazzaville, Republic of the Congo., Seydi ABW; Data Analytics and Knowledge Management, WHO Regional Office for Africa, Brazzaville, Republic of the Congo., Kidane SN; Data Analytics and Knowledge Management, WHO Regional Office for Africa, Brazzaville, Republic of the Congo., Balde T; Emergency Preparedness and Response, WHO Regional Office for Africa, Brazzaville, Republic of the Congo., Gueye AS; Emergency Preparedness and Response, WHO Regional Office for Africa, Brazzaville, Republic of the Congo., Makubalo L; Senior Management, WHO Regional Office for Africa, Brazzaville, Republic of the Congo., Moeti MR; Senior Management, WHO Regional Office for Africa, Brazzaville, Republic of the Congo.
Jazyk: angličtina
Zdroj: The Lancet. Global health [Lancet Glob Health] 2022 Aug; Vol. 10 (8), pp. e1099-e1114. Date of Electronic Publication: 2022 Jun 01.
DOI: 10.1016/S2214-109X(22)00233-9
Abstrakt: 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.
Competing Interests: Declaration of interests We declare no competing interests.
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Databáze: MEDLINE