An assessment of excess mortality during the COVID-19 pandemic, a retrospective post-mortem surveillance in 12 districts – Zambia, 2020–2022

Autor: Stephen Longa Chanda, Jonas Z. Hines, Warren Malambo, Amos Hamukale, Nathan Kapata, Nyambe Sinyange, Muzala Kapina, Luchenga Adam Mucheleng’anga, Roma Chilengi
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: BMC Public Health, Vol 24, Iss 1, Pp 1-11 (2024)
Druh dokumentu: article
ISSN: 1471-2458
DOI: 10.1186/s12889-024-20045-3
Popis: Abstract Background The number of COVID-19 deaths reported in Zambia (N = 4069) is most likely an underestimate due to limited testing, incomplete death registration and inability to account for indirect deaths due to socioeconomic disruption during the pandemic. We sought to assess excess mortality during the COVID-19 pandemic in Zambia. Methods We conducted a retrospective analysis of monthly-death-counts (2017–2022) and individual-daily-deaths (2020–2022) of all reported health facility and community deaths at district referral health facility mortuaries in 12 districts in Zambia. We defined COVID-19 wave periods based on a sustained nationally reported SARS-CoV-2 test positivity of greater than 5%. Excess mortality was calculated as the difference between observed monthly death counts during the pandemic (2020–2022) and the median monthly death counts from the pre-pandemic period (2017–2019), which served as the expected number of deaths. This calculation was conducted using a Microsoft Excel-based tool. We compared median daily death counts, median age at death, and the proportion of deaths by place of death (health facility vs. community) by wave period using the Mann-Whitney-U test and chi-square test respectively in R. Results A total of 112,768 deaths were reported in the 12 districts between 2020 and 2022, of which 17,111 (15.2%) were excess. Wave periods had higher median daily death counts than non-wave periods (median [IQR], 107 [95–126] versus 96 [85–107], p
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