| Autor: |
Lawrence Mwananyanda, William B MacLeod, Donald M Thea, Rachel C Pieciak, Christopher J Gill, Geoffrey Kwenda, Zachariah Mupila, Rotem Lapidot, Leah Forman, Lauren Etter, Ruth Nakazwe, Daniel Bridges, Chilufya Chikoti, Sarah Chirwa, Charles Chimoga, Ben Katowa, James Lungu, Japhet Matoba, Gift Mwinga, Benjamin Mubemba, Walter Muleya, Mulenga Mwenda, Benard Ngoma, Diana Nzara, Natalie Pawlak, Lillian Pemba, Ngonda Saasa, Edgar Simulundu, Baron Yankonde |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
BMJ Open, Vol 12, Iss 12 (2022) |
| Druh dokumentu: |
article |
| ISSN: |
2044-6055 |
| DOI: |
10.1136/bmjopen-2022-066763 |
| Popis: |
Objectives To determine the prevalence of COVID-19 postmortem setting in Lusaka, Zambia.Design A systematic, postmortem prevalence study.Setting A busy, inner-city morgue in Lusaka.Participants We sampled a random subset of all decedents who transited the University Teaching Hospital morgue. We sampled the posterior nasopharynx of decedents using quantitative PCR. Prevalence was weighted to account for age-specific enrolment strategies.Interventions Not applicable—this was an observational study.Primary outcomes Prevalence of COVID-19 detections by PCR. Results were stratified by setting (facility vs community deaths), age, demographics and geography and time.Secondary outcomes Shifts in viral variants; causal inferences based on cycle threshold values and other features; antemortem testing rates.Results From 1118 decedents enrolled between January and June 2021, COVID-19 was detected among 32.0% (358/1116). Roughly four COVID-19+ community deaths occurred for every facility death. Antemortem testing occurred for 52.6% (302/574) of facility deaths but only 1.8% (10/544) of community deaths and overall, only ~10% of COVID-19+ deaths were identified in life. During peak transmission periods, COVID-19 was detected in ~90% of all deaths. We observed three waves of transmission that peaked in July 2020, January 2021 and ~June 2021: the AE.1 lineage and the Beta and Delta variants, respectively. PCR signals were strongest among those whose deaths were deemed ‘probably due to COVID-19’, and weakest among children, with an age-dependent increase in PCR signal intensity.Conclusions COVID-19 was common among deceased individuals in Lusaka. Antemortem testing was rarely done, and almost never for community deaths. Suspicion that COVID-19 was the cause of deaths was highest for those with a respiratory syndrome and lowest for individuals |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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