TY - JOUR
T1 - Predictors of COVID-19 epidemics in countries of the World Health Organization African Region
AU - Zhang, Feifei
AU - Karamagi, Humphrey
AU - Nsenga, Ngoy
AU - Nanyunja, Miriam
AU - Karinja, Miriam
AU - Amanfo, Seth
AU - Chase-Topping, Margo
AU - Calder-Gerver, Giles
AU - McGibbon, Miles
AU - Huber, Alexandra
AU - Wagner-Gamble, Tara
AU - Guo, Chuan Guo
AU - Haynes, Samuel
AU - Morrison, Alistair
AU - Ferguson, Miranda
AU - Awandare, Gordon A.
AU - Mutapi, Francisca
AU - Yoti, Zabulon
AU - Cabore, Joseph
AU - Moeti, Matshidiso R.
AU - Woolhouse, Mark E.J.
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021/11
Y1 - 2021/11
N2 - Countries of the World Health Organization (WHO) African Region have experienced a wide range of coronavirus disease 2019 (COVID-19) epidemics. This study aimed to identify predictors of the timing of the first COVID-19 case and the per capita mortality in WHO African Region countries during the first and second pandemic waves and to test for associations with the preparedness of health systems and government pandemic responses. Using a region-wide, country-based observational study, we found that the first case was detected earlier in countries with more urban populations, higher international connectivity and greater COVID-19 test capacity but later in island nations. Predictors of a high first wave per capita mortality rate included a more urban population, higher pre-pandemic international connectivity and a higher prevalence of HIV. Countries rated as better prepared and having more resilient health systems were worst affected by the disease, the imposition of restrictions or both, making any benefit of more stringent countermeasures difficult to detect. Predictors for the second wave were similar to the first. Second wave per capita mortality could be predicted from that of the first wave. The COVID-19 pandemic highlights unanticipated vulnerabilities to infectious disease in Africa that should be taken into account in future pandemic preparedness planning.
AB - Countries of the World Health Organization (WHO) African Region have experienced a wide range of coronavirus disease 2019 (COVID-19) epidemics. This study aimed to identify predictors of the timing of the first COVID-19 case and the per capita mortality in WHO African Region countries during the first and second pandemic waves and to test for associations with the preparedness of health systems and government pandemic responses. Using a region-wide, country-based observational study, we found that the first case was detected earlier in countries with more urban populations, higher international connectivity and greater COVID-19 test capacity but later in island nations. Predictors of a high first wave per capita mortality rate included a more urban population, higher pre-pandemic international connectivity and a higher prevalence of HIV. Countries rated as better prepared and having more resilient health systems were worst affected by the disease, the imposition of restrictions or both, making any benefit of more stringent countermeasures difficult to detect. Predictors for the second wave were similar to the first. Second wave per capita mortality could be predicted from that of the first wave. The COVID-19 pandemic highlights unanticipated vulnerabilities to infectious disease in Africa that should be taken into account in future pandemic preparedness planning.
UR - http://www.scopus.com/inward/record.url?scp=85114614672&partnerID=8YFLogxK
U2 - 10.1038/s41591-021-01491-7
DO - 10.1038/s41591-021-01491-7
M3 - Article
C2 - 34480125
AN - SCOPUS:85114614672
SN - 1078-8956
VL - 27
SP - 2041
EP - 2047
JO - Nature Medicine
JF - Nature Medicine
IS - 11
ER -