New study challenges understanding of pandemic preparedness and
resilience in Africa

Date:
September 15, 2021
Source:
University of Edinburgh
Summary:
Countries in Africa assessed as being least vulnerable to an
epidemic were the worst affected by Covid-19, new research suggests.



FULL STORY ========================================================================== Countries in Africa assessed as being least vulnerable to an epidemic
were the worst affected by Covid-19, new research suggests.


========================================================================== Nations with more urban populations and strong international travel
links were worst affected by the pandemic, the study shows.

Mortality rates and levels of restrictions -- such as lockdowns and
travel bans -- were found to be lowest in countries previously thought
to be at greatest risk from Covid-19.

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

Professor Mark Woolhouse, TIBA Director, 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 findings
challenge our understanding of vulnerability to pandemics.

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



========================================================================== "That seemingly well-prepared, resilient countries have fared worst 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 44 countries of the WHO African Region
with available data, South Africa had the highest mortality rate during
the first wave between May and August 2020, at 33.3 deaths recorded per
100,000 people. Cape Verde and Eswatini had the next highest rates at
17.5 and 8.6 deaths per 100,000, respectively. At 0.26 deaths recorded
per 100,000, the lowest mortality rate was in Uganda.

South Africa also recorded the highest mortality rate during the
second wave between December 2020 and February 2021, at 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 early models which predicted how Covid-19 would lead to a massive
number of cases in Africa were largely the work of institutions not
from our continent. This collaboration between researchers in Africa
and Europe underlines the importance of anchoring analysis on Africa's epidemics firmly here," said Dr. Matshidiso Moeti, WHO Regional Director
for Africa and co- author. We can no longer focus our understanding of
disease transmission purely on the characteristics of a virus -- Covid-19 operates within a social context which has a major impact on its spread."
As well as those with large urban populations and strong international
travel links, countries with high rates of HIV were also more likely to
have higher mortality rates. This may be because people with HIV often
have other health conditions that put them at greater risk from Covid-19,
the team suggests.



==========================================================================
The weak link between mortality rate and the timing or severity of
government- imposed restrictions on day-to-day activities is shows
the impact of the wide range of application and enforcement of these restrictions across the region, making a consistent impact pattern
difficult to discern. Restrictions during peaks of infection are well documented to have interrupted transmission in the region.

The findings show that the earliest 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 25 February 2020. Most countries
had recorded cases by late March 2020, with Lesotho the last to report
one, on 14 May 2020.

Researchers document higher deaths during the second wave, as compared to
the first. The peak of infections during the second wave was also higher,
with 675 deaths across the continent on 18 January 2021 compared with 323 during the first wave peak on 5 August 2020. Potential under-reporting
was accounted for in the analysis.

Dr Sarah Puddicombe, NIHR's Assistant Director for Global Health
Research, said: "This study offers compelling results which challenge
accepted views of epidemic preparedness and resilience in Africa. It is
one of a series of important contributions that the TIBA partnership,
working 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, was supported by
the UK National Institute for Health Research and the Darwin Trust of Edinburgh. It also involved researchers from the Universities of Nairobi,
Ghana and Hong Kong.

========================================================================== Story Source: Materials provided by University_of_Edinburgh. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Feifei Zhang, Humphrey Karamagi, Ngoy Nsenga, Miriam Nanyunja,
Miriam
Karinja, Seth Amanfo, Margo Chase-Topping, Giles Calder-Gerver,
Miles McGibbon, Alexandra Huber, Tara Wagner-Gamble, Chuan-Guo
Guo, Samuel Haynes, Alistair Morrison, Miranda Ferguson, Gordon
A. Awandare, Francisca Mutapi, Zabulon Yoti, Joseph Cabore,
Matshidiso R. Moeti, Mark E. J. Woolhouse. Predictors of COVID-19
epidemics in countries of the World Health Organization African
Region. Nature Medicine, 2021; DOI: 10.1038/s41591-021-01491-7 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/09/210915135204.htm

--- up 1 week, 6 days, 8 hours, 25 minutes
* Origin: -=> Castle Rock BBS <=- Now Husky HPT Powered! (1:317/3)