An Assessment of Systemic Factors and COVID-19 Mortality in Africa

Owoyemi, Ayomide; Balogun, Tolulope; Okoro, Joy; Ndoro, Tariro; Fasominu, Oluwakayode; Atanda, Adejare; Abioye, Ibraheem

doi:10.3389/ijph.2022.1604915

Cited by 4 publications

(1 citation statement)

References 25 publications

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“…COVID-19 mortality has been shown to disproportionately affect the elderly (31)(32)(33)(34). We observed an increase in the overall median age at death (44 years vs 41 years, p < 0.001) and in the proportion of deceased persons aged 65 years and older (27.7 per cent vs 23.4 per cent, p < 0.001) during COVID-19 wave periods with a return to baseline between wave periods respectively.…”

Section: Discussionmentioning

confidence: 60%

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

Chanda,

Hines,

Malambo

et al. 2024

Preprint

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Background The number of COVID-19 deaths reported in Zambia (N=4,069) 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 defined as the difference between the pandemic monthly death counts (2020-2022) and the median pre-pandemic monthly death counts (2017-2019) 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<0.001). The median age at death during wave periods was older than non-wave periods (44.0 [25.0-67.0] versus 41.0 [22.0-63.0] years, p<0.001). Approximately half of all reported deaths occurred in the community, with an even greater proportion during wave periods (50.58% versus 53.11%, p<0.001), respectively. Conclusion There was excess mortality during the COVID-19 pandemic in Zambia, with more deaths among the elderly, and occurring within the community during wave periods. This analysis suggests more COVID-19 deaths likely occurred in Zambia than suggested by officially reported numbers. Mortality surveillance can provide important information to monitor population health and inform public health programming during pandemics.

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Section: Discussionmentioning

confidence: 60%

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

Chanda,

Hines,

Malambo

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

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

Chanda,

Hines,

Malambo

et al. 2024

BMC Public Health

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National governance and excess mortality due to COVID-19 in 213 countries: a retrospective analysis and perspectives on future pandemics

da Silva,

Novaes,

de Oliveira

et al. 2023

Global Health

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Background National governance may have influenced the response of institutions to the Covid-19 pandemic, being a key factor in preparing for the next pandemics. The objective was to analyze the association between excess mortality due to COVID-19 (daily and cumulative per 100 thousand people) and national governance indicators in 213 countries. Method Multiple linear regression models using secondary data from large international datasets that are in the public domain were performed. Governance indicators corresponded to six dimensions: (i) Voice and Accountability; (ii) Political Stability and Absence of Violence/Terrorism; (iii) Government Effectiveness; (iv) Regulatory Quality; (v) Rule of Law and (vi) Control of Corruption. The statistical analysis consisted of adjusting a multiple linear regression model. Excess mortality due to COVID-19 was adjusted for potential confounding factors (demographic, environmental, health, economic, and ethnic variables). Results The indicators Control of Corruption, Government Effectiveness, Regulatory Quality and Rule of Law had a significant inverse association (p < 0.0001) with the estimated excess mortality in 2020, 2021 and 2022. Furthermore, the governance indicators had a direct significant association (p < 0.0001) with the vaccination variables (People_fully_vaccinated; Delivered population; The total number of vaccination doses administered per 100 people at the country level), except for the variables Vaccination policies and Administration of first dose, which were inversely associated. In countries with better governance, COVID-19 vaccination was initiated earlier. Conclusion Better national governance indicators were associated with lower excess mortality due to COVID-19 and faster administration of the first dose of the COVID-19 vaccine.

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An Assessment of Systemic Factors and COVID-19 Mortality in Africa

Cited by 4 publications

References 25 publications

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

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

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

National governance and excess mortality due to COVID-19 in 213 countries: a retrospective analysis and perspectives on future pandemics

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