The need for COVID-19 research in low- and middle-income countries

Gupta, Madhu; Wahl, Brian; Adhikari, Binita; Bar-Zeev, Naor; Bhandari, Sudip; Coria, Alexandra; Erchick, Daniel J; Gupta, Nidhi; Hariyani, Shreya; Kagucia, E. Wangeci; Killewo, Japhet; Limaye, Rupali J.; McCollum, Eric D.; Pandey, Raghukul Ratan; Pomat, William; Rao, Krishna D.; Santosham, Mathuram; Sauer, Molly; Wanyenze, Rhoda K.; Peters, David H.

doi:10.1186/s41256-020-00159-y

Cited by 76 publications

(68 citation statements)

References 9 publications

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“…The challenges for modelling the effectiveness of these interventions will be enormous. In addition, these interventions were in most cases so complex that it is doubtful whether their effectiveness can be studied systematically [43,44]. Yet we were warned a few years ago in the region that "considering a public health measure with such dramatic social effects as containment, the transnational scienti c community should engage rapidly in building evidence about the e cacy of containment in the Ebola outbreak" [45].…”

Section: Discussionmentioning

confidence: 99%

“…However, our analysis also highlights the challenges of the quality of these data, particularly when, for example, when deaths are not counted in communities in Guinea in a disaggregated manner, when RDTs (Rapid Diagnostic Tests) are used in Benin or when the number of tests is reduced in Senegal or Guinea. The magnitude of the pandemic is thus likely to be underestimated here, as elsewhere [44]. Access to epidemiological data, if available, will make it possible to assess excess mortality in the countries, at different territorial scales, and thus estimate whether the gures disseminated re ect the real situation [42].…”

Section: Discussionmentioning

confidence: 99%

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The COVID-19 Pandemic in Francophone West Africa: From the First Cases to Responses in Seven Countries

Bonnet¹,

Bodson

Marcis³

et al. 2020

Preprint

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Background: In early March 2020, the COVID-19 pandemic hit West Africa. Countries in the region quickly set up crisis management committees and organised drastic measures to stem the spread of the coronavirus. The objective of this article is to analyse the epidemiological evolution of COVID-19 in seven Francophone West African countries (Benin, Burkina Faso, Côte d'Ivoire, Guinea, Mali, Niger, Senegal) as well as the public health measures decided upon during the first four months of the pandemic. Methods: Our method is based on quantitative and qualitative data from the pooling of information from a COVID-19 data platform and collected by a network of interdisciplinary collaborators present in the seven countries. Descriptive and spatial analyses of quantitative epidemiological data and content analyses of qualitative data on public measures and management committees were performed. Results: Attack rates for COVID-19 range from less than 10 per 100,000 inhabitants (Benin) to more than 45 per 100,000 inhabitants (Guinea). The spatio-temporal analysis shows three phases of incidence clusters. By the end of June 2020, case numbers had plateaued in some countries (Burkina Faso, Niger, Mali) while others continued to see the number of infections increasing (Benin, Côte d'Ivoire, Guinea, Senegal). The countries all reacted quickly to the crisis, in some cases before the first reported infection, and implemented public measures in a relatively homogeneous manner. None of the countries implemented country-wide lockdowns, but in some cases implemented partial or local containment measures. At the end of June 2020, countries began to lift certain restrictive measures, sometimes under pressure from the general population or from certain economic sectors. All the countries have adopted response plans and organized multiple crisis management committees, although their content and functioning have not always been transparent or easy to understand. Conclusion: Much research remains to be done in West Africa. It will be necessary to better understand the dynamics of the pandemic, which appears to be largely under control, as well as the effectiveness and implementation of the state responses, which have been rapidly formulated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The COVID-19 Pandemic in Francophone West Africa: From the First Cases to Responses in Seven Countries

Bonnet¹,

Bodson

Marcis³

et al. 2020

Preprint

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“…Although it is also argued that low GDP countries may lack testing capabilities, thus underestimating COVID-19 impacts. While this may be true in the early days or months of the pandemic, testing ability has increased to levels comparable to high-income countries 15 . This study found COVID-19 deaths not signi cantly correlated with total tests carried out by countries, although understandably COVID-19 cases signi cantly correlates with testing.…”

Section: Discussionmentioning

confidence: 99%

Worldwide inverse correlation between Bacille Calmette-Guérin immunization and COVID-19 mortality

2020

Preprint

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The coronavirus disease 2019 (COVID-19) pandemic has spread to all countries in the world after more than half a year since it was first reported in late 2019, and different countries have been impacted differently. Multivariate statistical analyses were used to evaluate COVID-19 deaths and cases relative to nine other demographic and socioeconomic factors in all countries and regions of the world using data as of August 1, 2020. The factors analyzed in the study include a country’s total COVID-19 deaths and cases per million population, per capita gross domestic product (GDP), population density, virus tests per million population, median age, government response stringency index, hospital beds availability per thousand population, extreme poverty rate, Bacille Calmette-Guérin (BCG) vaccination rate, and diphtheria-tetanus-pertussis (DTP3) immunization rate. The study reveals that COVID-19 deaths per million population in a country most significantly correlates, inversely, with the country’s BCG vaccination rate, and also significantly correlates a country’s per capita GDP and median age, while COVID-19 cases per million population significantly correlate with per capita GDP and tests per thousand population. This study contributes to a growing body of evidence supporting the notion that BCG vaccination may be protective against COVID-19 mortality.

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“…Therefore, the resource-poor countries remain at disproportionally higher risk of disease spread internally or overseas. These countries have limited diagnostic and research capacity that could help in timely estimation of COVID-19 incidence [8,9]. Such a knowledge base is vital to guide policy makers in understanding potential impact of risk-mitigation strategies and plan accordingly.…”

Section: Introductionmentioning

confidence: 99%

“…However, most of the models' estimation addressed situations in high-income countries [19][20][21]. To date, the limited disease modelling and research capacity prevented estimation of prevalence in LMICs [8,9]. In the absence of available evidence or scientific forecasting, the resource-limited or resource-constrained settings adopt developed countries' strategies that might not be suitable for them.…”

Section: Introductionmentioning

confidence: 99%

Application of disease model to ascertain risk-mitigation strategies during COVID-19 pandemic in 2020, an example from resource-constrained urban settings in Pakistan

Hassan

Salman

Mustafa

2020

Preprint

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Most COVID-19 affected resource-constrained settings have not ascertained their disease prevalence that pose a risk for global health. In wake of limited diagnostics and research capacity in such settings, this disease forecasting model provides an example to be adapted for evidence-based response efforts. Using officially reported data, this model forecasted COVID-19 prevalence in cosmopolitan cities. Several risk-mitigation strategies were analyzed for effectiveness in controlling disease incidence. Moreover, the reproduction rates to ascertain transmission, herd-immunity threshold, and performance of required laboratory tests were studied. The severe-critical cases were relatively low due to larger young population. Following any risk-mitigation strategy, at end of first wave, a susceptible population remained at risk of recurrent COVID-19 transmission. The herd-immunity threshold was in accordance with global estimates but would need careful monitoring based on adopted risk-mitigation strategy and variation in vaccines’ efficacy. A test-gap between performed vs required laboratory tests led to miss several cases from getting diagnosed. First of its kind, this study estimates sub-national COVID-19 prevalence in dense-urban living in low-middle income settings. Future response policies should consider such evidence to prevent recurrent COVID-19 waves of transmission. Unless sustained herd-immunity is achieved by effective immunization, risk of re-introduction to vulnerable population would remain.

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The need for COVID-19 research in low- and middle-income countries

Cited by 76 publications

References 9 publications

The COVID-19 Pandemic in Francophone West Africa: From the First Cases to Responses in Seven Countries

The COVID-19 Pandemic in Francophone West Africa: From the First Cases to Responses in Seven Countries

Worldwide inverse correlation between Bacille Calmette-Guérin immunization and COVID-19 mortality

Application of disease model to ascertain risk-mitigation strategies during COVID-19 pandemic in 2020, an example from resource-constrained urban settings in Pakistan

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