An in-depth statistical analysis of the COVID-19 pandemic’s initial spread in the WHO African region

During the first wave of the COVID-19 pandemic, sub-Saharan African countries experienced comparatively lower rates of SARS-CoV-2 infections and related deaths than in other parts of the world, the reasons for which remain unclear. Yet, there was also considerable variation between countries. Here,...

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Published in:BMJ global health 2022-04, Vol.7 (4), p.e007295
Main Authors: James, Ananthu, Dalal, Jyoti, Kousi, Timokleia, Vivacqua, Daniela, Câmara, Daniel Cardoso Portela, Dos Reis, Izabel Cristina, Botero Mesa, Sara, Ng’ambi, Wignston, Ansobi, Papy, Bianchi, Lucas M, Lee, Theresa M, Ogundiran, Opeayo, Stoll, Beat, Chimbetete, Cleophas, Mboussou, Franck, Impouma, Benido, Hofer, Cristina Barroso, Coelho, Flávio Codeço, Keiser, Olivia, Abbate, Jessica Lee
Format: Article
Language:English
Subjects:
Coronaviruses
COVID-19
Cross-Sectional Studies
cross-sectional survey
Disease transmission
Epidemics
epidemiology
Fatalities
GDP
Gross Domestic Product
Humans
mathematical modelling
Original Research
Pandemics
Per capita
Population density
Public health
Regression analysis
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Statistical analysis
Tourism
World Health Organization
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creator James, Ananthu
Dalal, Jyoti
Kousi, Timokleia
Vivacqua, Daniela
Câmara, Daniel Cardoso Portela
Dos Reis, Izabel Cristina
Botero Mesa, Sara
Ng’ambi, Wignston
Ansobi, Papy
Bianchi, Lucas M
Lee, Theresa M
Ogundiran, Opeayo
Stoll, Beat
Chimbetete, Cleophas
Mboussou, Franck
Impouma, Benido
Hofer, Cristina Barroso
Coelho, Flávio Codeço
Keiser, Olivia
Abbate, Jessica Lee
description During the first wave of the COVID-19 pandemic, sub-Saharan African countries experienced comparatively lower rates of SARS-CoV-2 infections and related deaths than in other parts of the world, the reasons for which remain unclear. Yet, there was also considerable variation between countries. Here, we explored potential drivers of this variation among 46 of the 47 WHO African region Member States in a cross-sectional study. We described five indicators of early COVID-19 spread and severity for each country as of 29 November 2020: delay in detection of the first case, length of the early epidemic growth period, cumulative and peak attack rates and crude case fatality ratio (CFR). We tested the influence of 13 pre-pandemic and pandemic response predictor variables on the country-level variation in the spread and severity indicators using multivariate statistics and regression analysis. We found that wealthier African countries, with larger tourism industries and older populations, had higher peak (p
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Countries applying more stringent early control policies experienced greater delay in detection of the first case (p&lt;0.001), but the initial propagation of the virus was slower in relatively wealthy, touristic African countries (p=0.023). Careful and early implementation of strict government policies were likely pivotal to delaying the initial phase of the pandemic, but did not have much impact on other indicators of spread and severity. An over-reliance on disruptive containment measures in more resource-limited contexts is neither effective nor sustainable. 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Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2022 Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. 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Yet, there was also considerable variation between countries. Here, we explored potential drivers of this variation among 46 of the 47 WHO African region Member States in a cross-sectional study. We described five indicators of early COVID-19 spread and severity for each country as of 29 November 2020: delay in detection of the first case, length of the early epidemic growth period, cumulative and peak attack rates and crude case fatality ratio (CFR). We tested the influence of 13 pre-pandemic and pandemic response predictor variables on the country-level variation in the spread and severity indicators using multivariate statistics and regression analysis. We found that wealthier African countries, with larger tourism industries and older populations, had higher peak (p&lt;0.001) and cumulative (p&lt;0.001) attack rates, and lower CFRs (p=0.021). More urbanised countries also had higher attack rates (p&lt;0.001 for both indicators). Countries applying more stringent early control policies experienced greater delay in detection of the first case (p&lt;0.001), but the initial propagation of the virus was slower in relatively wealthy, touristic African countries (p=0.023). Careful and early implementation of strict government policies were likely pivotal to delaying the initial phase of the pandemic, but did not have much impact on other indicators of spread and severity. An over-reliance on disruptive containment measures in more resource-limited contexts is neither effective nor sustainable. 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source BMJ Open Access Journals; PubMed Central (Open Access)
subjects Coronaviruses
COVID-19
Cross-Sectional Studies
cross-sectional survey
Disease transmission
Epidemics
epidemiology
Fatalities
GDP
Gross Domestic Product
Humans
mathematical modelling
Original Research
Pandemics
Per capita
Population density
Public health
Regression analysis
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Statistical analysis
Tourism
World Health Organization
title An in-depth statistical analysis of the COVID-19 pandemic’s initial spread in the WHO African region
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