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Cited by 108COVID-19 epidemiological studiesSARS-CoV-2 and COVID-19 ResearchMathematical and Theoretical Epidemiology and Ecology Models

COVID-19 in the 47 countries of the WHO African region: a modelling analysis of past trends and future patterns

Open access
Cabore, Joseph Waogodo, Karamagi, Humphrey Cyprian, Kipruto, Hillary Kipchumba, Mungatu, Joseph Kyalo, Asamani, James Avoka, Droti, Benson, Titi-ofei, Regina, Seydi, Aminata Binetou Wahebine +5 more·2022·The Lancet Global Health
DOI 10.1016/s2214-109x(22)00233-9PMC PMC9159735
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Abstract

BACKGROUND: COVID-19 has affected the African region in many ways. We aimed to generate robust information on the transmission dynamics of COVID-19 in this region since the beginning of the pandemic and throughout 2022. METHODS: For each of the 47 countries of the WHO African region, we consolidated COVID-19 data from reported infections and deaths (from WHO statistics); published literature on socioecological, biophysical, and public health interventions; and immunity status and variants of concern, to build a dynamic and comprehensive picture of COVID-19 burden. The model is consolidated through a partially observed Markov decision process, with a Fourier series to produce observed patterns over time based on the SEIRD (denoting susceptible, exposed, infected, recovered, and dead) modelling framework. The model was set up to run weekly, by country, from the date the first infection was reported in each country until Dec 31, 2021. New variants were introduced into the model based on sequenced data reported by countries. The models were then extrapolated until the end of 2022 and included three scenarios based on possible new variants with varying transmissibility, severity, or immunogenicity. FINDINGS: Between Jan 1, 2020, and Dec 31, 2021, our model estimates the number of SARS-CoV-2 infections in the African region to be 505·6 million (95% CI 476·0-536·2), inferring that only 1·4% (one in 71) of SARS-CoV-2 infections in the region were reported. Deaths are estimated at 439 500 (95% CI 344 374-574 785), with 35·3% (one in three) of these reported as COVID-19-related deaths. Although the number of infections were similar between 2020 and 2021, 81% of the deaths were in 2021. 52·3% (95% CI 43·5-95·2) of the region's population is estimated to have some SARS-CoV-2 immunity, given vaccination coverage of 14·7% as of Dec 31, 2021. By the end of 2022, we estimate that infections will remain high, at around 166·2 million (95% CI 157·5-174·9) infections, but deaths will substantially reduce to 22 563 (14 970-38 831). INTERPRETATION: The African region is estimated to have had a similar number of COVID-19 infections to that of the rest of the world, but with fewer deaths. Our model suggests that the current approach to SARS-CoV-2 testing is missing most infections. These results are consistent with findings from representative seroprevalence studies. There is, therefore, a need for surveillance of hospitalisations, comorbidities, and the emergence of new variants of concern, and scale-up of representative seroprevalence studies, as core response strategies. FUNDING: None.

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  • In the Africa region, recent studies have highlighted underestimation in reported COVID-19 statistics.

    “As another example, in the Africa region for which ACM data are most lacking, recent studies have highlighted the underestimation in the reported statistics20.”

    From The WHO estimates of excess mortality associated with the COVID-19 pandemic (2023) · cites this paper as [20]

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Research works printed but not linked: 35

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Authors
Cabore, J. W., Karamagi, H. C., Kipruto, H. K., Mungatu, J. K., Asamani, J. A., Droti, B., Titi-ofei, R., Seydi, A. B. W., Kidane, S. N., Balde, T., Gueye, A. S., Makubalo, L., & Moeti, M. R.
Affiliations
World Health Organization Regional Office for Africa (CG)
Corresponding author
Karamagi, Humphrey Cyprian
ORCID
Venue
The Lancet Global Health
Publisher
Elsevier BV
Published
2022-08
Volume
10
Issue
8
Pages
e1099-e1114
ISSN
2214-109X (ISSN-L)
DOI
10.1016/s2214-109x(22)00233-9
PMC
PMC9159735
OpenAlex
W4281641281
Cited by
108
References
42
Citations by year
2026: 7 · 2025: 16 · 2024: 31 · 2023: 33 · 2022: 21
FWCI
15.01
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Global Health (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
World Health Organization
Topics
  • Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mathematical and Theoretical Epidemiology and Ecology Models
Keywords
COVID-19 pandemic, SARS-CoV-2, Africa, transmission dynamics, underreporting of infections, COVID-19 mortality, SARS-CoV-2 variants of concern, Omicron variant, Delta variant, vaccination coverage, natural immunity, SEIRD model, partially observable Markov decision processes, epidemic forecasting, public health interventions, non-pharmaceutical interventions
MeSH terms
COVID-19, SARS-CoV-2, COVID-19 Testing, Humans, Population Growth, World Health Organization, Seroepidemiologic Studies

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