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COVID-19 in Africa 'vastly underestimated'

Thursday February 18th 2021

The number of COVID-19 deaths in Africa could be far greater than those reported, a study published today warns.

In the first observational study to provide systematic surveillance data capturing the impact of COVID-19 in Africa, outside of South Africa, the findings show that COVID-19 accounted for 15-20% of all sampled deaths at the University Teaching Hospital in Lusaka, Zambia, between June and September 2020.

The results are based on polymerase chain reaction (PCR) test results for 364 patients who died and were enrolled within 48 hours of death. The findings, says the research team, contradicts reports that the virus has largely skipped Africa and had little impact.

In today’s edition of The BMJ, they say COVID-19 deaths occurred across a wider age spectrum than reported elsewhere and were concentrated among people aged under 65, with an unexpectedly high number of deaths in children.

The virus was detected in 70 (19%) of people and the average age at death was 48 years. Of those who died, 70% were men.

73% of COVID-19 deaths occurred in the community and none had been tested for the virus before they died. Of the 19 people who died in hospital, six were tested before death.

COVID-19 was identified in seven children, only one of whom had been tested before death, and the proportion of deaths increased with age, but 76% of people who died were under 60 years of age.

The five most common comorbidities among people who died were tuberculosis (31%), high blood pressure (27%), HIV/AIDS (23%), alcohol misuse (17%), and diabetes (13%).

The researchers say it is critical that the extent of COVID-19 infection is understood in Africa.

Although it is an observational study that has several limitations, the team warn if the data are generalisable, the impact of COVID-19 in Africa has been vastly underestimated.

Mwananyanda L, Gill CJ, MacLeod W et al. COVID-19 deaths in Africa: prospective systematic postmortem surveillance study. BMJ 18 February 2021; doi: BMJ 2021;372:n334

[abstract]

Tags: Africa | Flu & Viruses

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