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Risk factors for COVID-19 infection, disease severity and related deaths in Africa: a systematic review.
Gesesew, Hailay Abrha; Koye, Digsu Negese; Fetene, Dagnachew Muluye; Woldegiorgis, Mulu; Kinfu, Yohannes; Geleto, Ayele Bali; Melaku, Yohannes Adama; Mohammed, Hassen; Alene, Kefyalew Addis; Awoke, Mamaru Ayenew; Birhanu, Mulugeta Molla; Gebremedhin, Amanuel Tesfay; Gelaw, Yalemzewod Assefa; Shifti, Desalegn Markos; Muluneh, Muluken Dessalegn; Tegegne, Teketo Kassaw; Abrha, Solomon; Aregay, Atsede Fantahun; Ayalew, Mohammed Biset; Gebre, Abadi Kahsu; Gebremariam, Kidane Tadesse; Gebremedhin, Tesfaye; Gebremichael, Lemlem; Leshargie, Cheru Tesema; Kibret, Getiye Dejenu; Meazaw, Maereg Wagnew; Mekonnen, Alemayehu Berhane; Tekle, Dejen Yemane; Tesema, Azeb Gebresilassie; Tesfay, Fisaha Haile; Tesfaye, Wubshet; Wubishet, Befikadu Legesse; Dachew, Berihun Assefa; Adane, Akilew Awoke.
  • Gesesew HA; College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia hailushepi@gmail.com.
  • Koye DN; Scool of Public Health, Mekelle University, Mekelle, Ethiopia.
  • Fetene DM; Department of Medicine at Royal Melbourne Hospital and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
  • Woldegiorgis M; Burnet Institute, Melbourne, Victoria, Australia.
  • Kinfu Y; Burnet Institute, Melbourne, Victoria, Australia.
  • Geleto AB; Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia.
  • Melaku YA; College of Medicine, Doha, Qatar.
  • Mohammed H; Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, New South Wales, Australia.
  • Alene KA; School of Public Health, Haramaya University, College of Health and Medical Sciences, Harar, Ethiopia.
  • Awoke MA; College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
  • Birhanu MM; Vaccinology and Immunology Research Trials Unit, Women's and Children's Hospital, Adelaide, South Australia, Australia.
  • Gebremedhin AT; Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.
  • Gelaw YA; School of Population Health, Curtin University, Perth, Western Australia, Australia.
  • Shifti DM; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia.
  • Muluneh MD; Institute of Public Health, University of Gondar, Gondar, Ethiopia.
  • Tegegne TK; School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
  • Abrha S; Department of Medicine, Monash University, Melbourne, Victoria, Australia.
  • Aregay AF; Saint Paul's Hospital, Millennium Medical College, Addis Ababa, Ethiopia.
  • Ayalew MB; School of Population Health, Curtin University, Perth, Western Australia, Australia.
  • Gebre AK; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia.
  • Gebremariam KT; Institute of Public Health, University of Gondar, Gondar, Ethiopia.
  • Gebremedhin T; Population Child Health Research Group, School of Women's & Children's Health, UNSW, Sydney, New South Wales, Australia.
  • Gebremichael L; Saint Paul's Hospital, Millennium Medical College, Addis Ababa, Ethiopia.
  • Leshargie CT; Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia.
  • Kibret GD; School of Nursing and Midwifery, Western Sydney University, Penrith South, New South Wales, Australia.
  • Meazaw MW; Amref Health Africa in Ethiopia, Addis Ababa, Ethiopia.
  • Mekonnen AB; Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia.
  • Tekle DY; College of Health Science, Debre Markos University, Debre Markos, Ethiopia.
  • Tesema AG; Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia.
  • Tesfay FH; Department of Pharmacology, Mekelle University, Mekelle, Ethiopia.
  • Tesfaye W; School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia.
  • Wubishet BL; School of Nursing, Mekelle University, Mekelle, Ethiopia.
  • Dachew BA; Department of Pharmacy, University of New England, Armidale, New South Wales, Australia.
  • Adane AA; Department of Clinical Pharmacy, University of Gondar, Gondar, Ethiopia.
BMJ Open ; 11(2): e044618, 2021 02 18.
Article in English | MEDLINE | ID: covidwho-1090927
ABSTRACT

OBJECTIVE:

The aim of this study was to provide a comprehensive evidence on risk factors for transmission, disease severity and COVID-19 related deaths in Africa.

DESIGN:

A systematic review has been conducted to synthesise existing evidence on risk factors affecting COVID-19 outcomes across Africa. DATA SOURCES Data were systematically searched from MEDLINE, Scopus, MedRxiv and BioRxiv. ELIGIBILITY CRITERIA Studies for review were included if they were published in English and reported at least one risk factor and/or one health outcome. We included all relevant literature published up until 11 August 2020. DATA EXTRACTION AND

SYNTHESIS:

We performed a systematic narrative synthesis to describe the available studies for each outcome. Data were extracted using a standardised Joanna Briggs Institute data extraction form.

RESULTS:

Fifteen articles met the inclusion criteria of which four were exclusively on Africa and the remaining 11 papers had a global focus with some data from Africa. Higher rates of infection in Africa are associated with high population density, urbanisation, transport connectivity, high volume of tourism and international trade, and high level of economic and political openness. Limited or poor access to healthcare are also associated with higher COVID-19 infection rates. Older people and individuals with chronic conditions such as HIV, tuberculosis and anaemia experience severe forms COVID-19 leading to hospitalisation and death. Similarly, high burden of chronic obstructive pulmonary disease, high prevalence of tobacco consumption and low levels of expenditure on health and low levels of global health security score contribute to COVID-19 related deaths.

CONCLUSIONS:

Demographic, institutional, ecological, health system and politico-economic factors influenced the spectrum of COVID-19 infection, severity and death. We recommend multidisciplinary and integrated approaches to mitigate the identified factors and strengthen effective prevention strategies.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans Country/Region as subject: Africa Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2020-044618

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans Country/Region as subject: Africa Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2020-044618