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Leveraging Serosurveillance and Postmortem Surveillance to Quantify the Impact of COVID-19 in Africa (preprint)
medrxiv; 2022.
Preprint
em Inglês
| medRxiv | ID: ppzbmed-10.1101.2022.07.03.22277196
ABSTRACT
Background The COVID-19 pandemic has had a devastating impact on global health, the magnitude of which appears to differ intercontinentally for example, reports suggest 271,900 per million people have been infected in Europe versus 8,800 per million people in Africa. While Africa is the second largest continent by population, its reported COVID-19 cases comprise <3% of global cases. Although social, environmental, and environmental explanations have been proposed to clarify this discrepancy, systematic infection underascertainment may be equally responsible. Methods We seek to quantify magnitude of underascertainment in COVID-19's cumulative incidence in Africa. Using serosurveillance and postmortem surveillance, we constructed multiplicative factors estimating ratios of true infections to reported cases in African nations since March 2020. Results Multiplicative factors derived from serology data - in a subset of 12 nations - suggested a range of COVID-19 reporting rates, from 1 in 630 infections reported in Kenya (May 2020) to 1 in 15 infections reported in South Africa (November 2021). The largest multiplicative factor, 3,795, corresponded to Malawi (June 2020), suggesting <0.05% of infections captured. A similar set of multiplicative factors for all nations derived from postmortem data points toward the same conclusion:
reported COVID-19 cases are unrepresentative of true infections, suggesting a key reason for low case burden in many African nations is significant underdetection and underreporting. Conclusions While estimating COVID-19's exact burden is challenging, the multiplicative factors we present provide incidence curves reflecting likely-to-worst-case ranges of infection. Our results stress the need for expansive surveillance to allocate resources in areas experiencing severe discrepancies between reported cases, projected infections, and deaths.
Texto completo:
Disponível
Coleções:
Preprints
Base de dados:
medRxiv
Assunto principal:
COVID-19
/
Infecções
Idioma:
Inglês
Ano de publicação:
2022
Tipo de documento:
Preprint
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