ABSTRACT
ContextIn low-income settings where access to biological diagnosis is limited, data on the spread of the COVID-19 epidemic are scarce. In September 2020, after the first COVID-19 wave, Mali reported 3,086 confirmed cases and 130 deaths. Most reports originated form Bamako, the capital city, with 1,532 reported cases and 81 deaths for an estimated 2.42 million population. This observed prevalence of 0.06% appeared very low. Our objective was to estimate SARS-CoV-2 infection among inhabitants of Bamako, after the first epidemic wave. We also assessed demographic, social and living conditions, health behaviors and knowledge associated with SARS-CoV-2 seropositivity. Material and methodsWe conducted a cross-sectional multistage cluster household survey in commune VI, which reported, September 2020, 30% (n=466) of the total cases reported at Bamako. We measured serological status by detection of SARS-CoV-2 spike protein Antibodies in venous blood sampled after informed consent. We documented housing conditions and individual health behaviors through KABP questionnaires among participants aged 12 years and older. We estimated the number of SARS-CoV-2 infections and deaths in the total population of Bamako using the age and sex distributions of SARS-CoV-2 seroprevalence. A logistic generalized additive multilevel model was performed to estimate household conditions and demographic factors associated with seropositivity. ResultsWe recruited 1,526 inhabitants in the 3 investigated areas (commune VI, Bamako) belonging to the 306 sampled households. We obtained 1,327 serological results, 220 household questionnaires and collected KABP answers for 962 participants. The prevalence of SARS-CoV-2 seropositivity was 16.4% after adjusting on the population structure. This suggested that [~]400,000 cases and [~] 2,000 deaths could have occurred of which only 0.4% of cases and 5% of deaths were officially reported. KABP analyses suggested strong agreement with washing hands but lower acceptability of movement restrictions (lockdown or curfew), and limited mask wearing. ConclusionIn spite of limited numbers of reported cases, the first wave of SARS-CoV-2 spread broadly in Bamako. Expected fatalities remained limited largely due to the population age structure and the low prevalence of comorbidities. This highlight the difficulty of developing epidemic control strategies when screening test are not available or not used, even more when the transmission modalities are not well known by the population. Targeted policies based on health education prevention have to be implemented to improve the COVID-19 risk perception among the local population and fight to false knowledge and beliefs.
ABSTRACT
Introduction : L'objectif de notre étude était d'établir le profil épidémiologique de la COVID-19 à Tombouctou. Matériel et méthodes : Il s'agissait d'une étude transversale descriptive des données de surveillance de la COVID-19 de la Région de Tombouctou du 3 avril au 1er octobre 2020. Nos variables d'intérêts ont été extraites de la base de données de surveillance et analysées sur Excel 2013. Les fréquences, taux et ratio ont été calculés. Résultats :Au total 1851 cas suspects en provenance de tous les districts de la région ont été testés à la RT-PCR dont 572 confirmés soit un taux de positivité de 30,90%. La tranche d'âge de 15-34 ans était la plus représentée avec une proportion de 48% de l'effectif des confirmés. Le sex ratio (homme/femme) des cas confirmés était de 2,67. La ville de Tombouctou était l'épicentre de la COVID-19. La région de Tombouctou avait un taux de dépistage d'environ 2 (1851/928.000) et a connu son pic entre les semaines 22 et 23 avec une létalité de 2,8%. Conclusion : Les jeunes et les hommes seraient les plus susceptibles d'être infectés par la COVID-19. Nous recommandons le renforcement de la sensibilisation pour le respect des mesures barrières
Introduction: The objective of our study was to establish the epidemiological profile of COVID-19 in Tombouctou. Material and methods: This was a descriptive cross-sectional study of COVID-19 surveillance data from Tombouctou from April 3 to October 1, 2020. Our variables of interest were extracted from the surveillance database and analyzed with Excel 2013. The frequencies, rate, and ratio were computed. Results: Overall, 1851 suspects from all districts of the region were screened by RT-PCR, including 572 confirmed, which indicate a positivity rate of 30.90%. The 15-34 age group was the most represented with 48% of the confirmed cases. The sex ratio (male / female) of confirmed cases was 2.67. The city of Tombouctou was the epicenter of COVID-19. The Tombouctou region had a detection rate of around 2 (1851/928,000) and peaked between weeks 22 and 23 with a case fatality of 2.8%. Conclusion: Young people and men were most likely to be infected with COVID-19. We recommend increasing awareness of compliance with barrier measures.
