Better prepared African nations ‘vulnerable to COVID-19’

streets of mali
A man takes precautions in Mali against COVID-19. Copyright: World Bank / Ousmane Traore, CC BY-NC-ND 2.0

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  • Researchers assessed predictors of deaths during the first and second COVID-19 waves
  • They found a link between COVID-19 deaths and HIV cases
  • But an expert says that the link to HIV may be coincidental

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[NAIROBI]  African countries that were deemed to have high preparedness and increased capacity to respond to COVID-19 were actually the most vulnerable to it, a study says.

The study found that countries with a higher prevalence of HIV, more urban populations, and higher pre-pandemic international connectivity, such as South Africa, were most impacted irrespective of having institutions, resources and more resilient health systems.

“The COVID-19 pandemic highlights unanticipated vulnerabilities to infectious disease in Africa that should be taken into account in future pandemic preparedness planning,” says the study, published in the journal Nature Medicine.

“Statistically higher HIV prevalence is associated with higher COVID-19 mortality [death].”

Humphrey Karamagi, WHO Regional Office for Africa

Humphrey Karamagi, study c0-author and a medical officer based at the WHO Regional Office for Africa, tells SciDev.Net that the findings will help African nations to respond effectively to future pandemics as re-emerging pathogens become a mainstay in public health.

“We need to place a stronger emphasis on understanding social dynamics influencing disease transmission. When mapping out how a pathogen affects a population, it is crucial to understand not only the pathogen dynamics – reflected in its infectivity rates — but also how socio-ecological interactions and the biophysical vulnerabilities affect its transmission and impacts,” says Karamagi.

The different patterns of transmission and deaths across countries, within countries and over time in a single community, he explains, suggests there are other issues driving how the pandemic progresses, beyond how infectious or severe the virus is.

“This observational study confirmed that early onsets of national COVID-19 epidemics were partly driven by international connectivity, whereas high urbanisation, international connectivity and HIV/AIDS prevalence predicted high first wave mortality rate,which, in turn, was a predictor of high second wave mortality rate,” says the study.

As of 14 March 2021, the WHO African Region had experienced two waves of infection and reported over 2.9 million cases of infection and more than 74,000 deaths, the report added.

Researchers identified factors that were responsible for the emergence of the first COVID-19 case and deaths relative to the total populations in the WHO African region during the first and second pandemic waves.

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Scientists used data on 47 African countries to identify the onset of the first case, 42 African countries to assess the factors that influenced COVID-19 deaths relative to each nation’s total population. They found that countries such as South Africa with high capacity to test for COVID-19 cases were more likely to have high death rates.

“Stringency and timing of government restrictions were not associated with the mortality rate but countries with higher proportions of urban population and higher infectious disease resilience scores were at increased risk of an adverse outcome,” the study explains. 

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Githinji Gitahi, CEO of Amref Health Africa, agrees that urbanisation is among the key drivers of COVID-19 infection in Africa because it is related to high mobility and high congestion.

He also says that that COVID-19 mortality among HIV infected people was higher than that of the average person  by almost 2.5 per cent, but  that it could be coincidental.

“It is true there is connection between the link between HIV and COVID-19 and the economy. As the economy deteriorates because of COVID-19, we might end up with increased HIV rates,” Gitahi told SciDev.Net.

He adds that other diseases such as tuberculosis are also correlated to COVID-19 and HIV. “There is a direct relationship of higher mortality with people with TB, and they are likely to have HIV,” he explains.

This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.