An in-depth statistical analysis of the COVID-19 pandemic’s initial spread in the WHO African region

作者：Ananthu James, Jyoti Dalal, Timokleia Kousi, Daniela Pires Ferreira Vivacqua, Daniel Cardoso Portela Câmara, Izabel Cristina dos Reis, Sara Botero Mesa, Wignston Ng’ambi, Papy Ansobi, L Bianchi, Theresa Min-Hyung Lee, Opeayo Ogundiran, Béat Stoll, Cleophas Chimbetete, Franck Mboussou, Bénido Impouma, Cristina Barroso Hofer, Flávio Codeço Coelho, Olivia Keiser, Jessica L. Abbate · 发表于：BMJ Global Health · 年份：2022 · DOI：10.1136/bmjgh-2021-007295 · 被引用次数：23 · 研究领域：COVID-19 epidemiological studies、COVID-19 Pandemic Impacts、Viral Infections and Outbreaks Research

During the first wave of the COVID-19 pandemic, sub-Saharan African countries experienced comparatively lower rates of SARS-CoV-2 infections and related deaths than in other parts of the world, the reasons for which remain unclear. Yet, there was also considerable variation between countries. Here, we explored potential drivers of this variation among 46 of the 47 WHO African region Member States in a cross-sectional study. We described five indicators of early COVID-19 spread and severity for each country as of 29 November 2020: delay in detection of the first case, length of the early epidemic growth period, cumulative and peak attack rates and crude case fatality ratio (CFR). We tested the influence of 13 pre-pandemic and pandemic response predictor variables on the country-level variation in the spread and severity indicators using multivariate statistics and regression analysis. We found that wealthier African countries, with larger tourism industries and older populations, had higher peak (p<0.001) and cumulative (p<0.001) attack rates, and lower CFRs (p=0.021). More urbanised countries also had higher attack rates (p<0.001 for both indicators). Countries applying more stringent early control policies experienced greater delay in detection of the first case (p<0.001), but the initial propagation of the virus was slower in relatively wealthy, touristic African countries (p=0.023). Careful and early implementation of strict government policies were likely pivotal to delay...