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Predictors of COVID-19 epidemics in countries of the World Health Organization African Region.

ABSTRACT: Countries of the World Health Organization (WHO) African Region have experienced a wide range of coronavirus disease 2019 (COVID-19) epidemics. This study aimed to identify predictors of the timing of the first COVID-19 case and the per capita mortality in WHO African Region countries during the first and second pandemic waves and to test for associations with the preparedness of health systems and government pandemic responses. Using a region-wide, country-based observational study, we found that the first case was detected earlier in countries with more urban populations, higher international connectivity and greater COVID-19 test capacity but later in island nations. Predictors of a high first wave per capita mortality rate included a more urban population, higher pre-pandemic international connectivity and a higher prevalence of HIV. Countries rated as better prepared and having more resilient health systems were worst affected by the disease, the imposition of restrictions or both, making any benefit of more stringent countermeasures difficult to detect. Predictors for the second wave were similar to the first. Second wave per capita mortality could be predicted from that of the first wave. The COVID-19 pandemic highlights unanticipated vulnerabilities to infectious disease in Africa that should be taken into account in future pandemic preparedness planning.

SUBMITTER: Zhang F

PROVIDER: S-EPMC8604723 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Predictors of COVID-19 epidemics in countries of the World Health Organization African Region.

Zhang Feifei F Karamagi Humphrey H Nsenga Ngoy N Nanyunja Miriam M Karinja Miriam M Amanfo Seth S Chase-Topping Margo M Calder-Gerver Giles G McGibbon Miles M Huber Alexandra A Wagner-Gamble Tara T Guo Chuan-Guo CG Haynes Samuel S Morrison Alistair A Ferguson Miranda M Awandare Gordon A GA Mutapi Francisca F Yoti Zabulon Z Cabore Joseph J Moeti Matshidiso R MR Woolhouse Mark E J MEJ

Nature medicine 20210903 11

Countries of the World Health Organization (WHO) African Region have experienced a wide range of coronavirus disease 2019 (COVID-19) epidemics. This study aimed to identify predictors of the timing of the first COVID-19 case and the per capita mortality in WHO African Region countries during the first and second pandemic waves and to test for associations with the preparedness of health systems and government pandemic responses. Using a region-wide, country-based observational study, we found th ...[more]

PMID: 34480125

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Project description:BackgroundAt a time when a highly contagious pandemic and global political and economic turmoil are intertwined, worldwide cooperation under the leadership of an international organization has become increasingly important. This study aimed to estimate the effect of COVID-19 on public confidence in the World Health Organization (WHO), which will serve as a reference for other international organizations regarding the maintenance of their credibility in crisis management and ability to play a greater role in global health governance.MethodsWe obtained individual data from the World Values Survey (WVS). A total of 44,775 participants aged 16 and older from 40 countries in six WHO regions were included in this study. The COVID-19 pandemic was used as a natural experiment. We obtained difference-in-differences (DID) estimates of the pandemic's effects by exploiting temporal variation in the timing of COVID-19 exposure across participants interviewed from 2017 to 2020 together with the geographical variation in COVID-19 severity at the country level. Public confidence in the WHO was self-reported by the respondents.ResultsAmong the participants, 28,087 (62.73%) reported having confidence in the WHO. The DID estimates showed that the COVID-19 pandemic could significantly decrease the likelihood of people reporting confidence in the WHO after controlling for multiple covariates (adjusted OR 0.54, 95% CI: 0.49-0.61), especially during the global outbreak (0.35, 0.24-0.50). The effect was found in both younger individuals (0.58, 0.51-0.66) and older adults (0.49, 0.38-0.63) and in both males (0.47, 0.40-0.55) and females (0.62, 0.53-0.72), with a vulnerability in males (adjusted P for interaction = 0.008).ConclusionOur findings are relevant regarding the impact of COVID-19 on people's beliefs about social institutions of global standing, highlighting the need for the WHO and other international organizations to shoulder the responsibility of global development for the establishment and maintenance of public credibility in the face of emergencies, as well as the prevention of confidence crises.

Project description:BackgroundIn the World Health Organization (WHO) African Region, many cases of serious and preventable diseases remain unmanaged because appropriate and good quality diagnostic support is not available at all levels within countries' health systems. Diagnostic and laboratory services influence the efficiency and effectiveness of both clinical and public health functions, including diagnosis, treatment, health promotion, disease prevention, surveillance and response, and research. Essential to global health security, these services are vital to decision-making processes by clinicians, epidemiologists, public health specialists, and health policymakers. To update, promote, and reinforce diagnostic and laboratory services, it was deemed necessary to organize consultation meetings. These consultation meetings hosted: national diagnostic and laboratory directors or heads of units within ministries of health; officers in charge of laboratories from WHO country offices; representatives of the WHO African Regional Office (AFRO) clusters, units, and Headquarters; experts; and strategic partners. This article details the consultation meetings hosted in Lomé, Togo from 14 to 17 June 2022 and in Kigali, Rwanda from 5 to 7 July 2022.MethodsAlthough the two meetings were made distinct due to their different operating languages-French and English, respectively-each consultative meeting sought to engage participants in the same thematic areas of discussion, thus containing the same presentations and areas of discussion. This article compiles the presentations of both meetings, where a total of 85 individuals attended, reflecting 30 countries in the African Region.ResultsSummaries of technical presentations at both meetings are provided, which have the following titles: (1) "AFRO: new vision for the laboratory sector;" (2) "WHO strategies for strengthening laboratories;" (3) "Collaborative registration process for in vitro diagnostic products: introduction and implementation;" (4) "Status of diagnostics and laboratory regulations in the African Region;" (5) "Health technology management;" (6) "The Global Laboratory Leadership Programme;" (7) "Model list of essential in vitro diagnostic devices;" (8) "Primary health care & laboratory and diagnostic services;" (9) "Antimicrobial resistance control and laboratory systems;" and (10) "Integrated laboratory systems' contributions to disease control programmes."DiscussionFollowing the technical presentations, thematic exchanges were planned around six key areas, with one country presenting their experiences per theme, both at the meeting held in French and for the meeting held in English. Therefore, two countries' experiences are detailed around each of the six thematic areas, which are: laboratory governance (Guinea and Sierra Leone), laboratory policy and planning (Togo and Zimbabwe), regulation and legislation (Senegal and Ghana), partnerships (the Democratic Republic of the Congo and Nigeria), management of laboratory technology (Gabon and Zambia), and national laboratory networks (Burkina Faso and Rwanda).ConclusionThrough these meetings, laboratory leaders were able to not only learn from best practices and anticipate challenges for their own respective countries, but also benefit from joining a platform for laboratory leaders to foster cross-country connections for the duration of their careers. Ultimately, these meetings signal the beginning of many fruitful collaborations and opportunities in the African Region in laboratory and diagnostic services.

Project description:BackgroundAchieving financial risk protection for the whole population requires significant financing for health. Health systems in low- and middle-income countries (LMIC) are plagued with persistent underfunding, and recent reductions in official development assistance have been registered. To create fiscal space for health, the pursuit of efficiency gains and exploring innovative health financing for health seem attractive. This paper sought to synthesize available evidence on the nature of innovative health financing instruments, mechanisms and policies implemented in Africa. We further reviewed the factors that hinder or facilitate implementation, the lessons learnt on the structure, the development process and the implementation.MethodsWe conducted a systematic scoping review of the literature to analyze the nature, type, and factors impacting the implementation of innovative health financing mechanisms in the World Health Organization (WHO) African region.ResultsInnovative health financing mechanisms are increasing in the WHO African region as a result of international policy, the need to improve healthy eating and social life of the populace, advocacy and the availability of international mechanisms to which countries can subscribe. The 41 documents included in this review reported ten innovative financing mechanisms in 43 out of the 47 WHO Africa region member states. The most common mechanisms include an excise tax on tobacco products (43 countries) and alcoholic beverages and spirits (41 countries), airline ticket levy (18 countries), sugar-based beverages tax (seven countries), and levy on oil, gas and mineral tax (four countries). Other mechanisms include the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) trust fund, the social impact bond, the financial transaction tax, mobile phone tax and equity funds. Funds generated from many mechanisms are not allocated to health, although some portions are allocated to health-related activities. In some countries where mechanisms implemented are public health-related, emphasis is placed on positive health behavior beyond raising funds. Persistent resistance from industries due to conflicting economic policies is a major challenge.ConclusionsLeveraging international policies and setting up intersectoral committees to develop and implement innovative mechanisms that involve excise taxes are recommended as possible solutions to the conflicts of interest.

Project description:BackgroundCOVID-19 protective behaviors are key interventions advised by the World Health Organization (WHO) to prevent COVID-19 transmission. However, achieving compliance with this advice is often challenging, particularly among socially vulnerable groups.ObjectiveWe developed a social vulnerability index (SVI) to predict individuals' propensity to adhere to the WHO advice on protective behaviors against COVID-19 and identify changes in social vulnerability as Omicron evolved in African countries between January 2022 and August 2022 and Asia Pacific countries between August 2021 and June 2022.MethodsIn African countries, baseline data were collected from 14 countries (n=15,375) during the first Omicron wave, and follow-up data were collected from 7 countries (n=7179) after the wave. In Asia Pacific countries, baseline data were collected from 14 countries (n=12,866) before the first Omicron wave, and follow-up data were collected from 9 countries (n=8737) after the wave. Countries' socioeconomic and health profiles were retrieved from relevant databases. To construct the SVI for each of the 4 data sets, variables associated with COVID-19 protective behaviors were included in a factor analysis using polychoric correlation with varimax rotation. Influential factors were adjusted for cardinality, summed, and min-max normalized from 0 to 1 (most to least vulnerable). Scores for compliance with the WHO advice were calculated using individuals' self-reported protective behaviors against COVID-19. Multiple linear regression analyses were used to assess the associations between the SVI and scores for compliance to WHO advice to validate the index.ResultsIn Africa, factors contributing to social vulnerability included literacy and media use, trust in health care workers and government, and country income and infrastructure. In Asia Pacific, social vulnerability was determined by literacy, country income and infrastructure, and population density. The index was associated with compliance with the WHO advice in both time points in African countries but only during the follow-up period in Asia Pacific countries. At baseline, the index values in African countries ranged from 0.00 to 0.31 in 13 countries, with 1 country having an index value of 1.00. The index values in Asia Pacific countries ranged from 0.00 to 0.23 in 12 countries, with 2 countries having index values of 0.79 and 1.00. During the follow-up phase, the index values decreased in 6 of 7 African countries and the 2 most vulnerable Asia Pacific countries. The index values of the least vulnerable countries remained unchanged in both regions.ConclusionsIn both regions, significant inequalities in social vulnerability to compliance with WHO advice were observed at baseline, and the gaps became larger after the first Omicron wave. Understanding the dimensions that influence social vulnerability to protective behaviors against COVID-19 may underpin targeted interventions to enhance compliance with WHO recommendations and mitigate the impact of future pandemics among vulnerable groups.

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Predictors of COVID-19 epidemics in countries of the World Health Organization African Region.

Publications

Predictors of COVID-19 epidemics in countries of the World Health Organization African Region.

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