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. 2022 Sep;12(3):316-327.
doi: 10.1007/s44197-022-00052-6. Epub 2022 Aug 3.

Epidemiological Comparison of Four COVID-19 Waves in the Democratic Republic of the Congo, March 2020-January 2022

John Otokoye Otshudiema #  1 , Gervais Léon T Folefack #  2 , Justus M Nsio #  3 , Placide Mbala-Kingebeni  4 , Cathy H Kakema  2 , Joel B Kosianza  2 , Antoine K Mfumu  2 , Guy N Saidi  2 , Patrice M Kabongo  2 , Raphael Okum  2 , Tshibambe N Tshimbombu  5 , Steve Ahuka-Mundeke  4 , Humphrey Cyprian Karamagi #  6 , Jean-Jacques T Muyembe #  4 , Amédée Prosper Djiguimde #  2
Affiliations

Epidemiological Comparison of Four COVID-19 Waves in the Democratic Republic of the Congo, March 2020-January 2022

John Otokoye Otshudiema et al. J Epidemiol Glob Health. 2022 Sep.

Abstract

Purpose: Nationwide analyses are required to optimise and tailor activities to control future COVID-19 waves of resurgence continent-wide. We compared epidemiological and clinical outcomes of the four COVID-19 waves in the Democratic Republic of Congo (DRC).

Methods: This retrospective descriptive epidemiological analysis included data from the national line list of confirmed COVID-19 cases in all provinces for all waves between 9 March 2020 and 2 January 2022. Descriptive statistical measures (frequencies, percentages, case fatality rates [CFR], test positivity rates [TPR], and characteristics) were compared using chi-squared or the Fisher-Irwin test.

Results: During the study period, 72,108/445,084 (16.2%) tests were positive, with 9,641/56,637 (17.0%), 16,643/66,560 (25.0%), 24,172/157,945 (15.3%), and 21,652/163,942 (13.2%) cases during the first, second, third, and fourth waves, respectively. TPR significantly decreased from 17.0% in the first wave to 13.2% in the fourth wave as did infection of frontline health workers (5.2% vs. 0.9%). CFR decreased from 5.1 to 0.9% from the first to fourth wave. No sex- or age-related differences in distributions across different waves were observed. The majority of cases were asymptomatic in the first (73.1%) and second (86.6%) waves, in contrast to that in the third (11.1%) and fourth (31.3%) waves.

Conclusion: Despite fewer reported cases, the primary waves (first and second) of the COVID-19 pandemic in the DRC were more severe than the third and fourth waves, with each wave being associated with a new SARS-CoV-2 variant. Tailored public health and social measures, and resurgence monitoring are needed to control future waves of COVID-19.

Keywords: COVID-19; Democratic Republic of the Congo; Epidemiological comparison; Resurgence; Wave.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Epidemic curve of confirmed COVID-19 cases reported by epidemiological week (EW) and by defined wave with related epidemiological characteristics in the DRC from EW11-2020 to EW52-2021
Fig. 2
Fig. 2
a Number of confirmed COVID-19 cases over time and temperature in Kinshasa. b Number of confirmed COVID-19 cases over time and rainfall in Kinshasa
See this image and copyright information in PMC

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Supplementary concepts