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. 2022 Jun 9;2(6):e0000169.
doi: 10.1371/journal.pgph.0000169. eCollection 2022.

COVID-19 mortality rate and its associated factors during the first and second waves in Nigeria

Kelly Elimian  1   2   3   4 , Anwar Musah  4   5 , Carina King  2 , Ehimario Igumbor  1   4   5 , Puja Myles  6 , Olaolu Aderinola  1 , Cyril Erameh  7 , William Nwanchukwu  1 , Oluwatosin Akande  1 , Ndembi Nicaise  8 , Oladipo Ogunbode  1 , Abiodun Egwuenu  1 , Emily Crawford  1 , Giulia Gaudenzi  2 , Ismail Abdus-Salam  9 , Olubunmi Olopha  1 , Yahya Disu  1 , Abimbola Bowale  10 , Cyprian Oshoma  3 , Cornelius Ohonsi  1 , Chinedu Arinze  1 , Sikiru Badaru  1 , Blessing Ebhodaghe  1 , Zaiyad Habib  11 , Michael Olugbile  12 , Chioma Dan-Nwafor  1 , Jafiya Abubakar  1 , Emmanuel Pembi  13 , Lauryn Dunkwu  14 , Ifeanyi Ike  1   15 , Ekaete Tobin  7 , Bamidele Mutiu  16 , Rejoice Luka-Lawal  1 , Obinna Nwafor  1 , Mildred Okowa  17 , Chidiebere Ezeokafor  4   18 , Emem Iwara  19 , Sebastian Yennan  1 , Sunday Eziechina  1 , David Olatunji  1 , Lanre Falodun  20 , Emmanuel Joseph  21 , Ifeanyi Abali  1 , Tarik Mohammed  1 , Benjamin Yiga  22 , Khadeejah Kamaldeen  23 , Emmanuel Agogo  24 , Nwando Mba  1 , John Oladejo  1 , Elsie Ilori  1 , Olusola Aruna  25 , Geoffrey Namara  26 , Stephen Obaro  27 , Khadeejah Hamza  4   28 , Michael Asuzu  4   29 , Shaibu Bello  4   30 , Friday Okonofua  31 , Yusuf Deeni  4   32 , Ibrahim Abubakar  33 , Tobias Alfven  2 , Chinwe Ochu  1 , Chikwe Ihekweazu  1
Affiliations

COVID-19 mortality rate and its associated factors during the first and second waves in Nigeria

Kelly Elimian et al. PLOS Glob Public Health. .

Abstract

COVID-19 mortality rate has not been formally assessed in Nigeria. Thus, we aimed to address this gap and identify associated mortality risk factors during the first and second waves in Nigeria. This was a retrospective analysis of national surveillance data from all 37 States in Nigeria between February 27, 2020, and April 3, 2021. The outcome variable was mortality amongst persons who tested positive for SARS-CoV-2 by Reverse-Transcriptase Polymerase Chain Reaction. Incidence rates of COVID-19 mortality was calculated by dividing the number of deaths by total person-time (in days) contributed by the entire study population and presented per 100,000 person-days with 95% Confidence Intervals (95% CI). Adjusted negative binomial regression was used to identify factors associated with COVID-19 mortality. Findings are presented as adjusted Incidence Rate Ratios (aIRR) with 95% CI. The first wave included 65,790 COVID-19 patients, of whom 994 (1∙51%) died; the second wave included 91,089 patients, of whom 513 (0∙56%) died. The incidence rate of COVID-19 mortality was higher in the first wave [54∙25 (95% CI: 50∙98-57∙73)] than in the second wave [19∙19 (17∙60-20∙93)]. Factors independently associated with increased risk of COVID-19 mortality in both waves were: age ≥45 years, male gender [first wave aIRR 1∙65 (1∙35-2∙02) and second wave 1∙52 (1∙11-2∙06)], being symptomatic [aIRR 3∙17 (2∙59-3∙89) and 3∙04 (2∙20-4∙21)], and being hospitalised [aIRR 4∙19 (3∙26-5∙39) and 7∙84 (4∙90-12∙54)]. Relative to South-West, residency in the South-South and North-West was associated with an increased risk of COVID-19 mortality in both waves. In conclusion, the rate of COVID-19 mortality in Nigeria was higher in the first wave than in the second wave, suggesting an improvement in public health response and clinical care in the second wave. However, this needs to be interpreted with caution given the inherent limitations of the country's surveillance system during the study.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. A flow chart showing how the records, by wave, analysed for the study were selected.
Fig 2
Fig 2. Kaplan Meier plots showing the survival patterns of COVID-19 patients by age group, gender, and geopolitical zone in wave 1 and wave 2.
Fig 3
Fig 3. Kaplan Meier plots showing the survival patterns of COVID-19 patients by hospitalisation and symptomatic status in wave 1 and wave 2.
Fig 4
Fig 4. A Nigerian map showing COVID-19 incidence and mortality rates during the first and second waves.
Fig 5
Fig 5. A Nigerian map showing the changes in COVID-19 incidence and mortality rates during the first and second waves.
See this image and copyright information in PMC

References

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