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. 2023 Sep 28:10:20499361231202116.
doi: 10.1177/20499361231202116. eCollection 2023 Jan-Dec.

Population-based assessment of the burden of COVID-19 infection in African countries: a first-year report card and public health implications

Osaro Mgbere  1   2   3   4 , Ogbonna Collins Nwabuko  5   6 , Olajumoke A Olateju  3 , Omolola E Adepoju  7 , Winston Liaw  7 , Charles Darkoh  8   9 , Ekere James Essien  2   3
Affiliations

Population-based assessment of the burden of COVID-19 infection in African countries: a first-year report card and public health implications

Osaro Mgbere et al. Ther Adv Infect Dis. .

Abstract

Background: The COVID-19 pandemic constitutes a global health threat and poses a major burden on the African continent. We assessed the real-world burden of COVID-19 infection in African Union (AU) member states to determine the distributional patterns of epidemiological measures during the first 1 year of the pandemic.

Methods: This retrospective cross-sectional study utilized COVID-19 data from publicly available data repositories of the African Center for Disease Control and Prevention and Our World in Data for the period February 2020 to January 2021. AU member states were classified into low, medium, and high burdens based on COVID-19 morbidity. We conducted descriptive and inferential analyses of COVID-19-reported cases, deaths, recoveries, active cases, COVID-19 tests, and epidemiological measures that included morbidity and mortality rates, case fatality rate (CFR), and case ratios.

Results: A total of 3.21 million cases were reported during the 1-year period, with 2.6 million recoveries, 536,784 cases remaining active, and 77,486 deaths. Most countries (49.1%, n = 26) in AU experienced a low burden of COVID-19 infection compared to 28.3% (n = 15) with medium burden and 22.6% (n = 12) with high burden. AU nations with a high burden of the disease were mainly in the northern and southern regions. South Africa recorded the highest number of cases (1.31 million), followed by Morocco with 457,625 and Tunisia with 175,065 cases. Correspondently, death tolls for these countries were 36,467, 7888, and 5528 deaths, respectively. Of the total COVID-19 tests performed (83.8 million) during the first 1 year, 62.43% were from high-burden countries. The least testing occurred in the medium-burden (18.42%) countries. The overall CFR of AU was 2.21%. A morbidity rate of 327.52/105 population and mortality rate of 5.96/105 population were recorded during the first 1-year period with significant variations (p < 0.0001) across burden levels. Continental morbidity and mortality rates of 17,359/105 and 315.933/105 populations were recorded with significant correlation (r = 0.863, p < 0.0001) between them and variations across selected epidemiological measures by COVID-19 burden levels.

Conclusion: Understanding the true burden of the disease in AU countries is important for establishing the impact of the pandemic in the African continent and for intervention planning, preparedness, and deployment of resources during COVID-19 surges and future pandemics.

Keywords: Africa; African countries; COVID-19; burden of COVID-19; case fatality rate; morbidity rate; mortality rate.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Map of Africa showing the burden of COVID-19 pandemic in AU member nations, 2020–2021. AU, African Union.
Figure 2.
Figure 2.
Reported, recoveries, and active cases of COVID-19 in AU member countries by the burden of COVID-19 infection. AU, African Union.
Figure 3.
Figure 3.
A number of COVID-19-related deaths overlaid the population of AU member countries by the burden of the COVID-19 pandemic. AU, African Union.
Figure 4.
Figure 4.
Ratios of active cases (A/C) and recoveries (R), and reported cases (RC) of COVID-19 in AU member countries by the burden of COVID-19 infection. AU, African Union.
Figure 5.
Figure 5.
Morbidity and mortality rates of COVID-19 in AU member countries by the burden of COVID-19 infection. AU, African Union.
Figure 6.
Figure 6.
Case fatality rates of COVID-19 in AU member countries by the burden of COVID-19 infection. AU, African Union.
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