Inter-Country COVID-19 Contagiousness Variation in Eight African Countries

Abstract

The estimates of contiguousness parameters of an epidemic have been used for health-related policy and control measures such as non-pharmaceutical control interventions (NPIs). The estimates have varied by demographics, epidemic phase, and geographical region. Our aim was to estimate four contagiousness parameters: basic reproduction number (R0), contact rate, removal rate, and infectious period of coronavirus disease 2019 (COVID-19) among eight African countries, namely Angola, Botswana, Egypt, Ethiopia, Malawi, Nigeria, South Africa, and Tunisia using Susceptible, Infectious, or Recovered (SIR) epidemic models for the period 1 January 2020 to 31 December 2021. For reference, we also estimated these parameters for three of COVID-19's most severely affected countries: Brazil, India, and the USA. The basic reproduction number, contact and remove rates, and infectious period ranged from 1.11 to 1.59, 0.53 to 1.0, 0.39 to 0.81; and 1.23 to 2.59 for the eight African countries. For the USA, Brazil, and India these were 1.94, 0.66, 0.34, and 2.94; 1.62, 0.62, 0.38, and 2.62, and 1.55, 0.61, 0.39, and 2.55, respectively. The average COVID-19 related case fatality rate for 8 African countries in this study was estimated to be 2.86%. Contact and removal rates among an affected African population were positively and significantly associated with COVID-19 related deaths (p-value < 0.003). The larger than one estimates of the basic reproductive number in the studies of African countries indicate that COVID-19 was still being transmitted exponentially by the 31 December 2021, though at different rates. The spread was even higher for the three countries with substantial COVID-19 outbreaks. The lower removal rates in the USA, Brazil, and India could be indicative of lower death rates (a proxy for good health systems). Our findings of variation in the estimate of COVID-19 contagiousness parameters imply that countries in the region may implement differential COVID-19 containment measures.

Examining the Role of Social Determinants of Health and Healthcare System Measures on COVID-19 Outcomes in 28 African Countries

“…These results are likely related to a difference in the ability of countries to detect and test patients, limited PPE availability, the high prevalence of younger population, a lack of rapid and more effective national health policies, and the possibility of under reporting of cases and deaths (48). This finding was also reported in similar related studies (49,50,51).…”

Examining the Role of Social Determinants of Health and COVID-19 Risk in 28 African Countries

“…The factors contributing to these low death rates in Africa, despite a weak healthcare infrastructure, have drawn fierce debate and raised big questions among scholars and civic leaders [2][3][4][5][6]. Several hypotheses have been provided to support the low reported death rates and case fatality rates, such as low vaccine coverage and/or underreporting [7][8][9][10][11][12][13][14][15][16].…”