The COVID-19 Prevalence among Children: Hypotheses for Low Infection Rate and Few Severe Forms among This Age Group in Sub-Saharan Africa

Njonnou, Sylvain Raoul Simeni; Anangmo, Nadia Christelle Noumedem; Lekpa, Fernando Kemta; Njinkui, Diomede Noukeu; Enyama, Dominique; Ouankou, Christian Ngongang; Balti, Eric Vounsia; Eloumba, Esther Astrid Mbono Samba; Tapouh, Jean Roger Moulion; Choukem, Siméon Pierre

doi:10.1155/2021/4258414

Cited by 7 publications

(4 citation statements)

References 32 publications

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“…While evidence is growing that, worldwide, children are less likely to develop severe forms of COVID-19 [ 26 ], in African countries a substantially lower rate of disease is observed. Several epidemiological factors (such as the protective effect of other endemic infections or vaccinations) are being studied.…”

Section: Discussionmentioning

confidence: 99%

Malaria, HIV and Malnutrition among Internally Displaced People in Mozambique During COVID-19 Pandemic: Results from a Community-Based Intervention

Gennaro

Segala²,

Ramirez³

et al. 2022

Annals of Global Health

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Background:The spread of COVID-19 poses an unprecedented challenge to care delivery in post-disaster and conflict situations. In Mozambique, the 2019 cyclone Idai and the violence by Non-State-Armed-Groups devastated the province of Sofala and Cabo Delgado respectively and led to the displacement of thousands of people living in poor and overcrowded conditions. The pandemic has further aggravated the situation. Doctors with Africa CUAMM (University college for aspiring missionary doctors) implemented surveillance activities in these regions between October 2020 and September 2021. The aim of this study is to give an overview of the prevalence of malaria, malnutrition, COVID-19 related symptoms and access to HIV testing. Methods: Data were collected in targeted internally displaced people (IDP) sites in Sofala and Cabo Delgado province between 31st January and 25th September 2021. The tool used enabled to assess COVID-19 symptoms, risk of HIV infection, malaria cases and malnutrition in children under five. Results:The project reached 93 503 people. During the study period, 13.6% people reported at least one symptom suggestive of COVID-19 infection. Malaria Rapid Diagnostic Tests (RDT) were administered to 86% of the recruited people (n = ?), with a positive 2 Di Gennaro et al.

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Section: Discussionmentioning

confidence: 99%

Malaria, HIV and Malnutrition among Internally Displaced People in Mozambique During COVID-19 Pandemic: Results from a Community-Based Intervention

Gennaro

Segala²,

Ramirez³

et al. 2022

Annals of Global Health

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“…In addition, data compiled from the Global Burden of Disease Study 2017 (29) reveals that except for malnutrition, HIV/AIDS, and tuberculosis, SSA reported lower mortality rates from obesity, smoking, cardiovascular disease, chronic kidney disease, chronic respiratory diseases, chronic liver disease, cancers, diabetes, and outdoor pollution, compared to other continents where the COVID-19 pandemic was more severe (figure 3b). At last, it is hypothesized that SSA populations possess a cross-protection against COVID-19 because of anterior infections by epidemic coronaviruses or other germs (14,30,31).…”

Section: Discussionmentioning

confidence: 99%

The spread and burden of the COVID-19 pandemic in sub-Saharan Africa: comparison between predictions and actual data and lessons learned

Fokoua-Maxime

Bellouche

Tchigui-Ariolle

et al. 2022

Preprint

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Introduction Sub-Saharan Africa (SSA) was predicted to be severely affected by the coronavirus disease 2019 (COVID-19) pandemic, but the actual data seem to have contradicted these forecasts. This study attempted to verify this observation by comparing predictions against actual data on the spread and burden of the COVID-19 pandemic in SSA. Methods Focused on the period from March 1 st to September 30 th , 2020, we compared (1) the predicted interval dates when each SSA country would report 1 000 and 10 000 COVID-19 cases, to the actual dates when these numbers were attained, as well as (2) the daily number of predicted versus actual COVID-19 cases. Further, we calculated the case fatality ratio of the COVID-19 infection in SSA, and the correlation coefficient between the weekly average number of confirmed COVID-19 cases reported by each country and the weekly average stringency index of its anti-COVID-19 policy measures. Results 84.61% (33) and 100% (39) of the 39 SSA countries for which predictions were made did not reach a total of 1 000 and 10 000 confirmed COVID-19 cases at the predicted interval dates. The daily number of confirmed COVID-19 cases was lower than the one projected for all SSA countries. The case fatality ratio of the COVID-19 infection in SSA was 3.42%. Among the 44 SSA countries for which the correlation could be estimated, it was negative for 17 (38.6%) of them. Conclusions The natural characteristics of SSA and the public health measures implemented might partly explain that the actual data were lower than the predictions on the COVID-19 pandemic in SSA, but the low case ascertainment and the numerous asymptomatic cases did significantly influence this observation.

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“…The young population age-structure in Africa with a median age of 19 years is significant in limiting morbidity and mortality associated with the disease [7,8]. Evidence from various studies have associated a greater risk of disease severity and mortality with older and immunocompromised individuals [11][12][13]. Increased resistance to infections can be acquired through enhanced immunity from vaccination or cross-protection from previous infections [14].…”

Section: Introductionmentioning

confidence: 99%

“…Increased resistance to infections can be acquired through enhanced immunity from vaccination or cross-protection from previous infections [14]. The latter is more conceivable among younger individuals who are more likely to be exposed to other coronaviruses and respiratory viruses [11,12,15]. Moreover, the younger population is more likely to experience milder (asymptomatic or paucisymptomatic) disease conditions, which are rarely noticed or reported [11], though, they remain transmissible.…”

Section: Introductionmentioning

confidence: 99%

Impact of age-structure and vaccine prioritization on COVID-19 in West Africa

Taboe

Asare-Baah

Yesmin

et al. 2022

Preprint

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The ongoing COVID-19 pandemic has been a major global health challenge since its emergence in 2019. Contrary to early predictions that sub-Saharan Africa (SSA) would bear a disproportionate share of the burden of COVID-19 due to the region’s vulnerability to other infectious diseases, weak healthcare systems, and socioeconomic conditions, the pandemic’s effects in SSA have been very mild in comparison to other regions. Interestingly, the number of cases, hospitalizations, and disease-induced deaths in SSA remain low, despite the loose implementation of non-pharmaceutical interventions (NPIs) and the low availability and administration of vaccines. Possible explanations for this low burden include epidemiological disparities, under-reporting (due to limited testing), climatic factors, population structure, and government policy initiatives. In this study, we formulate a model framework consisting of a basic model (in which only susceptible individuals are vaccinated), a vaccine-structured model, and a hybrid vaccine-age-structured model to reflect the dynamics of COVID-19 in West Africa (WA). The framework is trained with a portion of the confirmed daily COVID-19 case data for 16 West African countries, validated with the remaining portion of the data, and used to (i) assess the effect of age structure on the incidence of COVID-19 in WA, (ii) evaluate the impact of vaccination and vaccine prioritization based on age brackets on the burden of COVID-19 in the sub-region, and (iii) explore plausible reasons for the low burden of COVID-19 in WA compared to other parts of the world. Calibration of the model parameters and global sensitivity analysis show that asymptomatic youths are the primary drivers of the pandemic in WA. Also, the basic and control reproduction numbers of the hybrid vaccine-age-structured model are smaller than those of the other two models indicating that the disease burden is overestimated in the models which do not account for age-structure. This result is also confirmed through the vaccine-derived herd immunity thresholds. In particular, a comprehensive analysis of the basic (vaccine-structured) model reveals that if 84% (73%) of the West African populace is fully immunized with the vaccines authorized for use in WA, vaccine-derived herd immunity can be achieved. This herd immunity threshold is lower (68%) for the hybrid model. Also, all three thresholds are lower (60% for the basic model, 51% for the vaccine-structured model, and 48% for the hybrid model) if vaccines of higher efficacies (e.g., the Pfizer or Moderna vaccine) are prioritized, and higher if vaccines of lower efficacy are prioritized. Simulations of the models show that controlling the COVID-19 pandemic in WA (by reducing transmission) requires a proactive approach, including prioritizing vaccination of more youths or vaccination of more youths and elderly simultaneously. Moreover, complementing vaccination with a higher level of mask compliance will improve the prospects of containing the pandemic. Additionally, simulations of the model predict another COVID-19 wave (with a smaller peak size compared to the Omicron wave) by mid-July 2022. Furthermore, the emergence of a more transmissible variant or easing the existing measures that are effective in reducing transmission will result in more devastating COVID-19 waves in the future. To conclude, accounting for age-structure is important in understanding why the burden of COVID-19 has been low in WA and sustaining the current vaccination level, complemented with the WHO recommended NPIs is critical in curbing the spread of the disease in WA.

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The COVID-19 Prevalence among Children: Hypotheses for Low Infection Rate and Few Severe Forms among This Age Group in Sub-Saharan Africa

Cited by 7 publications

References 32 publications

Malaria, HIV and Malnutrition among Internally Displaced People in Mozambique During COVID-19 Pandemic: Results from a Community-Based Intervention

Malaria, HIV and Malnutrition among Internally Displaced People in Mozambique During COVID-19 Pandemic: Results from a Community-Based Intervention

The spread and burden of the COVID-19 pandemic in sub-Saharan Africa: comparison between predictions and actual data and lessons learned

Impact of age-structure and vaccine prioritization on COVID-19 in West Africa

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