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Using mortuary and burial data to place COVID-19 in Lusaka, Zambia within a global context

Article scientifique 2023 Anglais

Résumé

Reported COVID-19 cases and associated mortality remain low in many sub-Saharan countries relative to global averages, but true impact is difficult to estimate given limitations around surveillance and mortality registration. In Lusaka, Zambia, burial registration and SARS-CoV-2 prevalence data during 2020 allow estimation of excess mortality and transmission. Relative to pre-pandemic patterns, we estimate age-dependent mortality increases, totalling 3212 excess deaths (95% CrI: 2104-4591), representing an 18.5% (95% CrI: 13.0-25.2%) increase relative to pre-pandemic levels. Using a dynamical model-based inferential framework, we find that these mortality patterns and SARS-CoV-2 prevalence data are in agreement with established COVID-19 severity estimates. Our results support hypotheses that COVID-19 impact in Lusaka during 2020 was consistent with COVID-19 epidemics elsewhere, without requiring exceptional explanations for low reported figures. For more equitable decision-making during future pandemics, barriers to ascertaining attributable mortality in low-income settings must be addressed and factored into discourse around reported impact differences.

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Sheppard, R., Watson, O., Pieciak, R., Lungu, J., Kwenda, G., Moyo, C., Chanda, S., Barnsley, G., Brazeau, N., Gerard-Ursin, I., Mesa, D., Whittaker, C., Gregson, S., Okell, L., Ghani, A., MacLeod, W., Fava, E., Melegaro, A., Hines, J., Mulenga, L., Walker, P., Mwananyanda, L., Gill, C. (2023). Using mortuary and burial data to place COVID-19 in Lusaka, Zambia within a global context. https://doi.org/10.1038/s41467-023-39288-6

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