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Mortality before and during the COVID-19 pandemic in Manhiça district, Southern Mozambique

Article scientifique 2026 Anglais

Résumé

INTRODUCTION: Mozambique reported its first COVID-19 case in March 2020, and the pandemic exposed significant vulnerabilities in its healthcare system. Measuring mortality attributable to COVID-19 in Mozambique, has been challenging due to limitations in health information systems and incomplete death documentation outside health facilities. By mid-2023, a total of 2,234 deaths from 233,334 cases were confirmed but the figures can be much higher. METHODS : We conducted a trend analysis of mortality using data from the Manhiça Health and Demographic Surveillance System from the periods before (2016-2019) and during the pandemic (2020-2021) to measure sex differences in mortality patterns (life expectancy and mortality rates). Excess mortality ratios during the pandemic were assessed using time series analysis with COVID-19 a generalized additive model. RESULTS: From 2019 to 2020, the life expectancy in males increased 5.1%, from 61.3 (95% CI: 60.3-62.2) years to 64.4 (95% CI: 63.5-65.3) years, and 6.1%, from 69.3 (95% CI: 68.5-70.2) years to 73.5 (95% CI: 72.6-74.3) years in females. However, from 2020 to 2021, a decline was observed in both males and females. In males, it dropped 3.1% while in females the life expectancy dropped 3.5%. All-age male mortality rates decreased from 15.3 to 11.2 (26.8%) deaths per 1000 person-years from 2016 to 2020, then rose to approximately 13.4 in 2021. All-age female mortality experienced a similar trend, with an increase of 9.0% from 6.7 deaths per 1000 person-years in 2020 to 7.3 in 2021. During pandemic, the male elderly population (65+ years old) experienced the highest excess mortality in July 2021, reaching a ratio of 1.57 (CI: 1.37-1.84), whereas for females, the highest excess mortality among females was observed in the age group of 05-14 years, with a ratio of 1.86 (CI: 1.44 - 2.17) in January 2021 between the observed and expected deaths. CONCLUSION: Mortality in Manhiça district declined from 2016 until 2019 but increased during COVID-19 pandemic with excess deaths in 2021, particularly among those aged 65 and older. This study highlights the value of robust health and demographic information systems in resource-limited settings for assessing public health impacts.

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Sacoor, C., Nhacolo, A., Muir, J., Jamisse, E., Barr, B., Nhacolo, A., Kabudula, C., Bashingwa, J., Augusto, O., Chaúque, A., Matsena, T., Malheia, A., Hunguana, A., Saúte, F., Argeseanu, S., Tollman, S., Sevene, E., Bassat, Q., Mandomando, I. (2026). Mortality before and during the COVID-19 pandemic in Manhiça district, Southern Mozambique. https://doi.org/10.1186/s12963-025-00449-y

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Auteur(s)

Charfudin Sacoor Arsénio Nhacolo Jonathan A. Muir Edgar Jamisse Beth Tippet Barr Ariel Nhacolo Chodziwadziwa Kabudula Jean Juste Harrisson Bashingwa Orvalho Augusto Alberto Chaúque Teodimiro Matsena Arlindo Malheia Aura Hunguana Francisco Saúte Solveig A. Argeseanu Stephen Tollman Esperança Sevene Quique Bassat Inácio Mandomando

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