The relatively young and rural population may limit the spread and severity of COVID-19 in Africa: a modelling study
The relatively young and rural population may limit the spread and severity of COVID-19 in Africa: a modelling study
复制标题
DOI：
10.1136/bmjgh-2020-002699
复制
发表时间：
2020-05-01
影响因子：
8.1
通讯作者：
Pougue Biyong, John N.
中科院分区：
文献类型：
--
作者：
Diop, Binta Zahra;Ngom, Marieme;Pougue Biyong, John N.
导言一种新型冠状病毒病2019年(新冠肺炎)已蔓延至世界所有地区。各国的特点将如何影响疫情的传播存在很大的不确定性；迄今为止，很少有研究试图预测疫情在非洲国家的传播。在这篇文章中，我们调查了人口结构、城市化和共生对加纳、肯尼亚和塞内加尔新冠肺炎可能的发展轨迹的影响。方法在目前采取的控制措施下，利用增广确定性易感-感染-恢复模型预测疾病的真实传播。我们将感染的间隔分解为无症状、轻度症状和严重症状，以配合观察到的新冠肺炎的临床发展。我们还考虑了年龄结构、城市化和共病(艾滋病毒、结核病、贫血)。结果在我们的基线模型中，我们预计根据政策措施的有效性，活跃病例的高峰期将出现在7月份。考虑到城市化，并考虑到并存情况，高峰期可能出现在6月2日至6月17日(加纳)、7月22日至8月29日(肯尼亚)以及最后5月28日至6月15日(塞内加尔)。成功的遏制政策可能会降低严重感染率。虽然大多数病例将是轻微的，但我们预计，在缺乏进一步控制传播的政策的情况下，加纳、肯尼亚和塞内加尔分别有0.78%至1.03%、0.61%至1.22%以及0.60%至0.84%的个人可能在疫情高峰期出现严重症状。结论与欧洲相比，非洲的年轻和农村人口可能会改变疫情的严重性。大量的青年人口可能会导致更多的感染，但这些感染中的大多数都是无症状或轻微的，可能不会被发现。必须考虑到潜在疾病的较高患病率。
Introduction A novel coronavirus disease 2019 (COVID-19) has spread to all regions of the world. There is great uncertainty regarding how countries' characteristics will affect the spread of the epidemic; to date, there are few studies that attempt to predict the spread of the epidemic in African countries. In this paper, we investigate the role of demographic patterns, urbanisation and comorbidities on the possible trajectories of COVID-19 in Ghana, Kenya and Senegal. Methods We use an augmented deterministic Susceptible-Infected-Recovered model to predict the true spread of the disease, under the containment measures taken so far. We disaggregate the infected compartment into asymptomatic, mildly symptomatic and severely symptomatic to match observed clinical development of COVID-19. We also account for age structures, urbanisation and comorbidities (HIV, tuberculosis, anaemia). Results In our baseline model, we project that the peak of active cases will occur in July, subject to the effectiveness of policy measures. When accounting for the urbanisation, and factoring in comorbidities, the peak may occur between 2 June and 17 June (Ghana), 22 July and 29 August (Kenya) and, finally, 28 May and 15 June (Senegal). Successful containment policies could lead to lower rates of severe infections. While most cases will be mild, we project in the absence of policies further containing the spread, that between 0.78% and 1.03%, 0.61% and 1.22%, and 0.60% and 0.84% of individuals in Ghana, Kenya and Senegal, respectively, may develop severe symptoms at the time of the peak of the epidemic. Conclusion Compared with Europe, Africa's younger and rural population may modify the severity of the epidemic. The large youth population may lead to more infections but most of these infections will be asymptomatic or mild, and will probably go undetected. The higher prevalence of underlying conditions must be considered.