YPredicting the Impact of COVID-19 and the Potential Impact of the Public Health Response on Disease Burden in Uganda
YPredicting the Impact of COVID-19 and the Potential Impact of the Public Health Response on Disease Burden in Uganda
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DOI：
10.4269/ajtmh.20-0546
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发表时间：
2020-09-01
影响因子：
3.3
通讯作者：
Mbonye, Anthony K.
中科院分区：
文献类型：
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作者：
Bell, David;Hansen, Kristian Schultz;Mbonye, Anthony K.
目前，包括乌干达在内的撒哈拉以南非洲地区的 COVID-19 大流行和公共卫生“封锁”应对措施已得到广泛报道。尽管 COVID-19 对非洲人口的影响相对较小，但人们担心，重新调整卫生系统抗击 COVID-19 的重点和优先顺序可能会对获得非 COVID-19 疾病产生影响。我们将中国基于年龄的 COVID-19 死亡率数据应用于乌干达和先前爆发过疫情的非非洲国家的人口结构，比较理论死亡率和损失的伤残调整生命年 (DALY)。然后，我们预测了 COVID-19 公共卫生应对措施的可能情况对乌干达艾滋病毒/艾滋病、疟疾和孕产妇健康的发病率和死亡率的影响。仅根据人口年龄结构，与对比国家的同等传播率相比，预计乌干达的 COVID-19 负担相对较低，预计死亡率为意大利同等传播率的 12%，DALY 损失为意大利的 19%。相比之下，公共卫生应对措施对疟疾和艾滋病毒/艾滋病影响的情景预测，额外的疾病负担将超过 SARS-CoV-2 广泛传播所预测的疾病负担。乌干达的新发疾病数据表明，这种恶化可能已经发生。结果预测，COVID-19 对乌干达的影响相对较低，与其年轻人口有关，长期封锁应对措施对非 COVID-19 疾病负担产生负面影响的风险很高。这可能会扭转在解决妇女和儿童健康的基本脆弱性方面来之不易的成果，并强调根据人口结构和当地疾病脆弱性制定 COVID-19 应对措施的重要性。
The COVID-19 pandemic and public health "lockdown" responses in sub-Saharan Africa, including Uganda, are now widely reported. Although the impact of COVID-19 on African populations has been relatively light, it is feared that redirecting focus and prioritization of health systems to fight COVID-19 may have an impact on access to non-COVID-19 diseases. We applied age-based COVID-19 mortality data from China to the population structures of Uganda and non-African countries with previously established outbreaks, comparing theoretical mortality and disability-adjusted life years (DALYs) lost. We then predicted the impact of possible scenarios of the COVID-19 public health response on morbidity and mortality for HIV/AIDS, malaria, and maternal health in Uganda. Based on population age structure alone, Uganda is predicted to have a relatively low COVID-19 burden compared with an equivalent transmission in comparison countries, with 12% of the mortality and 19% of the lost DALYs predicted for an equivalent transmission in Italy. By contrast, scenarios of the impact of the public health response on malaria and HIV/AIDS predict additional disease burdens outweighing that predicted from extensive SARS-CoV-2 transmission. Emerging disease data from Uganda suggest that such deterioration mayalready be occurring. The results predict a relatively low COVID-19 impact on Uganda associated with its young population, with a high risk of negative impact on non-COVID-19 disease burden from a prolonged lockdown response. This may reverse hard-won gains in addressing fundamental vulnerabilities in women and children's health, and underlines the importance of tailoring COVID-19 responses according to population structure and local disease vulnerabilities.