COVID-19 in the 47 countries of the WHO African region: a modelling analysis of past trends and future patterns.
COVID-19 in the 47 countries of the WHO African region: a modelling analysis of past trends and future patterns.
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DOI：
10.1016/s2214-109x(22)00233-9
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发表时间：
2022-08
影响因子：
34.3
通讯作者：
Moeti, Matshidiso R.
中科院分区：
文献类型：
--
作者：
Cabore, Joseph Waogodo;Karamagi, Humphrey Cyprian;Kipruto, Hillary Kipchumba;Mungatu, Joseph Kyalo;Asamani, James Avoka;Droti, Benson;Titi-Ofei, Regina;Seydi, Aminata Binetou Wahebine;Kidane, Solyana Ngusbrhan;Balde, Thierno;Gueye, Abdou Salam;Makubalo, Lindiwe;Moeti, Matshidiso R.
COVID-19在许多方面影响了非洲地区。我们旨在就COVID-19自疫情开始以来及整个二零二二年在该地区的传播动态提供可靠的信息。对于世卫组织非洲区域的47个国家中的每一个国家，我们整合了来自报告的感染和死亡（来自世卫组织统计数据）的COVID-19数据;关于社会生态、生物物理和公共卫生干预措施的已发表文献;以及免疫状况和令人担忧的变异，以构建COVID-19负担的动态和全面情况。该模型通过部分观察到的马尔可夫决策过程进行整合，并根据SEIRD（表示易感、暴露、感染、康复和死亡）建模框架，使用傅立叶级数随时间推移产生观察到的模式。该模型每周按国家运行一次，从每个国家报告首次感染之日起至2021年12月31日。根据各国报告的测序数据，将新变体引入模型。然后将这些模型外推至2022年底，并包括三种基于可能的新变体的情景，这些变体具有不同的传播性，严重程度或免疫原性。在2020年1月1日至2021年12月31日期间，我们的模型估计非洲地区的SARS-CoV-2感染人数为5.056亿（95%CI 476.0 - 536.2），推断该地区仅报告了1.4%（71分之一）的SARS-CoV-2感染。死亡人数估计为439 500人（95% CI 344 374-574 785），其中35.3%（三分之一）报告为COVID-19相关死亡。尽管2020年和2021年的感染人数相似，但81%的死亡发生在2021年。鉴于截至2021年12月31日的疫苗接种覆盖率为14.7%，估计该地区52.3%（95%CI 43.5 - 95.2）的人口具有一定的SARS-CoV-2免疫力。到2022年底，我们估计感染人数仍将居高不下，约为1.662亿（95%CI 157.5 - 174.9）例感染，但死亡人数将大幅减少至22563例（14970 - 38831）。据估计，非洲地区的COVID-19感染人数与世界其他地区相似，但死亡人数较少。我们的模型表明，目前的SARS-CoV-2检测方法遗漏了大多数感染。这些结果与代表性血清阳性率研究的结果一致。因此，有必要监测住院情况、合并症和出现的新变异，并扩大代表性血清阳性率研究，作为核心应对策略。没有。
COVID-19 has affected the African region in many ways. We aimed to generate robust information on the transmission dynamics of COVID-19 in this region since the beginning of the pandemic and throughout 2022. For each of the 47 countries of the WHO African region, we consolidated COVID-19 data from reported infections and deaths (from WHO statistics); published literature on socioecological, biophysical, and public health interventions; and immunity status and variants of concern, to build a dynamic and comprehensive picture of COVID-19 burden. The model is consolidated through a partially observed Markov decision process, with a Fourier series to produce observed patterns over time based on the SEIRD (denoting susceptible, exposed, infected, recovered, and dead) modelling framework. The model was set up to run weekly, by country, from the date the first infection was reported in each country until Dec 31, 2021. New variants were introduced into the model based on sequenced data reported by countries. The models were then extrapolated until the end of 2022 and included three scenarios based on possible new variants with varying transmissibility, severity, or immunogenicity. Between Jan 1, 2020, and Dec 31, 2021, our model estimates the number of SARS-CoV-2 infections in the African region to be 505·6 million (95% CI 476·0–536·2), inferring that only 1·4% (one in 71) of SARS-CoV-2 infections in the region were reported. Deaths are estimated at 439 500 (95% CI 344 374–574 785), with 35·3% (one in three) of these reported as COVID-19-related deaths. Although the number of infections were similar between 2020 and 2021, 81% of the deaths were in 2021. 52·3% (95% CI 43·5–95·2) of the region's population is estimated to have some SARS-CoV-2 immunity, given vaccination coverage of 14·7% as of Dec 31, 2021. By the end of 2022, we estimate that infections will remain high, at around 166·2 million (95% CI 157·5–174·9) infections, but deaths will substantially reduce to 22 563 (14 970–38 831). The African region is estimated to have had a similar number of COVID-19 infections to that of the rest of the world, but with fewer deaths. Our model suggests that the current approach to SARS-CoV-2 testing is missing most infections. These results are consistent with findings from representative seroprevalence studies. There is, therefore, a need for surveillance of hospitalisations, comorbidities, and the emergence of new variants of concern, and scale-up of representative seroprevalence studies, as core response strategies. None.