Risk factors for COVID-19 infection, disease severity and related deaths in Africa: a systematic review

Objective The aim of this study was to provide a comprehensive evidence on risk factors for transmission, disease severity and COVID-19 related deaths in Africa.Design A systematic review has been conducted to synthesise existing evidence on risk factors affecting COVID-19 outcomes across Africa.Dat...

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Main Authors: Kefyalew Addis Alene, Akilew Awoke Adane, Digsu Negese Koye, Berihun Assefa Dachew, Abadi Kahsu Gebre, Mohammed Biset Ayalew, Yohannes Kinfu, Yohannes Adama Melaku, Mulugeta Molla Birhanu, Hassen Mohammed, Teketo Kassaw Tegegne, Yalemzewod Assefa Gelaw, Dagnachew Muluye Fetene, Muluken Dessalegn Muluneh, Solomon Abrha, Kidane Tadesse Gebremariam, Tesfaye Gebremedhin, Amanuel Tesfay Gebremedhin, Lemlem Gebremichael, Ayele Bali Geleto, Getiye Dejenu Kibret, Cheru Tesema Leshargie, Azeb Gebresilassie Tesema, Fisaha Haile Tesfay, Befikadu Legesse Wubishet, Hailay Abrha Gesesew, Mulu Woldegiorgis, Mamaru Ayenew Awoke, Desalegn Markos Shifti, Atsede Fantahun Aregay, Maereg Wagnew Meazaw, Alemayehu Berhane Mekonnen, Dejen Yemane Tekle, Wubshet Tesfaye
Format: Article
Language:English
Published: BMJ Publishing Group 2021-02-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/2/e044618.full
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author Kefyalew Addis Alene
Akilew Awoke Adane
Digsu Negese Koye
Berihun Assefa Dachew
Abadi Kahsu Gebre
Mohammed Biset Ayalew
Yohannes Kinfu
Yohannes Adama Melaku
Mulugeta Molla Birhanu
Hassen Mohammed
Teketo Kassaw Tegegne
Yalemzewod Assefa Gelaw
Dagnachew Muluye Fetene
Muluken Dessalegn Muluneh
Solomon Abrha
Kidane Tadesse Gebremariam
Tesfaye Gebremedhin
Amanuel Tesfay Gebremedhin
Lemlem Gebremichael
Ayele Bali Geleto
Getiye Dejenu Kibret
Cheru Tesema Leshargie
Azeb Gebresilassie Tesema
Fisaha Haile Tesfay
Befikadu Legesse Wubishet
Hailay Abrha Gesesew
Mulu Woldegiorgis
Mamaru Ayenew Awoke
Desalegn Markos Shifti
Atsede Fantahun Aregay
Maereg Wagnew Meazaw
Alemayehu Berhane Mekonnen
Dejen Yemane Tekle
Wubshet Tesfaye
author_facet Kefyalew Addis Alene
Akilew Awoke Adane
Digsu Negese Koye
Berihun Assefa Dachew
Abadi Kahsu Gebre
Mohammed Biset Ayalew
Yohannes Kinfu
Yohannes Adama Melaku
Mulugeta Molla Birhanu
Hassen Mohammed
Teketo Kassaw Tegegne
Yalemzewod Assefa Gelaw
Dagnachew Muluye Fetene
Muluken Dessalegn Muluneh
Solomon Abrha
Kidane Tadesse Gebremariam
Tesfaye Gebremedhin
Amanuel Tesfay Gebremedhin
Lemlem Gebremichael
Ayele Bali Geleto
Getiye Dejenu Kibret
Cheru Tesema Leshargie
Azeb Gebresilassie Tesema
Fisaha Haile Tesfay
Befikadu Legesse Wubishet
Hailay Abrha Gesesew
Mulu Woldegiorgis
Mamaru Ayenew Awoke
Desalegn Markos Shifti
Atsede Fantahun Aregay
Maereg Wagnew Meazaw
Alemayehu Berhane Mekonnen
Dejen Yemane Tekle
Wubshet Tesfaye
author_sort Kefyalew Addis Alene
collection DOAJ
description Objective The aim of this study was to provide a comprehensive evidence on risk factors for transmission, disease severity and COVID-19 related deaths in Africa.Design A systematic review has been conducted to synthesise existing evidence on risk factors affecting COVID-19 outcomes across Africa.Data sources Data were systematically searched from MEDLINE, Scopus, MedRxiv and BioRxiv.Eligibility criteria Studies for review were included if they were published in English and reported at least one risk factor and/or one health outcome. We included all relevant literature published up until 11 August 2020.Data extraction and synthesis We performed a systematic narrative synthesis to describe the available studies for each outcome. Data were extracted using a standardised Joanna Briggs Institute data extraction form.Results Fifteen articles met the inclusion criteria of which four were exclusively on Africa and the remaining 11 papers had a global focus with some data from Africa. Higher rates of infection in Africa are associated with high population density, urbanisation, transport connectivity, high volume of tourism and international trade, and high level of economic and political openness. Limited or poor access to healthcare are also associated with higher COVID-19 infection rates. Older people and individuals with chronic conditions such as HIV, tuberculosis and anaemia experience severe forms COVID-19 leading to hospitalisation and death. Similarly, high burden of chronic obstructive pulmonary disease, high prevalence of tobacco consumption and low levels of expenditure on health and low levels of global health security score contribute to COVID-19 related deaths.Conclusions Demographic, institutional, ecological, health system and politico-economic factors influenced the spectrum of COVID-19 infection, severity and death. We recommend multidisciplinary and integrated approaches to mitigate the identified factors and strengthen effective prevention strategies.
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spelling doaj-art-7d7b89d1e7674e598381e5ca17d21a252024-11-19T05:45:08ZengBMJ Publishing GroupBMJ Open2044-60552021-02-0111210.1136/bmjopen-2020-044618Risk factors for COVID-19 infection, disease severity and related deaths in Africa: a systematic reviewKefyalew Addis Alene0Akilew Awoke Adane1Digsu Negese Koye2Berihun Assefa Dachew3Abadi Kahsu Gebre4Mohammed Biset Ayalew5Yohannes Kinfu6Yohannes Adama Melaku7Mulugeta Molla Birhanu8Hassen Mohammed9Teketo Kassaw Tegegne10Yalemzewod Assefa Gelaw11Dagnachew Muluye Fetene12Muluken Dessalegn Muluneh13Solomon Abrha14Kidane Tadesse Gebremariam15Tesfaye Gebremedhin16Amanuel Tesfay Gebremedhin17Lemlem Gebremichael18Ayele Bali Geleto19Getiye Dejenu Kibret20Cheru Tesema Leshargie21Azeb Gebresilassie Tesema22Fisaha Haile Tesfay23Befikadu Legesse Wubishet24Hailay Abrha Gesesew25Mulu Woldegiorgis26Mamaru Ayenew Awoke27Desalegn Markos Shifti28Atsede Fantahun Aregay29Maereg Wagnew Meazaw30Alemayehu Berhane Mekonnen31Dejen Yemane Tekle32Wubshet Tesfaye33Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Perth, Western Australia, Australia1 Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia1 Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaSchool of Population Health, Curtin University, Perth, Western Australia, Australia1 Nutrition and Health Innovation Research Institute,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia12 Department of Pharmacy, University of New England, Armidale, New South Wales, Australia3 University of Canberra, Canberra, Australian Capital Territory, Australia1 Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, AustraliaDepartment of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Clayton, Victoria, Australia37 Vaccinology and Immunology Research Trials Unit, Women’s and Children’s Health Network, Adelaide, South Australia, AustraliaPublic Health, Debre Markos University, Debre Markos, Amhara, Ethiopia5 Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, EthiopiaBurnet Institute, Melbourne, Victoria, AustraliaWestern Sydney University, Penrith South, New South Wales, AustraliaFaculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia7 School of Public Health, Mekelle University, Mekelle, EthiopiaUniversity of Canberra, Canberra, Australian Capital Territory, AustraliaWesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, AustraliaCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, AustraliaHaramaya University, Dire Dawa, Ethiopia28 Public Health, Debre Markos University, Debre Markos, EthiopiaDepartment of Public Health, College of Health Science, Debre Markos University, Debre Markos, Amhara, EthiopiaThe George Institute for Global Health, Faculty of Medicine, University of New South Wales (UNSW), Sydney, NSW, AustraliaSchool of Public Health, Mekelle University, Mekelle University College of Health Sciences, Mekelle, EthiopiaSchool of Pharmacy, Mekelle University, Mekelle, EthiopiaResearch Centre for Public Health, Equity and Human Flourishing (PHEHF), Torrens University Australia, Adelaide, South Australia, AustraliaBurnet Institute, Melbourne, Victoria, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, AustraliaChild Health Research Centre, The University of Queensland School of Medicine Royal Brisbane Clinical Unit, Herston, Queensland, Australia10 Monash University, Clayton, Victoria, AustraliaResearch Centre for Generational Health and Ageing, University of Newcastle, Newcastle, New South Wales, AustraliaInstitute for Health Transformation, Deakin University, Burwood, Victoria, Australia6 The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, AustraliaHealth Research Institute, University of Canberra, Canberra, Australian Capital Territory, AustraliaObjective The aim of this study was to provide a comprehensive evidence on risk factors for transmission, disease severity and COVID-19 related deaths in Africa.Design A systematic review has been conducted to synthesise existing evidence on risk factors affecting COVID-19 outcomes across Africa.Data sources Data were systematically searched from MEDLINE, Scopus, MedRxiv and BioRxiv.Eligibility criteria Studies for review were included if they were published in English and reported at least one risk factor and/or one health outcome. We included all relevant literature published up until 11 August 2020.Data extraction and synthesis We performed a systematic narrative synthesis to describe the available studies for each outcome. Data were extracted using a standardised Joanna Briggs Institute data extraction form.Results Fifteen articles met the inclusion criteria of which four were exclusively on Africa and the remaining 11 papers had a global focus with some data from Africa. Higher rates of infection in Africa are associated with high population density, urbanisation, transport connectivity, high volume of tourism and international trade, and high level of economic and political openness. Limited or poor access to healthcare are also associated with higher COVID-19 infection rates. Older people and individuals with chronic conditions such as HIV, tuberculosis and anaemia experience severe forms COVID-19 leading to hospitalisation and death. Similarly, high burden of chronic obstructive pulmonary disease, high prevalence of tobacco consumption and low levels of expenditure on health and low levels of global health security score contribute to COVID-19 related deaths.Conclusions Demographic, institutional, ecological, health system and politico-economic factors influenced the spectrum of COVID-19 infection, severity and death. We recommend multidisciplinary and integrated approaches to mitigate the identified factors and strengthen effective prevention strategies.https://bmjopen.bmj.com/content/11/2/e044618.full
spellingShingle Kefyalew Addis Alene
Akilew Awoke Adane
Digsu Negese Koye
Berihun Assefa Dachew
Abadi Kahsu Gebre
Mohammed Biset Ayalew
Yohannes Kinfu
Yohannes Adama Melaku
Mulugeta Molla Birhanu
Hassen Mohammed
Teketo Kassaw Tegegne
Yalemzewod Assefa Gelaw
Dagnachew Muluye Fetene
Muluken Dessalegn Muluneh
Solomon Abrha
Kidane Tadesse Gebremariam
Tesfaye Gebremedhin
Amanuel Tesfay Gebremedhin
Lemlem Gebremichael
Ayele Bali Geleto
Getiye Dejenu Kibret
Cheru Tesema Leshargie
Azeb Gebresilassie Tesema
Fisaha Haile Tesfay
Befikadu Legesse Wubishet
Hailay Abrha Gesesew
Mulu Woldegiorgis
Mamaru Ayenew Awoke
Desalegn Markos Shifti
Atsede Fantahun Aregay
Maereg Wagnew Meazaw
Alemayehu Berhane Mekonnen
Dejen Yemane Tekle
Wubshet Tesfaye
Risk factors for COVID-19 infection, disease severity and related deaths in Africa: a systematic review
BMJ Open
title Risk factors for COVID-19 infection, disease severity and related deaths in Africa: a systematic review
title_full Risk factors for COVID-19 infection, disease severity and related deaths in Africa: a systematic review
title_fullStr Risk factors for COVID-19 infection, disease severity and related deaths in Africa: a systematic review
title_full_unstemmed Risk factors for COVID-19 infection, disease severity and related deaths in Africa: a systematic review
title_short Risk factors for COVID-19 infection, disease severity and related deaths in Africa: a systematic review
title_sort risk factors for covid 19 infection disease severity and related deaths in africa a systematic review
url https://bmjopen.bmj.com/content/11/2/e044618.full
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