One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in Rwanda
The African region was predicted to have worse COVID-19 infection and death rates due to challenging health systems and social determinants of health. However, in the 10 months after its first case, Rwanda recorded 10316 cases and 133 COVID-19-related deaths translating to a case fatality rate (CFR)...
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BMJ Publishing Group
2021-02-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/6/2/e004547.full |
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| author | Sabin Nsanzimana Fredrick Kateera Bethany L Hedt-Gauthier Clarisse Musanabaganwa Vincent Cubaka Etienne Mpabuka Muhammed Semakula Ernest Nahayo Kamela C S Ng |
| author_facet | Sabin Nsanzimana Fredrick Kateera Bethany L Hedt-Gauthier Clarisse Musanabaganwa Vincent Cubaka Etienne Mpabuka Muhammed Semakula Ernest Nahayo Kamela C S Ng |
| author_sort | Sabin Nsanzimana |
| collection | DOAJ |
| description | The African region was predicted to have worse COVID-19 infection and death rates due to challenging health systems and social determinants of health. However, in the 10 months after its first case, Rwanda recorded 10316 cases and 133 COVID-19-related deaths translating to a case fatality rate (CFR) of 1.3%, which raised the question: why does Rwanda have a low COVID-19 CFR? Here we analysed COVID-19 data and explored possible explanations to better understand the disease burden in the context of Rwanda’s infection control strategies.We investigated whether the age distribution plays a role in the observed low CFR in Rwanda by comparing the expected number of deaths for 10-year age bands based on the CFR reported in other countries with the observed number of deaths for each age group. We found that the age-specific CFRs in Rwanda are similar to or, in some older age groups, slightly higher than those in other countries, suggesting that the lower population level CFR reflects the younger age structure in Rwanda, rather than a lower risk of death conditional on age. We also accounted for Rwanda’s comprehensive SARS-CoV-2 testing strategies and reliable documentation of COVID-19-related deaths and deduced that these measures may have allowed them to likely identify more asymptomatic or mild cases than other countries and reduced their reported CFR.Overall, the observed low COVID-19 deaths in Rwanda is likely influenced by the combination of effective infection control strategies, reliable identification of cases and reporting of deaths, and the population’s young age structure. |
| format | Article |
| id | doaj-art-d97587bab789418ea1d1f3191b0dc89c |
| institution | Kabale University |
| issn | 2059-7908 |
| language | English |
| publishDate | 2021-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-d97587bab789418ea1d1f3191b0dc89c2024-12-05T07:05:09ZengBMJ Publishing GroupBMJ Global Health2059-79082021-02-016210.1136/bmjgh-2020-004547One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in RwandaSabin Nsanzimana0Fredrick Kateera1Bethany L Hedt-Gauthier2Clarisse Musanabaganwa3Vincent Cubaka4Etienne Mpabuka5Muhammed Semakula6Ernest Nahayo7Kamela C S Ng81 Institute of HIV, Diseases Prevention and Control, Rwanda Biomedical Center, Kigali, RwandaResearch Department, Partners In Health/Inshuti Mu Buzima, Kigali, RwandaDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USAMedical Research Center, Rwanda Biomedical Center, Kigali, RwandaDepartment of Research and Training, Partners in Health Rwanda, Kigali, RwandaMedical Research Center, Rwanda Biomedical Center, Kigali, RwandaInstitute of HIV, Disease Prevention and Control, Rwanda Biomedical Center, Gasabo, City of Kigali, RwandaRwanda Military Hospital, Kigali, Kigali City, RwandaDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USAThe African region was predicted to have worse COVID-19 infection and death rates due to challenging health systems and social determinants of health. However, in the 10 months after its first case, Rwanda recorded 10316 cases and 133 COVID-19-related deaths translating to a case fatality rate (CFR) of 1.3%, which raised the question: why does Rwanda have a low COVID-19 CFR? Here we analysed COVID-19 data and explored possible explanations to better understand the disease burden in the context of Rwanda’s infection control strategies.We investigated whether the age distribution plays a role in the observed low CFR in Rwanda by comparing the expected number of deaths for 10-year age bands based on the CFR reported in other countries with the observed number of deaths for each age group. We found that the age-specific CFRs in Rwanda are similar to or, in some older age groups, slightly higher than those in other countries, suggesting that the lower population level CFR reflects the younger age structure in Rwanda, rather than a lower risk of death conditional on age. We also accounted for Rwanda’s comprehensive SARS-CoV-2 testing strategies and reliable documentation of COVID-19-related deaths and deduced that these measures may have allowed them to likely identify more asymptomatic or mild cases than other countries and reduced their reported CFR.Overall, the observed low COVID-19 deaths in Rwanda is likely influenced by the combination of effective infection control strategies, reliable identification of cases and reporting of deaths, and the population’s young age structure.https://gh.bmj.com/content/6/2/e004547.full |
| spellingShingle | Sabin Nsanzimana Fredrick Kateera Bethany L Hedt-Gauthier Clarisse Musanabaganwa Vincent Cubaka Etienne Mpabuka Muhammed Semakula Ernest Nahayo Kamela C S Ng One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in Rwanda BMJ Global Health |
| title | One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in Rwanda |
| title_full | One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in Rwanda |
| title_fullStr | One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in Rwanda |
| title_full_unstemmed | One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in Rwanda |
| title_short | One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in Rwanda |
| title_sort | one hundred thirty three observed covid 19 deaths in 10 months unpacking lower than predicted mortality in rwanda |
| url | https://gh.bmj.com/content/6/2/e004547.full |
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