The University of Southampton
University of Southampton Institutional Repository
Warning ePrints Soton is experiencing an issue with some file downloads not being available. We are working hard to fix this. Please bear with us.

Variation in SARS-CoV-2 outbreaks across sub-Saharan Africa

Variation in SARS-CoV-2 outbreaks across sub-Saharan Africa
Variation in SARS-CoV-2 outbreaks across sub-Saharan Africa

A surprising feature of the SARS-CoV-2 pandemic to date is the low burdens reported in sub-Saharan Africa (SSA) countries relative to other global regions. Potential explanations (for example, warmer environments 1, younger populations 2–4) have yet to be framed within a comprehensive analysis. We synthesized factors hypothesized to drive the pace and burden of this pandemic in SSA during the period from 25 February to 20 December 2020, encompassing demographic, comorbidity, climatic, healthcare capacity, intervention efforts and human mobility dimensions. Large diversity in the probable drivers indicates a need for caution in interpreting analyses that aggregate data across low- and middle-income settings. Our simulation shows that climatic variation between SSA population centers has little effect on early outbreak trajectories; however, heterogeneity in connectivity, although rarely considered, is likely an important contributor to variance in the pace of viral spread across SSA. Our synthesis points to the potential benefits of context-specific adaptation of surveillance systems during the ongoing pandemic. In particular, characterizing patterns of severity over age will be a priority in settings with high comorbidity burdens and poor access to care. Understanding the spatial extent of outbreaks warrants emphasis in settings where low connectivity could drive prolonged, asynchronous outbreaks resulting in extended stress to health systems.

1078-8956
447-453
Rice, Benjamin L.
56d9a408-e48c-4394-b136-af9e79e4550a
Annapragada, Akshaya
28297bde-a0ec-4695-8e0a-ac94711c6abc
Baker, Rachel E.
b1110274-8d5b-4a54-be7e-c5aea37410bd
Bruijning, Marjolein
22a7d740-2f01-414a-ab4e-b16ed5ef4ef5
Dotse-Gborgbortsi, Winfred Worlanyo
11fe21e7-431a-442b-a8c7-6a7cb05176d9
Mensah, Keitly
425aec55-f4d7-48b3-b73c-7870a2bc55fe
Miller, Ian F.
9f6d9110-9d66-404a-8b21-3b96630ca266
Motaze, Nkengafac Villyen
2ba9456c-4034-4783-b85d-1e48feb5f1b4
Raherinandrasana, Antso
d0bf825c-f9d0-4f80-ab25-1df1353df405
Rajeev, Malavika
14d1327b-97e2-4878-bb79-a52701dd5afc
Rakotonirina, Julio
197a9f22-4d88-4b07-b6b3-1b432a7f947e
Ramiadantsoa, Tanjona
94c62834-46f6-4a7e-a321-4c510ee6b998
Rasambainarivo, Fidisoa
eec49e34-9285-43b7-b9b0-5522c2789268
Yu, Weiyu
4cca6f0a-badb-4f1c-8b38-da29ba0b9e09
Grenfell, Bryan T.
f80f3700-0b24-4932-80bf-d5ac2201882e
Tatem, Andrew
6c6de104-a5f9-46e0-bb93-a1a7c980513e
Metcalf, C. Jessica E.
ce1431b5-f784-4552-b66c-52fcb08f095c
Rice, Benjamin L.
56d9a408-e48c-4394-b136-af9e79e4550a
Annapragada, Akshaya
28297bde-a0ec-4695-8e0a-ac94711c6abc
Baker, Rachel E.
b1110274-8d5b-4a54-be7e-c5aea37410bd
Bruijning, Marjolein
22a7d740-2f01-414a-ab4e-b16ed5ef4ef5
Dotse-Gborgbortsi, Winfred Worlanyo
11fe21e7-431a-442b-a8c7-6a7cb05176d9
Mensah, Keitly
425aec55-f4d7-48b3-b73c-7870a2bc55fe
Miller, Ian F.
9f6d9110-9d66-404a-8b21-3b96630ca266
Motaze, Nkengafac Villyen
2ba9456c-4034-4783-b85d-1e48feb5f1b4
Raherinandrasana, Antso
d0bf825c-f9d0-4f80-ab25-1df1353df405
Rajeev, Malavika
14d1327b-97e2-4878-bb79-a52701dd5afc
Rakotonirina, Julio
197a9f22-4d88-4b07-b6b3-1b432a7f947e
Ramiadantsoa, Tanjona
94c62834-46f6-4a7e-a321-4c510ee6b998
Rasambainarivo, Fidisoa
eec49e34-9285-43b7-b9b0-5522c2789268
Yu, Weiyu
4cca6f0a-badb-4f1c-8b38-da29ba0b9e09
Grenfell, Bryan T.
f80f3700-0b24-4932-80bf-d5ac2201882e
Tatem, Andrew
6c6de104-a5f9-46e0-bb93-a1a7c980513e
Metcalf, C. Jessica E.
ce1431b5-f784-4552-b66c-52fcb08f095c

Rice, Benjamin L., Annapragada, Akshaya, Baker, Rachel E., Bruijning, Marjolein, Dotse-Gborgbortsi, Winfred Worlanyo, Mensah, Keitly, Miller, Ian F., Motaze, Nkengafac Villyen, Raherinandrasana, Antso, Rajeev, Malavika, Rakotonirina, Julio, Ramiadantsoa, Tanjona, Rasambainarivo, Fidisoa, Yu, Weiyu, Grenfell, Bryan T., Tatem, Andrew and Metcalf, C. Jessica E. (2021) Variation in SARS-CoV-2 outbreaks across sub-Saharan Africa. Nature Medicine, 27 (3), 447-453. (doi:10.1038/s41591-021-01234-8).

Record type: Article

Abstract

A surprising feature of the SARS-CoV-2 pandemic to date is the low burdens reported in sub-Saharan Africa (SSA) countries relative to other global regions. Potential explanations (for example, warmer environments 1, younger populations 2–4) have yet to be framed within a comprehensive analysis. We synthesized factors hypothesized to drive the pace and burden of this pandemic in SSA during the period from 25 February to 20 December 2020, encompassing demographic, comorbidity, climatic, healthcare capacity, intervention efforts and human mobility dimensions. Large diversity in the probable drivers indicates a need for caution in interpreting analyses that aggregate data across low- and middle-income settings. Our simulation shows that climatic variation between SSA population centers has little effect on early outbreak trajectories; however, heterogeneity in connectivity, although rarely considered, is likely an important contributor to variance in the pace of viral spread across SSA. Our synthesis points to the potential benefits of context-specific adaptation of surveillance systems during the ongoing pandemic. In particular, characterizing patterns of severity over age will be a priority in settings with high comorbidity burdens and poor access to care. Understanding the spatial extent of outbreaks warrants emphasis in settings where low connectivity could drive prolonged, asynchronous outbreaks resulting in extended stress to health systems.

Text
Variation in SARS-CoV-2 outbreaks across sub-Saharan Africa - Accepted Manuscript
Download (2MB)
Text
Variation in SARS-CoV-2 outbreaks across sub-Saharan Africa
Restricted to Repository staff only
Request a copy

More information

Accepted/In Press date: 11 January 2021
e-pub ahead of print date: 2 February 2021
Published date: March 2021

Identifiers

Local EPrints ID: 446867
URI: http://eprints.soton.ac.uk/id/eprint/446867
ISSN: 1078-8956
PURE UUID: 4723a325-2d68-41ed-80e3-4f6d66f1be56
ORCID for Winfred Worlanyo Dotse-Gborgbortsi: ORCID iD orcid.org/0000-0001-7627-1809
ORCID for Andrew Tatem: ORCID iD orcid.org/0000-0002-7270-941X

Catalogue record

Date deposited: 24 Feb 2021 17:32
Last modified: 26 Nov 2021 06:58

Export record

Altmetrics

Contributors

Author: Benjamin L. Rice
Author: Akshaya Annapragada
Author: Rachel E. Baker
Author: Marjolein Bruijning
Author: Keitly Mensah
Author: Ian F. Miller
Author: Nkengafac Villyen Motaze
Author: Antso Raherinandrasana
Author: Malavika Rajeev
Author: Julio Rakotonirina
Author: Tanjona Ramiadantsoa
Author: Fidisoa Rasambainarivo
Author: Weiyu Yu
Author: Bryan T. Grenfell
Author: Andrew Tatem ORCID iD
Author: C. Jessica E. Metcalf

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×