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- Title
Using mortuary and burial data to place COVID-19 in Lusaka, Zambia within a global context.
- Authors
Sheppard, Richard J.; Watson, Oliver J.; Pieciak, Rachel; Lungu, James; Kwenda, Geoffrey; Moyo, Crispin; Chanda, Stephen Longa; Barnsley, Gregory; Brazeau, Nicholas F.; Gerard-Ursin, Ines C. G.; Olivera Mesa, Daniela; Whittaker, Charles; Gregson, Simon; Okell, Lucy C.; Ghani, Azra C.; MacLeod, William B.; Del Fava, Emanuele; Melegaro, Alessia; Hines, Jonas Z.; Mulenga, Lloyd B.
- Abstract
Reported COVID-19 cases and associated mortality remain low in many sub-Saharan countries relative to global averages, but true impact is difficult to estimate given limitations around surveillance and mortality registration. In Lusaka, Zambia, burial registration and SARS-CoV-2 prevalence data during 2020 allow estimation of excess mortality and transmission. Relative to pre-pandemic patterns, we estimate age-dependent mortality increases, totalling 3212 excess deaths (95% CrI: 2104–4591), representing an 18.5% (95% CrI: 13.0–25.2%) increase relative to pre-pandemic levels. Using a dynamical model-based inferential framework, we find that these mortality patterns and SARS-CoV-2 prevalence data are in agreement with established COVID-19 severity estimates. Our results support hypotheses that COVID-19 impact in Lusaka during 2020 was consistent with COVID-19 epidemics elsewhere, without requiring exceptional explanations for low reported figures. For more equitable decision-making during future pandemics, barriers to ascertaining attributable mortality in low-income settings must be addressed and factored into discourse around reported impact differences. Estimates of COVID-19 impacts in many low- and middle-income countries remain very uncertain, with lack of high-quality data. Here, the authors reconstruct epidemic dynamics in Lusaka, Zambia and estimate that, when accounting for demographic patterns, the epidemic severity is comparable with global norms.
- Subjects
LUSAKA (Zambia); COVID-19; COVID-19 pandemic; MIDDLE-income countries; FUNERAL homes; PANDEMICS
- Publication
Nature Communications, 2023, Vol 14, Issue 1, p1
- ISSN
2041-1723
- Publication type
Article
- DOI
10.1038/s41467-023-39288-6