Modeling the interplay between demography, social contact patterns, and SARS-CoV-2 transmission in the South West Shewa Zone of Oromia Region, Ethiopia

BMC Medicine

Piero Poletti¹  Valentina Marziano¹  Stefano Merler¹  Giorgio Guzzetta¹  Filippo Trentini¹  Agnese Zardini²  Margherita Galli³  Marco Ajelli⁴  Ademe Tsegaye⁵  Alessandro Greblo⁶  Fabio Manenti⁶  Giovanni Putoto⁶  Worku Nigussa Gamshie⁷  Alessia Melegaro⁸ 

[1] Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy;Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy;University of Trento, Trento, Italy;Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy;University of Udine, Udine, Italy;Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA;Laboratory for the Modeling of Biological and Socio-technical Systems, Northeastern University, Boston, MA, USA;Doctors with Africa CUAMM, Addis Ababa, Ethiopia;Doctors with Africa CUAMM, Padova, Italy;Doctors with Africa CUAMM, Woliso, Ethiopia;Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy;Department of Social and Political Sciences, Bocconi University, Milan, Italy;

关键词: COVID-19;    SARS-CoV-2;    Mixing patterns;    Contact data;    Rural;    Urban;    Contact matrix;    Transmission model;    Epidemic;   

DOI  :  10.1186/s12916-021-01967-w

来源: Springer

【 摘 要 】

BackgroundCOVID-19 spread may have a dramatic impact in countries with vulnerable economies and limited availability of, and access to, healthcare resources and infrastructures. However, in sub-Saharan Africa, a low prevalence and mortality have been observed so far.MethodsWe collected data on individuals’ social contacts in the South West Shewa Zone (SWSZ) of Ethiopia across geographical contexts characterized by heterogeneous population density, work and travel opportunities, and access to primary care. We assessed how socio-demographic factors and observed mixing patterns can influence the COVID-19 disease burden, by simulating SARS-CoV-2 transmission in remote settlements, rural villages, and urban neighborhoods, under school closure mandate.ResultsFrom national surveillance data, we estimated a net reproduction number of 1.62 (95% CI 1.55–1.70). We found that, at the end of an epidemic mitigated by school closure alone, 10–15% of the population residing in the SWSZ would have been symptomatic and 0.3–0.4% of the population would require mechanical ventilation and/or possibly result in a fatal outcome. Higher infection attack rates are expected in more urbanized areas, but the highest incidence of critical disease is expected in remote subsistence farming settlements. School closure contributed to reduce the reproduction number by 49% and the attack rate of infections by 28–34%.ConclusionsOur results suggest that the relatively low burden of COVID-19 in Ethiopia observed so far may depend on social mixing patterns, underlying demography, and the enacted school closures. Our findings highlight that socio-demographic factors can also determine marked heterogeneities across different geographical contexts within the same region, and they contribute to understand why sub-Saharan Africa is experiencing a relatively lower attack rate of severe cases compared to high-income countries.

【 授权许可】

CC BY