Adult mortality before and during the first wave of COVID-19 pandemic in nine communities of Yemen: a key informant study

Conflict and Health

Research

Huda Basaleem¹  Khaled Alsakkaf¹  Pasquale Pepe²  Francesco Checchi²  Mervat Alhaffar²  Hannah Brindle²  Hussein Kolaise³  Sena Mohammed Mohsen Naji⁴  Yassin Abdulmalik Mahyoub Salem⁴  Fouad Othman⁵  Abdullah K. Babattah⁶  Najwa Yahya⁷ 

[1] Department of Community Medicine and Public Health, Faculty of Medicine and Health Science, University of Aden, Aden, Yemen;Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK;Department of Internal Medicine, Faculty of Medicine and Health Science, University of Aden, Aden, Yemen;Epidemiology Surveillance Office, Ta’iz Governorate Health Office, Ta’iz, Yemen;Faculty of Medicine and Health Science, Ta’iz University, Ta’iz, Yemen;Primary Health Care Program, Health Sector, HUMAN ACCESS for Partnership and Development, Aden, Yemen;Yemen Public Health Network, Aden, Yemen;

关键词: Yemen;    Humanitarian;    Armed conflict;    Crisis;    Mortality;    SARS-CoV-2;    COVID-19;    Key informant;    Capture recapture;    Multiple systems estimation;   

DOI  :  10.1186/s13031-022-00497-3

 received in 2022-05-15, accepted in 2022-12-05,  发布年份 2022

来源: Springer

【 摘 要 】

IntroductionWidespread armed conflict has affected Yemen since 2014. To date, the mortality toll of seven years of crisis, and any excess due to the COVID-19 pandemic, are not well quantified. We attempted to estimate population mortality during the pre-pandemic and pandemic periods in nine purposively selected urban and rural communities of southern and central Yemen (Aden and Ta’iz governorates), totalling > 100,000 people.MethodsWithin each study site, we collected lists of decedents between January 2014–March 2021 by interviewing different categories of key community informants, including community leaders, imams, healthcare workers, senior citizens and others. After linking records across lists based on key variables, we applied two-, three- or four-list capture-recapture analysis to estimate total death tolls. We also computed death rates by combining these estimates with population denominators, themselves subject to estimation.ResultsAfter interviewing 138 disproportionately (74.6%) male informants, we identified 2445 unique decedents. While informants recalled deaths throughout the study period, reported deaths among children were sparse: we thus restricted analysis to persons aged ≥ 15 years old. We noted a peak in reported deaths during May–July 2020, plausibly coinciding with the first COVID-19 wave. Death rate estimates featured uninformatively large confidence intervals, but appeared elevated compared to the non-crisis baseline, particularly in two sites where a large proportion of deaths were attributed to war injuries. There was no clear-cut evidence of excess mortality during the pandemic period.ConclusionsWe found some evidence of a peak in mortality during the early phase of the pandemic, but death rate estimates were otherwise too imprecise to enable strong inference on trends. Estimates suggested substantial mortality elevations from baseline during the crisis period, but are subject to serious potential biases. The study highlighted challenges of data collection in this insecure, politically contested environment.

【 授权许可】

CC BY   
© The Author(s) 2022

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