Pan African Medical Journal
Journal / Pan African Medical Journal / Vol. 45 No. 1 (2023) / Articles

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Published:

Apr 8, 2024

Keywords:

COVID-19 mortality SARS-CoV-2 demography Zambia Africa

Issue

Vol. 45 No. 1 (2023)

Section

Articles

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Stephen Longa Chanda

Field Epidemiology Training Program (FETP), Zambia National Public Health Institute, Lusaka, Zambia; Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia

Emmanuel Tembo

Field Epidemiology Training Program (FETP), Zambia National Public Health Institute, Lusaka, Zambia; Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia

Nyambe Sinyange

Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia

Nkomba Kayeyi

Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia

Kunda Musonda

Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia

Orbie Chewe

Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia

Mpanga Kasonde

Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia

Otridah Kapona

Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia

Albertina Ngomah

Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia

Amos Hamukale

Field Epidemiology Training Program (FETP), Zambia National Public Health Institute, Lusaka, Zambia; Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia

Paul Msanzya Zulu

Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia

Muzala Kapina

Zambia National Public Health Program, Surveillance and Disease Intelligence Cluster, Lusaka, Zambia

Abstract

Introduction: since March 2020, Zambia has been experiencing a SARS-CoV-2 epidemic. Little data has been reported on cases and deaths arising from COVID-19 in Africa. We described the demographic characteristics of these cases and deaths in Zambia.

Methods: we analyzed data on all persons testing positive for SARS-CoV-2 from 18^th March 2020 to 25^th April 2021 in Zambia. COVID-19 cases were identified through port-of-entry surveillance, contact-tracing, health-care-worker testing, health-facility-based and community-based screening and community-death screening. All diagnoses were confirmed using real-time-polymerase-chain-reaction and rapid-antigen-test-kits of nasopharyngeal specimens. We analyzed age, sex, and date-of-reporting according to whether the cases or deaths occurred during the first wave (1^st July to 15^th September 2020) or the second wave (15^th December 2020 to 10^th April 2021). We computed Mann-Whitney-U-test to compare medians of continuous variables and chi-square tests to compare differences between proportions using R.

Results: a total 1,246 (1.36%) deaths were recorded among 91,378 confirmed cases during March 2020-April 2021 in Zambia. Persons who died were older than those who did not (median age 50 years versus 32.0 years, p< 0.001). Although only 4.7% of cases were among persons aged >60 years, most deaths (31.6%) occurred in this age group (p<0.001). More deaths (83.5%) occurred in the community than in health facilities (p<0.001).

Conclusion: during the SARS-CoV-2 epidemic in Zambia, most deaths occurred in the community, indicating potential gaps in public health messaging about COVID-19. Improving health-seeking behaviors for COVID-19 through public messaging campaigns and engaging key community stakeholders in Zambia might reduce avoidable mortality. As the group most impacted by COVID-19 mortality, older persons might need enhanced outreach and linkage to care.

Journal Identifiers

eISSN: 1937-8688