Modeling the interplay between demography, social contact patterns, and SARS-CoV-2 transmission in the South West Shewa Zone of Oromia Region, Ethiopia
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Abstract
Background
COVID-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.
Methods
We 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.
Results
From 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%.
Conclusions
Our 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.
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SciScore for 10.1101/2020.11.24.20237560: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:To properly interpret the results presented in our study, it is important to consider the following limitations. First, the target study population may be not representative of all Ethiopia, and in particular of epidemic patterns observed in highly urbanized areas such as the capital Addis Abeba. Second, the net reproduction number was …
SciScore for 10.1101/2020.11.24.20237560: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:To properly interpret the results presented in our study, it is important to consider the following limitations. First, the target study population may be not representative of all Ethiopia, and in particular of epidemic patterns observed in highly urbanized areas such as the capital Addis Abeba. Second, the net reproduction number was estimated from national surveillance data9. This data reports cases aggregated at the country level and may suffer from a number of biases: it does not account for reporting delays; the growth over time in the number of cases may partly be ascribable to the increase in testing capacity; total cases represent the superimposition of different, asynchronous epidemics in multiple parts of the country, a majority of which coming from the highly urbanized Addis Abeba area9. However, we show that, assuming no restriction to school contacts, the reproduction number estimated by the model is in the range 1.87-2.18, just slightly lower than estimates of the SARS-CoV-2 basic reproduction number from other countries 25,26,27,28. Moreover, our conclusions remain robust when considering a 20% increase or a 20% decrease of the reproduction number. In this case, we estimated an attack rate of critical cases ranging from 0.24 to 0.37 for rural villages and from 0.34 to 0.42 for remote settlements (see Appendix). Third, the model lacks of spatial structure. The finding from the survey that about 97% of recorded contacts have occurred within the participant’s nei...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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