In a systematic review of decedents at a clinic in Zambia, SARS-CoV-2 was detected in 1 in 3 of the dead. At the peak of the disease wave, the proportion rose as high as 90%.
The findings, contradict a widely held hypothesis of an African paradox, according to which the pandemic largely spared sub-Saharan countries except South Africa.
The university hospital in Lusaka has the largest morgue in the city. Not only are patients who have died at the clinic autopsied there. The pathologists also clarify the causes of deaths from the urban environment.
For several years, a team led by Christopher Gill of the Boston University School of Public Health has been conducting a research project to determine how frequently infections with the respiratory syncytial (RS) virus and the pertussis bacterium Bordetella pertussis, which are usually mild in wealthier countries, lead to death in Africa.
In the pandemic, the focus of the study was shifted to COVID-19. Already in the 1st wave of illness from June to September 2020, it was shown that every 5th person who died was infected with SARS-CoV-2. In contrast to Western countries, most deaths occurred among younger people: 80% were between 20 and 59 years old, and 10% were children and adolescents, the researchers reported in the British Medical Journal.
Strikingly, few patients were known to have the infection: of the 19 patients who died in the hospital, only 6 had tested positive premortem. Of the 51 who died outside the hospital, none had been tested. Of the 70 total deaths with a positive PCR test, 44 were likely to have died from COVID-19, according to the researchers, and a link was considered possible in another 7 deaths. Most had died from, rather than with, COVID-19, according to the findings.
Meanwhile, researchers evaluated results from 1,118 people who died between January and June 2021. That period included the next two waves of disease caused by the beta and delta variants in Zambia. This time, 1/3 (32.0%) of the dead were found to be infected with SARS-CoV-2. At the peak of the disease wave, the proportion increased to 90%. Gill estimates that COVID-19 was likely or possibly responsible for death in 73.9%.
The Africa paradox is based on a misconception, according to the researcher. The impression that Africa was spared from the pandemic was created because the causes of death in large parts of the population were not investigated, he said. The lower life expectancy compared to more developed countries is also not a "protective factor."
Because of the poor health of many people, the number of deaths among younger people could even be far higher than in richer countries.
Categories: Africa, Social Issues
Tags: covid-19, Zambia, Sub-Saharan
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