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Int J Infect Dis . Quantifying Excess Mortality during the Covid-19 pandemic in 2020 in The Gambia: A time-series analysis of three Health and Demog

tetano

Editor, Senior Moderator
Int J Infect Dis


. 2022 Dec 22;S1201-9712(22)00654-3.
doi: 10.1016/j.ijid.2022.12.017. Online ahead of print.
Quantifying Excess Mortality during the Covid-19 pandemic in 2020 in The Gambia: A time-series analysis of three Health and Demographic Surveillance Systems


Nuredin I Mohammed[SUP] 1 [/SUP], Grant Mackenzie[SUP] 2 [/SUP], Esu Ezeani[SUP] 3 [/SUP], Mamadi Sidibeh[SUP] 3 [/SUP], Lamin Jammeh[SUP] 3 [/SUP], Golam Sarwar[SUP] 3 [/SUP], Aji Kumba Folawiyo Saine[SUP] 3 [/SUP], Bakary Sonko[SUP] 3 [/SUP], Pierre Gomez[SUP] 3 [/SUP], Bai Lamin Dondeh[SUP] 3 [/SUP], M Jahangir Hossain[SUP] 3 [/SUP], Momodou Jasseh[SUP] 3 [/SUP], Effua Usuf[SUP] 3 [/SUP], Andrew M Prentice[SUP] 3 [/SUP], David Jeffries[SUP] 3 [/SUP], Umberto Dalessandro[SUP] 3 [/SUP], Anna Roca[SUP] 4 [/SUP]



Affiliations

Abstract

Background: Estimates for coronavirus disease 2019 (COVID-19) related excess mortality for African populations using local data are needed to design and implement effective control policies.
Methods: We applied time-series analysis using data from three Health and Demographic Surveillance Systems (HDSSs) in The Gambia (Basse, Farafenni and Keneba) to examine pandemic-related excess mortality during 2020, when the first SARS-CoV-2 wave was observed, compared to pre-pandemic period (2016-2019).
Results: Across the three sites, average mortality during the pre-pandemic period and the total deaths during 2020 were 1512 and 1634, respectively (Basse: 1099 vs 1179, Farafenni: 316 vs 351, Keneba: 98 vs 104). The overall crude mortality rates per 100,000(95%CI) were 589(559, 619) and 599(571, 629) for the pre-pandemic and 2020 periods, respectively. The adjusted excess mortality rate was 8.8(-34.3, 67.6) per 100,000 person-months with the adjusted rate ratio (aRR)=1.01(0.94,1.11). The age stratified analysis showed excess mortality in Basse for infants [aRR=1.22(1.04, 1.46)] and in Farafenni for the 65+ years age group [aRR=1.19(1, 1.44)].
Conclusions: We did not find significant excess overall mortality in 2020 in The Gambia. However, some age groups may have been at risk of excess death. Public health response in countries with weak health systems needs to consider vulnerable age groups and the potential for collateral damage.

Keywords: Africa; COVID-19; Excess mortality; Health and Demographic Surveillance Systems; The Gambia.
 
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