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Using mortuary and burial data to place COVID-19 in Lusaka, Zambia within a global context

Author

Listed:
  • Richard J. Sheppard

    (Imperial College)

  • Oliver J. Watson

    (Imperial College
    London School of Hygiene and Tropical Medicine)

  • Rachel Pieciak

    (Boston University School of Public Health)

  • James Lungu

    (Avencion Limited)

  • Geoffrey Kwenda

    (University of Zambia)

  • Crispin Moyo

    (Avencion Limited)

  • Stephen Longa Chanda

    (Zambia National Public Health Institute)

  • Gregory Barnsley

    (Imperial College)

  • Nicholas F. Brazeau

    (Imperial College)

  • Ines C. G. Gerard-Ursin

    (Imperial College)

  • Daniela Olivera Mesa

    (Imperial College)

  • Charles Whittaker

    (Imperial College)

  • Simon Gregson

    (Imperial College
    Biomedical Research and Training Institute)

  • Lucy C. Okell

    (Imperial College)

  • Azra C. Ghani

    (Imperial College)

  • William B. MacLeod

    (Boston University School of Public Health)

  • Emanuele Fava

    (Bocconi University
    Max Planck Institute for Demographic Research)

  • Alessia Melegaro

    (Bocconi University
    Bocconi University)

  • Jonas Z. Hines

    (Centers for Disease Control and Prevention)

  • Lloyd B. Mulenga

    (Zambia Ministry of Health)

  • Patrick G. T. Walker

    (Imperial College)

  • Lawrence Mwananyanda

    (Boston University School of Public Health
    Avencion Limited)

  • Christopher J. Gill

    (Boston University School of Public Health)

Abstract

Reported COVID-19 cases and associated mortality remain low in many sub-Saharan countries relative to global averages, but true impact is difficult to estimate given limitations around surveillance and mortality registration. In Lusaka, Zambia, burial registration and SARS-CoV-2 prevalence data during 2020 allow estimation of excess mortality and transmission. Relative to pre-pandemic patterns, we estimate age-dependent mortality increases, totalling 3212 excess deaths (95% CrI: 2104–4591), representing an 18.5% (95% CrI: 13.0–25.2%) increase relative to pre-pandemic levels. Using a dynamical model-based inferential framework, we find that these mortality patterns and SARS-CoV-2 prevalence data are in agreement with established COVID-19 severity estimates. Our results support hypotheses that COVID-19 impact in Lusaka during 2020 was consistent with COVID-19 epidemics elsewhere, without requiring exceptional explanations for low reported figures. For more equitable decision-making during future pandemics, barriers to ascertaining attributable mortality in low-income settings must be addressed and factored into discourse around reported impact differences.

Suggested Citation

  • Richard J. Sheppard & Oliver J. Watson & Rachel Pieciak & James Lungu & Geoffrey Kwenda & Crispin Moyo & Stephen Longa Chanda & Gregory Barnsley & Nicholas F. Brazeau & Ines C. G. Gerard-Ursin & Danie, 2023. "Using mortuary and burial data to place COVID-19 in Lusaka, Zambia within a global context," Nature Communications, Nature, vol. 14(1), pages 1-15, December.
    • Handle: RePEc:nat:natcom:v:14:y:2023:i:1:d:10.1038_s41467-023-39288-6
    DOI: 10.1038/s41467-023-39288-6
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    References listed on IDEAS

    as
    1. Oliver J. Watson & Mervat Alhaffar & Zaki Mehchy & Charles Whittaker & Zack Akil & Nicholas F. Brazeau & Gina Cuomo-Dannenburg & Arran Hamlet & Hayley A. Thompson & Marc Baguelin & Richard G. FitzJohn, 2021. "Leveraging community mortality indicators to infer COVID-19 mortality and transmission dynamics in Damascus, Syria," Nature Communications, Nature, vol. 12(1), pages 1-10, December.
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    3. Thomas Hale & Noam Angrist & Rafael Goldszmidt & Beatriz Kira & Anna Petherick & Toby Phillips & Samuel Webster & Emily Cameron-Blake & Laura Hallas & Saptarshi Majumdar & Helen Tatlow, 2021. "A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker)," Nature Human Behaviour, Nature, vol. 5(4), pages 529-538, April.
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