Abstract Introduction: The aim of this systematic review was to collect evidence and recommendations for the applicability of the concept of evidence-based policy making (EBPM) during the coronavirus disease 2019 (COVID-19) pandemic and to discuss the implementation of this concept from a medical science perspective. Methods: This study was performed according to the guidelines, checklist, and flow diagram of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. An electronic literature search was conducted on September 20, 2022 using PubMed, Web of Science, Cochrane Library, and CINAHL databases with the following search terms: “evidence based policy making” and “infectious disease.” Study eligibility assessment was performed based on the flow diagram of PRISMA 2020, and risk of bias assessment was performed using The Critical Appraisal Skills Program. Results: Eleven eligible articles were included in this review and divided into three groups as follows: early, middle, and late stages of the COVID-19 pandemic. Basics of COVID-19 control were suggested in the early stage. The articles published in the middle stage discussed the importance of the collection and analysis of evidence of COVID-19 from around the world for the establishment of EBPM in the COVID-19 pandemic. The articles published in the late stage discussed the collection of large amounts of high-quality data and the development of methods to analyze them, as well as emerging issues related to the COVID-19 pandemic. Conclusions: This study revealed that the concept of EBPM applicable to emerging infectious disease pandemics changed between the early, middle, and late stages of the pandemic. The concept of EBPM will play an important role in medicine in the future.

Evidence-Based Policy Making during the Coronavirus Disease 2019 Pandemic: A Systematic Review

Background: COVID-19 has impacted the world differentially with the highest mortality and morbidity rate burden in Europe and the USA and the lowest mortality and morbidity burden in Africa. This study aims to investigate the possible reasons why Africa recorded the lowest COVID-19 mortality and morbidity. Methods: The following search terms were used PubMed database: [“mortalit*” (tw) OR “morbidit*” (tw) AND “COVID-19” (tw) AND “Africa” (tw)]. Studies that discuss a factor for the low COVID-19 burden in Africa have a defined methodology, discuss its research question and mention its limitations are selected for review. Data from the final articles were extracted using a data collection tool. Results: Twenty-one studies were used in this integrative review. Results were grouped into 10 themes, which are younger African population, lower health capacity, weather, vaccines and drugs, effective pandemic response, lower population density and mobility, African socioeconomic status, lower prevalence of comorbidities, genetic difference and previous infection exposure. The low COVID-19 mortality and morbidity in Africa is largely a result of a combined effect of the younger African population and underreporting of COVID-19 cases. Conclusions: There is a need to strengthen the health capacities of African countries. Moreover, African countries that have other health problem priorities may use a tailored approach to vaccinating the elderly. More definitive studies are needed to know the role of BCG vaccination, weather, genetic makeup and prior infection exposure in the differential impact of the COVID-19 pandemic.

https://journals.lww.com/pidj/Fulltext/9900/Investigating_the_Possible_Reasons_for_the_Low.412.aspx

Investigating the Possible Reasons for the Low Reported Morbidity and Mortality of COVID-19 in African Countries: An Integrative Review

COVID-19 has impacted the world differentially with the highest mortality and morbidity rate burden in Europe and the USA and the lowest mortality and morbidity burden in Africa. This study aims to investigate the possible reasons why Africa recorded the lowest COVID-19 mortality and morbidity.The following search terms were used PubMed database: ["mortalit*" (tw) OR "morbidit*" (tw) AND "COVID-19" (tw) AND "Africa" (tw)]. Studies that discuss a factor for the low COVID-19 burden in Africa have a defined methodology, discuss its research question and mention its limitations are selected for review. Data from the final articles were extracted using a data collection tool.Twenty-one studies were used in this integrative review. Results were grouped into 10 themes, which are younger African population, lower health capacity, weather, vaccines and drugs, effective pandemic response, lower population density and mobility, African socioeconomic status, lower prevalence of comorbidities, genetic difference and previous infection exposure. The low COVID-19 mortality and morbidity in Africa is largely a result of a combined effect of the younger African population and underreporting of COVID-19 cases.There is a need to strengthen the health capacities of African countries. Moreover, African countries that have other health problem priorities may use a tailored approach to vaccinating the elderly. More definitive studies are needed to know the role of BCG vaccination, weather, genetic makeup and prior infection exposure in the differential impact of the COVID-19 pandemic. 

Introduction: Africa has surprisingly recorded better gains in containing the coronavirus spread than countries with the better health indices, such as the USA and UK. The low rate of coronavirus disease 2019 (COVID-19) cases and death in Africa represents a puzzle with different biological and social theories such as low COVID-19 testing capacity, substantial young population, few old people, favourable climate, genetic admixture, infectious disease antibodies, and sound community health care systems proposed. We aimed to understand the COVID-19 preventive measures in a group of twenty-one systematically selected African countries that may explain the low burden of COVID-19 in Africa. Methods: Data (COVID-19, health, socioeconomic, and demographics indices) of twenty-one systemically selected African countries were retrieved from the various official country and multilateral organization sources such as Worldbank, and the United nations development Programme (UNDP). The extracted data were analyzed in three large groups: international travel restrictions, physical and social distancing, and movement restrictions (lockdown measures; curfews, partial or/and national lockdowns). Data cleaning, analysis (including Pearson correlation), and visualization were done with Microsoft Excel and Graph Pad Prism version 9 (https://www.graphpad.com/). Result: Southern Africa had the greatest number of cases and deaths within the period studied compared to East Africa, which was the least COVID-19 affected sub-region (in terms of COVID-19 cases and deaths). We observed that coronary artery disease death rate was highly correlated with COVID-19 death density (number of COVID-19 deaths/total population) and similarly observed a correlation between the number of cases and deaths and number of in-country arrivals, pandemic preparedness (health security index), COVID-19 containment, and health index (not correlated with deaths). Finally, we noted that the most effective preventive strategy was the 'use of a face mask'. Conclusion: Africa had fewer COVID-19 cases and COVID-19 related deaths. Our data shows that the rapidity and stringency of COVID-19 preventive measures and government policies, and the low level of tourism in Africa compared to other countries (i.e., low COVID-19 seeding rate) may have been contributory to these favorable statistics. We hope these findings impact how the preparedness for pandemics can be enhanced to decrease the burden of preventable deaths and morbidity.

/pdf/covid-19-in-africa-an-explorative-cross-sectional-analysis-2jgfrder.pdf

Olubukola Adedayo

Papers

COVID-19 in Africa: An Explorative Cross-Sectional Analysis of Twenty-One African Countries From January to June 2020