Predicting the Impact of COVID-19 and the Potential Impact of the Public Health Response on Disease Burden in Uganda

Am J Trop Med Hyg. 2020 Sep;103(3):1191-1197. doi: 10.4269/ajtmh.20-0546.

Abstract

The COVID-19 pandemic and public health "lockdown" responses in sub-Saharan Africa, including Uganda, are now widely reported. Although the impact of COVID-19 on African populations has been relatively light, it is feared that redirecting focus and prioritization of health systems to fight COVID-19 may have an impact on access to non-COVID-19 diseases. We applied age-based COVID-19 mortality data from China to the population structures of Uganda and non-African countries with previously established outbreaks, comparing theoretical mortality and disability-adjusted life years (DALYs) lost. We then predicted the impact of possible scenarios of the COVID-19 public health response on morbidity and mortality for HIV/AIDS, malaria, and maternal health in Uganda. Based on population age structure alone, Uganda is predicted to have a relatively low COVID-19 burden compared with an equivalent transmission in comparison countries, with 12% of the mortality and 19% of the lost DALYs predicted for an equivalent transmission in Italy. By contrast, scenarios of the impact of the public health response on malaria and HIV/AIDS predict additional disease burdens outweighing that predicted from extensive SARS-CoV-2 transmission. Emerging disease data from Uganda suggest that such deterioration may already be occurring. The results predict a relatively low COVID-19 impact on Uganda associated with its young population, with a high risk of negative impact on non-COVID-19 disease burden from a prolonged lockdown response. This may reverse hard-won gains in addressing fundamental vulnerabilities in women and children's health, and underlines the importance of tailoring COVID-19 responses according to population structure and local disease vulnerabilities.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Betacoronavirus*
  • COVID-19
  • Child
  • Child, Preschool
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / mortality
  • Cost of Illness
  • Humans
  • Infant
  • Infant, Newborn
  • Malaria / epidemiology
  • Maternal Mortality
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / mortality
  • Public Health*
  • SARS-CoV-2
  • Uganda / epidemiology
  • Young Adult