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OBJECTIVES: In low-income settings with limited access to diagnosis, COVID-19 information is scarce. In September 2020, after the first COVID-19 wave, Mali reported 3086 confirmed cases and 130 deaths. Most reports originated from Bamako, with 1532 cases and 81 deaths (2.42 million inhabitants). This observed prevalence of 0.06% appeared very low. Our objective was to estimate SARS-CoV-2 infection among inhabitants of Bamako, after the first epidemic wave. We assessed demographic, social and living conditions, health behaviours and knowledges associated with SARS-CoV-2 seropositivity. SETTINGS: We conducted a cross-sectional multistage household survey during September 2020, in three neighbourhoods of the commune VI (Bamako), where 30% of the cases were reported. PARTICIPANTS: We recruited 1526 inhabitants in 3 areas, that is, 306 households, and 1327 serological results (≥1 years), 220 household questionnaires and collected answers for 962 participants (≥12 years). PRIMARY AND SECONDARY OUTCOME MEASURES: We measured serological status, detecting SARS-CoV-2 spike protein antibodies in blood sampled. We documented housing conditions and individual health behaviours through questionnaires among participants. We estimated the number of SARS-CoV-2 infections and deaths in the population of Bamako using the age and sex distributions. RESULTS: The prevalence of SARS-CoV-2 seropositivity was 16.4% (95% CI 15.1% to 19.1%) after adjusting on the population structure. This suggested that ~400 000 cases and ~2000 deaths could have occurred of which only 0.4% of cases and 5% of deaths were officially reported. Questionnaires analyses suggested strong agreement with washing hands but lower acceptability of movement restrictions (lockdown/curfew), and mask wearing. CONCLUSIONS: The first wave of SARS-CoV-2 spread broadly in Bamako. Expected fatalities remained limited largely due to the population age structure and the low prevalence of comorbidities. Improving diagnostic capacities to encourage testing and preventive behaviours, and avoiding the spread of false information remain key pillars, regardless of the developed or developing setting. ETHICS: This study was registered in the registry of the ethics committee of the Faculty of Medicine and Odonto-Stomatology and the Faculty of Pharmacy, Bamako, Mali, under the number: 2020/162/CA/FMOS/FAPH.
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COVID-19 , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , Estudos Soroepidemiológicos , Estudos Transversais , Mali/epidemiologia , Condições Sociais , Controle de Doenças Transmissíveis , Anticorpos AntiviraisRESUMO
INTRODUCTION: The objective of our study was to establish the epidemiological profile of COVID-19 in Tombouctou. MATERIAL AND METHODS: This was a descriptive cross-sectional study of COVID-19 surveillance data from Tombouctou from April 3 to October 1, 2020. Our variables of interest were extracted from the surveillance database and analyzed with Excel 2013. The frequencies, rate, and ratio were computed. RESULTS: Overall, 1851 suspects from all districts of the region were screened by RT-PCR, including 572 confirmed, which indicate a positivity rate of 30.90%. The 15-34 age group was the most represented with 48% of the confirmed cases. The sex ratio (male / female) of confirmed cases was 2.67. The city of Tombouctou was the epicenter of COVID-19. The Tombouctou region had a detection rate of around 2 (1851/928,000) and peaked between weeks 22 and 23 with a case fatality of 2.8%. CONCLUSION: Young people and men were most likely to be infected with COVID-19. We recommend increasing awareness of compliance with barrier measures.
INTRODUCTION: L'objectif de notre étude était d'établir le profil épidémiologique de la COVID-19 à Tombouctou. MATÉRIEL ET MÉTHODES: Il s'agissait d'une étude transversale descriptive des données de surveillance de la COVID-19 de la Région de Tombouctou du 3 avril au 1er octobre 2020. Nos variables d'intérêts ont été extraites de la base de données de surveillance et analysées sur Excel 2013. Les fréquences, taux et ratio ont été calculés. RÉSULTATS: Au total 1851 cas suspects en provenance de tous les districts de la région ont été testés à la RT-PCR dont 572 confirmés soit un taux de positivité de 30,90%. La tranche d'âge de 15-34 ans était la plus représentée avec une proportion de 48% de l'effectif des confirmés. Le sex ratio (homme/femme) des cas confirmés était de 2,67. La ville de Tombouctou était l'épicentre de la COVID-19. La région de Tombouctou avait un taux de dépistage d'environ 2 (1851/928.000) et a connu son pic entre les semaines 22 et 23 avec une létalité de 2,8%. CONCLUSION: Les jeunes et les hommes seraient les plus susceptibles d'être infectés par la COVID-19. Nous recommandons le renforcement de la sensibilisation pour le respect des mesures barrières.
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Background: According to the World Health Organization, there were more than 228 million cases of malaria globally in 2018, with 93% of cases occurring in Africa; in Mali, a 13% increase in the number of cases was observed between 2015 and 2018; this study aimed to evaluate the impact of meteorological and environmental factors on the geo-epidemiology of malaria in the health district of Dire, Mali. Methods: Meteorological and environmental variables were synthesized using principal component analysis and multiple correspondence analysis, the relationship between malaria incidence and synthetic indicators was determined using a multivariate general additive model; hotspots were detected by SaTScan. Results: Malaria incidence showed high inter and intra-annual variability; the period of high transmission lasted from September to February; health areas characterized by proximity to the river, propensity for flooding and high agricultural yield were the most at risk, with an incidence rate ratio of 2.21 with confidence intervals (95% CI: 1.85-2.58); malaria incidence in Dire declined from 120 to 20 cases per 10,000 person-weeks between 2013 and 2017. Conclusion: The identification of areas and periods of high transmission can help improve malaria control strategies.