{"paper_id":"400733ed-7457-432c-8ce7-3c4095edde01","body_text":"The heterogeneous severity of COVID-19 in African countries: A modeling approach | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The heterogeneous severity of COVID-19 in African countries: A modeling approach Salihu Sabiu Musa, Xueying Wang, Shi Zhao, Shudong Li, Nafiu Hussaini, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-426664/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 24 Jan, 2022 Read the published version in Bulletin of Mathematical Biology → Version 1 posted You are reading this latest preprint version Abstract Background: The COVID-19 pandemic has had a considerable impact on global health and economics. The impact in African countries has not been investigated through fitting epidemic models to the reported COVID-19 deaths. Method: We downloaded data for the twelve most affected countries with the highest cumulative COVID-19 deaths to estimate the time-varying basic reproductive number (R 0 (t)) and infection attack rate (IAR). We developed a simple epidemic model and fitted the model to reported COVID-19 deaths in twelve African countries using iterated filtering and allowing a flexible transmission rate. Results: We observed high heterogeneity in the case-fatality rate across countries, which may be due to different reporting or testing efforts. South Africa, Tunisia, and Libya were affected most strongly, exhibiting a relatively higher (R 0 (t)) and infection attack rate. Conclusion: To effectively control the spread of COVID-19 epidemics in Africa, there is a need to consider other mitigation strategies (such as improvements in socioeconomic well-being, healthcare systems, the water supply, and awareness campaigns). Epidemiology Mathematical and Theoretical Biology SARS-CoV-2 pandemic reproduction number attack rate seroprevalence Figures Figure 1 Figure 2 Figure 3 Full Text Cite Share Download PDF Status: Published Journal Publication published 24 Jan, 2022 Read the published version in Bulletin of Mathematical Biology → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-426664\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":21531237,\"identity\":\"b218ba57-be51-4c00-b952-bfcd318fc0d6\",\"order_by\":0,\"name\":\"Salihu Sabiu Musa\",\"email\":\"\",\"orcid\":\"https://orcid.org/0000-0001-6335-2335\",\"institution\":\"Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, China\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Salihu\",\"middleName\":\"Sabiu\",\"lastName\":\"Musa\",\"suffix\":\"\"},{\"id\":21531238,\"identity\":\"9d56c346-9deb-4182-8417-96d9896f13ba\",\"order_by\":1,\"name\":\"Xueying Wang\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Department of Mathematics and Statistics, Washington State University, Pullman, WA, US\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Xueying\",\"middleName\":\"\",\"lastName\":\"Wang\",\"suffix\":\"\"},{\"id\":21531239,\"identity\":\"c89e4941-bc7b-48d7-a28e-050c31e36fc8\",\"order_by\":2,\"name\":\"Shi Zhao\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Shi\",\"middleName\":\"\",\"lastName\":\"Zhao\",\"suffix\":\"\"},{\"id\":21531240,\"identity\":\"078f2ca5-fd07-4f0a-99cb-5bcf3d20d30b\",\"order_by\":3,\"name\":\"Shudong Li\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Cyberspace Institute of Advanced Technology, Guangzhou University, Guangzhou 510006, China\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Shudong\",\"middleName\":\"\",\"lastName\":\"Li\",\"suffix\":\"\"},{\"id\":21531241,\"identity\":\"44cfabe2-752a-4de0-a402-7e53349136b7\",\"order_by\":4,\"name\":\"Nafiu Hussaini\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Department of Mathematical Sciences, Bayero University Kano, 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confirmed cases (in black triangles) and deaths (in red triangles) of COVID-19 in twelve African countries with the most cases of deaths from COVID-19 (population standardized, cases and deaths per 1 million people).\",\"description\":\"\",\"filename\":\"1.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-426664/v1/b04c438701f13f59aae14688.jpg\"},{\"id\":8057572,\"identity\":\"c763fa9e-49f3-48aa-b1d8-640d1434ed2c\",\"added_by\":\"auto\",\"created_at\":\"2021-04-15 19:30:17\",\"extension\":\"jpg\",\"order_by\":2,\"title\":\"Figure 2\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":163083,\"visible\":true,\"origin\":\"\",\"legend\":\"Time series fitting results of weekly confirmed COVID-19 deaths (in red circles) in nine of the twelve African countries with the most COVID-19 deaths, which were hit milder (with low reporting rates). Deaths are population standardized (i.e., deaths per 1 million people). The medium of the simulation is represented by the black curve, and the time varying basic reproductive number (𝑅0(𝑡)) is denoted by the blue dashed curve. The 95% confidence interval of the simulation is shown by the shaded (gray) region. The estimated IAR is displayed in the title of each panel.\",\"description\":\"\",\"filename\":\"2.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-426664/v1/92f93182026cadbcc99a494c.jpg\"},{\"id\":8057552,\"identity\":\"7d95477b-7d6f-420c-a2a4-032d59db47b1\",\"added_by\":\"auto\",\"created_at\":\"2021-04-15 19:30:15\",\"extension\":\"jpg\",\"order_by\":3,\"title\":\"Figure 3\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":139165,\"visible\":true,\"origin\":\"\",\"legend\":\"Time series fitting results of weekly confirmed COVID-19 deaths (in red circles) in three of the twelve African countries with most COVID-19 deaths, which were hit harder (or with a relatively higher reporting effort): (a) Libya, (b) South Africa, (c) Tunisia, (d) South Africa with excess deaths. Deaths are population standardized (i.e., deaths per 1 million people). The medium of the simulation is represented by the black curve, and the time varying basic reproductive number (𝑅0(𝑡)) is denoted by the blue dashed curve. The 95% confidence interval of the simulation is shown by the shaded (gray) region. 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Ltd. Collaborative Research grant (ZG9Z). SL was supported by a grant from the Guangdong Recruitment Program of Foreign Experts (2020A1414010081).\",\"isAcceptedByJournal\":true,\"isAuthorSuppliedPdf\":true,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"SARS-CoV-2, pandemic, reproduction number, attack rate, seroprevalence\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-426664/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-426664/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003eBackground: The COVID-19 pandemic has had a considerable impact on global health and economics. The impact in African countries has not been investigated through fitting epidemic models to the reported COVID-19 deaths.\\u003c/p\\u003e\\u003cp\\u003eMethod: We downloaded data for the twelve most affected countries with the highest cumulative COVID-19 deaths to estimate the time-varying basic reproductive number (R\\u003csub\\u003e0\\u003c/sub\\u003e(t)) and infection attack rate (IAR). We developed a simple epidemic model and fitted the model to reported COVID-19 deaths in twelve African countries using iterated filtering and allowing a flexible transmission rate.\\u003c/p\\u003e\\u003cp\\u003eResults: We observed high heterogeneity in the case-fatality rate across countries, which may be due to different reporting or testing efforts. South Africa, Tunisia, and Libya were affected most strongly, exhibiting a relatively higher\\u003c/p\\u003e\\u003cp\\u003e(R\\u003csub\\u003e0\\u003c/sub\\u003e(t))\\u0026nbsp;and infection attack rate.\\u003c/p\\u003e\\u003cp\\u003eConclusion: To effectively control the spread of COVID-19 epidemics in Africa, there is a need to consider other mitigation strategies (such as improvements in socioeconomic well-being, healthcare systems, the water supply, and awareness campaigns).\\u003c/p\\u003e\",\"manuscriptTitle\":\"The heterogeneous severity of COVID-19 in African countries: A modeling approach\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2021-04-15 19:28:39\",\"doi\":\"10.21203/rs.3.rs-426664/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"a47b812b-9cf3-4a16-ae1b-85ed463dd5dc\",\"owner\":[],\"postedDate\":\"April 15th, 2021\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"published-in-journal\",\"subjectAreas\":[{\"id\":3671783,\"name\":\"Epidemiology\"},{\"id\":3671784,\"name\":\"Mathematical and Theoretical Biology\"}],\"tags\":[],\"updatedAt\":\"2022-01-24T05:54:46+00:00\",\"versionOfRecord\":{\"articleIdentity\":\"rs-426664\",\"link\":\"https://doi.org/10.1007/s11538-022-00992-x\",\"journal\":{\"identity\":\"bulletin-of-mathematical-biology\",\"isVorOnly\":false,\"title\":\"Bulletin of Mathematical Biology\"},\"publishedOn\":\"2022-01-24 05:54:46\",\"publishedOnDateReadable\":\"January 24th, 2022\"},\"versionCreatedAt\":\"2021-04-15 19:28:39\",\"video\":\"\",\"vorDoi\":\"10.1007/s11538-022-00992-x\",\"vorDoiUrl\":\"https://doi.org/10.1007/s11538-022-00992-x\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-426664\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-426664\",\"identity\":\"rs-426664\",\"version\":[\"v1\"]},\"buildId\":\"wLkW0s4AflPzk-lpfg-fK\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}