Mabuka Thabo, Naidoo Natalie, Ncube Nesisa, Yiga Thabo, Ross Michael, Kurehwa Kuzivakwashe, Nare Nyathi Mothabisi, Silaji Andrea, Ndemera Tinashe, Lemeke Tlaleng, Taiwo Ridwan, Macharia Willie, Sithole Mthokozisi
The Afrikan Research Initiative Motloung South Africa.
JMIRx Med. 2023 Jul 3;4:e34598. doi: 10.2196/34598. eCollection 2023.
Emerging SARS-CoV-2 variants have been attributed to the occurrence of secondary, tertiary, quaternary, and quinary COVID-19 epidemic waves threatening vaccine efforts owing to their immune invasiveness. Since the importation of SARS-CoV-2 in South Africa, with the first reported COVID-19 case on March 5, 2020, South Africa has observed 5 consecutive COVID-19 epidemic waves. The evolution of SARS-CoV-2 has played a major role in the resurgence of COVID-19 epidemic waves in South Africa and across the globe.
We aimed to conduct descriptive and inferential statistical analysis on South African COVID-19 epidemiological data to investigate the impact of SARS-CoV-2 lineages and COVID-19 vaccinations in South African COVID-19 epidemiology.
The general methodology involved the collation and stratification, covariance, regression analysis, normalization, and comparative inferential statistical analysis through null hypothesis testing (paired 2-tailed tests) of South African COVID-19 epidemiological data.
The mean daily positive COVID-19 tests in South Africa's first, second, third, fourth, and fifth COVID-19 epidemic wave periods were 11.5% (SD 8.58%), 11.5% (SD 8.45%), 13.3% (SD 9.72%), 13.1% (SD 9.91%), and 14.3% (SD 8.49%), respectively. The COVID-19 transmission rate in the first and second COVID-19 epidemic waves in South Africa was similar, while the COVID-19 transmission rate was higher in the third, fourth, and fifth COVID-19 epidemic waves than in the aforementioned waves. Most COVID-19 hospitalized cases in South Africa were in the general ward (60%-79.1%). Patients with COVID-19 on oxygen were the second-largest admission status (11.2%-16.8%), followed by patients with COVID-19 in the intensive care unit (8.07%-16.7%). Most patients hospitalized owing to COVID-19 in South Africa's first, second, third, and fourth COVID-19 epidemic waves were aged between 40 and 49 years (16.8%-20.4%) and 50 and 59 years (19.8%-25.3%). Patients admitted to the hospital owing to COVID-19 in the age groups of 0 to 19 years were relatively low (1.98%-4.59%). In general, COVID-19 hospital admissions in South Africa for the age groups between 0 and 29 years increased after each consecutive COVID-19 epidemic wave, while for age groups between 30 and 79 years, hospital admissions decreased. Most COVID-19 hospitalization deaths in South Africa in the first, second, third, fourth, and fifth COVID-19 epidemic waves were in the ages of 50 to 59 years (15.8%-24.8%), 60 to 69 years (15.9%-29.5%), and 70 to 79 years (16.6%-20.7%).
The relaxation of COVID-19 nonpharmaceutical intervention health policies in South Africa and the evolution of SARS-CoV-2 were associated with increased COVID-19 transmission and severity in the South African population. COVID-19 vaccination in South Africa was strongly associated with a decrease in COVID-19 hospitalization and severity in South Africa.
新型严重急性呼吸综合征冠状病毒2(SARS-CoV-2)变体被认为是导致新冠疫情出现第二、三、四、五波流行的原因,因其具有免疫侵袭性,对疫苗接种工作构成威胁。自2020年3月5日南非首次报告新冠病例以来,SARS-CoV-2输入该国,南非已连续经历了5波新冠疫情。SARS-CoV-2的进化在南非乃至全球新冠疫情的卷土重来中发挥了重要作用。
我们旨在对南非新冠疫情流行病学数据进行描述性和推断性统计分析,以研究SARS-CoV-2谱系和新冠疫苗接种对南非新冠疫情流行病学的影响。
总体方法包括对南非新冠疫情流行病学数据进行整理与分层、协方差分析、回归分析、归一化处理,以及通过零假设检验(配对双尾检验)进行比较推断性统计分析。
南非第一、二、三、四、五波新冠疫情期间,每日新冠病毒检测阳性的平均比例分别为11.5%(标准差8.58%)、11.5%(标准差8.45%)、13.3%(标准差9.72%)、13.1%(标准差9.91%)和14.3%(标准差8.49%)。南非第一、二波新冠疫情的传播率相似,而第三、四、五波新冠疫情的传播率高于上述两波。南非大多数新冠住院病例在普通病房(60%-79.1%)。使用氧气的新冠患者是第二大入院类型(11.2%-16.8%),其次是重症监护病房的新冠患者(8.07%-16.7%)。在南非第一、二、三、四波新冠疫情中,因新冠住院的大多数患者年龄在40至49岁(16.8%-20.4%)和50至59岁(19.8%-25.3%)之间。0至19岁年龄组因新冠住院的患者相对较少(1.98%-4.59%)。总体而言,南非0至29岁年龄组的新冠住院人数在每一波新冠疫情后都有所增加,而30至79岁年龄组的住院人数则有所减少。在南非第一、二、三、四、五波新冠疫情中,大多数新冠住院死亡病例年龄在50至59岁(15.8%-24.8%)、60至69岁(15.9%-29.5%)和70至79岁(16.6%-20.7%)之间。
南非新冠疫情非药物干预卫生政策的放宽以及SARS-CoV-2的进化与南非人群中新冠传播率和严重程度的增加有关。南非的新冠疫苗接种与南非新冠住院率和严重程度的降低密切相关。