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Accessing the syndemic of COVID-19 and malaria intervention in Africa
Benyun Shi1, Jinxin Zheng2,3,4,5,6,7, Shang Xia2,3,4,5,6,7
1School of Computer Science and Technology, Nanjing Tech University, Nanjing, 211800, Jiangsu, China.
Insights
The COVID-19 pandemic and non-pharmaceutical interventions (NPIs) can increase malaria transmission potential in Africa. Early COVID-19 intervention is crucial to mitigate its impact on malaria, even with NPIs.
Area of Science:
- Epidemiology
- Public Health
- Infectious Disease Modeling
Background:
- COVID-19 pandemic disrupted health services in low- and middle-income countries.
- Sub-Saharan Africa faces a high burden of diseases like malaria.
- Assessing COVID-19's impact on malaria transmission in Africa is critical.
Purpose of the Study:
- To quantify the impact of the COVID-19 pandemic and non-pharmaceutical interventions (NPIs) on malaria transmission potential in African countries.
- To evaluate how NPIs affect malaria transmission dynamics.
- To provide insights for jointly addressing the COVID-19 and malaria syndemic.
Main Methods:
- Utilized a data-driven approach with particle Markov Chain Monte Carlo (pMCMC) to estimate COVID-19 epidemiological parameters.
- Simulated COVID-19 epidemic dynamics under different NPI scenarios (contact restriction, social distancing, early case isolation).
- Quantified the impact of COVID-19 and NPIs on insecticide-treated net (ITN) distribution and malaria vectorial capacity.
Main Results:
- Case studies conducted in Ethiopia, Nigeria, Tanzania, and Zambia.
- Estimated COVID-19 epidemiological parameters (R0, infection duration) for each country.
- Simulations showed earlier NPI implementation leads to better epidemic control; combined NPIs are more effective.
- Malaria transmission potential remained higher than expected in late 2020, despite stringent NPIs.
Conclusions:
- Early COVID-19 intervention effectively reduces epidemic scale and mitigates impact on malaria transmission potential.
- The study offers a method to jointly manage the COVID-19 and malaria syndemic in Africa.
- Findings emphasize the need for integrated strategies to address overlapping health crises.
Background:
The pandemic of the coronavirus disease 2019 (COVID-19) has caused substantial disruptions to health services in the low and middle-income countries with a high burden of other diseases, such as malaria in sub-Saharan Africa. The aim of this study is to assess the impact of COVID-19 pandemic on malaria transmission potential in malaria-endemic countries in Africa.
Methods:
We present a data-driven method to quantify the extent to which the COVID-19 pandemic, as well as various non-pharmaceutical interventions (NPIs), could lead to the change of malaria transmission potential in 2020. First, we adopt a particle Markov Chain Monte Carlo method to estimate epidemiological parameters in each country by fitting the time series of the cumulative number of reported COVID-19 cases. Then, we simulate the epidemic dynamics of COVID-19 under two groups of NPIs: (1) contact restriction and social distancing, and (2) early identification and isolation of cases. Based on the simulated epidemic curves, we quantify the impact of COVID-19 epidemic and NPIs on the distribution of insecticide-treated nets (ITNs). Finally, by treating the total number of ITNs available in each country in 2020, we evaluate the negative effects of COVID-19 pandemic on malaria transmission potential based on the notion of vectorial capacity.
Results:
We conduct case studies in four malaria-endemic countries, Ethiopia, Nigeria, Tanzania, and Zambia, in Africa. The epidemiological parameters (i.e., the basic reproduction number [Formula: see text] and the duration of infection [Formula: see text]) of COVID-19 in each country are estimated as follows: Ethiopia ([Formula: see text], [Formula: see text]), Nigeria ([Formula: see text], [Formula: see text]), Tanzania ([Formula: see text], [Formula: see text]), and Zambia ([Formula: see text], [Formula: see text]). Based on the estimated epidemiological parameters, the epidemic curves simulated under various NPIs indicated that the earlier the interventions are implemented, the better the epidemic is controlled. Moreover, the effect of combined NPIs is better than contact restriction and social distancing only. By treating the total number of ITNs available in each country in 2020 as a baseline, our results show that even with stringent NPIs, malaria transmission potential will remain higher than expected in the second half of 2020.
Conclusions:
By quantifying the impact of various NPI response to the COVID-19 pandemic on malaria transmission potential, this study provides a way to jointly address the syndemic between COVID-19 and malaria in malaria-endemic countries in Africa. The results suggest that the early intervention of COVID-19 can effectively reduce the scale of the epidemic and mitigate its impact on malaria transmission potential.
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