Imperial College London
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ProfessorAzraGhani

Faculty of Medicine, School of Public Health

Chair in Infectious Disease Epidemiology
 
 
 
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Contact

 

+44 (0)20 7594 5764a.ghani Website

 
 
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Location

 

Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Mangal:2021:10.1136/bmjopen-2020-045196,
author = {Mangal, T and Whittaker, C and Nkhoma, D and Ng'ambi, W and Watson, O and Walker, P and Ghani, A and Revill, P and Colbourn, T and Phillips, A and Hallett, T and Mfusto-Bengo, J},
doi = {10.1136/bmjopen-2020-045196},
journal = {BMJ Open},
title = {The potential impact of intervention strategies on COVID-19 transmission in Malawi: a mathematical modelling study},
url = {http://dx.doi.org/10.1136/bmjopen-2020-045196},
volume = {11},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundCOVID-19 mitigation strategies have been challenging to implement in resource-limited settings due to the potential for widespread disruption to social and economic well-being. Here we predict the clinical severity of COVID-19 in Malawi, quantifying the potential impact of intervention strategies and increases in health system capacity.MethodsThe infection fatality ratios (IFR) were predicted by adjusting reported IFR for China accounting for demography, the current prevalence of comorbidities and health system capacity. These estimates were input into an age-structured deterministic model, which simulated the epidemic trajectory with non-pharmaceutical interventions and increases in health system capacity. Findings The predicted population-level IFR in Malawi, adjusted for age and comorbidity prevalence, is lower than estimated for China (0.26%, 95% uncertainty interval [UI] 0.12 – 0.69%, compared with 0.60%, 95% CI 0.4% – 1.3% in China), however the health system constraints increase the predicted IFR to 0.83%, 95% UI 0.49% – 1.39%. The interventions implemented in January 2021 could potentially avert 54,400 deaths (95% UI 26,900 – 97,300) over the course of the epidemic compared with an unmitigated outbreak. Enhanced shielding of people aged ≥ 60 years could avert a further 40,200 deaths (95% UI 25,300 – 69,700) and halve ICU admissions at the peak of the outbreak. A novel therapeutic agent, which reduces mortality by 0.65 and 0.8 for severe and critical cases respectively, in combination with increasing hospital capacity could reduce projected mortality to 2.5 deaths per 1,000 population (95% UI 1.9 – 3.6).ConclusionWe find the interventions currently used in Malawi are unlikely to effectively prevent SARS-CoV-2 transmission but will have a significant impact on mortality. Increases in health system capacity and the introduction of novel therapeutics are likely to further reduce the projected numbers of deaths.
AU  - Mangal,T
AU  - Whittaker,C
AU  - Nkhoma,D
AU  - Ng'ambi,W
AU  - Watson,O
AU  - Walker,P
AU  - Ghani,A
AU  - Revill,P
AU  - Colbourn,T
AU  - Phillips,A
AU  - Hallett,T
AU  - Mfusto-Bengo,J
DO  - 10.1136/bmjopen-2020-045196
PY  - 2021///
SN  - 2044-6055
TI  - The potential impact of intervention strategies on COVID-19 transmission in Malawi: a mathematical modelling study
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2020-045196
UR  - http://hdl.handle.net/10044/1/89474
VL  - 11
ER  -
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