Study from Zambia on Sars-CoV-2-positive dead

The researchers suspect that the extent of the corona pandemic is significantly underestimated not only in Zambia, but also in other African countries.

In large parts of Africa little has been tested so far, so the true extent of the corona pandemic on the continent is unclear.  In the picture: The grave is disinfected before the burial of a Covid corpse in a Nairobi cemetery.

In large parts of Africa little has been tested so far, so the true extent of the corona pandemic on the continent is unclear. In the picture: The grave is disinfected before the burial of a Covid corpse in a Nairobi cemetery.

Brian Inganga / AP

Africa is still a big corona puzzle: the virus seems to have almost flown over the continent on its way from Asia to Europe and America. Only in South Africa has there been an intense infection rate with over 20,000 dead, more than 750,000 infected and now even a new virus variant against which the previously approved vaccines are only effective to a limited extent. According to a research team from Zambia and Boston led by Lawrence Mwanayanda, the solution to the riddle could be as simple as it is alarming: The Sars-CoV-2 spread is being overlooked in large parts of Africa because there is little and incomplete testing.

The team found Sars-CoV-2 in almost 20 percent of a small group of deceased. The 364 deceased were examined between June and September 2020 in the pathology department of the University Teaching Hospital in the capital Lusaka. A nasal swab was taken from them a maximum of 48 hours after death and examined using a PCR test. The rate of corona-positives among the deceased roughly corresponds to that in Switzerland and Germany during the high phases of the pandemic.

It is unclear whether the people died from or with the virus. However, according to the information provided by the relatives, the majority had symptoms typical of Covid 19, the researchers report. At least three quarters of the Sars-CoV-2-positive deaths probably died of Covid-19, in the remaining cases this was also possible, but there was no medical information about the condition of the patients before their death.

Almost 75 percent of the test subjects died outside the hospital. None of them had ever been tested for Sars-CoV-2. Almost none of the people who died in the hospital had previously been tested for the corona virus. This allows the conclusion that Sars-CoV-2 is at least as rampant in Lusaka as elsewhere, but is not recognized due to a lack of test and other medical capacities, the authors emphasize.

According to them, this is the first systematic monitoring of Sars-CoV-2 using laboratory data in an African country beyond South Africa. It is true that it is only a short and small study that was only carried out in a hospital in Zambia. But it is quite possible that the situation is similar in other African countries, according to the publication in the British Medical Journal.

The investigation also provides other surprises. There were three small children and two young people among the fatalities with Sars-CoV-2. That is an unusually high number compared to Europe or the USA. However, only a small group was examined, so it could be a coincidence.

Before their death, the children mainly suffered from gastrointestinal complaints such as nausea, vomiting and diarrhea. These Covid-19 problems were also found increasingly in children in other studies.

At least in Zambia, pre-existing illnesses that are different from those in more developed countries are apparently risk factors for a fatal Covid 19 disease. In addition to the well-known ailments such as high blood pressure and diabetes, tuberculosis, HIV infection and alcohol abuse are in the top 5 of the list. However, due to the lack of detailed patient files, no conclusive statements can be made here, the researchers say.

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