Open AccessThe first sixty days of COVID-19 in a humanitarian response setting: a descriptive epidemiological analyses of the outbreak in South Sudan
Author(s) -
Joy Luba Lomole Waya,
Richard Lako,
Sudhir Bunga,
Helen Chun,
Valerie Mize,
Boniface Ambani,
Joseph Francis Wamala,
Argata Guracha Guyo,
John Gray,
Malick Gai,
Sylvester Maleghemi,
Matthew Kol,
John Rumunu,
Michael Tukuru,
Olushayo Oluseun Olu
Publication year - 2020
Publication title -
the pan african medical journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.287
H-Index - 30
ISSN - 1937-8688
DOI - 10.11604/pamj.2020.37.384.27486
Subject(s) - medicine , outbreak , case fatality rate , pandemic , demography , attack rate , epidemiology , confidence interval , population , asymptomatic , covid-19 , pediatrics , environmental health , disease , virology , infectious disease (medical specialty) , sociology
the coronavirus disease 2019 (COVID-19) was declared a pandemic on March 11, 2020. South Sudan, a low-income and humanitarian response setting, reported its first case of COVID-19 on April 5, 2020. We describe the socio-demographic and epidemiologic characteristics of COVID-19 cases in this setting. Methods we conducted a cross-sectional descriptive analysis of data for 1,330 confirmed COVID-19 cases from the first 60 days of the outbreak. Results among the 1,330 confirmed cases, the mean age was 37.1 years, 77% were male, 17% were symptomatic with 95% categorized as mild, and the case fatality rate was 1.1%. Only 24.7% of cases were detected through alerts and sentinel site surveillance, with 95% of the cases reported from the capital, Juba. Epidemic doubling time averaged 9.8 days (95% confidence interval [CI] 7.7 - 13.4), with an attack rate of 11.5 per 100,000 population. Test positivity rate was 18.2%, with test rate per 100,000 population of 53 and mean test turn-around time of 9 days. The case to contact ratio was 1: 2.2. Conclusion this 2-month initial period of COVID-19 in South Sudan demonstrated mostly young adults and men affected, with most cases reported as asymptomatic. Systems´ limitations highlighted included a small proportion of cases detected through surveillance, low testing rates, low contact elicitation, and long collection to test turn-around times limiting the country´s ability to effectively respond to the outbreak. A multi-pronged response including greater access to testing, scale-up of surveillance, contact tracing and community engagement, among other interventions are needed to improve the COVID-19 response in this setting.