Factors associated with COVID-19 fatality among patients admitted in Mashonaland West Province, Zimbabwe 2020-2022: a secondary data analysis

Introduction

approximately 15% of COVID-19 patients develop symptoms necessitating admission. From 2020 to 2022, Mashonaland West Province had an institutional case fatality rate of 23% against a national rate of 7%. Therefore, we evaluated the COVID-19 admissions in the province to determine the factors associated with COVID-19 mortality.

Methods

we conducted an analytical cross-sectional study based on secondary data from isolation centers across the province using all 672 death audit forms and patient records. We obtained data on patient demographics, signs and symptoms, clinical management and oxygen therapy administered, among other things. Data were entered into an electronic form and imported into Epi-info 7 for analysis bivariate and multivariate conducted. Results: we found that being an older man, aOR 1.04 (1.03-1.05), who had diabetes aOR 6.0 (95% CI: 3.8-9.2) and hypertension aOR 4.5 (95% CI: 2.8-6.5) were independent risk factors. Patients put on dexamethasone aOR 2.4 (95% CI: 1.6-3.4) and heparin/clexane aOR 1.6 (95% CI: 1.1-2.2) had a higher mortality risk. However, vitamin C aOR 0.48 (95% CI: 0.31-0.71) and oxygen therapy aOR 0.14 (95% CI: 0.10-0.19) and being pregnant aOR 0.06 (95% CI: 0.02-0.14) were protective. Conclusion: mortality risk increased in older male patients with comorbidities and with those on dexamethasone and heparin therapy. Oxygen therapy and vitamin C were protective. There is a need to conduct further study of the source of these variations in risk across patients to establish the true impact of differences in individuals' mortality.

Evaluation of the weekly disease surveillance system for epidemic-prone diseases in Makonde District, Zimbabwe 2020: a descriptive cross-sectional study

Introduction

the weekly disease surveillance system (WDSS) is a tool used to provide an early warning of potential public health threats in Zimbabwe. In 2020, Makonde District failed to detect an anthrax outbreak at one of its facilities, this untimely and poor response of the district increased morbidity. We evaluated the weekly disease surveillance system to determine reasons for missing outbreaks and determine the usefulness of the system in the detection of outbreaks.

Methods

we conducted descriptive cross-sectional study using updated Centres for Disease Control and Prevention guidelines for surveillance system evaluation. We recruited 46 health workers. A structured pretested interviewer-administered questionnaire was used to collect data on reasons for missing outbreaks, knowledge, usefulness and surveillance system attributes. Data were cleaned and bivariate analysis was conducted.

Results

health workers found the system simple (85%), acceptable (75%) and flexible (60%). However, we found only 5 (11%) health workers could correctly describe the surveillance system, only 2 (3%) were trained in disease surveillance, only 31 (65%) sent data on time, 57% of clinics had stock outs of forms, 60% of forms had entries with 100% of the data filled out and 22 (46%) of health workers analysed the data gathered and used it in meetings.

Conclusion

the surveillance system was simple, flexible, acceptable, but unstable, untimely and not useful. There was poor knowledge on the surveillance system, health workers were not trained on disease surveillance, and quality of data was poor. Health workers should be trained in surveillance and data validation and adequate reporting tools provided.