Abstract

Excess mortality among community deaths during the COVID-19 pandemic Lusaka, Zambia 2021

Stephen Chanda¹, Amos Hamukale, Mr¹, Warren Malambo, Mr², Muzala Kapina, Dr³, Jonas Hines, Dr², Nyambe Sinyange, Dr³ (1)Zambia Field Epidemiology Training Program, (2)US Centers for Disease Control and Prevention, Lusaka, Zambia, , (3)Zambia National Public Health Institute

APHA 2022 Annual Meeting and Expo

Introduction
In Zambia, approximately half of deaths occur outside health facilities. During Zambia’s COVID-19 pandemic >3,700 confirmed deaths were reported in 2021, although the true number might be greater given the high proportion of community deaths in the country. We sought to determine if community deaths from all causes increased during COVID-19 waves at the University Teaching Hospital (UTH) morgue in Lusaka.
Methods
We collected daily counts of community deaths from all causes at the UTH morgue from 01/01/21-31/12/21. We dichotomized days as wave or non-wave and compared median daily community death counts. The 2nd wave occurred from 03/01/21-17/03/21 and the 3rd wave occurred from 27/05/21-19/08/21. Excess mortality was defined as the difference between the total deaths during waves minus total deaths during non-wave in 2021. We compared median daily community death counts during wave and non-wave days using the Mann-Whitney-U test.
Results
A total of 7,937 community deaths from all causes were reported at UTH in 2021, with a median daily count of 23.0 (interquartile range [IQR]: 18.7-28.8). The median daily number of community deaths during non-wave days was 20.0 (IQR: 17.0-25.0) versus 27.0 (IQR: 21.0-37.0) during wave days (p<0.001). There were 1,548 excess deaths during wave periods.
Conclusion
Community deaths from all causes increased in Lusaka during COVID-19 waves. Many of these community deaths were likely related to COVID-19. The true toll of COVID-19 in Lusaka is likely greater than official statistics reflect. Expanding mortality surveillance can provide useful information on impact of COVID-19 pandemic in the country.