COVID-19 Epidemiology in Fragile Contexts: A Descriptive Analysis of COVID-19 in Host Communities in Cox’s Bazar, Bangladesh During the First Year of the Pandemic.

COVID-19 Epidemiology in Fragile Contexts: A Descriptive Analysis of COVID-19 in Host Communities in Cox’s Bazar, Bangladesh During the First Year of the Pandemic.

Publication date: Dec 20, 2024

In 2020, COVID-19 modeling studies predicted rapid epidemic growth and quickly overwhelmed health systems in humanitarian and fragile settings due to preexisting vulnerabilities and limited resources. Despite the growing evidence from Bangladesh, no study has examined the epidemiology of COVID-19 in out-of-camp settings in Cox’s Bazar during the first year of the pandemic (March 2020-March 2021). This paper aims to fill this gap. Secondary data analyses were conducted on case and testing data from the World Health Organization and the national health information system via the District Health Information Software 2. COVID-19 in Cox’s Bazar was characterized by a large peak in June 2020, followed by a smaller wave in August/September and a new wave from March 2021. Males were more likely to be tested than females (68% vs. 32%, P < 0. 001) and had higher incidence rates (305. 29/100 000 males vs. 114. 90/100 000 female, P < 0. 001). Mortality was significantly associated with age (OR: 87. 3; 95% CI: 21. 03-350. 16, P < 0. 001) but not sex. Disparities existed in testing and incidence rates among upazilas. Incidence was lower than expected, with indicators comparable to national-level data. These findings are likely influenced by the younger population age, high isolation rates, and low testing capacity. With testing extremely limited, true incidence and mortality rates are likely higher, highlighting the importance of improving disease surveillance in fragile settings. Data incompleteness and fragmentation were the main study limitations.

Concepts Keywords
August Adolescent
Bangladesh Adult
Females Aged
Pandemic Bangladesh
Child
Child, Preschool
COVID-19
COVID-19
disease outbreaks
epidemiology
Female
fragile settings
Humans
Incidence
Infant
Male
Middle Aged
Pandemics
pandemics
SARS-CoV-2

Semantics

Type Source Name
disease MESH COVID-19
disease IDO host
drug DRUGBANK Cyclic Adenosine Monophosphate

Original Article

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