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SARS-CoV-2 Surveillance in the Middle East and North Africa: Longitudinal Trend Analysis Open Access (recommended)

Post L, Marogi E, Moss CB, Murphy RL, Ison MG, Achenbach CJ, Resnick D, Singh L, White J, Boctor MJ, Welch SB, Oehmke JF. SARS-CoV-2 Surveillance in the Middle East and North Africa: Longitudinal Trend Analysis. Journal of Medical Internet Research. 2021;23(1):11.

Descriptions

Resource type(s)
Article
Keyword
COVID-19
SARS-CoV-2 surveillance
wave two
second wave
global COVID-19 surveillance
MENA public health surveillance
MENA COVID-19
Middle East and North Africa surveillance metrics
dynamic panel data
MENA econometrics
MENA SARS-CoV-2
Middle East and North Africa COVID-19 surveillance system
MENA COVID-19 transmission speed
MENA COVID-19 transmission acceleration
COVID-19 transmission deceleration
COVID-19 transmission jerk
COVID-19 7-day lag
SARS-CoV-2
Arellano-Bond estimator
generalized method of moments
GMM
Bahrain
Iran
Iraq
Israel
Jordan
Kuwait
Lebanon
Oman
Qatar
Saudi Arabia
Syria
United Arab Emirates
Yemen
Algeria
Djibouti
Egypt
Libya
Morocco
Tunisia
Rights
Attribution 4.0 International

Creator
Post, Lori Ann
Marogi, Emily Philip
Moss, Charles B.
Murphy, Robert Leo
Ison, Michael G.
Achenbach, Chad J.
Resnick, Danielle
Singh, Lauren
White, Janine Inui
Boctor, Michael J.
Welch, Sarah B.
Oehmke, James Francis
Abstract
Background: The COVID-19 pandemic has disrupted the lives of millions and forced countries to devise public health policies to reduce the pace of transmission. In the Middle East and North Africa (MENA), falling oil prices, disparities in wealth and public health infrastructure, and large refugee populations have significantly increased the disease burden of COVID-19. In light of these exacerbating factors, public health surveillance is particularly necessary to help leaders understand and implement effective disease control policies to reduce SARS-CoV-2 persistence and transmission. Objective: The goal of this study is to provide advanced surveillance metrics, in combination with traditional surveillance, for COVID-19 transmission that account for weekly shifts in the pandemic speed, acceleration, jerk, and persistence to better understand a country's risk for explosive growth and to better inform those who are managing the pandemic. Existing surveillance coupled with our dynamic metrics of transmission will inform health policy to control the COVID-19 pandemic until an effective vaccine is developed. Methods: Using a longitudinal trend analysis study design, we extracted 30 days of COVID-19 data from public health registries. We used an empirical difference equation to measure the daily number of cases in MENA as a function of the prior number of cases, the level of testing, and weekly shift variables based on a dynamic panel data model that was estimated using the generalized method of moments approach by implementing the Arellano-Bond estimator in R. Results: The regression Wald statistic was significant (chi(2)(5)=859.5, P<.001). The Sargan test was not significant, failing to reject the validity of overidentifying restrictions (chi(2)(294)=16, P=.99). Countries with the highest cumulative caseload of the novel coronavirus include Iran, Iraq, Saudi Arabia, and Israel with 530,380, 426,634, 342,202, and 303,109 cases, respectively. Many of the smaller countries in MENA have higher infection rates than those countries with the highest caseloads. Oman has 33.3 new infections per 100,000 population while Bahrain has 12.1, Libya has 14, and Lebanon has 14.6 per 100,000 people. In order of largest to smallest number of cumulative deaths since January 2020, Iran, Iraq, Egypt, and Saudi Arabia have 30,375, 10,254, 6120, and 5185, respectively. Israel, Bahrain, Lebanon, and Oman had the highest rates of COVID-19 persistence, which is the number of new infections statistically related to new infections in the prior week. Bahrain had positive speed, acceleration, and jerk, signaling the potential for explosive growth. Conclusions: Static and dynamic public health surveillance metrics provide a more complete picture of pandemic progression across countries in MENA. Static measures capture data at a given point in time such as infection rates and death rates. By including speed, acceleration, jerk, and 7-day persistence, public health officials may design policies with an eye to the future. Iran, Iraq, Saudi Arabia, and Israel all demonstrated the highest rate of infections, acceleration, jerk, and 7-day persistence, prompting public health leaders to increase prevention efforts.
Related URL
Publisher
JMIR PUBLICATIONS, INC
Date Created
2021-01-15
Original Identifier
(PMID) 33302252
Grants and funding
Feed the Future through the US Agency for International DevelopmentUnited States Agency for International Development (USAID) [7200LA1800003]
DOI
10.2196/25830

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