背景:由SARS-CoV-2感染引起的冠状病毒病(COVID-19)仍然是全球重大的健康挑战。关于全民健康覆盖(UHC)和全球健康安全(GHS)关系对SARS-CoV-2感染风险和结果的影响的证据很少。本研究旨在调查UHC和GHS的联系和相互作用对非洲SARS-CoV-2感染率和病死率(CFR)的影响。
方法:该研究采用描述性方法来分析来自多个来源的数据,并使用具有最大似然估计的结构方程模型(SEM)来建模和评估自变量和因变量之间的关系通过进行路径分析。
结果:在非洲,GHS对SARS-CoV-2感染和RT-PCRCFR的影响分别为100%和18%,分别是直接的。SARS-CoV-2CFR增加与全国人口的中位年龄相关(β=-0.1244,[95%CI:-0.24,-0.01],P=0.031);COVID-19感染率(β=-0.370,[95%CI:-0.66,-0.08],P=0.012);18岁以上成年人的肥胖患病率(β=0.128,[95%CI:0.06,0.20],P=0.0001)有统计学意义。SARS-CoV-2感染率与全国人口的中位年龄密切相关(β=0.118,[95%CI:0.02,0.22],P=0.024);每平方公里的人口密度,(β=-0.003,[95%CI:-0.0058,-0.00059],P=0.016)和服务覆盖指数的UHC(β=0.089,[95%CI:0.04,0.14,P=0.001),其中它们的关系具有统计学意义。
结论:这项研究掩盖了UHC对服务覆盖范围的影响,和全国人口的平均年龄,人口密度对COVID-19感染率有显著影响,全国人口的中位年龄和18岁以上成年人的肥胖患病率与COVID-19病死率相关.两者,UHC和GHS的出现并不能防止COVID-19相关的病死率。
BACKGROUND: The Coronavirus Disease (COVID-19) caused by SARS-CoV-2 infections remains a significant health challenge worldwide. There is paucity of evidence on the influence of the universal health coverage (UHC) and global health security (GHS) nexus on SARS-CoV-2 infection risk and outcomes. This study aimed to investigate the effects of UHC and GHS nexus and interplay on SARS-CoV-2 infection rate and
case-fatality rates (CFR) in Africa.
METHODS: The study employed descriptive methods to analyze the data drawn from multiple sources as well used structural equation modeling (SEM) with maximum likelihood estimation to model and assess the relationships between independent and dependent variables by performing path analysis.
RESULTS: In Africa, 100% and 18% of the effects of GHS on SARS-CoV-2 infection and RT-PCR CFR, respectively were direct. Increased SARS-CoV-2 CFR was associated with median age of the national population (β = -0.1244, [95% CI: -0.24, -0.01], P = 0.031 ); COVID-19 infection rate (β = -0.370, [95% CI: -0.66, -0.08], P = 0.012 ); and prevalence of obesity among adults aged 18 + years (β = 0.128, [95% CI: 0.06,0.20], P = 0.0001) were statistically significant. SARS-CoV-2 infection rates were strongly linked to median age of the national population (β = 0.118, [95% CI: 0.02,0.22 ], P = 0.024); population density per square kilometer, (β = -0.003, [95% CI: -0.0058, -0.00059], P = 0.016 ) and UHC for service coverage index (β = 0.089, [95% CI: 0.04,0.14, P = 0.001 ) in which their relationship was statistically significant.
CONCLUSIONS: The study shade a light that UHC for service coverage, and median age of the national population, population density have significant effect on COVID-19 infection rate while COVID-19 infection rate, median age of the national population and prevalence of obesity among adults aged 18 + years were associated with COVID-19
case-fatality rate. Both, UHC and GHS do not emerge to protect against COVID-19-related
case fatality rate.