Evidence map›Paper›PMID 34301651›Full record

ArticleBMJ open2021

Potential impact of intervention strategies on COVID-19 transmission in Malawi: a mathematical modelling study.

Tara Mangal, Charlie Whittaker, Dominic Nkhoma, Wingston Ng'ambi, Oliver Watson, Patrick Walker, Azra Ghani, Paul Revill, Timothy Colbourn, Andrew Phillips and 2 more

Abstract read
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Tara MangalInfectious Disease Epidemiology, Imperial College London, London, UK t.mangal@imperial.ac.uk.ORCID 0000-0001-9222-8632
Charlie WhittakerInfectious Disease Epidemiology, Imperial College London, London, UK.
Dominic NkhomaCollege of Medicine, University of Malawi, Lilongwe, Malawi.
Wingston Ng'ambiCollege of Medicine, University of Malawi, Lilongwe, Malawi.
Oliver WatsonInfectious Disease Epidemiology, Imperial College London, London, UK.ORCID 0000-0003-2374-0741
Patrick WalkerInfectious Disease Epidemiology, Imperial College London, London, UK.
Azra GhaniInfectious Disease Epidemiology, Imperial College London, London, UK.
Paul RevillCentre for Health Economics, University of York, York, UK.
Timothy ColbournInstitute for Global Health, University College London, London, UK.
Andrew PhillipsHIV Epidemiology and Biostatistics Group, University College London, London, UK.
Timothy HallettInfectious Disease Epidemiology, Imperial College London, London, UK.
Joseph Mfutso-BengoCollege of Medicine, University of Malawi, Lilongwe, Malawi.

Funding

Medical Research Council MC_PC_19012Medical Research Council MR/P028004/1Medical Research Council MR/R015600/1
6 · The paper itself

Abstract

backgroundCOVID-19 mitigation strategies have been challenging to implement in resource-limited settings due to the potential for widespread disruption to social and economic well-being. Here we predict the clinical severity of COVID-19 in Malawi, quantifying the potential impact of intervention strategies and increases in health system capacity.

methodsThe infection fatality ratios (IFR) were predicted by adjusting reported IFR for China, accounting for demography, the current prevalence of comorbidities and health system capacity. These estimates were input into an age-structured deterministic model, which simulated the epidemic trajectory with non-pharmaceutical interventions and increases in health system capacity.

findingsThe predicted population-level IFR in Malawi, adjusted for age and comorbidity prevalence, is lower than that estimated for China (0.26%, 95% uncertainty interval (UI) 0.12%-0.69%, compared with 0.60%, 95% CI 0.4% to 1.3% in China); however, the health system constraints increase the predicted IFR to 0.83%, 95% UI 0.49%-1.39%. The interventions implemented in January 2021 could potentially avert 54 400 deaths (95% UI 26 900-97 300) over the course of the epidemic compared with an unmitigated outbreak. Enhanced shielding of people aged ≥60 years could avert 40 200 further deaths (95% UI 25 300-69 700) and halve intensive care unit admissions at the peak of the outbreak. A novel therapeutic agent which reduces mortality by 0.65 and 0.8 for severe and critical cases, respectively, in combination with increasing hospital capacity, could reduce projected mortality to 2.5 deaths per 1000 population (95% UI 1.9-3.6).

conclusionWe find the interventions currently used in Malawi are unlikely to effectively prevent SARS-CoV-2 transmission but will have a significant impact on mortality. Increases in health system capacity and the introduction of novel therapeutics are likely to further reduce the projected numbers of deaths.

Indexed as

COVID-19ChinaHumansMalawiModels, TheoreticalSARS-CoV-2COVID-19epidemiologyinfection controlpublic health

Identifiers

PMID34301651
PMCPMC8300555

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.