A Comparative Appraisal of the Covid-19 Waves in Kadoma City, Mashonaland West, Zimbabwe 2021

Abstract

Covid19, an infection of the respiratory system, is a global pandemic that has ridden the world since November 2019. Countries have been implementing various mitigatory and response strategies to flatten the epidemic curve. Government has been up scaling Covid19 testing to improve case identification. This enables isolation of positive Covid19 cases and contact tracing, so as to contain the spread of contagion. The Viruses of Concern (VOC) have been mutating and exhibiting different characteristics of the waves, within the population. The pandemic has been described in terms of Covid19 waves, and these have exhibited different characteristics over time. This entails devising different response strategies to be used depending on the characteristics exhibited by each Covid19 wave. Case definitions are also very crucial in case identification and need to be reviewed regularly, based on current epidemiologic studies. This study was undertaken in Kadoma City which is situated in Mashonaland West, Zimbabwe. Descriptive statistics undertaken in Kadoma City on 2 July 2021 revealed an increase in Covid19 positive cases complaining of backache, sore eyes, itchy eyes, tingling sensation and night sweats, which were not on the case definition, which led to a lot of cases being missed, as they continue to spread infection. The study sought to compare characteristics of the Covid19 waves two and three, and determine the differences, so as to enable informed interventions and decision making. A retrospective analytical cross-sectional study was explored in Kadoma City using secondary data. 745 records from the Covid19 line list of the Covid19 waves two and wave three were employed for analysis of signs and symptoms, comorbidities, disease burden and treatment outcomes, by person, place and time. Univariate, bivariate and multivariate analysis were undertaken on the data. Mean age for contracting Covid19 was 35(Q1=28; Q3=50). Wave three had the highest: attack rate (86%) as compared to wave two (48%); p-value=0.0001, incident rate for wave three (0.863) compared to wave two (0.067); p-value= 0.0001, and wave three Mortality rate (71%) compared to wave two (11.2%); p-value=0.001, which were all significant differences between the two waves. Mean Survival Time for wave three was 4.7days. Factors associated with mortality were being aged 81 and above (ß=4.674; p=0.049), being vaccinated (ß=-83.768; p=0.014) and having pre-existing asthma (ß=162.712; p=0.005). From the findings of the study, it can be concluded that there were significant differences between the two waves. Wave three was more severe than wave two, and vaccines were protective against severe disease. Asthma had the worst outcome amongst other comorbidities in severe disease. The researcher recommends up-scaling of testing and vaccination so as to prevent poor disease outcomes, as well as equitable resource allocation amongst Kadoma suburbs and townships.