BroadReach Syndemic Advisory:

COVID-19 Highest Risk Populations Remains with HIV, Hypertension, Diabetes and TB

Broadreach Observational Research Aims to Inform Departments of Health to Proactively Activate Targeted Testing and Treatment Triaging

Globally, health systems have demonstrated limited testing and treatment capacity to manage critically ill patients in the current COVID-19 pandemic. Older people and people with uncontrolled pre-existing conditions are at high risk of adverse outcomes. The BroadReach Syndemic Advisory is based on observational data analysis for early identification of high-risk populations for targeted testing and rapid treatment response, aimed to curb the burden on the health system.

Key findings:

  • We observed that the most prevalent comorbidities within presumptive COVID-19 cases were, in order of prevalence:
    • HIV
    • Hypertension
    • Diabetes
    • TB
    • Asthma
    • Obesity
    • Cardiac disease
    • Chronic Obstructive Pulmonary Disorder (COPD)
  • When comparing presumptive versus non-presumptive cases in each comorbidity as a percentage; TB and obesity had the highest prevalence within presumptive cases.
  • More females were screened than males. However, the presumptive gender and age pyramid distribution shows that the highest number of presumptive cases were amongst both males and females at the 45-49 range, followed by 70-74 age range for males.
  • A high prevalence of TB, diabetes, asthma and HIV in people with suspected COVID-19 infection underscores the importance of continuously monitoring this population to ensure treatment adherence.

“This information is aimed to better inform Departments of Health to proactively activate targeted testing and treatment triaging within their province, said Lynsey Stewart Isherwood, Director of Client Engagement at BroadReach.”It also highlights the ‘perfect storm’ faced within healthcare. As we strive to cope with the COVID-19 pandemic, we must not neglect other priority diseases and hence aim to provide equal attention to these within our health system.”

Methodology:

A cohort of data from Mpumalanga Province was analysed to observe the frequency of comorbidities and age distribution during the national screening and testing campaign in South Africa. The Vantage app was launched on 9 April 2020. The observational data analysis was conducted from data extracted between 9 April 2020 to 26 June 2020.

Community Healthcare Workers in the Mpumalanga Province of South Africa conducted community screenings to identify people with presumptive COVID-19 infection in the province. The screening tool used was designed to identify comorbidities that included HIV, TB, Chronic Obstructive Pulmonary Disorder (COPD), obesity, cardiac disease, asthma, diabetes and hypertension. An analysis was then conducted to observe the co-morbidity frequency within the cohort of 1.6m screenings. Age and gender distribution were also analysed.

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