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Peer reviewedOpen accessCOVID-19SARS

Assessing the burden of COVID-19 in developing countries: systematic review, meta-analysis and public policy implications

BMJ Global Health·

Andrew T Levin, Nana Owusu-Boaitey, Sierra Pugh, Bailey K Fosdick, Anthony B Zwi, Anup Malani, Satej Soman, Lonni Besançon, Ilya Kashnitsky, Sachin Ganesh, Aloysius McLaughlin, Gayeong Song, Rine Uhm, Daniel Herrera-Esposito, Gustavo de los Campos, Ana Carolina Peçanha Antonio, Enyew Birru Tadese, Gideon Meyerowitz-Katz

DOI
10.1136/bmjgh-2022-008477
PMID
35618305
PMCID
PMC9136695
OpenAlex
W4281556556
Study type
Systematic review
Publisher
BMJ
Article type
journal-article
Integrity
current

Why this research matters now

The findings indicate that COVID-19 burden in developing countries substantially exceeds that of high-income countries due to elevated transmission to vulnerable age groups and constrained healthcare access. The results emphasize the urgent need for medical equity through vaccine and effective medication provision to populations in developing countries.

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Structured evidence summary

Research question

The study aimed to estimate age-specific seroprevalence and infection fatality rates for COVID-19 in developing countries, where systematic analysis had not previously been conducted.

Study design

This was a systematic review and meta-analysis of COVID-19 serology studies from developing countries using representative samples collected through February 2021. A Bayesian model was applied to account for sampling uncertainty and assay characteristics including sensitivity, specificity, and seroreversion.

Population and setting

The analysis examined populations in developing countries across multiple locations. Individual case reports and aggregated public health data were used to calculate infection fatality rates, with age-specific estimates generated where feasible.

Main findings

Seroprevalence among older adults in developing countries was similar to younger cohorts, indicating limited protection of older populations. Age-specific infection fatality rates were approximately twice as high as in high-income countries. The median population-level infection fatality rate was around 0.5%, similar to high-income countries, as differences in healthcare access were counterbalanced by younger population age structures.

Public-health relevance

The findings indicate that COVID-19 burden in developing countries substantially exceeds that of high-income countries due to elevated transmission to vulnerable age groups and constrained healthcare access. The results emphasize the urgent need for medical equity through vaccine and effective medication provision to populations in developing countries.

Important limitations

This summary relies on the supplied single-article abstract and metadata. The original peer-reviewed paper is required for decision-grade interpretation of methodological constraints, heterogeneity across included studies, and applicability of findings.

GIDS interpretation

This systematic review is discoverable through classifier links for COVID-19, SARS, health policy, outbreak investigation, transmission dynamics, vaccination, and diagnostics. These links facilitate retrieval when literature related to pandemic response in resource-limited settings is needed for context.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 14 auditable classifier relationships to diseases, places, topics, and study design.

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