PERSPECTIVE
Call for proper documentation of COVID-19 deaths in poor resource setting:
a necessity for management of future occurrences
Ahoma V. Mbanuzuru
a
, Chukwuemeka C. Okoro
b
, Chinyere M. Mbanuzuru
c
and Christian C. Ibeh
a
a
Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria;
b
Department of Obstetrics and
Gynaecology, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria;
c
Department of Animal Production, Ministry of Agriculture,
Awka, Nigeria
ABSTRACT
Introduction: A Pandemic is an epidemic at a global scale. The word ‘epidemic’ has the potential to
lead to chaotic, unreasoned responses to health problems, especially when used by journalists. Nigeria
like other poor resource countries is equally affected by the current coronavirus disease 2019 (COVID-
19) pandemic. Standardization and proper documentation of the mortality of the COVID-19 in the poor-
resource countries will help in managing other disease outbreaks in future. This paper calls for
improvement in capturing of these data for better planning in the future.
Areas covered: Quality data is very essential for policy makers to appreciate any disease condition. In
order to present a comprehensive picture of COVID-19 mortality, the deaths were broadly grouped into
two as follows: direct and indirect COVID-19 deaths. Most of the current reported deaths seem to be
direct deaths.
Expert opinion: We propose that for better estimation and standardization, verbal autopsy could be
used to differentiate direct/indirect COVID deaths. At full development, this model could be applied to
other diseases, outbreaks, or pandemics. The disease surveillance officers, and other health workers can
be trained in this regard as well as scaling up the e-surveillance of the DSNOs.
ARTICLE HISTORY
Received 18 April 2020
Accepted 23 July 2020
KEYWORDS
COVID-19; deaths; poor-
resource setting; Nigeria;
disease surveillance
notification officers (DSNOs)
1. Introduction
Pandemic is epidemic at a global scale. Epidemic is the occur-
rence in excess of normal of an illness, health event, or health-
related behavior that occurs in a specific place or among
a group [1]. The word ‘epidemic’ has the potential to lead to
chaotic, unreasoned responses to health problems, especially
when used by the journalists. Most practicing public health
professionals would use words like ‘outbreak’, ‘cluster’ to avoid
unreasoned responses [1]. Nigeria like other poor-resource
countries is equally affected by the current coronavirus dis-
ease 2019 (COVID-19) pandemic. Standardization and proper
documentation of the mortality (and morbidity) of the COVID-
19 in the poor-resource countries will help in managing other
disease outbreaks in future. This paper calls for improvement
in capturing these data better planning in the future.
Coronaviruses are not unknown in human history. They are
enveloped positive-strand RNA viruses with helical capsid
structures enclosed in the viral envelope formed by the com-
plex of the nucleocapsid protein and the genome RNA. The
envelope has peplomers embedded on it formed by the tri-
mers of the spike proteins. The corona got its name from its
crown-like morphology. They cause diseases which are part of
emerging and reemerging diseases of public health impor-
tance. They constitute a large family of viruses that can
cause diseases in humans ranging from common cold to
severe acute respiratory syndrome (SARS) seen first in China
in 2002, Middle East Respiratory Syndrome (MERS) first seen in
Saudi Arabia in 2012, to now COVID-19, first seen in Wuhan
China in late 2019 [2–4].
COVID-19 is caused by a novel coronavirus called SARS-
CoV2. The disease most commonly presents with fever, cough,
and fatigue [5–8]. It can also present with other respiratory
tract symptoms like rhinorrhea, sneezing, sore throat, dyspnea,
and hemoptysis [5–8]. Severe forms of the diseases can lead to
pulmonary failure and death arising from acute lung injury
(ALI) and acute respiratory distress syndrome (ARDS) [7,8].
Other possible complications seen in COVID -19 include septic
shock and multi-organ failure, including acute kidney injury
and cardiac injury [9].
Most patients with COVID-19 will present with mild illness
(80%), 15% will be severely ill and require supplemental oxy-
gen while only about 5% will require intensive care unit (ICU)
care [10]. Old age and co-morbid diseases such as chronic
obstructive pulmonary disease (COPD), hypertension, and dia-
betes mellitus increase the risk of death [5,11].
The World Health Organization (WHO) corroborates that
most people who become infected with COVID-19 experi-
ence mild illness and recover, but the disease may be more
severe for others [12]. According to the Nigeria’s National
Center for Disease Control (NCDC) National interim guide-
line for clinical management of COVID -19, there are var-
ious modes of transmission of the virus including person-to-
CONTACT Ahoma V. Mbanuzuru mvahoma@gmail.com Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital (NAUTH),
Nnewi, Anambra State, Nigeria
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
2021, VOL. 19, NO. 1, 17–21
https://doi.org/10.1080/14787210.2020.1801418
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