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Housing, sanitation and living conditions affecting SARS-CoV-2 prevention interventions in 54 African countries

Brewer, Timothy F., Zhang, Mary, Gordon, David, Chung, Roger Yat-Nork, Dejene, Negussie, Fonta, Cynthia L., Grieve, Tigist, Halleröd, Björn, Harris, Richard, Lanau, Alba, Leibbrandt, Murray, Mekonen, Yehualashet, Muguni, Bongai, Najera, Hector, Nandy, Shailen ORCID: and Heymann, S. Jody 2021. Housing, sanitation and living conditions affecting SARS-CoV-2 prevention interventions in 54 African countries. Epidemiology and Infection 149 , e183. 10.1017/S0950268821001734

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The feasibility of non-pharmacological public health interventions (NPIs) such as physical distancing or isolation at home to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in low-resource countries is unknown. Household survey data from 54 African countries were used to investigate the feasibility of SARS-CoV-2 NPIs in low-resource settings. Across the 54 countries, approximately 718 million people lived in households with ⩾6 individuals at home (median percentage of at-risk households 56% (95% confidence interval (CI), 51% to 60%)). Approximately 283 million people lived in households where ⩾3 people slept in a single room (median percentage of at-risk households 15% (95% CI, 13% to 19%)). An estimated 890 million Africans lack on-site water (71% (95% CI, 62% to 80%)), while 700 million people lacked in-home soap/washing facilities (56% (95% CI, 42% to 73%)). The median percentage of people without a refrigerator in the home was 79% (95% CI, 67% to 88%), while 45% (95% CI, 39% to 52%) shared toilet facilities with other households. Individuals in low-resource settings have substantial obstacles to implementing NPIs for mitigating SARS-CoV-2 transmission. These populations urgently need to be prioritised for coronavirus disease 2019 vaccination to prevent disease and to contain the global pandemic.

Item Type: Article
Date Type: Published Online
Status: Published
Schools: Social Sciences (Includes Criminology and Education)
Additional Information: This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Publisher: Cambridge University Press
ISSN: 0950-2688
Date of First Compliant Deposit: 9 August 2021
Date of Acceptance: 19 July 2021
Last Modified: 16 May 2023 17:03

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