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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 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: 17 Aug 2021 11:30

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