Between 13 March and 21 June, 2020, a total of 216,328 individuals were tested for COVID-19 using oropharyngeal and nasopharyngeal swab. Among these examined individuals, 4,534 were tested positive for COVID-19 with a positivity rate of 2.1%.
Socio-demographic characteristics of cases: The median age of the cases was 28 years with a range of 3 months to 115 years and Inter Quartile Range (IQR) of 22 - 37 years. Majority of the cases, 1,978(43.6%) were found in the age-group 20-29 years followed by 30-39 years, 1,018(22.5%) and 63% of all the cases were male (Figure 1 below).
Health Care Workers contributed for 244 (5.4%) of the total COVID-19 cases, which comprise 151 technical staff, and 93 supportive staff (see Table 1 for the specific professions).
Of the total cases, 4180 (92.2%) were asymptomatic on detection. On admission, the most common clinical manifestations for the symptomatic cases were cough 255 (72%) and fever 169 (47.7%). Other symptoms detected includes shortness of breath, sore throat, headache and generalized body weakness (Table 2).
Table 1: Distribution of COVID-19 infected Health Care Workers by professions, Ethiopia, March 13-June 21, 2020 (N=244)
Professions
|
Number
|
Percent
|
Health professionals (collectively)
|
151
|
61.9%
|
Nurses
|
69
|
45.7%
|
Physician
|
35
|
23.2%
|
Health officer
|
12
|
7.9%
|
Midwifery
|
9
|
6.0%
|
Laboratory technicians
|
11
|
7.3%
|
Anesthetists
|
7
|
4.6%
|
Pharmacists
|
6
|
4.0%
|
Radiographer
|
2
|
1.3%
|
Support staffs[1]
|
93
|
38.1%
|
Total
|
244
|
|
Table 2: Distribution of COVID-19 confirmed cases by common symptoms, Ethiopia, 13 March -21 June, 2020
Symptoms
|
Number of cases (%)
|
Percent
|
Cough
|
255
|
72%
|
Fever
|
169
|
47.7%
|
Headache
|
109
|
30.8%
|
Generalized Body Weakness
|
80
|
22.6%
|
Sore throat
|
75
|
21.2%
|
Shortness of breath
|
60
|
16.9%
|
Geographical distribution of case: All (nine) regional states[2] and two city administration have reported confirmed cases. Majority, 171(69.8%) of the cases were reported from Addis Ababa city administration followed by Somali, 387 (8.6%) and Amhara, 278 (6.1%) regional states (see Table 3).
Looking at the distribution of cases outside of Addis Ababa City Administration, cases were more concentrated along border areas where there are international ground-crossing entry points (Aisha, Humera, Metema) that connects Ethiopia with Djibouti and Sudan (Map 1).
Table 3: Distribution of COVID-19 confirmed cases by region states and city administration, Ethiopia, 13 March – 21 June, 2020 (N=4534)
Regions
|
Total cases (%)
|
Total deaths (%)
|
Addis Ababa
|
3,222 (71.1%)
|
63 (85.1%)
|
Somali
|
388 (8.6%)
|
0
|
Amhara
|
278 (6.1%)
|
2 (2.7%)
|
Oromia
|
254 (5.6%)
|
6 (8.1%)
|
Tigray
|
182 (4.0%)
|
1 (1.35%)
|
Afar
|
65 (1.4%)
|
0
|
SNNPR
|
51 (1.1%)
|
0
|
Dire Dawa
|
46 (1.0%)
|
1 (1.35%)
|
Harari
|
32 (0.7%)
|
1 (1.35%)
|
Gambella
|
10 (0.2%)
|
0
|
Benishangul Gumuz
|
6 (0.1%)
|
0
|
Total
|
4534
|
74
|
Possible sources of infection: Of the total cases, 982 (21.7%) had travel history to COVID-19 affected areas, 413 (9.1%) had contact with confirmed COVID-19 cases, and source of infection for 3,139 (69.2%) cases could not be identified. Among the cases, 1,254 (27.7%) were reported from quarantine centers (Figure 2).
Death: Ethiopia reported its first COVID-19 related death on April 05, 2020, which is after 24 days of detection of the first COVID-19 confirmed case in the country. From 13 March to 21 June 2020, a total of 74 deaths were recorded with a CFR of 1.6%. Of the total deaths 63 (85.1%) were reported by Addis Ababa City Administration followed by Oromia Regional State 6 (8.1%). Of the total deaths, 24(32.4%) were people aged 60 years and above, 38(58.5%) were male, and nine (12.2%) had comorbid medical conditions. About 87.8% of the deceased people were cases from an Intensive Care Unit in the treatment centers admitted for about three days on average, while nine deaths were detected after post mortem examination.
Recovery: Of the total COVID-19 confirmed cases in Ethiopia, 1,213 (26.8%) have recovered as of 21 June, 2020. The average duration between diagnosis and recovery was 17.4 days (4 to 49 days). Average duration between diagnosis and recovery for age-group 60 and above is 19.5 days, age-group less than 5 years 19 days, symptomatic cases 20 days, asymptomatic cases 16.4 days, and no difference by sex, which was 17 days.
Comorbidity: the study revealed that of the total cases reported, 179 (3.9%) had comorbidity and other medical condition that include Hypertension (30.7%), Diabetic Mellitus (28.5%), Other type of cardiovascular diseases (12.3%), Chronic respiratory diseases such as Bronchial Asthma (10.1%), Retroviral Infection (6.7%) and Cancer of any type (5%).
Contacts: A total of 31,753 contacts of confirmed cases have been identified. Of the contacts identified, 18,352 (57.8%), 13,401 (42.2%), 18,378 (57.88%), 8,147 (25.7%) were close contacts, casual contacts, male, and Health Care Workers respectively. On average, seven contacts were identified per confirmed case. Among contacts of confirmed cases, 708 (2.23%) tested positive of which 550 (77.7%) among close contacts and 484 (68.4%) were asymptomatic.
Cases and deaths description by time: Of the total cases and deaths recorded in 100 days (from 13 March to 21 June, 2020), 85% and 86% were reported in the fourth quarter respectively. Dividing a hundred days in to quarters (which is 25 days), 44 cases detected during the first 25 days, 133 cases at day 50 (showing a 67% increment in cases), 700 cases at days 75 (showing a 94% and 81% increase in cases compared with day 25th and 50th respectively) and 4,534 at day 100, which shows a 99%, 97% and 84% increase in cases compared with the days 25th, 50th and 75th respectively.