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Article ; Online: Evaluating Healthcare Performance in Low- and Middle-Income Countries: A Pilot Study on Selected Settings in Ethiopia, Tanzania, and Uganda.

Belardi, Paolo / Corazza, Ilaria / Bonciani, Manila / Manenti, Fabio / Vainieri, Milena

International journal of environmental research and public health

2022 Volume 20, Issue 1

Abstract: The literature reports some experiences regarding the design of integrated healthcare Performance Evaluation Systems (PES) applied in Low- and Middle-income Countries (LMIC). This study describes the design of an integrated and bottom-up PES aimed at ... ...

Abstract	The literature reports some experiences regarding the design of integrated healthcare Performance Evaluation Systems (PES) applied in Low- and Middle-income Countries (LMIC). This study describes the design of an integrated and bottom-up PES aimed at evaluating healthcare services delivery in rural settings. The analysis involved four hospitals and their relative health districts in Ethiopia, Tanzania, and Uganda. The evaluation process was undertaken for those indicators that could be evaluated using the same reference standard. The evaluation scores were determined through the international standards identified in the literature or through benchmarking assessment. Both administrative and health data were extracted from the hospitals' registers and District Health Information Systems (DHIS) from 2017 to 2020. We defined 128 indicators: 88 were calculated at the hospital level and 40 at the health district level. The evaluation process was undertaken for 48 indicators. The evaluated indicators are represented using effective graphical tools. In settings characterised by multiple healthcare providers, this framework may contribute to achieving good governance through performance evaluation, benchmarking, and accountability. It may promote evidence-based decision-making in the planning and allocation of resources, thus ultimately fostering quality improvement processes and practices, both at the hospital and health district level.
MeSH term(s)	Developing Countries ; Pilot Projects ; Uganda ; Tanzania ; Ethiopia ; Delivery of Health Care
Language	English
Publishing date	2022-12-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20010041
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Book ; Article ; Online: Selling Cross-Border in Online Markets

Bourreau, Marc / Manenti, Fabio M.

The Impact of the Ban on Geoblocking Strategies

2020

Abstract: We develop a model of strategic geoblocking, where two competing multi-channel retailers, located in different countries, can decide to block access to their online store from foreign consumers. We characterize the equilibrium when firms decide ... ...

Abstract	We develop a model of strategic geoblocking, where two competing multi-channel retailers, located in different countries, can decide to block access to their online store from foreign consumers. We characterize the equilibrium when firms decide unilaterally whether to introduce geoblocking restrictions. We show that geoblocking results in a “puppy dog” strategy (Fudenberg and Tirole, 1984) for firms, which allows them to soften competition, but that it comes at the cost of lower demand. In the short term, a ban on geoblocking leads to lower prices, both offline and online. However, in the longer term, when firms can invest in increasing the demand from online shoppers, the ban may have adverse effects on investment and social welfare. We extend our analysis to account for price discrimination and investigate the role of shipping costs.
Keywords	ddc:330 ; L13 ; L41 ; L81 ; cross-border sales ; geoblocking ; e-commerce ; investment
Subject code	338
Language	English
Publisher	Munich: Center for Economic Studies and Ifo Institute (CESifo)
Publishing country	de
Document type	Book ; Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Causes of maternal deaths in Sierra Leone from 2016 to 2019: analysis of districts' maternal death surveillance and response data.

Shafiq, Yasir / Caviglia, Marta / Juheh Bah, Zainab / Tognon, Francesca / Orsi, Michele / K Kamara, Abibatu / Claudia, Caracciolo / Moses, Francis / Manenti, Fabio / Barone-Adesi, Francesco / Sessay, Tom

BMJ open

2024 Volume 14, Issue 1, Page(s) e076256

Abstract: Introduction: Sierra Leone is among the top countries with the highest maternal mortality rates. Although progress has been made in reducing maternal mortality, challenges remain, including limited access to skilled care and regional disparities in ... ...

Abstract	Introduction: Sierra Leone is among the top countries with the highest maternal mortality rates. Although progress has been made in reducing maternal mortality, challenges remain, including limited access to skilled care and regional disparities in accessing quality care. This paper presents the first comprehensive analysis of the burden of different causes of maternal deaths reported in the Maternal Death Surveillance and Response (MDSR) system at the district level from 2016 to 2019. Methods: The MDSR data are accessed from the Ministry of Health and Sanitation, and the secondary data analysis was done to determine the causes of maternal death in Sierra Leone. The proportions of each leading cause of maternal deaths were estimated by districts. A subgroup analysis of the selected causes of death was also performed. Results: Overall, obstetric haemorrhage was the leading cause of maternal death (39.4%), followed by hypertensive disorders (15.8%) and pregnancy-related infections (10.1%). Within obstetric haemorrhage, postpartum haemorrhage was the leading cause in each district. The burden of death due to obstetric haemorrhage slightly increased over the study period, while hypertensive disorders showed a slightly decreasing trend. Disparities were found among districts for all causes of maternal death, but no clear geographical pattern emerged. Non-obstetric complications were reported in 11.5% of cases. Conclusion: The MDSR database provides an opportunity for shared learning and can be used to improve the quality of maternal health services. To improve the accuracy and availability of data, under-reporting must be addressed, and frontline community staff must be trained to accurately capture and report death events.
MeSH term(s)	Pregnancy ; Female ; Humans ; Maternal Death/etiology ; Maternal Mortality ; Sierra Leone/epidemiology ; Hypertension, Pregnancy-Induced ; Postpartum Hemorrhage
Language	English
Publishing date	2024-01-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-076256
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Article ; Online: Epidemiological factors affecting outpatient department service utilization and hospitalization in patients with diabetes: A time-series analysis from an Ethiopian hospital between 2018 and 2021.

Benoni, Roberto / Sartorello, Anna / Uliana, Monica / Solomon, Hiwot / Bertolino, Alessia / Pedot, Andrea / Tsegaye, Ademe / Gulo, Berhanu / Manenti, Fabio / Andreani, Giacomo

Journal of global health

2022 Volume 12, Page(s) 4087

Abstract: Background: The burden of diabetes-related deaths reached two million in 2019 globally. Accessibility to health care services and adherence to follow-up and therapy are key to improving outcomes for diabetic patients. We aimed to assess outpatient ... ...

Abstract	Background: The burden of diabetes-related deaths reached two million in 2019 globally. Accessibility to health care services and adherence to follow-up and therapy are key to improving outcomes for diabetic patients. We aimed to assess outpatient department (OPD) service utilization and diabetes-related hospitalizations over a period of 44 months. Methods: A retrospective cohort study was conducted on OPD visits and hospitalizations recorded between January 1, 2018, and August 31, 2021, at the St Luke Catholic Hospital (Ethiopia). All diabetic patients were included in the analysis. A linear regression model was used for univariate analysis of OPD visits and hospitalizations and their association with potential predictors. The autoregressive integrated moving average (ARIMA) method was applied to both the time series of OPD visits and hospitalizations. Potential predictors were sociodemographic factors, COVID-19 cases, mean monthly temperature and precipitations. Results: In the time series analysis, OPD visits increased over time (P < 0.01) while hospitalizations were stable. The time series model was ARIMA (0,1,1) for OPD visits and ARIMA (0,0,0) for hospitalizations. There were 1685 diabetes OPD patients (F = 732, 43%). Females had an average of 16% fewer OPD accesses per month (P < 0.01) and a lower number of hospitalizations per month (P = 0.03). There were 801 patients missing follow-up (48%). The time between follow-up increased with age (P < 0.01). OPD visits decreased differently by geographic area as COVID-19 cases increased (P < 0.01). There were 57 fewer forecast OPD visits per month on average using COVID-19 cases as ARIMA regressor. The odds ratio (OR) of new diagnosis at hospitalization was lower in patients with type 2 diabetes (OR = 0.26, 95% CI = 0.14-0.49, P = 0.02). Conclusions: Despite an increase in OPD visits for diabetic patients over the study period, the number of losses at follow-up and diagnoses at hospitalization remains high. Female sex, older age, and COVID-19 were associated with impaired OPD service accessibility. Primary health care should be implemented to achieve better health coverage and improve diabetes management.
MeSH term(s)	Humans ; Female ; Diabetes Mellitus, Type 2 ; Ethiopia/epidemiology ; Retrospective Studies ; COVID-19/epidemiology ; COVID-19/therapy ; Outpatients ; Emergency Service, Hospital ; Hospitalization ; Ambulatory Care ; Hospitals
Language	English
Publishing date	2022-10-23
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	2741629-X
ISSN	2047-2986 ; 2047-2986
ISSN (online)	2047-2986
ISSN	2047-2986
DOI	10.7189/jogh.12.04087
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Article ; Online: "This Is Not Our Disease": A Qualitative Study of Influencers of COVID-19 Preventive Behaviours in Nguenyyiel Refugee Camp (Gambella, Ethiopia).

Tsegaye, Ademe / Wilunda, Calistus / Manenti, Fabio / Bottechia, Matteo / D'Alessandro, Michele / Putoto, Giovanni / Atzori, Andrea / Frehun, Daniel / Cardona-Fox, Gabriel

Frontiers in public health

2022 Volume 9, Page(s) 723474

Abstract: The COVID-19 pandemic has infected more than 263 million people and claimed the lives of over 5 million people worldwide. Refugees living in camp settings are particularly vulnerable to infection because of the difficulty implementing preventive measures ...

Abstract	The COVID-19 pandemic has infected more than 263 million people and claimed the lives of over 5 million people worldwide. Refugees living in camp settings are particularly vulnerable to infection because of the difficulty implementing preventive measures and lack of medical resources. However, very little is known about the factors that influence the behavioural response of refugees towards COVID-19. There is an urgent need for field evidence to inform the design and implementation of a robust social and behaviour change communication strategy to respond to the threat posed by COVID-19 in humanitarian settings. This study examines factors influencing COVID-19-related behavioural decisions in the Nguenyyiel refugee camp located in Gambella, Ethiopia using data collected from focus group discussions and key informant interviews in September 2020. The evidence suggests that while a number of factors have been facilitating the adoption of COVID-19 prevention measures, including good general knowledge about the virus and the necessary preventive strategies and the active engagement by community leaders and non-governmental organisations, important structural and cultural factors have hindered the uptake of COVID-19 prevention measures. These include: difficultly staying at home to minimise physical contact; overcrowding in the camp and within home dwellings; a lack of hand sanitizers and masks and of funds to purchase these; inconsistent use of facemasks when available; COVID-19 denial and misconceptions about the disease, and other cultural beliefs and habits. Overall, the study found that refugees perceived COVID-19 to pose a low threat (susceptibility and severity) and had mixed beliefs about the efficacy of preventive behaviours. This study identified gaps in the existing information education and communication strategy, including a lack of consistency, inadequate messaging, and a limited use of communication channels. While awareness of COVID-19 is a necessary first step, it is not sufficient to increase adoption of prevention measures in this setting. The current communication strategy should move beyond awareness raising and emphasise the threat posed by COVID-19 especially among the most vulnerable members of the camp population. This should be accompanied by increased community support and attention to other barriers and incentives to preventive behaviours.
MeSH term(s)	COVID-19 ; Community Support ; Ethiopia/epidemiology ; Humans ; Pandemics ; Refugee Camps ; SARS-CoV-2
Language	English
Publishing date	2022-01-04
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2021.723474
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Article ; Online: Training on the Silverman and Andersen score improved how special care unit nurses assessed neonatal respiratory distress in a low-resource setting.

Cavallin, Francesco / Balestri, Eleonora / Calia, Margherita / Biasci, Filippo / Tolera, Jiksa / Pietravalle, Andrea / Manenti, Fabio / Trevisanuto, Daniele

Acta paediatrica (Oslo, Norway : 1992)

2022 Volume 111, Issue 10, Page(s) 1866–1869

Abstract: Aim: Identifying the severity of neonatal respiratory distress (RD) is essential, so that resources can be appropriately allocated. We assessed the ability of nurses to grade neonatal RD in a low-resource setting before and after they were trained to ... ...

Abstract	Aim: Identifying the severity of neonatal respiratory distress (RD) is essential, so that resources can be appropriately allocated. We assessed the ability of nurses to grade neonatal RD in a low-resource setting before and after they were trained to use a dedicated scoring tool. Methods: The study was conducted in the Special Care Unit of St Luke Wolisso Hospital, Ethiopia. Ten nurses reviewed nine local video recordings and graded neonatal RD without a standardised method, which was current practice, and then after they were trained to use the Silverman and Andersen score. The data were analysed using the McNemar test and Cohen's kappa. Results: Training increased the identification of mild RD from 63% to 93% (p = 0.008) and moderate RD from 40% to 73% (p = 0.03). Severe RD was 93% before and 90% after training (p = 0.99). Overall, the agreement improved from kappa 0.59 to 0.84, mainly by reducing the overestimation of milder degrees of RD. Conclusion: Being trained on how to use the Silverman and Andersen score improved the ability of nurses to identify mild and moderate neonatal RD. This improvement has the potential to optimise the use of equipment, staff and time.
MeSH term(s)	Ethiopia ; Hospitals ; Humans ; Infant, Newborn ; Respiratory Distress Syndrome, Newborn/diagnosis ; Respiratory Distress Syndrome, Newborn/therapy ; Respiratory Insufficiency
Language	English
Publishing date	2022-06-23
Publishing country	Norway
Document type	Journal Article
ZDB-ID	203487-6
ISSN	1651-2227 ; 0365-1436 ; 0803-5253
ISSN (online)	1651-2227
ISSN	0365-1436 ; 0803-5253
DOI	10.1111/apa.16450
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Book ; Online: Measuring Physical access to primary health care facilities in Gambella Region (Western Ethiopia)

Fantozzi, Pier Lorenzo / Baracca, Giuseppe / Manenti, Fabio / Putoto, Giovanni

eISSN: 2570-2092

2021

Abstract: As part of the project “More equity and quality of health services in Gambella, Gambella Region”, financed by the Italian Agency for Development Cooperation (AICS) and implemented by the Italian NGO Doctors with Africa CUAMM (Padua, Italy) a geographic ... ...

Abstract	As part of the project “More equity and quality of health services in Gambella, Gambella Region”, financed by the Italian Agency for Development Cooperation (AICS) and implemented by the Italian NGO Doctors with Africa CUAMM (Padua, Italy) a geographic database of the distribution of health facilities of Gambella Region (western Ethiopia) was created. This data collection was carried out in two missions carried out in February 2018 and November-December 2019. It allowed a mapping of the access roads and the location of health facilities using Geomatic Approaches and related technologies (Remote Survey, Field Survey, GPS, GIS). The field work has allowed the investigation in 11 Waredas (i.e. districts) with the census of 3 primary hospitals, 26 health centres and 121 HPs and related road access by car or, in case of inaccessibility of vehicles, by foot or boat.The final result of this work is the availability of a detailed cartographic picture of the geographical distribution of Health Facilities (HFs) in order to support the modern decision-making tools to be adopted for the distribution of human and instrumental resources. As an example we describe a network analysis performed by ESRI™ Network Analyst which showed the importance of this approach to remodel a more efficient referral system.
Subject code	910
Language	English
Publishing date	2021-12-02
Publishing country	de
Document type	Book ; Online
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Article ; Online: Risk factors for mortality among neonates admitted to a special care unit in a low-resource setting.

Cavallin, Francesco / Bonasia, Teresa / Yimer, Desalegn Abebe / Manenti, Fabio / Putoto, Giovanni / Trevisanuto, Daniele

BMC pregnancy and childbirth

2020 Volume 20, Issue 1, Page(s) 722

Abstract: Background: Although under-5 mortality has decreased in the last two decades, neonatal mortality remains a global health challenge. Despite achieving notable progress, Ethiopia has still one of the highest neonatal mortality rates worldwide. We aimed to ...

Abstract	Background: Although under-5 mortality has decreased in the last two decades, neonatal mortality remains a global health challenge. Despite achieving notable progress, Ethiopia has still one of the highest neonatal mortality rates worldwide. We aimed to assess the risk factors for mortality among neonates admitted to a special care unit in a referral hospital in rural Ethiopia. Methods: This was a retrospective observational study including all 4182 neonates admitted to the special care unit of the St. Luke Wolisso Hospital (Ethiopia) from January 2014 to December 2017. Data were retrieved from hospital charts and entered in an anonymized dataset. A logistic regression model was applied to identify predictors of mortality and effect sizes were expressed as odds ratios with 95% confidence intervals. Results: Proportion of deaths was 17% (709/4182 neonates). Neonates referred from other health facilities or home (odds ratio 1.52, 95% confidence interval 1.21 to 1.91), moderate hypothermia at admission (odds ratio 1.53, 95% confidence interval 1.09 to 2.15) and diagnosis of late-onset sepsis (odds ratio 1.63, 95% confidence interval 1.12 to 2.36), low birthweight (odds ratio 2.48, 95% confidence interval 2.00 to 3.09), very low birthweight (odds ratio 11.71, 95% confidence interval 8.63 to 15.94), extremely low birthweight (odds ratio 76.04, 95% confidence interval 28.54 to 263.82), intrapartum-related complications (odds ratio 4.69, 95% confidence interval 3.55 to 6.20), meconium aspiration syndrome (odds ratio 2.34, 95% confidence interval 1.15 to 4.43), respiratory distress (odds ratio 2.25, 95% confidence interval 1.72 to 2.95), other infections (odds ratio 1.92, 95% confidence interval 1.31 to 2.81) or malformations (odds ratio 2.32, 95% confidence interval 1.49 to 3.57) were associated with increased mortality. Being admitted in 2017 vs. 2014 (odds ratio 0.71, 95% confidence interval 0.52 to 0.97), and older age at admission (odds ratio 0.95, 95% confidence interval 0.93 to 0.97) were associated with decreased likelihood of mortality. Conclusions: The majority of neonatal deaths was associated with preventable and treatable conditions. Education on neonatal resuscitation and postnatal management, and the introduction of an on-call doctor for high-risk deliveries might have contributed to the reduction in neonatal mortality over time.
MeSH term(s)	Birth Weight ; Ethiopia/epidemiology ; Female ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Intensive Care Units, Neonatal/statistics & numerical data ; Logistic Models ; Male ; Multivariate Analysis ; Referral and Consultation ; Respiration Disorders/epidemiology ; Retrospective Studies ; Risk Factors ; Rural Population ; Sepsis/epidemiology
Language	English
Publishing date	2020-11-23
Publishing country	England
Document type	Journal Article ; Observational Study
ISSN	1471-2393
ISSN (online)	1471-2393
DOI	10.1186/s12884-020-03429-2
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Article ; Online: Adherence to WHO guidelines on severe pneumonia management in children and its impact on outcome: an observational study at Jinka General Hospital in Ethiopia.

La Vecchia, Adriano / Teklie, Bereket Gebremedhin / Mulu, Dagmawi Awoke / Toitole, Kusse Koirita / Montalbetti, Francesca / Agostoni, Carlo / Hessebo, Tesfayesus Tefera / Tsegaye, Ademe / Pietravalle, Andrea / Manenti, Fabio / Tognon, Francesca / Pisani, Luigi / Hagos, Eleni

Frontiers in public health

2023 Volume 11, Page(s) 1189684

Abstract: Introduction: Poor adherence to guidelines during empirical antibiotic prescription in low-income countries could increase antimicrobial resistance without improving outcomes. Revised World Health Organization (WHO) guidelines published in 2014 on ... ...

Abstract	Introduction: Poor adherence to guidelines during empirical antibiotic prescription in low-income countries could increase antimicrobial resistance without improving outcomes. Revised World Health Organization (WHO) guidelines published in 2014 on childhood (2-59 months) pneumonia re-defined the classification of severe pneumonia and changed the first-line treatment. The adherence to WHO guidelines in southern Ethiopia at the hospital level is unknown. We sought to determine the adherence to WHO guidelines on severe pneumonia first-line treatment in children in an Ethiopian referral hospital and assess the impact of non-adherence on patient outcomes. Methods: An observational study was conducted on all children (2-59 months) clinically diagnosed with severe pneumonia and admitted to the Pediatric Ward of Jinka Hospital from 1 June 2021 to 31 May 2022. Exclusion criteria included a known HIV infection, ongoing antibiotic treatment before the event not related to acute pneumonia, or any other severe bacterial infection, confirmed or suspected. Adherence to guidelines was defined as first-line treatment with ampicillin or benzylpenicillin and gentamicin at the recommended dose. We compared the patients treated adherently vs. non-adherently. For categorical variables, the chi-square or Fisher's exact test was used, while for continuous variables, the Mann-Whitney U-test was used. Multivariate logistic regression was used to evaluate the association between adherence and demographic and clinical characteristics. Results: During the observational period, 266 patients were registered as having severe pneumonia with an age between 2 and 59 months. After excluding 114 patients due to missing charts or other exclusion criteria, a total of 152 patients were included in the analysis. Of these, 78 (51%) were girls with a median age of 10 months (IQR 7-14). Overall, 75 (49%) patients received therapy according to the WHO guidelines. Compared to patients treated adherently to the guidelines, patients not treated adherently had similar outcomes [median length of stay of 3 (IQR 3-5) and 4 (IQR 3-6) days], median duration of oxygen therapy of 2 (IQR 1-3) for both the groups, and self-discharge rates of 5% and 6.5%, respectively). Conclusion: Adherence to the revised WHO guideline was limited and not associated with outcomes. Efforts should focus on reducing the gap between theory and practice.
MeSH term(s)	Female ; Humans ; Child ; Infant ; Child, Preschool ; Male ; Hospitals, General ; Ethiopia ; HIV Infections/drug therapy ; Pneumonia/drug therapy ; Anti-Bacterial Agents/therapeutic use ; World Health Organization
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2023-07-27
Publishing country	Switzerland
Document type	Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2023.1189684
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Article ; Online: Priority age targets for COVID-19 vaccination in Ethiopia under limited vaccine supply.

Galli, Margherita / Zardini, Agnese / Gamshie, Worku Nigussa / Santini, Stefano / Tsegaye, Ademe / Trentini, Filippo / Marziano, Valentina / Guzzetta, Giorgio / Manica, Mattia / d'Andrea, Valeria / Putoto, Giovanni / Manenti, Fabio / Ajelli, Marco / Poletti, Piero / Merler, Stefano

Scientific reports

2023 Volume 13, Issue 1, Page(s) 5586

Abstract: The worldwide inequitable access to vaccination claims for a re-assessment of policies that could minimize the COVID-19 burden in low-income countries. Nine months after the launch of the national vaccination program in March 2021, only 3.4% of the ... ...

Abstract	The worldwide inequitable access to vaccination claims for a re-assessment of policies that could minimize the COVID-19 burden in low-income countries. Nine months after the launch of the national vaccination program in March 2021, only 3.4% of the Ethiopian population received two doses of COVID-19 vaccine. We used a SARS-CoV-2 transmission model to estimate the level of immunity accrued before the launch of vaccination in the Southwest Shewa Zone (SWSZ) and to evaluate the impact of alternative age priority vaccination targets in a context of limited vaccine supply. The model was informed with available epidemiological evidence and detailed contact data collected across different geographical settings (urban, rural, or remote). We found that, during the first year of the pandemic, the mean proportion of critical cases occurred in SWSZ attributable to infectors under 30 years of age would range between 24.9 and 48.0%, depending on the geographical setting. During the Delta wave, the contribution of this age group in causing critical cases was estimated to increase on average to 66.7-70.6%. Our findings suggest that, when considering the vaccine product available at the time (ChAdOx1 nCoV-19; 65% efficacy against infection after 2 doses), prioritizing the elderly for vaccination remained the best strategy to minimize the disease burden caused by Delta, irrespectively of the number of available doses. Vaccination of all individuals aged ≥ 50 years would have averted 40 (95%PI: 18-60), 90 (95%PI: 61-111), and 62 (95%PI: 21-108) critical cases per 100,000 residents in urban, rural, and remote areas, respectively. Vaccination of all individuals aged ≥ 30 years would have averted an average of 86-152 critical cases per 100,000 individuals, depending on the setting considered. Despite infections among children and young adults likely caused 70% of critical cases during the Delta wave in SWSZ, most vulnerable ages should remain a key priority target for vaccination against COVID-19.
MeSH term(s)	Child ; Aged ; Young Adult ; Humans ; Adult ; COVID-19 Vaccines ; Ethiopia ; ChAdOx1 nCoV-19 ; COVID-19 ; SARS-CoV-2 ; Vaccines ; Vaccination
Chemical Substances	COVID-19 Vaccines ; ChAdOx1 nCoV-19 (B5S3K2V0G8) ; Vaccines
Language	English
Publishing date	2023-04-05
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-32501-y
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