Influence of population density and access to sanitation on Covid-19 in Mozambique


Edgar Cambaza


In 2020, as COVID-19 spread through the world, prestigious entities published faulty predictions about the level of dissemination, especially when describing African countries and others with “weak healthcare systems.” How could the best fall so short, even when using well-known epidemiological variables to predict the behavior of a hygiene-related malady? It might have been due to insufficient data since COVID-19 was a novelty, still poorly understood. The current study aimed to analyze how two variables – population density and percentage of people with access to improved sanitation – affected the number of confirmed COVID-19 cases in Mozambique by February 2021, almost one year since the country's first case. All data were publicly available: population density in Census 2017, access to sanitation in the Mozambique Public Expenditure Review 2014, and the number of COVID-19 cases in the Ministry of Health’s COVID-19 daily bulletin (no. 332). JASP allowed correlating all variables, and Microsoft Excel was the choice to perform fitting analysis to model the algebraic relationship between the number of cases and the other variables. The cases showed a positive correlation (r = 0.663) with density, and their relationship was consistent with a cubic function. Sanitation coverage also showed a positive correlation (r = 0.679), but the most straightforward algebraic representation was a quadratic function. The impact of population density on the number of COVID-19 cases was intuitive, but the logic points towards the highest number of cases where sanitation facilities lacked the most. Perhaps the influence of other factors outweighed the effect of sanitation, or people tend to be careless before the sense of security where the sanitation is better. These findings can support predictions and decision-making, and the population needs to abide by the Government’s recommendations.


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Cambaza, E. (2021). Influence of population density and access to sanitation on Covid-19 in Mozambique. Revista Angolana De Ciências Da Saúde / Angolan Journal Of Health Sciences, 2(1), 3-8. Obtido de
Artigo Original / Original Article


- Cambaza EM. The African miracle: why COVID-19 seems to spread slowly in Sub-Saharan Africa. Revista Científica da UEM: Série Ciências Biomédicas e Saúde Pública 2020; Preprint: 1-8.

- Bhadra A, Mukherjee A, Sarkar K. Impact of population density on Covid-19 infected and mortality rate in India. Modeling Earth Systems and Environment 2021; 7(1): 623-9.

- Coşkun H, Yıldırım N, Gündüz S. The spread of COVID-19 virus through population density and wind in Turkey cities. Science of The Total Environment 2021; 751: 141663.

- Sun Z, Zhang H, Yang Y, Wan H, Wang Y. Impacts of geographic factors and population density on the COVID-19 spreading under the lockdown policies of China. Science of The Total Environment 2020; 746: 141347.

- Arnaldo C, Arau A, Hansine R, et al. Características Sociodemográficas e Risco de Transmissão da COVID-19 em Moçambique. Revista Moçambicana de Ciências de Saúde 2020; 6(1).

- Houssin D, Ghebreyesus TA, Yang, Keaton J, Lanche J, Kupferschmidt K. WHO Emergencies Coronavirus Emergency Committee Second Meeting, 30 January 2020. In: Lindmeier C, editor. Coronavirus Disease (COVID-2019) Press Briefings. Geneva, Switzerland: World Health Organization; 2020.

- Gates M. Melinda Gates: Covid-19 will be horrible in the developing world. In: Harlow P, editor. CNN Business. Atlanta, GA, United States: Cable News Network (CNN), Turner Broadcasting System, Inc.; 2020.

- Hessel L. The initiative against diarrheal and enteric diseases in Africa and Asia: The role of field actors to successfully address the fight against cholera. International Journal of Infectious Diseases 2014; 21: 112.

- Cambaza E, Viegas G, Cambaza C, Mongo E. Relevância das Condições Meteorológicas para a Ocorrência da COVID-19. Revista Moçambicana de Ciências de Saúde 2020; 6(1): 15-20.

- Chongo AE, Sineque AR, Augusto O, et al. COVID-19 Reproduction Rate: Relevance in the Mozambican Context. Revista Científica da UEM: Série Ciências Biomédicas e Saúde Pública 2020; Preprint: 6.

- Macaza BS. Avaliação da qualidade e segurança microbiológica de alimentos de rua vendidos nos mercados municipais da cidade de Nampula, Moçambique. Porto, Portugal: Universidade do Porto; 2017.

- Manhique GA. Avaliação das condições higiênico-sanitárias e contaminação microbiológica de alimentos, manipuladores e utensílios utilizados na preparação de alimentos em mercados e nas ruas de Maputo, Moçambique. Porto Alegre, Brazil: Universidade Federal do Rio Grande do Sul; 2020.

- Cambaza EM, Viegas GC, Cambaza CM. Potential impact of temperature and atmospheric pressure on the number of cases of COVID-19 in Mozambique, Southern Africa. Journal of Public Health and Epidemiology 2020; 12(3): 246-60.

- Agulhas and Somali Current Large Marine Ecosystems. National Marine Ecosystem Diagnostic Analysis. Mozambique. New York, United States: Global Environment Facility (GEF), 2012.

- Instituto Nacional de Estatística. Censo 2017: IV Recenseamento Geral da População e Habitação. Maputo, Mozambique: Gabinete do Presidente, Instituto Nacional de Estatística, 2017.

- Cambaza EM. The Double Burden of Malnutrition since the Beginning of the Millennium in Adults from Maputo City. Crawley, Western Australia: The University of Western Australia; 2013.

- World Bank Group. Mozambique Poverty Assessment: “Strong but not Broadly Shared Growth”. Washington, DC, USA: World Bank Group, 2018.

- Cambaza EM, Mongo E, Anapakala E, Nhambire R, Singo J, Machava E. An Update on Cholera Studies in Mozambique. In: Bacha U, Rozman U, Turk SŠ, eds. Healthcare Access - Regional Overviews. London, UK: IntechOpen Limited; 2020: 1-20.

- Chissaque A, de Deus N, Vubil D, Mandomando I. The Epidemiology of Diarrhea in Children Under 5 Years of Age in Mozambique. Current Tropical Medicine Reports 2018; 5(3): 115-24.

- Library of Congress. Mozambique. 1995. (accessed 1 March 2021 2021).

- Maunze XH, Dade A, Zacarias MdF, et al. IV Recenseamento Geral da População e Habitação, 2017: Resultados Definitivos – Moçambique. Maputo Mozambique: Instituto Nacional de Estatística, 2019.

- The World Bank Group. Mozambique Public Expenditure Review: Addressing the Challenges of Today, Seizing the Opportunities of Tomorrow. Washington, DC, United States: The World Bank Group, 2014.

- Ministério da Saúde. Boletim Diário COVID-19. In: Departamento de Saúde Pública, editor. Maputo, Mozambique: Ministério da Saúde; 2020. p. 2.

- Nyusi J. Comunicação à Nação de Sua Excelência Filipe Jacinto Nyusi, Presidente da República de Moçambique, sobre o Balanço da Implementação das Medidas Decretadas no Contexto da Declaração da Situação de Calamidade Pública, no âmbito da Pandemia do Corona Vírus – COVID-19. In: Presidência da República, editor. Maputo, Mozambique: Presidência da República; 2021. p. 15.

- Kodera S, Rashed EA, Hirata A. Correlation between COVID-19 Morbidity and Mortality Rates in Japan and Local Population Density, Temperature, and Absolute Humidity. 2020; 17(15): 5477.

- Kadi N, Khelfaoui M. Population density, a factor in the spread of COVID-19 in Algeria: statistic study. Bulletin of the National Research Centre 2020; 44(1): 138.

- Ekumah B, Armah FA, Yawson DO, et al. Disparate on-site access to water, sanitation, and food storage heighten the risk of COVID-19 spread in Sub-Saharan Africa. Environmental Research 2020; 189: 109936.

- Ha YP, McDonald N, Hersh S, Fenniri SR, Hillier A, Cannuscio CC. Using Informational Murals and Handwashing Stations to Increase Access to Sanitation Among People Experiencing Homelessness During the COVID-19 Pandemic. American Journal of Public Health 2020; 111(1): 50-3.

- Amaechina E, Amoah A, Amuakwa-Mensah F, et al. Policy Note: Policy Responses to Ensure Access to Water and Sanitation Services During COVID-19: Snapshots from the Environment for Development (EfD) Network. Water Economics and Policy 2020; 06(04): 2071002.