Influence of population density and access to sanitation on Covid-19 in Mozambique. Rev. Ang. de Ciênc. da Saúde. 2021 Jan – Jul ; 2 (1): 3-8
but it takes the system’s shape as it fills, and in the end, it i s more abundant in the tanks. By the same logic,highly populated areas imply more encounters among people, thus, more occasions for COVID-19transmission. Still, the relationship between density and the number of cases seemed more complex, moreeasily represented through a cubic function. This complex relationship might result from other factors such asweather 9 , reinforcement of methods to control the pandemic, and the pattern of migration or people’s behavior 1 .Several correlation-based and linear regression-based studies analyze the influence of population density onthe pandemic, but they do not search for algebraic functions that had better represent such influence.To the best of the author’s knowledge, the only peer -reviewed study published (locally) in Mozambique aboutthe influence of density on the number of COVID-19 cases, by Arnaldo et al. 5 , assumed a relationship betweenthe variables, arbitrarily using the idea for further analyses. The authors aimed to predict the risk of COVID-19dissemination based on different variables, including population density. However, they had no clear informationon how severely density could affect the number of cases, resting their proposition on speculation. The currentstudy attempts to clarify and provide statistical support to Arnaldo et al. 5 .Regarding how access to sanitation facilities affected the number of confirmed cases, the result seemedcounterintuitive, i.e., more people with access to sanitation should imply more hygiene and fewer cases ofCOVID- 19. There are some possible explanations: (1) the country’s more developed areas have more peoplewith access to sanitation, but are also the busiest, where the disease can spread more easily; (2) people withlimited sanitation facilities tend to value more such resources, using more adequately. Ekumah et al. 26 collecteddata on access to sanitation and the number of COVID-19 cases in 25 countries of Sub-Saharan Africa,including Mozambique, but their overall result indicate that lack of sanitation, combined with lack of clean waterand food storage, is associated with a higher level of violation of lockdown regulations, and a higher risk ofCOVID-19. The authors analyzed the issue at an international level, thus using data biased due to differencesin COVID-19 emergency or lockdown policies and other social and natural factors. Ha et al. 27 and Amaechinaet al. 28 also discussed the importance of sanitation for COVID-19 prevention, but they were more concernedabout policies to facilitate the distribution of water and sanitation facilities. Thus, this might be the first studyanalyzing at a country level how the sanitation coverage affected the cases of COVID-19. Perhaps time willallow gathering more robust data to understand the phenomenon, but so far, it is crucial to persuade thepopulation in densely inhabited areas to abide more responsibly by COVID-19 preventive measures, particularlyhygiene.Future studies shall revisit how COVID-19 dissemination in Mozambique relates to population density,access to sanitation, and include other variables such as the access to healthcare services and the variablesmentioned in the paper about the “African miracle” 1 : level of implementation of the Strategic Preparedness andResponse Plan 29 and other guidelines from the World Health Organization (WHO), population migrationpatterns, the dynamics and management of other illnesses, population age profile, immunity, and vaccination.
CONCLUSION The study suggests that the number of COVID-19 cases is directly proportional to population density andsanitation access. The correlations were significant ( p < 0.05) and high enough to admit their strength ( r > 0.5).Fitting analysis showed consistency with algebraic curves representing the predictability of COVID-19confirmed cases through the population density (cubic function) and access to sanitation in percent (square).More important than understanding a phenomenon is to reason on what to do about it. In this case, populationdensity is a good tool for predictions and decision-making. Knowing how density affects COVID-19dissemination allows one to understand the spatial pattern of the number of cases throughout the country if thesituation does not change. Regarding sanitation, the mere availability of facilities is not enough to ensure thecontrol of COVID-19. It is also essential to promote good hygiene practices and strict fulfillment of theGovernment’s recommendations.
REFERENCES
1- 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: 1-8.2- Bhadra A, Mukherjee A, Sarkar K. Impact of population density on COVID-19 infected and mortality ratein India. Modeling Earth Systems and Environment 2021; 7(1): 623-9.3- Coşkun H, Yıldırım N, Gündüz S. The spread of COVID -19 virus through population density and wind inTurkey cities. Science of The Total Environment 2021; 751: 141663.
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