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
The density did not seem related to the percentage of people with access to sanitation, reinforcing the ideathat these variables had an independent impact on the number of cases. This independence is essentialbecause both variables could be “two sides of the same coin,” i.e., one could be affecting the other as the rootof the impact both present on the number of cases. Thus, only one would be enough to perform the analysisfrom this point forward.Figure 2 presents the result of a fitting analysis showing the simplest algebraic curves representing how devalues population density and the number of people with access to sanitation facilities can serve as predictorsof the number of confirmed cases by 8 February 2021 in Mozambique. Both independent variables presentedstrong coefficients of determination (R2 > 0.5).
8000
6000
5000
4000
3000
2000
1000
0
0
20
40
60
80
100
Population density (inhabitants/km 2 )
7000
y = 0,0858x 3 - 10,82x 2 + 396,47x -2133,4R² = 0,8377
8000
7000
6000
5000
4000
3000
2000
1000
0
0
10
20
30
40
50
People with access to sanitation facilities (%)
y = 6,4931x 2 - 225,73x + 3619,2R² = 0,9024
Figure 2. Regression analysis of the number of confirmed COVID-19 cases as a function of (a) population density and (b)percentage of people with access to sanitation in Mozambique.
The curve of population density and number of cases presented some consistency (R 2 = 0,84) with a cubicfunction, being such regression more complex than the square function (with R 2 = 0,9) between access tosanitation and the confirmed cases. From this data, access to sanitation seems to be a more reliable predictorof the number of cases, although this curve’s shape seems counterintuitive, an aspect discussed in the followingsection.
Discussion The results suggested that the number of COVID-19 confirmed cases present positive correlations withpopulation density and the percentage of people accessing sanitation in Mozambique. Furthermore, aspredictors of the number of cases, the population density showed a relationship consistent with a cubic function,and the access to sanitation presented a quadratic curve. In advance, it is essential to know that the literaturepresents plenty of studies about the impact of population density on the number of cases of COVID-19 but notas frequently discussing the relationship between access to sanitation and the pandemic.Maputo City, its considerably dense population, high access to sanitation facilities, and many COVID-19confirmed cases. As the capital, Maputo City is the country’s most develo ped and arguably the busiest area,with people arriving every day from all over the country to study or search for labor opportunities, and it is amongthe main entry points for people coming from abroad. As mentioned in a previous study 9 , the city’s featuresturned it into a “hotspot” of COVID -19 dissemination since the pandemic entered the country. Due to the NewYear-related events, the situation worsened in Maputo City, with many tourists from South Africa and the weakenforcement of COVID-19 preventive measures 23 . Other areas were also busy, had New Year parties, andreceived tourists, bu t not likely as much as Maputo City. Thus, the city was the “stage” of a unique situation forpeculiar reasons.The correlation cubic regression analyses reinforced the idea that population density influences COVID-19cases in Mozambique. The correlation suggested that, from a simplistic perspective, the intuitive idea that themore people live in a particular area, the more susceptible it is for COVID-19 dissemination. More than intuitive,there is evidence backing up the idea 3,24,25 . Some studies did not find enough evidence to conclude thatpopulation density affects COVID-19 spreading 2,4, but they resulted from early analyses when data wasinsufficient to find consistent patterns The impact of density on disseminating the pandemic compares to anetwork of pipes and tanks as water runs through it. In the beginning, water is more abundant in the source,6
RACSAÚDE – Revista Angolana de Ciências da Saúde. www.racsaude.com