Covid-19 has been deadly for pregnant women in Sub-saharan Africa. At least half of the pregnant women who contracted Covid-19 in sub-Saharan Africa either died, were admitted in ICU while others needed oxygen therapy. This is according to a study carried out in six nations.
Prof Jean Nachega revealed the findings at a science cafe organized by the Media for Environment, Science and Agriculture (MESHA).
The study looked at the records of 1,315 patients admitted between March 2020 and March 2021 in 22 health facilities spread across South Africa, Kenya, Ghana, the Democratic Republic of Congo, Nigeria and Uganda.
Prof Nachega, who has over 30 years experience in HIV and TB research in pregnant women, said half of the pregnant women who were enrolled in the study were found to be at risk of death from COVID-19 infection.
“We demonstrated that pregnancy independently increased the risk of ICU admission, oxygen supplementation and death among COVID-19 patients,” said Prof Nachega.
The risk of death was attributed to the effect of the viral infection on the pregnant woman’s immune system.
“As you progress in pregnancy, the risk of admission, oxygen therapy and death increases. So that may make sense to the majority of them to make some adjustments,” Prof Nachega said.
According to Prof Nachega, “Pregnancy by itself is a relatively natural event that lowers the mother’s overall immunity and increases her vulnerability to infections,”.
Prof Nachega, who serves as an Adjunct Associate Professor of Epidemiology and International Health at Johns Hopkins Bloomberg School of Public Health in Baltimore, USA, confirmed that COVID -19 infection adds to the overall burden of morbidity and death among pregnant and non-pregnant women.
“What jumped out at us right away is that those who are pregnant with COVID-19 are more likely to be admitted to the intensive care unit (ICU), require oxygen therapy and more likely to die,” said Prof Nachega.
The non-pregnant women who had COVID-19 were also likely to be admitted to the ICU upon infection, but at a lesser rate than the pregnant infected women.
Risk of Death Higher in Patients with Comorbidities
The risk of death among COVID-19 patients was higher among patients with comorbidities such as HIV, TB and sickle cell anaemia.
Scientists found that pregnant COVID-19 patients were 2.4 times more at risk of needing intensive care and two times higher in the risk of death compared to non-pregnant women.
Those with COVID-19 had five times increased risk of death as compared to those without the disease.
“HIV, prior TB and sickle cell anaemia also increased the burden of morbidity in this group by two and a half times Patients with sickle cell anaemia were more likely to be admitted to ICU,” said Prof Nachega.
Most of the women enrolled in the study were in the third trimester. Prof Nachega attributed the trend to a lack of data for expectant mothers in the other trimester.
“We did not have a sufficient number of women in the second trimester to make the comprehensive comparison between the groups. Most that were included in the study were in the third trimester,” said the scientist.
He said the team had observed that women in sub-Saharan countries are affected by a different set of comorbidities not commonly experienced in the West.
Prof Nachega is now calling on the global health system to prioritize the vaccination of pregnant mothers to stave off high hospitalization and death rates due to COVID-19 infection.
Vaccination is Key
“Vaccination for pregnant women should be prioritized as part of public health and antenatal health care,” said Prof Nachega.
The World Health Organization (WHO) updated guideline for 2022 recommends vaccination for pregnant women.
“Apart from pathogenesis and treatment management, the WHO has also recommended vaccination of pregnant women as a measure to reduce the risk and consequences of severe COVID-19 infection,” he said.
The researcher vouched for their safety and efficacy, saying they could be used by expectant mothers.
“All pregnant women should be prioritized for COVID-19 vaccination. A growing amount of data confirms mRNA , vector and adenovirus-based vaccines are completely safe for use during pregnancy,” said Prof Nachega who is also a tenured Associate Professor of Medicine, Infectious Diseases, Microbiology and Epidemiology, at Graduate School of Public Health, University of Pittsburgh, USA.
He admitted that falsities about vaccinations have scared pregnant women.
“Pregnant women have been bombarded with false information that they will become infertile. All these allegations are completely false, and cannot stand scientific scrutiny,” said Prof Nachega.
Vaccine hesitancy continues to be a major obstacle to the drive to immunize at least 2 billion Africans from COVID-19.
So far, Africa Centres for Disease Control (CDC) data indicates that some 620.1 m doses have been administered on the continent, which procured most of its shots through the COVAX facility. Fully vaccinated individuals represent just 19.7 per cent of the continent’s population currently estimated at slightly over 1.4 bn.
The study has also laid bare the need for continued public health information to sensitize communities on COVID-19.
The study was sponsored by a National Institutes of Health grant, Africa Forum for Research and Education in Health (AFREHealth), Central and West Africa Implementation Science Alliance (CAWISA),