Article
Immunology
Marco Del Riccio, Peter Spreeuwenberg, Richard Osei-Yeboah, Caroline K. Johannesen, Liliana Vazquez Fernandez, Anne C. Teirlinck, Xin Wang, Terho Heikkinen, Mathieu Bangert, Saverio Caini, Harry Campbell, John Paget
Summary: This study estimated that an average of 245,244 children aged under 5 years are hospitalized annually due to RSV in the EU, with the highest hospitalization rates in children aged less than 2 months (71.6 per 1000 children).
JOURNAL OF INFECTIOUS DISEASES
(2023)
Article
Immunology
Katherine M. Begley, Arnold S. Monto, Lois E. Lamerato, Anurag N. Malani, Adam S. Lauring, H. Keipp Talbot, Manjusha Gaglani, Tresa McNeal, Fernanda P. Silveira, Richard K. Zimmerman, Donald B. Middleton, Shekhar Ghamande, Kempapura Murthy, Lindsay Kim, Jill M. Ferdinands, Manish M. Patel, Emily T. Martin
Summary: In this study, adults hospitalized with respiratory syncytial virus (RSV) were found to have worse outcomes compared with influenza. They were more likely to have cardiopulmonary comorbidities, experience a longer stay, and require mechanical ventilation. This study highlights the importance of RSV surveillance and informs future vaccination strategies.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Medicine, General & Internal
Jocelyn Moyes, Stefano Tempia, Sibongile Walaza, Meredith L. McMorrow, Florette Treurnicht, Nicole Wolter, Anne von Gottberg, Kathleen Kahn, Adam L. Cohen, Halima Dawood, Ebrahim Variava, Cheryl Cohen
Summary: Based on a study in South African children, the burden of RSV-associated illness was estimated, with newborns and infants being the most affected group. Implementing maternal vaccination and monoclonal antibody products for this group can help reduce the disease burden.
Article
Medicine, General & Internal
Jocelyn Moyes, Stefano Tempia, Sibongile Walaza, Meredith L. McMorrow, Florette Treurnicht, Nicole Wolter, Anne von Gottberg, Kathleen Kahn, Adam L. Cohen, Halima Dawood, Ebrahim Variava, Cheryl Cohen
Summary: Studying the economic burden of RSV-associated illness can help inform decisions on the implementation of maternal vaccines and monoclonal antibodies. A costing study conducted in South Africa estimated the cost of RSV-associated illness in infants and found that the highest cost burden was in the youngest infants.
Review
Immunology
Stefania Maggi, Nicola Veronese, Marianna Burgio, Giorgia Cammarata, Maria Elena Ciuppa, Stefano Ciriminna, Francesco Di Gennaro, Lee Smith, Mike Trott, Ligia J. Dominguez, Giovanni M. Giammanco, Simona De Grazia, Claudio Costantino, Francesco Vitale, Mario Barbagallo
Summary: This systematic review and meta-analysis compared the rate of hospitalization and mortality between RSV and influenza in older adults. The results showed that the rate of hospitalization and mortality was similar between RSV and influenza in this population. Vaccination for RSV in older people is important for preventing negative outcomes such as mortality and hospitalization.
Article
Virology
Hatice Bolek, Lale Ozisik, Zafer Caliskan, Mine Durusu Tanriover
Summary: This study aimed to investigate the clinical outcomes and cost of illness due to respiratory virus infections in hospitalized adult patients. The results showed that patients infected with influenza had higher rates of clinical support, intensive care unit admission, and mortality, as well as higher average hospitalization costs.
JOURNAL OF MEDICAL VIROLOGY
(2023)
Article
Medicine, General & Internal
B. Kampmann, S. A. Madhi, I. Munjal, E. A. F. Simoes, B. A. Pahud, C. Llapur, J. Baker, G. Perez Marc, D. Radley, E. Shittu, J. Glanternik, H. Snaggs, J. Baber, P. Zachariah, S. L. Barnabas, M. Fausett, T. Adam, N. Perreras, M. A. Van Houten, A. Kantele, L. -M Huang, L. J. Bont, T. Otsuki, S. L. Vargas, J. Gullam, B. Tapiero, R. T. Stein, F. P. Polack, H. J. Zar, N. B. Staerke, M. Duron Padilla, P. C. Richmond, K. Koury, K. Schneider, E. V. Kalinina, D. Cooper, K. U. Jansen, A. S. Anderson, K. A. Swanson, W. C. Gruber, A. Gurtman
Summary: Vaccination of pregnant women with RSVpreF vaccine was effective in reducing severe RSV-associated lower respiratory tract illness in infants. The vaccine showed 81.8% efficacy within 90 days and 69.4% efficacy within 180 days. The vaccine was found to be safe for both mothers and infants.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Immunology
Ymir Oskarsson, Asgeir Haraldsson, Bryndis Hogna Oddsdottir, Tinna Laufey Asgeirsdottir, Valtyr Thors
Summary: The clinical and socioeconomic burden of respiratory syncytial virus (RSV) in Iceland is substantial, despite slightly lower hospital admission rates compared to other high-income countries. Prevention of RSV in young children has the potential to decrease both the clinical and financial impact of annual epidemics.
PEDIATRIC INFECTIOUS DISEASE JOURNAL
(2022)
Article
Infectious Diseases
Jocelyn Moyes, Stefano Tempia, Sibongile Walaza, Meredith L. McMorrow, Adam L. Cohen, Florette Treurnicht, Orienka Hellferscee, Nicole Wolter, Anne Von Gottberg, Halima Dawood, Ebrahim Variava, Kathleen Kahn, Shabir A. Madhi, Cheryl Cohen
Summary: This study aimed to calculate the attributable fraction (AF) of respiratory syncytial virus (RSV) in clinical syndromes across different age groups. Using logistic regression models, the AF of RSV-associated influenza-like illness (ILI) and severe acute respiratory illness (SARI) cases were estimated by comparing RSV detection prevalence among cases and healthy controls in South Africa from 2012-2016. The results showed significant associations between RSV and ILI and SARI cases, particularly in younger age groups.
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
(2023)
Article
Infectious Diseases
Lise Beier Havdal, Hakon Boas, Terese Bekkevold, Anne-Marte Bakken Kran, Astrid Elisabeth Rojahn, Ketil Stordal, Sara Debes, Henrik Dollner, Svein Arne Nordbo, Bjorn Barstad, Elisebet Haarr, Liliana Vazquez Fernandez, Britt Nakstad, Christopher Inchley, Elmira Flem
Summary: This study estimated the age-specific incidence of medically attended RSV infections in hospitalised Norwegian children and provided insights into the epidemiology of the disease. The highest incidence rates were observed in 1-month-old children, while lower rates were found in children aged 24-59 months.
JOURNAL OF INFECTION
(2022)
Article
Immunology
Koos Korsten, Niels Adriaenssens, Samuel Coenen, Chris C. Butler, Theo J. M. Verheij, Louis J. Bont, Joanne G. Wildenbeest
Summary: The accuracy of the influenza-like illness (ILI) case definition from the World Health Organization (WHO) in identifying acute respiratory tract infections (ARTI) caused by respiratory syncytial virus (RSV) in older adults is uncertain. The ILI definition, which includes fever, underestimates the occurrence of RSV-ARTI. There is a need for a better approach to measure RSV disease occurrence and the impact of future RSV vaccine introduction.
JOURNAL OF INFECTIOUS DISEASES
(2022)
Article
Biochemistry & Molecular Biology
Deidre Wilkins, Yuan Yuan, Yue Chang, Anastasia A. Aksyuk, Beatriz Seoane Nunez, Ulrika Wahlby-Hamren, Tianhui Zhang, Michael E. Abram, Amanda Leach, Tonya Villafana, Mark T. Esser
Summary: Nirsevimab is an extended half-life monoclonal antibody that provides sustained, high levels of neutralizing antibodies (NAbs) against the respiratory syncytial virus (RSV) while allowing the development of an immune response. It effectively protects infants from RSV disease throughout their first RSV season and has similar seroresponse rates compared with placebo recipients. It is likely due to the prolonged persistence of nirsevimab at elevated levels that leads to this observed protection.
Article
Infectious Diseases
Benjamin Leaver, Benjamin Smith, Louis Irving, Douglas Johnson, Steven Tong
Summary: RSV has been identified as a significant contributor to morbidity and hospitalization, especially in older adults. The study compared demographic characteristics, testing patterns, hospitalizations, and outcomes between patients with influenza and RSV, finding that RSV patients were older, had more comorbidities, and were less likely to be tested in the emergency department. RSV was found to be the strongest predictor of 6-month representation, highlighting the need for targeted therapies.
INFLUENZA AND OTHER RESPIRATORY VIRUSES
(2022)
Article
Infectious Diseases
C. Demont, N. Petrica, I Bardoulat, S. Duret, L. Watier, A. Chosidow, M. Lorrot, A. Kieffer, M. Lemaitre
Summary: RSV is a significant cause of child hospitalization in France, with an average of 45,225 RSV-associated hospitalizations reported per season. The economic burden is mainly driven by infants under 1 year old, representing 80% of the cost. Preventive strategies should be implemented before the first RSV season.
BMC INFECTIOUS DISEASES
(2021)
Article
Infectious Diseases
Marco Heppe-Montero, Stefan Walter, Valentin Hernandez-Barrera, Ruth Gil-Prieto, Angel Gil-de-Miguel
Summary: This study collected data on hospitalizations for respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (ALRI) in children in Spain from 2012 to 2018. The results showed that RSV-related respiratory infections remain a leading cause of infant hospitalization in Spain, with a significant increase in the hospitalization rate for pneumonia over the study period. Effective antiviral treatments and preventive vaccines are urgently needed for the management of RSV infection in children, especially for those aged 6 to 12 months.
BMC INFECTIOUS DISEASES
(2022)
Article
Infectious Diseases
Soa Fy Andriamandimby, Cara E. Brook, Norosoa Razanazatovo, Jean-Marius Rakotondramanga, Fidisoa Rasambainarivo, Vaomalala Raharimanga, Iony Manitra Razanajatovo, Reziky Mangahasimbola, Richter Razafindratsimandresy, Santatra Randrianarisoa, Barivola Bernardson, Joelinotahiana Hasina Rabarison, Mirella Randrianarisoa, Frederick Stanley Nasolo, Roger Mario Rabetombosoa, Anne-Marie Ratsimbazafy, Vololoniaina Raharinosy, Aina H. Rabemananjara, Christian H. Ranaivoson, Helisoa Razafimanjato, Rindra Randremanana, Jean-Michel Heraud, Philippe Dussart, Tsiry H. Randriambolamanantsoa
Summary: This study conducted an analysis on the first wave of the COVID-19 epidemic in Madagascar using laboratory data, demonstrating that C-t values can serve as a biomarker for infection stage and can be used to estimate population-level epidemiological dynamics. Public reporting of C-t values can provide important resources for epidemiological inference and forecasting in low surveillance settings.
Article
Public, Environmental & Occupational Health
Ozren Polasek, Kerri Wazny, Davies Adeloye, Peige Song, Kit Y. Chan, Danladi A. Bojude, Sajjad Ali, Sheri Bastien, Francisco Becerra-Posada, Florencia Borrescio-Higa, Sohaila Cheema, Darien A. Cipta, Smiljana Cvjetkovic, Lina D. Castro, Bassey Ebenso, Omolade Femi-Ajao, Balasankar Ganesan, Anton Glasnovic, Longtao He, Jean M. Heraud, Chinonso Igwesi-Chidobe, Per O. Iversen, Bismeen Jadoon, Abdulkarim J. Karim, Johra Khan, Raaj K. Biswas, Giuseppe Lanza, Shaun W. H. Lee, You Li, Li-Lin Liang, Mat Lowe, Mohammad M. Islam, Ana Marusic, Suleiman Mshelia, Anthony M. Manyara, Mila N. N. Htay, Michelle Parisi, Prince Peprah, Emma Sacks, Kabiru O. Akinyemi, Fariba Shahraki-Sanavi, Konstantin Sharov, Elena S. Rotarou, Srdjan Stankov, Wenang Supriyatiningsih, Benjamin T. Y. Chan, Mark Tremblay, Dialechti Tsimpida, Sandro Vento, Josipa Glasnovic, Liang Wang, Xin Wang, Zhi X. Ng, Jianrong Zhang, Yanfeng Zhang, Harry Campbell, Mickey Chopra, Simon Cousens, Goran Krstic, Calum Macdonald, Parisa Mansoori, Smruti Patel, Aziz Sheikh, Mark Tomlinson, Alexander C. Tsai, Sachiyo Yoshida, Igor Rudan
Summary: This study used the CHNRI method to identify research priorities related to COVID-19, highlighting the importance of vaccination and healthcare delivery in low- and middle-income countries. The research emphasizes the urgent need for health policy and systems research in these countries.
JOURNAL OF GLOBAL HEALTH
(2022)
Article
Infectious Diseases
Rila Ratovoson, Mihaja Raberahona, Rado Razafimahatratra, Lova Randriamanantsoa, Emmanuel Harizaka Andriamasy, Perlinot Herindrainy, Norosoa Razanajatovo, Soa Fy Andriamandimby, Andoniaina Rakotonaivo, Fanirisoa Randrianarisaona, Philippe Dussart, Jean Michel Heraud, Mamy Jean de Dieu de Randria, Matthieu Schoenhals, Rindra Vatosoa Randremanana
Summary: This study aimed to estimate the risk of SARS-CoV-2 infection among healthcare workers in Madagascar during the first wave of the epidemic. The results showed a high incidence of infection among HCWs, including a significant proportion of asymptomatic cases. Young HCWs were found to be more at risk compared to others.
INFLUENZA AND OTHER RESPIRATORY VIRUSES
(2022)
Review
Infectious Diseases
Hannah C. Lewis, Adrian J. Marcato, Niamh Meagher, Marta Valenciano, Juan-Pablo Villanueva-Cabezas, Violeta Spirkoska, James E. Fielding, Amalia Karahalios, Lorenzo Subissi, Anthony Nardone, Brianna Cheng, Soatiana Rajatonirina, Joseph Okeibunor, Eman A. Aly, Amal Barakat, Pernille Jorgensen, Tasnim Azim, Pushpa R. Wijesinghe, Linh-Vi Le, Angel Rodriguez, Andrea Vicari, Maria D. Van Kerkhove, Jodie McVernon, Richard Pebody, David J. Price, Isabel Bergeri
Summary: This study aimed to estimate the household secondary infection attack rate (hSAR) of SARS-CoV-2 in investigations aligned with the WHO Unity Studies Household Transmission Investigations (HHTI) protocol. The findings revealed a large unexplained variance in hSAR estimates, highlighting the need for further support in standardization and comprehensive reporting of research results.
INFLUENZA AND OTHER RESPIRATORY VIRUSES
(2022)
Article
Virology
Idrissa Dieng, Amadou Diallo, Mignane Ndiaye, Moufid Mhamadi, Moussa Moise Diagne, Safietou Sankhe, Marie Henriette Dior Ndione, Aboubacry Gaye, Samba Niang Sagne, Jean Michel Heraud, Amadou Alpha Sall, Gamou Fall, Cheikh Loucoubar, Ousmane Faye, Oumar Faye
Summary: This study assessed the genetic diversity of circulating dengue virus 2 (DENV-2) in Senegal and identified two distinct clades with nonsynonymous mutations in different genes. These findings are important for further understanding the transmission and impact of the virus.
JOURNAL OF MEDICAL VIROLOGY
(2022)
Article
Zoology
Angelo Andrianiaina, Santino Andry, Anecia Gentles, Sarah Guth, Jean-Michel Heraud, Hafaliana Christian Ranaivoson, Ny Anjara Fifi Ravelomanantsoa, Timothy Treuer, Cara E. Brook
Summary: This study provides detailed information on the reproductive calendar and physiological changes of endemic fruit bats in Madagascar and highlights the conservation issues faced by these species. The findings are important for population viability modeling, understanding pathogen persistence mechanisms in host populations, and providing crucial data for human public health.
JOURNAL OF MAMMALOGY
(2022)
Article
Virology
Richter Razafindratsimandresy, Marie-Line Joffret, Jonhson Raharinantoanina, Patsy Polston, Nelson S. Andriamamonjy, Iony Manitra Razanajatovo, Ousmane M. Diop, Francis Delpeyroux, Jean-Michel Heraud, Mael Bessaud
Summary: This study implemented reinforced poliovirus surveillance in three regions of Madagascar from January 2016 to December 2017 to assess the circulation of the Sabin 2 poliovirus vaccine strain. Polioviruses were detected during almost the entire study period, but all isolates were related to the vaccine strains and no wild poliovirus was found. Most isolates belonged to serotype 3 and no vaccine-derived poliovirus was observed. The results indicate that with good vaccine coverage, the transmission of polioviruses can be effectively stopped even in countries with poor sanitation.
JOURNAL OF MEDICAL VIROLOGY
(2022)
Article
Virology
Norosoa Harline Razanajatovo, Tsiry Hasina Randriambolamanantsoa, Joelinotahiana Hasina Rabarison, Laurence Randrianasolo, Miamina Fidy Ankasitrahana, Arve Ratsimbazafy, Antso Hasina Raherinandrasana, Helisoa Razafimanjato, Vololoniaina Raharinosy, Soa Fy Andriamandimby, Jean-Michel Heraud, Philippe Dussart, Vincent Lacoste
Summary: Three waves of COVID-19 occurred in Madagascar from March 2020 to May 2022, with a positivity rate of SARS-CoV-2 ranging from 21% to 33%. The study aimed to investigate the impact of COVID-19 on the epidemiology of respiratory viruses in Madagascar. The results showed that 19% of samples from COVID-19 negative patients tested positive for at least one respiratory virus.
Article
Virology
Arianna Ceruti, Ndongo Dia, Adeleye Solomon Bakarey, Judah Ssekitoleko, Soa Fy Andriamandimby, Padra Malwengo-Kasongo, Rasheeda H. A. Ahmed, Rea Maja Kobialka, Jean Michel Heraud, Moussa Moise Diagne, Marie Henriette Dior Dione, Idrissa Dieng, Martin Faye, Ousmane Faye, Jean Theophile Rafisandratantsoa, Jean-Pierre Ravalohery, Claudio Raharinandrasana, Tsiry H. Randriambolamanantsoa, Norosoa Razanajatovo, Iony Razanatovo, Joelinotahina H. Rabarison, Phillipe Dussart, Louis Kyei-Tuffuor, Abigail Agbanyo, Olubusuyi Moses Adewumi, Adeola Fowotade, Muideen Kolawole Raifu, Patient Okitale-Talunda, Gracia Kashitu-Mujinga, Christelle Mbelu-Kabongo, Steve Ahuka-Mundeke, Anguy Makaka-Mutondo, Enas M. Abdalla, Sanaa M. Idris, Wisal A. Elmagzoub, Rahma H. Ali, Eman O. M. Nour, Rasha S. M. Ebraheem, Huda H. H. Ahmed, Hamadelniel E. Abdalla, Musab Elnegoumi, Izdihar Mukhtar, Muatsim A. M. Adam, Nuha Y. I. Mohamed, Shahinaz A. Bedri, Hamdan Mustafa Hamdan, Magid Kisekka, Monica Mpumwiire, Sharley Melissa Aloyo, Joanita Nabwire Wandera, Andrew Agaba, Rogers Kamulegeya, Hosea Kiprotich, David Patrick Kateete, Paul Kadetz, Uwe Truyen, Kamal H. Eltom, Anavaj Sakuntabhai, Julius Boniface Okuni, Sheila Makiala-Mandanda, Vincent Lacoste, George Olusegun Ademowo, Michael Frimpong, Amadou Alpha Sall, Manfred Weidmann, Ahmed Abd El Wahed
Summary: In this study, a novel isothermal amplification method was validated for rapid detection of SARS-CoV-2 in seven sub-Saharan African countries. The RdRP-based amplification method showed the best assay accuracy. The study highlighted the challenges of implementing rapid molecular assays in field conditions, emphasizing the importance of standardized operation procedures, continuous training for staff, and enhanced quality control measures for successful deployment.
JOURNAL OF CLINICAL VIROLOGY
(2023)
Article
Virology
Moussa Dia, Ndeye Sakha Bob, Cheikh Talla, Anne Dupressoir, Camille Escadafal, Mareme Seye Thiam, Amadou Diallo, Oumar Ndiaye, Jean Michel Heraud, Oumar Faye, Amadou Alpha Sall, Ousmane Faye, Gamou Fall
Summary: Yellow fever (YF) virus is a mosquito-borne virus that poses a threat to travelers and unvaccinated populations. A newly developed YF PRNT has shown good robustness and high precision, making it suitable for YF diagnosis and evaluation of vaccine response.
JOURNAL OF MEDICAL VIROLOGY
(2023)
Article
Infectious Diseases
Jocelyn Moyes, Stefano Tempia, Sibongile Walaza, Meredith L. McMorrow, Adam L. Cohen, Florette Treurnicht, Orienka Hellferscee, Nicole Wolter, Anne Von Gottberg, Halima Dawood, Ebrahim Variava, Kathleen Kahn, Shabir A. Madhi, Cheryl Cohen
Summary: This study aimed to calculate the attributable fraction (AF) of respiratory syncytial virus (RSV) in clinical syndromes across different age groups. Using logistic regression models, the AF of RSV-associated influenza-like illness (ILI) and severe acute respiratory illness (SARI) cases were estimated by comparing RSV detection prevalence among cases and healthy controls in South Africa from 2012-2016. The results showed significant associations between RSV and ILI and SARI cases, particularly in younger age groups.
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
(2023)
Article
Multidisciplinary Sciences
Nicole Wolter, Stefano Tempia, Anne von Gottberg, Jinal N. Bhiman, Sibongile Walaza, Jackie Kleynhans, Jocelyn Moyes, Sue Aitken, Sarah Magni, Jessica Yun, Tamika Fellows, Tetelo Makamadi, Renay Weiner, Cherie Cawood, Neil Martinson, Limakatso Lebina, Cheryl Cohen
Summary: This study investigated healthcare utilization in the catchment areas of healthcare facilities in three provinces during the COVID-19 pandemic. The findings showed that less than half of ILI cases and only 71% of SRI cases received medical care during the first two waves of COVID-19 in South Africa. This suggests that facility-based surveillance data may underestimate the burden of COVID-19.
Article
Virology
Anais Broban, Marie-Marie Olive, Michael Luciano Tantely, Anne-Claire Dorsemans, Fanjasoa Rakotomanana, Jean-Pierre Ravalohery, Christophe Rogier, Jean-Michel Heraud, Soa Fy Andriamandimby
Summary: This study estimated the seroprevalence of three arboviruses (dengue, chikungunya, and West Nile) in Madagascar and identified risk factors associated with seropositivity. The results showed that 6.5% were seropositive for dengue virus, 13.7% for chikungunya virus, and 12.7% for West Nile virus. Dengue and chikungunya viruses were recently introduced, with higher prevalence in the eastern and northern parts of the country, while West Nile virus circulated in all regions. Factors such as vegetation cover, forest work, cultivated areas, and standard of living were associated with seropositivity.
Article
Microbiology
Iony Manitra Razanajatovo, Lova Andrianomiadana, Azimdine Habib, Mirella Malala Randrianarisoa, Helisoa Razafimanjato, Maheninasy Rakotondrainipiana, Prisca Andriantsalama, Ravaka Randriamparany, Soa Fy Andriamandimby, Pascale Vonaesch, Philippe Jean Sansonetti, Vincent Lacoste, Rindra Vatosoa Randremanana, Jean-Marc Collard, Jean-Michel Heraud, Afribiota Invest
Summary: The study aimed to assess whether enteric viral carriage plays a role in stunting in poor settings. Researchers obtained stool samples from 464 healthy children aged 2 to 5 years and tested for enteric and non-enteric viruses. The results showed no direct link between stunting and enteropathogenic viral carriage.
Article
Public, Environmental & Occupational Health
Joelinotahiana Hasina Rabarison, Jean Marius Rakotondramanga, Rila Ratovoson, Bruno Masquelier, Anjaraso Maharavo Rasoanomenjanahary, Anou Dreyfus, Andres Garchitorena, Fidisoa Rasambainarivo, Norosoa Harline Razanajatovo, Soa Fy Andriamandimby, C. Jessica Metcalf, Vincent Lacoste, Jean-Michel Heraud, Philippe Dussart
Summary: Estimating COVID-19-associated mortality in sub-Saharan Africa is challenging due to the lack of comprehensive death registration systems. This study used death registers from the capital city of Madagascar to estimate excess mortality during the pandemic and calculate the loss of life expectancy. The results showed high excess mortality associated with waves of COVID-19, with a drop in life expectancy for men and women beyond the age of 60. Implementing death registration systems in low-income countries is important for documenting the true toll of a pandemic.