Epidemiology of COVID-19 Outbreak in Oromia Region of Ethiopia: The First Six Months Surveillance – 13 March 2020 to 13 September 2020

Abstract

Background: Despite unrelenting global efforts to contain its spread, Coronavirus disease 2019 (COVID-19) is still causing unprecedented crises globally with no proven vaccine or cure so far. Ethiopia reported its first case on 13 March 2020 but has an accelerated increase in caseload and geographic distribution since recently. We now describe the epidemiology of COVID-19 in Oromia Regional State, the largest and most populous region in Ethiopia, during the early months of the outbreak.Methods: We analyzed data from the COVID-19 surveillance database of the Oromia Regional Health Bureau. We included RT-PCR confirmed COVID-19 cases diagnosed at healthcare facilities across the region during the period of 13 March to 13 September 2020.Findings: COVID-19 was confirmed in 8955 (5·5%) of 164206 individuals tested during the surveillance period. The test positivity rate increased from an average of 1·0% in the first three months to 6·3% in August and September. About 70% (6230) of the cases were male; the mean age was 30·0 years (SD=13·3) and 87·8% were between 10 and 49 years of age. Only 64 (0·7%) of the cases had symptoms at diagnosis. Among symptomatic cases, cough was the most common, reported in 48 (75·0%) and fever the least common, reported in 11 (17·2%) of cases. Moreover, only 6 (0·1%) cases presented with severe disease. Overall, 4346 (48·5%) have recovered from the virus and a total of 52 deaths were reported with a case fatality rate of 1·2%. However, the reported case fatality rate should be interpreted cautiously since in 44 (84·6%) of those reported as COVID-19 death, the virus was detected from a dead body.Interpretation: The COVID-19 infection rate in the Oromia Region of Ethiopia is surging six months after the onset of the pandemic in the country. So far, the proportion of symptomatic cases and severe diseases besides the fatality rate are lower than reports from most other developing and developed countries. This epidemiologic profile might have prevented the anticipated health system crisis to date, but it can hinder efforts to contain the outbreak.Funding: NoneDeclaration of Interests: The authors declare no competing interests.Ethics Approval Statement: The authors have obtained authorization to use the surveillance data from Oromia Regional Health Bureau Public Health Emergency Management and Health Research Directorate