Outbreak Investigation: First Ten COVID – 19 Infection Related Deaths in Hodeidah, Yemen

Abstract

Background: Many acute respiratory syndrome coronavirus 2 (SARS-CoV-2) related deaths were reported in Yemen. The question is about what risk factors contribute to this excess death. Hodeidah governorate in the Western part of Yemen is exposed to the COVID-19 pandemic like other governorates in Yemen, adding to the current chronic problems. No study till now documented the SARS-CoV-2 pandemic process in Hodeidah, Yemen, especially deaths.
 Objective: The aim of this short report is to explore more data about the first ten SARS-CoV-2-related deaths in Hodeidah. Yemen. 
 Methods: An outbreak investigation was carried out directly with patients before death and their families based on world health organization (WHO) guideline and Center for Disease Control and Prevention -US (CDC-US) guideline. On the other hand, the medical reports of patients were investigated in the triage area of the Center of Tropical Medicine and Infectious Diseases (CTMID), AL-Thawrah Public Hospital Authority, Hodeidah, Yemen from 24th to 31st May 2020.
 Results: The first ten death patients at the same time were investigated, the age ranging from 25-65 years with a median age of 57 years, seven deaths (70%) were at age over 50 years while males are more exposed to deaths (eight cases; 80%). The deaths are more in residents of urban (eight cases; 80%) than in rural areas (20%). Co-infections with other communicable diseases were reported in 3 dead patients (30%); tuberculosis, dengue, and hepatitis B (HVB). While six died patients (60%) had non-communicable diseases namely diabetes mellitus, heart disease, hypertension, chronic asthma, and chronic renal failure uncontrolled. One death (10%) of medication error in the private sector (non–isolation center facilities ; sub-standard management)
 Conclusion: Old age and co-morbidity with non-communicable diseases may be contributing factors to excess deaths among SARS-CoV-2 patients. Co-infections with other infections like dengue is of high concern in Hodeidah, Yemen. The post-epidemiological investigation, the control and prevention measures were implemented by local authorities in collaboration with the private sector and non-governmental organizations namely re-habitation of SARS-CoV-2 isolation centers to reduce the mortality rate, also different practices and knowledge to reduce the morbidity rate.