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Housing, Sanitation and Living Conditions Affecting SARS-CoV-2 Prevention Interventions in 54 African Countries
Authors: Timothy F. Brewer, Mary Zhang, David Gordon, Roger Yat-Nork Chung, Negussie Dejene, Cynthia L. Fonta, Tigist Grieve, Bjorn Hallerod, Richard Harris, Alba Lanau, Murray Leibbrandt, Yehualashet Mekonen, Bongai Muguni, Hector Najera, Shailen Nandy, and S. Jody Heymann
Source: Epidemiology & Infection, DOI:
Topic(s): COVID-19
Family structure
Wealth Index
Country: Africa
  Multiple African Countries
Published: JUL 2021
Abstract: The feasibility of non-pharmacological interventions (NPIs) such as physical distancing or isolation at home to prevent Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) transmission in low-resource countries is unknown. Household survey data from 54 African countries were used to investigate the feasibility of SARS-CoV-2 NPIs in low-resource settings. Across the 54 countries, approximately 718 million people lived in households with =6 individuals at home (median percentage of at-risk households 56% (95% confidence interval (CI), 51% to 60%)). Approximately 283 million people lived in households where =3 people slept in a single room (median percentage of at-risk households 15% (95% CI, 13% to 19%)). An estimated 890 million Africans lack on-site water (71% (95% CI, 62% to 80%)), while 700 million people lacked in-home soap/washing facilities (56% (95% CI, 42% to 73%)). The median percentage of people without a refrigerator in the home was 79% (95% CI, 67% to 88%), while 45% (95% CI, 39% to 52%) shared toilet facilites with other households. Individuals in low-resource settings have substantial obstacles to implementing NPIs for mitigating SARS CoV-2 transmission. These populations urgently need to be prioritized for COVID-19 vaccination to prevent disease and to contain the global pandemic.