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Concern for severe COVID-19 disease during the initial two years of pandemic in a rural South African community: A population-based study
by
Dzomba, Armstrong
, Kelly, Nicole K.
, Ginsburg, Carren
, Moffett, Bianca
, Kahn, Kathleen
, Pettifor, Audrey
, Kabudula, Chodziwadziwa
, Mataboge, Palesa
, Oladimeji, Kelechi Elizabeth
, Gutu, Kimberley
, Gómez-Olivé, Francesc Xavier
in
Adolescent
/ Adult
/ Adults
/ Aged
/ Asymptomatic
/ Behavior
/ Chronic conditions
/ Chronic illnesses
/ Consent
/ COVID-19
/ COVID-19 - epidemiology
/ COVID-19 - pathology
/ COVID-19 - psychology
/ COVID-19 vaccines
/ Data collection
/ Disease prevention
/ Disease transmission
/ Emergency medical care
/ Epidemics
/ Ethics
/ Fatalities
/ Female
/ Households
/ Humans
/ Illnesses
/ Infections
/ Male
/ Masks
/ Medical research
/ Medicine, Experimental
/ Middle Aged
/ Pandemics
/ Population
/ Population studies
/ Public health
/ Respiratory diseases
/ Respiratory tract diseases
/ Risk assessment
/ Risk factors
/ Risk perception
/ Rural Population
/ SARS-CoV-2 - isolation & purification
/ Severity of Illness Index
/ Shelter in place
/ South Africa - epidemiology
/ Surveillance
/ Surveys
/ Surveys and Questionnaires
/ Young Adult
2025
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Concern for severe COVID-19 disease during the initial two years of pandemic in a rural South African community: A population-based study
by
Dzomba, Armstrong
, Kelly, Nicole K.
, Ginsburg, Carren
, Moffett, Bianca
, Kahn, Kathleen
, Pettifor, Audrey
, Kabudula, Chodziwadziwa
, Mataboge, Palesa
, Oladimeji, Kelechi Elizabeth
, Gutu, Kimberley
, Gómez-Olivé, Francesc Xavier
in
Adolescent
/ Adult
/ Adults
/ Aged
/ Asymptomatic
/ Behavior
/ Chronic conditions
/ Chronic illnesses
/ Consent
/ COVID-19
/ COVID-19 - epidemiology
/ COVID-19 - pathology
/ COVID-19 - psychology
/ COVID-19 vaccines
/ Data collection
/ Disease prevention
/ Disease transmission
/ Emergency medical care
/ Epidemics
/ Ethics
/ Fatalities
/ Female
/ Households
/ Humans
/ Illnesses
/ Infections
/ Male
/ Masks
/ Medical research
/ Medicine, Experimental
/ Middle Aged
/ Pandemics
/ Population
/ Population studies
/ Public health
/ Respiratory diseases
/ Respiratory tract diseases
/ Risk assessment
/ Risk factors
/ Risk perception
/ Rural Population
/ SARS-CoV-2 - isolation & purification
/ Severity of Illness Index
/ Shelter in place
/ South Africa - epidemiology
/ Surveillance
/ Surveys
/ Surveys and Questionnaires
/ Young Adult
2025
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Concern for severe COVID-19 disease during the initial two years of pandemic in a rural South African community: A population-based study
by
Dzomba, Armstrong
, Kelly, Nicole K.
, Ginsburg, Carren
, Moffett, Bianca
, Kahn, Kathleen
, Pettifor, Audrey
, Kabudula, Chodziwadziwa
, Mataboge, Palesa
, Oladimeji, Kelechi Elizabeth
, Gutu, Kimberley
, Gómez-Olivé, Francesc Xavier
in
Adolescent
/ Adult
/ Adults
/ Aged
/ Asymptomatic
/ Behavior
/ Chronic conditions
/ Chronic illnesses
/ Consent
/ COVID-19
/ COVID-19 - epidemiology
/ COVID-19 - pathology
/ COVID-19 - psychology
/ COVID-19 vaccines
/ Data collection
/ Disease prevention
/ Disease transmission
/ Emergency medical care
/ Epidemics
/ Ethics
/ Fatalities
/ Female
/ Households
/ Humans
/ Illnesses
/ Infections
/ Male
/ Masks
/ Medical research
/ Medicine, Experimental
/ Middle Aged
/ Pandemics
/ Population
/ Population studies
/ Public health
/ Respiratory diseases
/ Respiratory tract diseases
/ Risk assessment
/ Risk factors
/ Risk perception
/ Rural Population
/ SARS-CoV-2 - isolation & purification
/ Severity of Illness Index
/ Shelter in place
/ South Africa - epidemiology
/ Surveillance
/ Surveys
/ Surveys and Questionnaires
/ Young Adult
2025
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Concern for severe COVID-19 disease during the initial two years of pandemic in a rural South African community: A population-based study
Journal Article
Concern for severe COVID-19 disease during the initial two years of pandemic in a rural South African community: A population-based study
2025
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Overview
Globally, as of December 2023, over 700 million cases of COVID-19 were confirmed since the initial outbreak late in 2019, claiming around 7 million lives and fuelling widespread fear and anxiety. However, prospective patient-data are unavailable to assess individuals' perceptions of risk of severe COVID-19 illness, which may imply actual disease severity and inform risk perception for future epidemics.
We surveyed 1701 adults about their concern for severe COVID-19 disease using a population-based survey of rural South Africans. The initial telephonic survey was conducted between August-October 2020 with a follow-up survey conducted between August-October 2021. Multinomial logistic regression was used to investigate predictors of perceived COVID-19 illness severity (low, medium, or high) controlling for measured confounders.
The prevalence of concern for COVID-19 illness severity in 2020 was 28.7% low, 26.8% moderate and 44.5% severe, with corresponding levels in 2021 of 42%, 31.8% and 29.2%, respectively. Although older age was associated with a lower odds of COVID-19 concern [50-59 years (aOR=0.54, 95% CI: 0.38-0.75)], [≥60 years (aOR=0.41,95% CI: 0.41-0.57)], adults having ≥1 chronic conditions (aOR=1.38,1.00-1.89) or residing outside of the study community (aOR=1.29,1.01-1.65) were more likely to experience moderate and high concern for illness severity, respectively.
Understanding presumptive COVID-19 disease severity may help disentangle various underlying mechanisms behind personal risk assessment. This may inform current thinking and practice of public health emergency medicine in managing emerging and re-emerging respiratory diseases with pandemic potential such as hPMV.
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