{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:39:41Z","timestamp":1790987981366,"version":"4.1.0"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>COVID-19 has had considerable global impact; however, in sub-Saharan Africa, it is one of several infectious disease priorities. Prioritization is normally guided by disease burden, but the highly age-dependent nature of COVID-19 and that of other infectious diseases make comparisons challenging unless considered through metrics that incorporate life-years lost and time lived with adverse health. Therefore, we compared the 2020 mortality and disability-adjusted life-years (DALYs) lost estimates for malaria, tuberculosis, and HIV\/AIDS in sub-Saharan African populations with more than 12 months of COVID-19 burden (until the end of March 2021) by applying known age-related mortality to United Nations estimates of the age structure. We further compared exacerbations of disease burden predicted from the COVID-19 public health response. Data were derived from public sources and predicted exacerbations were derived from those published by international agencies. For sub-Saharan African populations north of South Africa, the estimated recorded COVID-19 DALYs lost in 2020 were 3.7%, 2.3%, and 2.4% of those for tuberculosis, HIV\/AIDS, and malaria, respectively. Predicted exacerbations of these diseases were greater than the estimated COVID-19 burden. Including South Africa and Lesotho, COVID-19 DALYs lost were &lt; 12% of those for other compared diseases; furthermore, the mortality of compared diseases were dominant in all age groups younger than 65 years. This analysis suggests the relatively low impact of COVID-19. Although all four epidemics continue, tuberculosis, HIV\/AIDS, and malaria remain far greater health priorities based on their disease burdens. Therefore, resource diversion to COVID-19 poses a high risk of increasing the overall disease burden and causing net harm, thereby further increasing global inequities in health and life expectancy.<\/jats:p>","DOI":"10.4269\/ajtmh.21-0899","type":"journal-article","created":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T10:02:18Z","timestamp":1633946538000},"page":"1510-1515","source":"Crossref","is-referenced-by-count":45,"title":["Relative Burdens of the COVID-19, Malaria, Tuberculosis, and HIV\/AIDS Epidemics in Sub-Saharan Africa"],"prefix":"10.4269","volume":"105","author":[{"given":"David","family":"Bell","sequence":"first","affiliation":[{"name":"1Independent Consultant, Issaquah, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Schultz Hansen","sequence":"additional","affiliation":[{"name":"2Department of Public Health and Centre for Health Economics and Policy, University of Copenhagen, Copenhagen, Denmark;"},{"name":"3The National Research Center of Working Environment, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/105\/6\/article-p1510.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/105\/6\/article-p1510.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T18:02:11Z","timestamp":1638381731000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/105\/6\/article-p1510.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,1]]},"references-count":0,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.21-0899","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2021.03.27.21254483","asserted-by":"object"}]},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,1]]}}}