Epidemiological Profile of SARS-CoV-2 Cases in the Gambia from 2020 to 2022: An E-Surveillance-Based Study

COVID-19 is a respiratory infection instigated by a novel coronavirus, which was initially discovered in Wuhan, China, in December 2019. This disease is characterized as highly contagious, with primary symptoms including fever, cough, and breathing difficulties. Following the report of its first case in March 2020, the Gambia swiftly enacted a series of public health measures aimed at curbing the transmission of the virus. These interventions included the closure of schools and non-essential public services, the prohibition of public gatherings, and the implementation of social distancing protocols. This research endeavor seeks to provide a comprehensive description of the sociodemographic characteristics of the affected population and to delineate the infection trends observed throughout the pandemic period in the Gambia. The study’s findings are anticipated to aid the Ministry of Health in making informed public health decisions and implementing social measures to combat the pandemic effectively. The research is based on analysis of surveillance and laboratory data collected in the Gambia from January 2020 to December 2022. The data was sourced from the national COVID-19 E-tracker within the DHIS-2 system. COVID-19 testing was carried out across all districts, utilizing both health facilities and dedicated testing centers. To evaluate the relationships between COVID-19 outcomes (positive or negative) and various demographic factors, the chi-square test was employed. Additionally, binary logistic regression was used to further investigate the associations between the study variables. For all statistical analyses, significance was established at a p-value of less than 0.05 within a 95% confidence interval. The data analysis was performed using IBM SPSS (Version 25). The study found a SARS-CoV-2 prevalence of 6.3%, corresponding to 10,019 positive cases out of 158,281 samples analyzed. Infection rates were higher among males, who accounted for 5,680 (57.3%) of the cases. When disaggregated by age, the 21-30 age group recorded the highest number of infections, with 2,176 cases (22.1%), whereas the age group over 80 years had the lowest incidence, with 130 cases (1.3%). However, logistic regression analysis revealed that the 81-100 age group had significantly higher odds of testing positive for the virus (odds ratio 3.57, CI 2.89-4.43; p = 0.001) when compared to the reference group of individuals aged 10 and under. The outbreak resulted in a total of 372 deaths from 12,646 cumulative cases, yielding a case fatality ratio of 2.9%. The findings suggest that the Gambia experienced a relatively mild COVID-19 outbreak characterized by a low fatality rate. A significant portion of the recorded deaths was associated with pre-existing comorbidities, with a particular emphasis on non-communicable diseases such as diabetes and hypertension, as well as advanced age. The utilization of an e-tracker surveillance system proved to be an effective and efficient tool for monitoring the pandemic. It is recommended that the Ministry of Health continues to strengthen and utilize this system for the detection and containment of future public health threats.