TY - JOUR T1 - COVID-19 mortality in women and men in sub-Saharan Africa: a cross-sectional study JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2021-007225 VL - 6 IS - 11 SP - e007225 AU - Jyoti Dalal AU - Isotta Triulzi AU - Ananthu James AU - Benedict Nguimbis AU - Gabriela Guizzo Dri AU - Akarsh Venkatasubramanian AU - Lucie Noubi Tchoupopnou Royd AU - Sara Botero Mesa AU - Claire Somerville AU - Giuseppe Turchetti AU - Beat Stoll AU - Jessica Lee Abbate AU - Franck Mboussou AU - Benido Impouma AU - Olivia Keiser AU - Flávio Codeço Coelho Y1 - 2021/11/01 UR - http://gh.bmj.com/content/6/11/e007225.abstract N2 - Introduction Since sex-based biological and gender factors influence COVID-19 mortality, we wanted to investigate the difference in mortality rates between women and men in sub-Saharan Africa (SSA).Method We included 69 580 cases of COVID-19, stratified by sex (men: n=43 071; women: n=26 509) and age (0–39 years: n=41 682; 40–59 years: n=20 757; 60+ years: n=7141), from 20 member nations of the WHO African region until 1 September 2020. We computed the SSA-specific and country-specific case fatality rates (CFRs) and sex-specific CFR differences across various age groups, using a Bayesian approach.Results A total of 1656 deaths (2.4% of total cases reported) were reported, with men accounting for 70.5% of total deaths. In SSA, women had a lower CFR than men (mean = −0.9%; 95% credible intervals (CIs) −1.1% to −0.6%). The mean CFR estimates increased with age, with the sex-specific CFR differences being significant among those aged 40 years or more (40–59 age group: mean = −0.7%; 95% CI −1.1% to −0.2%; 60+ years age group: mean = −3.9%; 95% CI −5.3% to −2.4%). At the country level, 7 of the 20 SSA countries reported significantly lower CFRs among women than men overall. Moreover, corresponding to the age-specific datasets, significantly lower CFRs in women than men were observed in the 60+ years age group in seven countries and 40–59 years age group in one country.Conclusions Sex and age are important predictors of COVID-19 mortality globally. Countries should prioritise the collection and use of sex-disaggregated data so as to design public health interventions and ensure that policies promote a gender-sensitive public health response.Data are available on reasonable request. The data (data dictionary, statistical code) that support the findings of this study are available upon reasonable request from the corresponding author. Some of the data are publicly available through situation reports produced by Ministries of Health and WHO/AFRO on their respective websites. ER -