Increased number of brought-in-dead cases with COVID-19 in Zambia

1 February, 2021

Dear HIFA-Zambia and HIFA members,

Zambian health professionals report an increase in the number of brought-in-dead cases with COVID-19, which they suggest could be due to poor healthcare-seeking behaviour and lack of knowledge about the disease.

A short report in the Pan African Medical Journal. Citation, extracts and a comment from me below.

CITATION: Increased number of brought-in-dead cases with COVID-19: Is it due to poor health-seeking behaviour among the Zambian population?.

Pan African Medical Journal. 37 (pp 1-4), 2020. Article Number: 136. Date of Publication: September-December 2020.

Chileshe M.; Mulenga D.; Mfune R.L.; Nyirenda T.H.; Mwanza J.; Mukanga B.; Mudenda S.; Daka V.


'Zambia has seen an increase in the number of COVID-19 cases and associated deaths. As of September 7, 2020, there were 12,836 confirmed cases of COVID-19 and a total of 295 deaths. Of concern is that there has also been an increase in the number of COVID-19 brought-in-dead (BID) in the recent weeks with peak number being 28 BIDs on 9th August, 2020 within 24-hours... Of the total 295 deaths, 214 were BIDs, indicating that 72.5% of the COVID-19 deaths are occurring in the community...

'We hypothesize that this increase could be attributed to a poor healthcare-seeking behaviour among the Zambian population which may be due to a lack of knowledge about the disease, perception of the illness, stigma associated with the disease, readily available drug stores aiding self-medication as well as misconceptions about the severity of the disease due to the relative high proportion of recoveries with respect to cases. We recommend that studies on the perceptions of the Zambian population regarding COVID-19 be carried out to determine the drivers of the observed poor health seeking behaviour. We also recommend that there must be continuous and effective community sensitization and engagement programmes with regards to COVID-19 prevention and management. This information could be key in strengthening existing mitigation strategies against COVID-19 in Zambia.'

COMMENT (NPW): Fear of hospitals seems likely to be a key factor, especially during this pandemic. It would be interesting to hear the experience from other countries. Email:

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Best wishes, Neil

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - ), a global community with more than 20,000 members in 180 countries, interacting on six global forums in four languages in collaboration with WHO. Twitter: @hifa_org FB: