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Record W4412396146 · doi:10.1186/s12963-025-00390-0

Socio-economic inequalities in all-cause mortality during the COVID-19 period in north-western Tanzania, 2018–2021

2025· article· en· W4412396146 on OpenAlex
Sophia Kagoye, Charles Mangya, Eveline T. Konje, Jim Todd, Chodziwadziwa Kabudula, Jean Juste Harrisson Bashingwa, Jacqueline Materu, Coleman Kishamawe, Ties Boerma, Milly Marston, Mark Urassa

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.
fundA Canadian funder is recorded on the work.

Bibliographic record

VenuePopulation Health Metrics · 2025
Typearticle
Languageen
FieldMedicine
TopicCOVID-19 and healthcare impacts
Canadian institutionsUniversity of ManitobaManitoba Health
FundersCanada Research ChairsMedical Research CouncilUniversity of the Witwatersrand, JohannesburgSouth African Medical Research CouncilGlobal Affairs CanadaBill and Melinda Gates Foundation
KeywordsMedicineDemographyResidenceTanzaniaPandemicEpidemiologyProportional hazards modelPublic healthHazard ratioMortality ratePopulationCoronavirus disease 2019 (COVID-19)Environmental healthConfidence intervalGeographyDiseaseInternal medicineInfectious disease (medical specialty)Pathology

Abstract

fetched live from OpenAlex

BACKGROUND: Evidence suggests that the COVID-19 pandemic has exacerbated social and demographic inequalities in the communities through pathways of unequal exposure, vulnerability, and susceptibility. In Tanzania, evidence on COVID-19-related mortality is limited to health facility data, with little to no information on the mortality patterns in the general population. This study assessed sociodemographic inequalities in all-cause mortality during the COVID-19 period in north-western Tanzania. METHODS: We utilized available longitudinal data from the Magu Health and Demographic Surveillance System (HDSS) from January 2018 to December 2021. We compared the crude death rates between subgroups of age, sex, area of residence, and wealth index for a period before (2018/2019) and during (2020/2021) the COVID-19 pandemic. To quantify how mortality risk varies across the subgroups we fitted a Cox proportional hazard model with an interaction of the COVID-19 period. RESULTS: Overall mortality declined from 5.9 in 2018/2019 to 5.4 and 5.5 deaths per 1000 person-years in 2020 and 2021, respectively. We observed an increase in differences in crude death rates by age groups, area of residence, and wealth quintiles during the COVID-19 period. In the Cox proportional hazards model, compared to adults aged 15-49, we observed greater mortality risk in children under five (AHR:2.9; 95%CI: 2.2-3.9), older individuals aged 50-64 years (AHR:3.02; 95%CI:2.11-4.33) and 65 + (AHR:18.65; 95%CI:14.28-24.35) during COVID-19 period. Males were also at greater risk of death compared to females (AHR:1.30; 95%CI:1.06-1.59). CONCLUSION: Despite the overall mortality decline during the pandemic, we observed an increased risk of mortality among vulnerable subgroups (aged < 5 years and > 60 years) in the population. This highlights the need to take into account vulnerable subpopulations when addressing major public health issues in communities.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.002
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.074
Threshold uncertainty score0.998

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.002
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0010.002
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.254
GPT teacher head0.480
Teacher spread0.226 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it