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Accepted for/Published in: JMIR Public Health and Surveillance

Date Submitted: Aug 2, 2021
Open Peer Review Period: Aug 2, 2021 - Aug 16, 2021
Date Accepted: Aug 16, 2021
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Excess Mortality During the COVID-19 Pandemic in Jordan: Secondary Data Analysis

Khader Y, Al Nsour M

Excess Mortality During the COVID-19 Pandemic in Jordan: Secondary Data Analysis

JMIR Public Health Surveill 2021;7(10):e32559

DOI: 10.2196/32559

PMID: 34617910

PMCID: 8500348

Excess Mortality During the COVID-19 Pandemic in Jordan: Secondary Data Analysis

  • Yousef Khader; 
  • Mohannad Al Nsour

ABSTRACT

Background:

All-cause mortality and estimates of excess deaths were commonly used in different countries to estimate the burden of COVID-19 and assess its direct and indirect effects.

Objective:

This study aimed to analyze the excess mortality during the COVID-19 in Jordan in April-December, 2020.

Methods:

Official data on deaths in Jordan for 2020 and previous years (2016-2019) were obtained for the Department of Civil Status. We contrasted mortality rates in 2020 with those in each year and the pooled period 2016-2020 using a standardized mortality ratio measure (SMR). Expected deaths for 2020 were estimated by fitting the overdispersed Poisson generalized linear models to the monthly death counts for the period of 2016-2019.

Results:

Overall, a 21% increase in standardized mortality (SMR = 1.21, 95% CI: 1.19–1.22) occurred in April-December 2020 compared to April-December months in the pooled period 2016-2019. The SMR was more pronounced for men compared to women (1.26 (95% CI: 1.24, 1.29) vs. 1.12 (95% CI: 1.10, 1.14)) and it was statistically significant for both genders (p<0.05). Using overdispersed Poisson generalized linear models, the number of expected deaths in April-December 2020 was 12845 (7957 in women and 4888 in men). The total excess deaths during this period was estimated at 4583 (95% CI: 4451, 4716) with higher excess deaths in men (3112 (95% CI: 3003, 3221)) compared to those in women (1503 (95% CI: 1427, 1579)). Almost 83.6% of excess deaths were attributed to COVID-19 in the MoH database. The vast majority of excess deaths occurred in people aged 60 years or more.

Conclusions:

The reported COVID-19 death counts underestimated mortality attributable to COVID-19. Excess deaths could reflect the increased deaths secondary to the pandemic and its containment measures. The majority of excess deaths occurred among old age groups. It is, therefore, important to maintain essential services for the elderly during pandemics.


 Citation

Please cite as:

Khader Y, Al Nsour M

Excess Mortality During the COVID-19 Pandemic in Jordan: Secondary Data Analysis

JMIR Public Health Surveill 2021;7(10):e32559

DOI: 10.2196/32559

PMID: 34617910

PMCID: 8500348

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