مقالة

Excess All-Cause Mortality in Four Gulf Cooperation Council States and Three Arab Comparator Countries, 2020 to 2023: A Multi-Country Time-Series Analysis with Back-Tested Baselines

المؤلفون

  • lumora fatema
    • College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
  • Moath Aljohani
    • College of Medicine and Medical Sciences, Qassim University, Al Qassim, Saudi Arabia
  • Mohammed Elawad
    • Faculty of Health Sciences, Al-Leeth / Umm Al-Qura University, Al-Leith, Saudi Arabia
  • Mona A. Alfadeel
    • Assistant Professor Community Medicine, Almaarefah University, Riyadh, Saudi Arabia
  • Muhammad Irfanullah Siddiqui
    • College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia

المجلة متعددة التخصصات للرعاية الصحية مجلد 1 عدد 5 (2025) نُشر في

وصول مفتوح CC BY 4.0
لغة النص: العربية
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اقتباس

اقتبس هذه المقالة

fatema, lumora, Aljohani, M., Elawad, M., Alfadeel, M. A., & Siddiqui, M. I. (2025). Excess All-Cause Mortality in Four Gulf Cooperation Council States and Three Arab Comparator Countries, 2020 to 2023: A Multi-Country Time-Series Analysis with Back-Tested Baselines. المجلة متعددة التخصصات للرعاية الصحية, 1(5). https://doi.org/10.68608/hm9pxw05
مشاركة

الملخص

Background: Reported COVID-19 deaths are an incomplete measure of the pandemic's mortality burden, and estimates for Gulf Cooperation Council (GCC) states remain scarce beyond 2021. We estimated excess all-cause mortality in four GCC states and three Arab comparator countries from 2020 to 2023.

Methods: Population time-series study of monthly all-cause deaths from the World Mortality Dataset for Kuwait, Oman, Qatar and the United Arab Emirates, with Egypt, Jordan and Tunisia as comparators. Expected deaths were projected from 2015 to 2019 with a prespecified linear trend and month-of-year model; uncertainty was quantified by simulation. Five alternative baselines (negative binomial, seasonal ARIMA, Holt-Winters, gradient-boosted trees and an ensemble) were back-tested on 2018 and 2019, and excess deaths were compared with deaths reported to the World Health Organization.

Results: Across the four GCC states, 135,359 deaths were registered in 2020 to 2023 against 113,667 expected, an excess of 21,692 (95% PI 18,760 to 24,660), or 19.1% (95% PI 16.5 to 21.7). Cumulative P-scores ranged from 9.4% in Oman to 27.9% in the United Arab Emirates, and from 7.6% in Tunisia to 16.1% in Egypt. Most excess occurred in 2020 and 2021; Kuwait, Oman and Tunisia fell below expected levels by 2023, whereas Qatar and the United Arab Emirates remained above baseline. Excess deaths were 5.37 times reported COVID-19 deaths overall (range 0.78 to 14.51). In back-testing, annual errors of all baselines were between 4.0% and 5.4%.

Conclusions: The pandemic was associated with substantial excess mortality in GCC states, concentrated in 2020 and 2021 and exceeding reported COVID-19 deaths in most countries. Persistent excess in Qatar and the United Arab Emirates is difficult to separate from population change and data discontinuities. Monthly vital statistics by age, sex and nationality, including from Saudi Arabia, are needed for robust surveillance.

الكلمات المفتاحية

  • excess mortality
  • COVID-19
  • Gulf Cooperation Council
  • time-series analysis
  • vital statistics
  • forecasting
  • Middle East

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