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Six out of seven COVID-19 infections go undetected in Africa

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Six out of seven COVID-19 infections go undetected in Africa

With limited testing, we are still flying blind in far too many communities in Africa

BRAZZAVILLE, Congo (Republic of), October 14, 2021 / Groupe APO / –

A new assessment by the World Health Organization (WHO) shows that only 14.2% – or one in seven infections – with COVID-19 are detected in Africa. To reverse this trend and curb transmission, the WHO Regional Office for Africa today announced a new initiative to improve community testing for COVID-19 in eight countries. The program aims to reach over 7 million people with rapid diagnostic tests over the next year.

The WHO analysis used the COVID-19 calculator developed by Resolve to Save Lives which estimates infections based on the number of reported cases and deaths and an infection death rate based on studies based on the population. He revealed that as of October 10, 2021, the cumulative number of COVID-19 infections was estimated at 59 million in Africa, seven times more than the more than 8 million reported cases.

To date, detection of COVID-19 in Africa has focused on people presenting to health facilities with symptoms, in addition to testing international travelers arriving and departing, resulting in widespread underreporting. scale given the high percentage of asymptomatic cases on the continent.

Since the start of the pandemic and as of October 10, more than 70 million COVID-19 tests have been reported by African countries, which represents a fraction of the continent’s 1.3 billion people. In contrast, the United States, with around a third of the population, is said to have administered over 550 million tests, while the United Kingdom, with less than 10% of the African population, is said to have administered more than 280 million tests. .

“With limited testing, we are still flying blind in far too many communities in Africa. Most of the tests are done on people with symptoms, but much of the transmission is caused by people who are asymptomatic, so what we’re seeing might just be the tip of the iceberg. The number of tests has increased in Africa, but this community initiative is a radically new approach that is expected to help dramatically increase detection rates. More testing means rapid isolation, less transmission and more lives saved through targeted action, ”said Dr Matshidiso Moeti, WHO Regional Director for Africa.

The countries participating in the program are Burundi, Côte d’Ivoire, Democratic Republic of Congo, Guinea-Bissau, Mozambique, Republic of Congo, Senegal and Zambia. To kick-start implementation, WHO provided US $ 1.8 million to the eight countries. WHO will help countries interrupt transmission of the disease, through active case finding by deploying teams to local communities to trace possible contacts of people who test positive for COVID-19 and offer rapid diagnostic tests for the antigen.

The initiative will use a ‘ring strategy’, which was successfully launched in the eradication of smallpox in the second half of the 20th century to immunize those most likely to be infected, and during recent epidemics of smallpox. Ebola in West Africa and in the Democratic Republic of Congo. The ring approach will target people living in a circle 100 meters in radius around each new confirmed case to prevent further spread of the disease.

In addition, every household within a 100-meter radius will receive hygiene kits that include face masks and hand sanitizers, and anyone who tests positive will be assessed based on the severity of their condition to determine if they should receive any further. home care or must be transferred to designated COVID-19 treatment centers.

The program aims to increase testing capacity in each participating country by 40%, ensuring they meet the WHO recommended benchmark of 10 tests performed per 10,000 people per week. Currently, around 20 countries – more than a third of African countries – do not reach this benchmark

All tests will be performed on a voluntary basis and will be performed using WHO-approved antigen-based rapid diagnostic tests, which can produce results on the spot in as little as 15 minutes and can be administered with minimal training. Rapid diagnostic tests are considered very accurate in detecting infections that have reached the transmissible stage. Currently, most countries perform polymerase chain reaction or PCR tests, which require reagents and experts, and are significantly more time-consuming and expensive than rapid diagnostic tests.

There are now more than 8.4 million recorded cases of COVID-19 in Africa, including 214,000 deaths. Despite a decline in the number of cases in recent weeks, immunization rates remain low, with just 30% of the continent’s 54 countries having fully immunized 10% of their population against the disease, compared to nearly 90% of high-income countries. Meanwhile, just under half of African countries that have received COVID-19 vaccines have only fully vaccinated 2% or less of their population.

In the absence of enough vaccines, a more proactive community screening effort is particularly important to reduce transmission in African countries where a relatively young population contributes to a high rate of asymptomatic infections. Estimates show that between 65% and 85% of COVID-19 infections in Africa generate little or no symptoms. As a result, most Africans infected with the disease do not seek treatment at local health facilities where most testing is currently taking place. Yet asymptomatic people play a key role in facilitating transmission to vulnerable people who may have serious illness or die.

“So far, public health authorities in Africa have rightly focused on managing cases entering treatment centers and hospitals,” said Dr Moeti. “But now is the time to go on the offensive against COVID-19 and work with local communities to break chains of transmission and prevent larger epidemics from occurring.”

Dr Moeti spoke at a virtual press conference today facilitated by APO Group. She was joined by Dr Aly Ngon Tambdou, Deputy Chief Medical Officer, Dakar Health Region, Senegal, and Dr Ngozi Erondu Senior Scholar, O’Neill Institute, Georgetown University and Associate Fellow, Chatham House Global Health Program.

Dr Richard Mihigo, Coordinator, Immunization and Vaccine Development Program, WHO Regional Office for Africa, Dr Fiona Braka, Team Leader, Emergency Operations, WHO Regional Office for Africa, and Dr Thierno Balde, COVID-19 regional, were also present to answer questions. Deputy Incident Manager, WHO Regional Office for Africa.

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