Six in seven COVID-19 infections go undetected in Africa

The initiative will use a “ring strategy”, which was pioneered successfully in the eradication of smallpox in the latter half of the 20th century to vaccinate people who are most likely to be infected, and during the recent Ebola outbreaks in West Africa and in the Democratic Republic of the Congo.

The ring approach will target people living inside a circle of 100 metres radius around each new confirmed case to prevent further spread of the disease.

In addition, each household within the 100 metres radius will receive hygiene kits including face masks and hand sanitizers and anyone who tests positive will be assessed for the severity of their condition to determine whether they should receive home-based care or need to be transferred to designated COVID-19 treatment centres.

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

All testing will be carried out on a voluntary basis and will be conducted using WHO-approved antigen based rapid diagnostic tests, which can produce results on-site in as little as 15 minutes and can be administered with minimal training.

Rapid diagnostic tests are considered highly accurate for detecting infections that have reached the transmissible stage. Currently, most countries carry out polymerase chain reaction or PCR tests, which require reagents and experts, and are significantly more time-consuming and expensive than rapid diagnostic tests.

There have now been over 8.4 million COVID-19 cases recorded in Africa, including 214 000 deaths.

Despite a decline in case numbers in recent weeks, vaccination rates remain low, with only 30% of the continent’s 54 nations having fully vaccinated 10% of their population against the disease—compared with almost 90% of high-income countries.

Meanwhile, just under half of the African countries that have received COVID-19 vaccines have fully vaccinated just 2% or less of their populations.

In the absence of enough vaccines, a more proactive community testing effort is especially important for reducing transmission in African countries where a relatively youthful population is contributing to a high rate of asymptomatic infections.

Estimates show that between 65% and 85% of COVID-19 infections in Africa generate few or no symptoms. As a result, most Africans infected with the disease do not seek out treatment in local health facilities where most testing now occurs. Yet, asymptomatic individuals are playing a key role in facilitating transmission to vulnerable individuals who can suffer severe disease or death.

“Public health authorities in Africa have so far been rightly focused on managing the cases coming into treatment centres and hospitals,” Dr Moeti said. “But now is the time to go on the offensive against COVID-19, and work with local communities to break transmission chains and stop wider outbreaks from happening.”

By APO Group on behalf of WHO Regional Office for Africa.

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