Estimating the SARS-CoV2 infections detection rate and cumulative incidence in the World Health Organization African Region 10 months into the pandemic.

Benido Impouma,Bridget Farham,Zabulon Yoti,Antoine Flahault,Cyrus Shahpar,Francis Kasolo,Olivia Keiser,Ngoy Nsenga,George Sie Williams,Humphrey Karamagi,Franck Mboussou,Caitlin M Wolfe,Roland Ngom,Cláudia Torres Codeço

doi:10.1017/s0950268821002417

Abstract

As of 03 January 2021, the WHO African region is the least affected by the coronavirus disease-2019 (COVID-19) pandemic, accounting for only 2.4% of cases and deaths reported globally. However, concerns abound about whether the number of cases and deaths reported from the region reflect the true burden of the disease and how the monitoring of the pandemic trajectory can inform response measures.We retrospectively estimated four key epidemiological parameters (the total number of cases, the number of missed cases, the detection rate and the cumulative incidence) using the COVID-19 prevalence calculator tool developed by Resolve to Save Lives. We used cumulative cases and deaths reported during the period 25 February to 31 December 2020 for each WHO Member State in the region as well as population data to estimate the four parameters of interest. The estimated number of confirmed cases in 42 countries out of 47 of the WHO African region included in this study was 13 947 631 [95% confidence interval (CI): 13 334 620-14 635 502] against 1 889 512 cases reported, representing 13.5% of overall detection rate (range: 4.2% in Chad, 43.9% in Guinea). The cumulative incidence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was estimated at 1.38% (95% CI: 1.31%-1.44%), with South Africa the highest [14.5% (95% CI: 13.9%-15.2%)] and Mauritius [0.1% (95% CI: 0.099%-0.11%)] the lowest. The low detection rate found in most countries of the WHO African region suggests the need to strengthen SARS-CoV-2 testing capacities and adjusting testing strategies.

Highlights

In late December 2019, a novel coronavirus identified as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was detected in a cluster of pneumonia cases reported in Wuhan City, Hubei Province, China [1]
We used the cumulative number of COVID-19 cases and deaths, the estimated population in 2019 [12] in each Member State and an empirical infection fatality ratio (IFR) from available literature to estimate the true number of COVID-19 cases, the detection rate and the cumulative incidence
In accordance with the (IHR 2005) [17], all member states in the African region share their national situation reports on the COVID-19 pandemic with the World Health Organization (WHO) Regional Office for Africa

Summary

Introduction

In late December 2019, a novel coronavirus identified as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was detected in a cluster of pneumonia cases reported in Wuhan City, Hubei Province, China [1]. The first case of COVID-19 was reported in the WHO African region, the last of the six WHO regions to be affected, on 25 February 2020 in a traveller in Algeria [3]. With fragile health systems, limited testing capacities and potentially vulnerable populations, it was anticipated that countries in the WHO African region would be among the worst affected by the COVID-19 pandemic [4]. By 3 January 2021, the region remained among the least affected accounting for 2.4% (n = 1.9 million out of 83.3 million) and 2.4% (n = 43 600 out of 1.8 million) of globally reported COVID-19 cases and deaths, respectively [6]. IP address: 35.174.170.246, on 19 Jan 2022 at 10:01:19, subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms.

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