Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is evolving differently in Africa than in other regions. Africa has lower SARS-CoV-2 transmission rates and milder clinical manifestations. Detailed SARS-CoV-2 epidemiologic data are needed in Africa. We used publicly available data to calculate SARS-CoV-2 infections per 1,000 persons in The Gambia. We evaluated transmission rates among 1,366 employees of the Medical Research Council Unit The Gambia (MRCG), where systematic surveillance of symptomatic cases and contact tracing were implemented. By September 30, 2020, The Gambia had identified 3,579 SARS-CoV-2 cases, including 115 deaths; 67% of cases were identified in August. Among infections, MRCG staff accounted for 191 cases; all were asymptomatic or mild. The cumulative incidence rate among nonclinical MRCG staff was 124 infections/1,000 persons, which is >80-fold higher than estimates of diagnosed cases among the population. Systematic surveillance and seroepidemiologic surveys are needed to clarify the extent of SARS-CoV-2 transmission in Africa.
Highlights
We considered Medical Research Council Unit The Gambia (MRCG) staff as a cohort to provide additional insights into the nature of the COVID-19 epidemic in The Gambia
Persons 60 years of age are underrepresented in the MRCG cohort compared with the population of The Gambia, (Table)
Urban residents are overrepresented in the MRCG cohort; 67.6% of MRCG staff live in cities or towns compared with 59.4% of the overall population
Summary
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is evolving differently in Africa than in other regions. The cumulative incidence rate among nonclinical MRCG staff was 124 infections/1,000 persons, which is >80-fold higher than estimates of diagnosed cases among the population. By the end of October 2020, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic had spread to 6 continents and caused >45 million coronavirus disease (COVID-19) cases and 1.1 million deaths [1]. Mild First Epidemic Wave of COVID-19, The Gambia avoidance of medical care during the pandemic, as described in other regions [7], could partly explain the low number of hospitalized patients, the milder COVID-19 disease severity reported appears to be genuine, and several biologic and environmental factors have been proposed as potential contributing factors [8,9,10]
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