Abstract
Background: After the worldwide spread of the coronavirus pandemic, several experts predicted a health catastrophe in Africa. However, the expected earthquake ultimately did not occur and the statistics of the number COVID-19 cases and deaths for other continents (Europe, America, Asia) were far higher than those of Africa. This study focused on Central Africa tried to explain this low incidence of COVID-19.
 Methodology: A cross-sectional time series method was adopted and the data of COVID-19 cases and deaths for Angola, Cameroon, Chad, Central African Republic, Congo Brazzaville, Democratic Republic of Congo, Gabon, Equatorial Guinea and Sao Tome and Principe between March and November 2020 were extracted from the World Health Organization COVID-19 database. The evolution of COVID-19 cases and deaths for each country were plotted and the accuracy measures such as Mean Absolute Percentage Error, Median Absolute Deviation and Mean Squared Displacement were calculated. Association between the countries and the prevalence of cases, deaths and recovered was visualized through principal component analysis.
 Results: The results showed that the highest number of cases was observed in Cameroon (21,793) while Sao Tome and Principe scored the smallest one (962). However, based on the total population, the prevalence of COVID-19 cases was high in Sao Tome and Principe (0.436%) and Gabon (0.400%). The highest death percentages (≥2%) were observed in Chad (6.742%), RDC (2.708%) and Angola (2.592%) while the highest recovered percentages were in Gabon (99.10%), Equatorial Guinea (97.62%) and Cameroon (97.02%). Development of traditional medicines and modification of food behavior including consumption of plant extracts appear as the reasons for the highest recovered rates. The accuracy measurements showed that the trend curves were not correlated with the actual evolution of the pandemic, but the Spearman correlation test revealed that except Equatorial Guinea (r=0.042, p=0.817), the evolution of COVID-19 cases and deaths were strongly correlated.
 Conclusion: The overall prevalence and incidence of COVID-19 is low in the countries of the Central Africa sub-region despite the problems facing the health systems of these countries.
Highlights
The current outbreak of COVID-19 (SARS-CoV2; previously 2019-nCoV), which started in Hubei province in the People's Republic of China, has spread to all the continents and almost all countries
The present study aims to study this phenomenon of low incidence of COVID-19 in Africa by using data provided by the WHO database on the evolution of the pandemic
The linear regression of the trend of COVID-19 cases confirmed the previous observations made in Angola and showed a growing trend in the number of cases
Summary
The current outbreak of COVID-19 (SARS-CoV2; previously 2019-nCoV), which started in Hubei province in the People's Republic of China, has spread to all the continents and almost all countries. Given the proven dangerousness of SARS-CoV-2, several states have set up various protocols to limit its spread among the population by closing borders or limiting flights, strict lockdown, social distancing, individual protection measures (wearing masks and gloves) since a specific treatment or vaccine were still unavailable [2,3,4] Despite all these measures, the situation remained complex and after the exit from lockdown which was observed between February and August 2020 in most countries around the world, several countries saw the number of confirmed cases starts to rise again but with fewer deaths than at the beginning of the pandemic [5]. Conclusion: The overall prevalence and incidence of COVID-19 is low in the countries of the Central Africa sub-region despite the problems facing the health systems of these countries
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