Africa: Covid Cases in Africa Were 'Underreported'

Learners are screened during the reopening of schools in South Africa.
24 February 2021

New studies indicate that COVID infections and deaths in Africa could have been higher than previously reported.

In Zambia, nearly one in every five recently deceased people brought into Lusaka's central morgue tested positive for the coronavirus, a study by the Boston University School of Public Health showed. The authors of the study said that challenges the view that Africa somehow "dodged" the COVID-19 pandemic.

The findings, published in theBMJ global health journal, indicate that low numbers of reported infections and deaths across Africa may be from lack of testing, with the coronavirus taking a terrible but invisible toll on the continent.

"Our findings cast doubt on the assumption that COVID-19 somehow skipped Africa or has not impacted the continent as heavily," says study co-author Dr. Lawrence Mwananyanda.

Rapid spread

However, in a recent interview with DW, the director of the Africa Centres for Disease Control and Prevention (Africa CDC), John Nkengasong, said the coronavirus had spread rapidly in Africa too. That, he said, could be behind the discrepancies in the number of reported cases.

"We have to admit that we now know that the reported cases based on molecular PCR (Polymerase Chain Reaction) test might underestimate the exposure, and we are seeing that many more people might have been exposed to the virus than they are currently been reported," Nkengasong said.

He downplayed the notion that there are were more COVID-19 deaths occurring in Africa than reported: "We have to understand that more deaths have occurred during the second wave and have been reported to the best of our knowledge." .

The Boston University researchers said they hope their findings will encourage African governments to look closer at the rollout of COVID-19 testing and empower Africans to take proactive steps -- such as wearing masks, physically distancing, and skipping handshakes -- to protect themselves.

"This study shows that with proper diagnostics and testing, we can begin to identify the scale of COVID-19 in African countries such as Zambia," said study co-author Dr. Christopher Gill.

The researchers noted that the high proportion of pediatric deaths they encountered was shocking given the rare COVID-19 deaths in children have been reported elsewhere.

Nigeria's dilemma

In Nigeria's Lagos state alone, one in every five people had COVID-19 antibodies by the end of October 2020, according to a study by the Nigeria Centre for Disease Control (NCDC) and Nigeria Institute for Medical Research (NIMR). The researchers surveyed four states between September and October 2020.

Blood samples were taken from more than 10,000 individuals living in a representative sample of households. According to the NCDC findings, the prevalence of antibodies was 23% in Lagos state -- which is home to more than 16 million people -- and Enugu, 19% in Nasarawa, and 9% in Gombe state. The number of confirmed infections amounted to tens of thousands at the time.

The surveys were designed to improve the estimate of the burden of COVID-19 infection in the country and provide a more detailed assessment of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus -- the virus that causes COVID-19. The findings offer the first detailed look into infections in Africa's most populous country.

A lack of testing supplies has hampered authorities'ability to ascertain the spread of the virus altogether. Such seroprevalence studies are seen as the only way of revealing the actual burden of COVID-19 in Africa.

New variants

New variants emerged quickly in Nigeria, the NCDC said, and continued to do so until transmission rates fell. It said the country is scaling up its sequencing capacity to understand the transmission of the virus and the impact of vaccines. The Nigerian study came amid reports indicating that a new COVID-19 variant -- dubbed B.1.525 and different from the UK variant -- was detected in Nigeria.

"So far, this [new variant] has been detected among cases in five states in Nigeria. B.1.525 cases have also been reported in other countries in travelers from Nigeria," the NCDC said.

The disease control agency says, researchers and scientists are conducting studies to understand whether the new variant has any impact on immunity, diagnostic severity, transmissibility, or the vaccines that have been approved. The number of COVID-19 cases detected in Nigeria in recent weeks indicates that the country risks losing the gains it has made so far in fighting the pandemic nine.

Tough measures

Rising infections, prompted the Nigeria Presidential Task Force (NPTF) to order the immediate closure of bars,nightclubs, and a halt to public gatherings. Recreational venues and restaurants have been operating without observing COVID-19 protocols leading to a spike in cases countrywide. Dauda Muhammad, a political analyst in Nigeria, blames the government in Abuja for failing to curb coronavirus infections.

"Restriction in terms of gatherings is not there, and the government is not doing enough to restrict passengers from high-risk countries from entering Nigeria," analyst Muhammad told DW.

"At the beginning, the government was quick to stop people from affected countries coming into Nigeria. But now it has failed Nigerians."

Yerma Ahmad Adamu, a consultant epidemiologist, is confident that Nigeria will contain the virus if COVID-19 protocols are observed.

"We need to do a lot more than what we are doing. The Center for Disease Control CDC is now trying to restrict anybody coming into the country either by air, by road, or by sea," Adamu told DW.

More than 152,000 cases of COVID-19 have been recorded in Nigeria so far, with 1,862 deaths and over 129,000 recoveries, according to the Niger Centre for Disease Control. It is worrisome however that the emergence of new variants with mutations is a feature of the second wave of COVID-19, the NCDC said.

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