COVID-19 testing in Africa: lessons learnt

Ondoa, Pascale; Kebede, Yenew; Loembé, Marguerite Massinga; Bhiman, Jinal N.; Tessema, Sofonias K.; Sow, Abdourahmane; Sall, Amadou Alpha; Nkengasong, John N.

doi:10.1016/s2666-5247(20)30068-9

Cited by 75 publications

(72 citation statements)

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“…While maintaining its robust mobilization against COVID-19, faced with a public-health crisis of unprecedented scale, Africa has demonstrated solidarity and unified leadership in responding quickly. Nevertheless, Africa is still on a trajectory to reach-out global regions more affected by COVID-19, especially at surveillance and the test-trace-isolate-treat strategy [ 5 ].…”

Section: The Low Prevalence Of Covid-19 In Malaria-endemic Countriesmentioning

confidence: 99%

Malaria and COVID-19: unmasking their ties

Hussein

Albashir

Elawad

et al. 2020

Malar J

139

117

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The incidence and mortality of COVID-19, according to the World Health Organization reports, shows a noticeable difference between North America, Western Europe, and South Asia on one hand and most African countries on the other hand, especially the malaria-endemic countries. Although this observation could be attributed to limited testing capacity, mitigation tools adopted and cultural habits, many theories have been postulated to explain this difference in prevalence and mortality. Because death tends to occur more in elders, both the role of demography, and how the age structure of a population may contribute to the difference in mortality rate between countries were discussed. The variable distribution of the ACEI/D and the ACE2 (C1173T substitution) polymorphisms has been postulated to explain this variable prevalence. Up-to-date data regarding the role of hydroxychloroquine (HCQ) and chloroquine (CQ) in COVID-19 have been summarized. The article also sheds lights on how the similarity of malaria and COVID-19 symptoms can lead to misdiagnosis of one disease for the other or overlooking the possibility of co-infection. As the COVID-19 pandemic threatens the delivery of malaria services, such as the distribution of insecticide-treated nets (ITNs), indoor residual spraying, as well as malaria chemoprevention there is an urgent need for rapid and effective responses to avoid malaria outbreaks.

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Section: The Low Prevalence Of Covid-19 In Malaria-endemic Countriesmentioning

confidence: 99%

Malaria and COVID-19: unmasking their ties

Hussein

Albashir

Elawad

et al. 2020

Malar J

139

117

View full text Add to dashboard Cite

show abstract

“…In the early stages of the COVID-19 pandemic, testing capabilities were often insufficient to resolve rapidly-increasing case and death numbers. This is still the case in some parts of the world, in particular in many developing countries [ 45 ]. Standard mortality measures such as the IFR and CFR thus suffer from a time-lag problem.…”

Section: Discussionmentioning

confidence: 99%

Using excess deaths and testing statistics to improve estimates of COVID-19 mortalities

Böttcher¹,

D’Orsogna

Chou

2021

Preprint

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Factors such as non-uniform definitions of mortality, uncertainty in disease prevalence, and biased sampling complicate the quantification of fatality during an epidemic. Regardless of the employed fatality measure, the infected population and the number of infection-caused deaths need to be consistently estimated for comparing mortality across regions. We combine historical and current mortality data, a statistical testing model, and an SIR epidemic model, to improve estimation of mortality. We find that the average excess death across the entire US is 13% higher than the number of reported COVID-19 deaths. In some areas, such as New York City, the number of weekly deaths is about eight times higher than in previous years. Other countries such as Peru, Ecuador, Mexico, and Spain exhibit excess deaths significantly higher than their reported COVID-19 deaths. Conversely, we find negligible or negative excess deaths for part and all of 2020 for Denmark, Germany, and Norway.

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“…The benefits and the challenges that come with large-scale deployment of molecular techniques in malaria endemic regions have been discussed elsewhere 48 . And now, the COVID-19 pandemic has renewed the discussion regarding the importance of molecular testing as part of public health systems across Africa 49 and will likely accelerate efforts to integrate molecular tools for larger scale genomic surveillance of malaria into control programs.…”

Section: Discussionmentioning

confidence: 99%

Analysis of nucleic acids extracted from rapid diagnostic tests reveals a significant proportion of false positive test results associated with recent malaria treatment

Hosch

et al. 2021

Preprint

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Surveillance programs often use malaria rapid diagnostic tests (RDTs) to determine the proportion of the population carrying parasites in their peripheral blood to assess the malaria transmission intensity. Despite an increasing number of reports on false-negative and false-positive RDT results, there is a lack of systematic quality control activities for RDTs deployed in malaria surveillance programs. Our study provides a larger scale comparative evaluation of RDTs used in the 2018 Malaria Indicator Survey (MIS) conducted on Bioko Island, Equatorial Guinea. We conducted a molecular analysis by extraction of nucleic acids from 1,800 negative and 1,065 positive RDTs followed by qPCR analysis. These results were combined with a dataset collected in a comprehensive questionnaire from each MIS participant. Of the 2,865 RDTs that were collected in 2018 on Bioko Island and analysed in our study, 4.7% had a false-negative result. These false-negative RDT results were associated with low parasite density infections. In a substantial proportion of samples, we identified masked pfhrp2 and pfhrp3 gene deletions in which at least one P. falciparum strain carried a gene deletion. Among all positive RDTs analysed, 28.4% were tested negative by qPCR and therefore considered to be false-positive. Analysing the questionnaire data collected from the participants, this high proportion of false-positive RDT results could be explained by PfHRP2 antigen persistence after recent malaria treatment. We conclude that malaria surveillance depending solely on RDTs needs well-integrated quality control procedures assessing the extend and impact of reduced sensitivity and specificity of RDTs on malaria control programs.

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COVID-19 testing in Africa: lessons learnt

Cited by 75 publications

References 0 publications

Malaria and COVID-19: unmasking their ties

Malaria and COVID-19: unmasking their ties

Using excess deaths and testing statistics to improve estimates of COVID-19 mortalities

Analysis of nucleic acids extracted from rapid diagnostic tests reveals a significant proportion of false positive test results associated with recent malaria treatment

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