WHO African Region Report : Eritrea, zero new confirmed COVID-19 cases

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COVID-19 Situation update for the WHO African Region, External Situation Report 10 (5 May 2020)

The coronavirus disease 2019 (COVID-19) outbreak continues to evolve in the WHO African Region since the first case was reported on 25 February 2020 in Algeria. Since then, the disease has spread to over 30 countries in less than a month, now affecting all Member States except for Lesotho. The latest country to report a confirmed case was Comoros on 30 May 2020.

Since our last situation report on 29 April 2020 (External Situation Report 9), an additional 10 577 confirmed COVID-19 cases (a 47% increase) and 294 additional deaths (a 33% increase) were reported across the WHO African Region. During this period, a sharp rise in the number of confirmed COVID-19 cases was observed in five countries: Sao Tome and Principe (from 11 to 171 cases, 1455%), Guinea Bissau (from 77 to 292 cases, 279%), Chad (from 52 to 170 cases, 227%), Nigeria (from 1 532 to 2 950 cases, 93%) and Central African Republic (from 50 to 94 cases, 88%). Meanwhile, five countries, including Eritrea, Mauritius, Namibia and Seychelles have reported zero new confirmed COVID-19 cases. Of note, Namibia, Seychelles and Eritrea have reported zero new confirmed COVID-19 cases in the past 30, 28 and 16 days, respectively.

As of 5 May 2020, a cumulative total of 32 953 confirmed COVID-19 cases with 1 193 deaths (case fatality ratio 3.6%) have been reported across the 46 affected countries in the region. The list of affected countries and their respective number of cases and deaths is presented in Table 1.

Figures 1 and 2 show the daily and weekly distribution of cases by date and week of reporting, respectively. During the reporting period, the region recorded its highest daily case-count since the beginning of the outbreak, with more than 1 000 new cases reported each day in the past seven days. Of the 46 affected countries, eight have registered more than 1 000 confirmed COVID-19 cases, including, South Africa (7 572), Algeria (4 838), Nigeria (2 950), Ghana (2 719), Cameroon (2 265), Guinea (1 811), Côte d’Ivoire (1 464) and Senegal (1 329). Senegal is the latest country to cross the 1 000 cases mark. Together, these eight most-affected countries account for 76% of all reported cases in the region.

Algeria has reported the highest mortality in the region, with 470 deaths, followed by South Africa with 148, Cameroon (108), Nigeria (98) and Burkina Faso (48). The highest case fatality ratios were observed in Algeria (9.7%), Liberia (11.8%), Chad (10.0%), Togo (7.0%) and Burkina Faso (7.0%). Algeria alone accounted for 39% of all COVID-19 deaths reported in the region. Figure 3 shows the distribution of cases and deaths by week of notification in six most affected countries.

Notably, a critical group of people, health workers, have been greatly affected by the COVID-19 outbreak, with 945 health workers being infected in 28 counties in the region since the beginning of the outbreak. Four countries, Chad, Liberia, Sao Tome and Principe and United Republic of Tanzania, reported their first health worker infections this week. Overall, South Africa has been the most affected, with 325 health workers infected, followed by Niger (126), Côte d’Ivoire (85), Gabon (57) and Cameroon (40), Other countries that recorded health worker infections include Democratic Republic of the Congo (39), Liberia (33), Sao Tome and Principe (32), Mauritius (30), Sierra Leone (29), Senegal (27), Equatorial Guinea (26), Ghana (25), Zambia (15), Guinea-Bissau (15), Eswatini (8), Togo (6), Chad (5), Madagascar (5), Congo (4), Uganda (3), Benin (2), Kenya (2), Namibia (2), Burundi (1), Central African Republic (1), United Republic of Tanzania (1) and Zimbabwe (1).

According to available data on age and gender distribution (n=4 639), the male to female ratio among confirmed cases is 1.8, and the median age is 42 years old (range: 0 – 105). Males (62%) in the 31-39 and 40-49 age-groups are more affected than females (38%) across the same age-groups. The distribution of cases by age and sex is presented in figure 4

Currently, the majority of the countries in the region are experiencing local transmission of COVID-19 and the number of countries with widespread community transmission also increasing. The region has also observed increased incidences of importation of cases from affected countries within the region.

Overall, in the African continent, a total of 49 121 cases and 1 956 deaths (case fatality ratio 4.0%) have been reported as of 5 May 2020, including 32 953 cases and 1 193 deaths in the WHO African Region and 16 168 cases and 763 deaths in the WHO Eastern Mediterranean Region.