Contact Tracing and the COVID-19 Response in Africa: Best Practices, Key Challenges, and Lessons Learned from Nigeria, Rwanda, South Africa, and Uganda
Year: 2021
Type: article
Abstract: Most African countries have recorded relatively lower COVID-19 burdens than Western countries. This has been attributed to early and strong political commitment and robust implementation of public health measures, such as nationwide lockdowns, travel restrictions, face mask wearing, testing, contact tracing, and isolation, along with community education and engagement. Other factors include the younger population age strata and hypothesized but yet-to-be confirmed partially protective cross-immunity from parasitic diseases and/or other circulating coronaviruses. However, the true burden may also be underestimated due to operational and resource issues for COVID-19 case identification and reporting. In this perspective article, we discuss selected best practices and challenges with COVID-19 contact tracing in Nigeria, Rwanda, South Africa, and Uganda. Best practices from these country case studies include sustained, multi-platform public communications; leveraging of technology innovations; applied public health expertise; deployment of community health workers; and robust community engagement. Challenges include an overwhelming workload of contact tracing and case detection for healthcare workers, misinformation and stigma, and poorly sustained adherence to isolation and quarantine. Important lessons learned include the need for decentralization of contact tracing to the lowest geographic levels of surveillance, rigorous use of data and technology to improve decision-making, and sustainment of both community sensitization and political commitment. Further research is needed to understand the role and importance of contact tracing in controlling community transmission dynamics in African countries, including among children. Also, implementation science will be critically needed to evaluate innovative, accessible, and cost-effective digital solutions to accommodate the contact tracing workload.
Authors: Jean B. Nachega, Rhoda Atteh, Chikwe Ihekweazu, Nadia A. Sam-Agudu, Prisca Adejumo, Sabin Nsanzimana, Edson Rwagasore, Jeanine Condo, Masudah Paleker, Hassan Mahomed, Fatima Suleman, Alex Riolexus Ario, Elsie Kiguli-Malwadde, Francis G. Omaswa, Nelson K. Sewankambo, Cecile Viboud, Michael J. A. Reid, Alimuddin Zumla, Peter H. Kilmarx
Institutions: Johns Hopkins University, University of Pittsburgh, Stellenbosch University, Nigeria Centre for Disease Control, University of Maryland, Baltimore, University of Cape Coast, Institute of Human Virology, University of Ibadan, Rwanda Biomedical Center, Ministry of Health, Tulane University, University of Rwanda, Western Cape Department of Health, University of KwaZulu-Natal, Ministry of Health, African Centre for Global Health and Social Transformation, Makerere University, National Institutes of Health, Fogarty International Center, University of California, San Francisco, UCL Biomedical Research Centre, University College London
Language: English
Subfield: Information Systems
Field: Computer Science
Domain: Physical Sciences
Open Access status: hybrid
Funders: American Society of Tropical Medicine and Hygiene, University of Pittsburgh, National Institutes of Health, Centers for Disease Control and Prevention, Fogarty International Center, National Institute of Child Health and Human Development, European and Developing Countries Clinical Trials Partnership
Awards: G1442824167, G1897216522, G1979267443, G208887824, University of Pittsburgh HIV-Comorbidities Research Training Program in South Africa, G2197361284, G2411606554, G2454219733, G2592314015, G2705591391, G3623044530, G3963720733, G438972410, Cardiometabolic Outcomes, Mechanisms and approach to prevention of Dolutegravir Associated Weight Gain In South Africa, G5514976981, G6454905430, G6927563293, G7200865844, G7867132706, G9000139246, African Association for Health Professions Education and Research
OpenAlex ID: W3127790195