Enhanced COVID-19 Surveillance at the Community Level in Africa

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Enhanced COVID-19 Surveillance at the Community Level in Africa

In alignment with the Adapted Africa Joint Continental Strategy for COVID-19 Pandemic, Africa CDC developed the Enhanced COVID-19 Surveillance at the Community Level in Africa strategy to aid Member States with:

  • rapid detection and isolation of cases during phases of low to moderate incidence;
  • identifying sub-national hotspots where interventions can be targeted; and
  • reducing the overall spread of SARS-CoV-2 and impact of COVID-19 on the continent

This strategy is needed given that highly transmissible and more deadly variants continue to circulate and overwhelm public health systems and health care facilities.  Additionally, vaccination rates and access to vaccines across the continent remain low, leaving the general population vulnerable to more severe outcomes if they do become infected.

The strategy recommends that AU Member States should enhance, where feasible, existing COVID-19 surveillance to include:

  1. Community-based surveillance to detect symptomatic cases early for treatment and to avert viral transmission;
  2. Sentinel surveillance in high-risk populations to detect and track both presymptomatic and asymptomatic cases; and
  3. Wastewater surveillance to monitor early environmental signs of virus transmission and identify communities where targeted interventions can be implemented to decrease transmission.

These recommendations are linked to the epidemic phases as defined in the Africa CDC Step-wise Guidance as well as the public health and social measure tiers.

To ensure successful implementation, testing and reporting considerations have been aligned with existing Africa CDC guidance on the implementation of rapid antigen testing and genomics surveillance.

The strategy links to recommendations for isolation, contact tracing and quarantine to decrease transmission of SARS-CoV-2 and ensure adequate treatment for those experiencing severe symptoms. At the community level, guidance for other key interventions are discussed to mitigate the primary and secondary harms of COVID-19.

We encourage all African Union Member States to take up this surveillance strategy.

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EXECUTIVE SUMMARY:

The Africa Centres for Disease Control and Prevention (Africa CDC) launched its Southern Africa Regional Collaborating Centre (SA-RCC) on 31st March 2021, from 9:00 am to 1:00 pm at Mulungushi Conference Centre in Lusaka, Zambia. The lunch was organised by the Southern Africa RCC in collaboration with the Ministry of Health (MoH) of the Republic of Zambia under the auspices of Dr. Kennedy Malama, Permanent Secretary of the MOH of the Republic of Zambia, and Chair of the organizing committee.

The overall objective of the launch was to highlight the technical support and planned initiatives for the Southern Africa Region that include Health Security, information sharing, policy dialogue, regional collaboration and partnership, and challenges affecting the Member States, as well as coordination across borders in the context of COVID-19 and beyond.

The launch was well attended, and officially declared open by Her Excellency, Mrs. Inonge Mutukwa Wina, the Vice President of the Republic of Zambia, and supported by His Excellency Moussa Faki Mahamat, Chairperson of the African Union Commission, represented by Mrs. Josefa Leonel Correia Sacko, the Commissioner for Rural Economy & Agriculture. Other participants in attendance include Hon. Dr. Jonas Chanda, MP, Minister of Health of the Republic of Zambia; Ministers from the Southern Africa Region; Her Excellency, Amira Elfadil Mohammed Elfadil, Acting Commissioner for Health, Humanitarian Affairs and Social Development, – and over 6,000 persons who attended the launch, majority of them virtually via Africa CDC Twitter Handle and Facebook page. Also in attendance were representatives from WHO, UNICEF, US-CDC, AU-SARO, RECs and SADC, Public Health England, World Bank, COMESA, AMERA, and EFENET in Zambia (See ANNEX 3).

The meeting concluded by requesting the Southern Africa RCC to present the findings of the Role of Regional public health institutions in improving disease surveillance and response in the region; introduce the framework of the Regional Integrated Surveillance and Laboratory Networks (RISLNET); organize a high-level regional meeting to improve cross border surveillance in the context of health security; organize a Technical Advisory Committee (TAC) meeting, and encourage African Union Member States that don’t have National Public Health Institute to establish one (See the table on agreed action points in No. 9 below)

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