Treatment and case fatality rate of COVID-19 in Africa
Accepted: 6 July 2022
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
In Africa, the treatment of COVID-19 depends on each country. Several protocols are observed with real results that we described in this study. The objective of this review was to describe the treatment of COVID-19 and the case fatality rate in African countries, by reviewing the literature on treatment and case fatality in African countries whose data was available through the internet during the writing period until February 7, 2021. The majority of African countries had a treatment based on hydroxychloroquine or chloroquine + azithromycin, used in varying doses depending on the country. The lethality in Africa remains low compared to European and American countries. The same treatment being used in some northern countries does not fully explain the low case fatality.
Coronavirus Disease (COVID-19) Situation Reports. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus 2019/situation reports
Wang M, Cao R, Zhang L, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res 2020;30:269–71.
De Wit E, Feldmann F, Cronin J, et al. Prophylactic and therapeutic remdesivir (GS-5734) treatment in the rhesus macaque model of MERS-CoV infection. Proc Natl Acad Sci U S A 2020;117:6771-76.
Sheahan TP, Sims AC, Leist SR, et al. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon-beta against MERS-CoV. Nat Commun 2020;11:222.
Yao TT, Qian JD, Zhu WY, et al. A systematic review of lopinavir therapy for SARS coronavirus and MERS coronavirus-A possible reference for coronavirus disease-19 treatment option. J Med Virol 2020;92:556-63.
Young BE, Ong SWX, Kalimuddin S, et al. Epidemiologic Features and Clinical Course of Patients Infected With SARS-CoV-2 in Singapore. JAMA 2020;323:1488-94.
Vincent MJ, Bergeron E, Benjannet S, et al. Chloroquine is a potent inhibitor of SARS coronavirus infection and spread. Virol J 2005;2:69.
Savarino A, Boelaert JR, Cassone A, et al. Effects of chloroquine on viral infections: an old drug against today’s diseases? Lancet Infect Dis 2003;3:722–27.
Corticosteroids for COVID-19. 2020. Available at https://www.who.int/publications/i/item/WHO-2019-nCoV-Corticosteroids-2020.1
RECOVERY Collaborative Group. Dexamethasone in Hospitalized Patients with Covid-19. N Engl J Med. 2021;384:693-704.
COVID-19 case management protocol. 2020. Available at: https://www.santé.gov.ma
Preparedness and response plan for the threat of coronavirus COVID-19 infection in Algeria. 2020. Available at: https://www.santé.gov.dz
A guide for the patient suspected or affected by Covid-19 version of 25 April 2020. Available at: https://www.ineas.tn/sites/default/files/gpc_covid_19_version_25_april_2020.pdf
ECMO experts.com: COVID-19 diagnosis and treatment - Egyptian protocol
COVID-19 treatment protocol. Available at: https://www.sante.gov.mr/?lang=fr
Management of COVID-19 in Libya. Available at: https://www.theLibyaobserver.com
Interim guidelines and management of Covid in Kenya. Available at: https://www.health.go.ke
National guidelines and management of Covid-19. Available at: https://www.health.go
COVID-19 infection treatment guidelines for Rwanda. Available at: https://www.rbc.gov.rw
Burundi guidelines for Covid-19 treatment protocol. Available at: https://www.c19hub.10
Case management protocol for Corona Virus Disease-19 (COVID-19) in Ethiopia. Available at: https://www.ephi.gov.et
Management of COVID-19 in Africa. Available at: https://www.imeas.fr
COVID-19 guidelines for Ghana. Available at: https://www.moh.gov.gh/wp-content/uploads/2016/02/COVID-19-STG-JUNE-2020-1.pdf
Interim guidance on clinical care for patients with Covid-19 in Liberia. Available at: http://moh.gov.lr/wp-content/uploads/Interim_Guidance_for_care_of_Pts_with_Covid_19_in_Liberia.pdf
National Interim Guidelines for Clinical Management of COVID-19 in Nigeria. Available at: https://covid19.ncdc.gov.ng/media/files/National_Interim_Guidelines_for_Clinical_Management_of_COVID-19_v3.pdf
Management of COVID-19 in South Africa. Available at: https://www.nicd.ac.za/wp-content/uploads/2021/08/MANAGING-COVID19-2-FINAL_v3.35-DR-NDJEKA.pdf
Zimbabwe guideline for the management of COVID-19. Available at: https://cquin.icap.columbia.edu/wp-content/uploads/2020/04/ZIMBABWE_COVID-19-CLINICAL-GUIDELINES-APRIL-2020.pdf
Taieb F, Mbaye KD, Tall B, et al. Hydroxychloroquine and Azithromycin Treatment of Hospitalized Patients Infected with SARS-CoV-2 in Senegal from March to October 2020. J Clin Med 2021;10:2954.
Kayembe JMN, D Ishoso, C Mbongopasi, et al. Our experience of using Hydroxychloroquine and Azithromycin in the treatment of COVID-19: an observational study from Kinshasa, Democratic Republic of Congo. Biomedical Research and Clinical Reviews. 2021;4:1.
Mitjà O, Corbacho-Monné M, Ubals M, et al. A Cluster-Randomized Trial of Hydroxychloroquine for Prevention of Covid-19. N Engl J Med. 2021;384:417-427.
Boulware DR, Pullen MF, Bangdiwala AS, et al. A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19. N Engl J Med. 2020;383:517-525.
Cavalcanti AB, Zampieri FG, Rosa RG, et al. Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19. N Engl J Med. 2020;383:2041-2052
Dubée V, Roy PM, Vielle B, et al. Hydroxychloroquine in mild-to-moderate coronavirus disease 2019: a placebo-controlled double-blind trial. Clin Microbiol Infect. 2021;27:1124-1130
Abella BS, Jolkovsky EL, Biney BT, et al. Efficacy and Safety of Hydroxychloroquine vs Placebo for Pre-exposure SARS-CoV-2 Prophylaxis Among Health Care Workers: A Randomized Clinical Trial. JAMA Intern Med. 2021;181:195-202
Cao B, Wang Y, Wen D, et al. A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19. N Engl J Med. 2020;382:1787-1799.
Njenga MK, Dawa J, Nanyingi M, et al. Why is There Low Morbidity and Mortality of COVID-19 in Africa? Am J Trop Med Hyg. 2020;103:564-569
Lawal Y. Africa's low COVID-19 mortality rate: A paradox? Int J Infect Dis. 2021;102:118-122
Osei SA, Biney RP, Anning AS, et al. Low incidence of COVID-19 case severity and mortality in Africa; Could malaria co-infection provide the missing link? BMC Infect Dis. 2022;22:78.
Copyright (c) 2022 Ben Bepouka, Patricia Bandubuila Kaja, Hippolyte Situakibanza
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.