1. Background
The outbreak of acute respiratory syndrome in Wuhan, China, occurred in late 2019 (1-3). After investigating to identify the source of the disease, health officials concluded that the seafood market was the source of the disease (4-7). Acute respiratory syndrome has spread in China and other parts of the world (8). The coronavirus caused this viral respiratory disease, and the World Health Organization (WHO) named it coronavirus disease 2019 (COVID-19) (9). The COVID-19 pandemic was officially announced in March 2019 (4).
Transmission of emerging respiratory disease was done with patients' respiratory droplets and could not be treated with conventional therapies (2, 5, 7, 10). Fever, cough, and shortness of breath are common symptoms of this disease that are seen in patients within two days to two weeks after exposure to the virus (11). Loss of smell and taste is also a mild to moderate symptom of COVID-19. The need for hospitalization and ventilation support is greater in severe patients (12). Obesity, diabetes, heart and kidney disease, cancer, and hypertension are risk factors that increase the risk of severe cases of COVID-19 (12-14).
This contagious disease is currently one of the threats to human health (15). Important factors affecting the transmission rate of COVID-19 are the transmission of the disease by asymptomatic carriers and the lack of complete identification of patients due to insufficient diagnostic tests (1). One of the consequences of the COVID- 19 pandemic is the imposition of quarantine restrictions and traffic laws, which have had negative consequences on the global economy, especially in low- and middle-income countries (16-18). According to epidemiological estimates and models, deaths from COVID-19 are likely to be more than one million in densely populated countries (19).
2. Objectives
We described the epidemiology of COVID-19 in Africa.
3. Methods
This ecological study examined the status of the COVID-19 in continental Africa. Data on the total number of definitive COVID-19 cases as well as the total number of deaths due to definitive COVID-19 by country and also the population of Africa were obtained from the WHO reports (20, 21) from the beginning until October 6, 2021. The obtained data were transferred to SPSS 24 software, and the case fatality rate was achieved separately for each country by the following formulas (22): Case fatality rates (percent) = (No. of individuals dying during a specific period after disease onset or diagnosis/of the individuaks.duals with the specified disease) × 100.
4. Results
The total number of countries on the continent, according to the WHO, of 45 countries, the most populous of which is Nigeria with 185990000 people, and the least populous is Seychelles with 94000 people. The highest number of confirmed cases of COVID-19 is related to South Africa with 2907619 cases, the lowest is Sao Tome and Principe with 3564 cases, and the highest number of definitive deaths due to COVID-19 is in South Africa with 87922, and the lowest is in Togo with 37 deaths was reported. The highest case fatality rate in Liberia was 4.93%, and the lowest was 0.14% in the Cayman Islands (Table 1).
Table 1.Frequency Distribution of Identified Definite Cases, Death, Case Fatality Rates of Coronavirus Disease 2019 in Continental Africa
| Country | Population | Total Case COVID-19 | Total Death COVID-19 | Case Fatality Rates |
|---|---|---|---|---|
| South Africa | 56015000 | 2907619 | 87922 | 3.02 |
| Ethiopia | 102403000 | 350204 | 5811 | 1.66 |
| Kenya | 48462000 | 250380 | 5150 | 2.06 |
| Zambia | 16150000 | 209199 | 3650 | 1.74 |
| Nigeria | 185990000 | 206561 | 2731 | 1.32 |
| Algeria | 40606000 | 204046 | 5831 | 2.86 |
| Botswana | 2250000 | 180197 | 2374 | 1.32 |
| Mozambique | 28829000 | 150826 | 1919 | 1.27 |
| Ghana | 28207000 | 127878 | 1157 | 0.90 |
| Namibia | 2480000 | 127862 | 3517 | 2.75 |
| Uganda | 28813000 | 124190 | 1290 | 1.04 |
| Cameroon | 23439000 | 95399 | 1517 | 1.59 |
| Senegal | 15412000 | 73806 | 1860 | 2.52 |
| Malawi | 18092000 | 61629 | 2286 | 3.71 |
| Democratic Republic of the Congo | 78736000 | 57083 | 1086 | 1.90 |
| Angola | 28813000 | 59895 | 524 | 0.87 |
| Eswatini | 1343000 | 46152 | 1226 | 2.66 |
| Madagascar | 24895000 | 43610 | 960 | 2.20 |
| Cabo Verde | 540000 | 37718 | 345 | 0.91 |
| Mauritania | 4301000 | 36229 | 782 | 2.16 |
| Gabon | 1980000 | 31058 | 94 | .30 |
| Guinea | 12396000 | 30452 | 383 | 1.26 |
| Tanzania | 55572000 | 25957 | 723 | 2.79 |
| Togo | 7606000 | 25623 | 37 | 0.14 |
| Benin | 10872000 | 24335 | 445 | 1.83 |
| Seychelles | 94000 | 21626 | 70 | 0.32 |
| Lesotho | 2204000 | 21363 | 650 | 3.04 |
| Mayotte | 18092000 | 20373 | 180 | 0.88 |
| Burundi | 10524000 | 18825 | 160 | 0.85 |
| Mauritius | 1262000 | 16083 | 100 | 0.62 |
| Mali | 17995000 | 15338 | 551 | 3.59 |
| Congo | 5126000 | 14561 | 199 | 1.37 |
| Burkina Faso | 18646000 | 14356 | 191 | 1.33 |
| Equatorial Guinea | 1221000 | 12532 | 150 | 1.20 |
| South Sudan | 12231000 | 12080 | 130 | 1.08 |
| Central African Republic | 4595000 | 11391 | 100 | 0.88 |
| Gambia | 2039000 | 9939 | 338 | 3.40 |
| Eritrea | 4955000 | 6725 | 42 | 0.62 |
| Sierra Leone | 7396000 | 6396 | 121 | 1.89 |
| Guinea-Bissau | 1816000 | 6112 | 135 | 2.21 |
| Niger | 20673000 | 6057 | 204 | 3.37 |
| Liberia | 4614000 | 5799 | 286 | 4.93 |
| Chad | 14453000 | 5051 | 174 | 3.44 |
| Comoros | 796000 | 4156 | 147 | 3.54 |
| Sao Tome and Principe | 200000 | 3564 | 55 | 1.54 |
5. Discussion
According to the results of this study, the highest definitive cases of COVID-19 detected in Africa belonged to three countries of South Africa, Ethiopia, and Kenya, respectively. In a study by Nachega et al., which examined COVID-19 in Africa, most patients were men with a mean age of 40 years, which led to a lower mortality rate than the global average. At the beginning of the pandemic, most importers of COVID-19 from the European Union and the United States transmitted the disease to Africa (23). According to Maeda and Nkengasong, who assessed the challenges of COVID-19 in Africa, poor health systems, insufficient financial resources, lack of human resources, and challenges related to indigenous diseases in Africa, including AIDS, tuberculosis, and malaria, have led to taking measures to control COVID-19 and have caused problems in Africa (24). Ataguba examined the COVID-19 consequences on the African continent's economy, and they reported that the COVID-19 diagnosis and treatment costs had affected household economies in Cameroon, Comoros, Equatorial Guinea, and Nigeria, where most people lacked insurance. In South Africa, the closure of official businesses due to traffic restrictions led to the closure of shops, restaurants, and hotels, and the closure of sporting and educational events and companies related to transportation and tourism, which had a devastating effect on the country's gross domestic product (25). The results of a study by Elhadi et al., which examined the COVID-19 in Libya, showed that the study of international travelers at the country's borders is an important step in reducing the emission of COVID-19 in Libya (26). According to a study by Getaneh et al. on the COVID-19 in Ethiopia, due to the limited ability of the health system to identify and treat COVID-19 patients, local participation in the implementation of accurate social distance and active participation of religious institutions and youth mobilization in raising public awareness about COVID-19 are of great importance (27). Nas et al. conducted an epidemiological study on COVID-19 in Nigeria and showed that COVID-19 is more common in men than women, which may be due to their chances of exposure because of the greater presence of men outdoors. Women in Nigeria are mostly housewives and less likely to be outdoors (28).
