African countries have started to lift lockdown restrictions, raising fears that coronavirus infections could rise.
The World Health Organisation says countries should consider their ability to test and trace before lifting lockdown.
The continent has so far conducted 1.2 million tests since the start of the epidemic.
But is that enough? Africa’s most populous nation Nigeria has now begun to relax some of its lockdown measures despite having one of the lowest testing rates on the continent.
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It’s is a big challenge in country of 200 million people, and there are limited laboratories to process tests.
Chikwe Ihekweazu, director general for the Nigeria Centre for Disease Control, said in late April: “I would rather go a little bit slower and get it right than speed into a situation that we will end up regretting.”
The Nigerian government says it’s focused on clusters of outbreaks, not mass testing of the population. Lagos and northern Kano state are the worst-hit areas. But these regions have the most laboratories for processing tests.
But the Nigerian Medical Association has expressed concern that the low rate of testing means the real incidence of the virus remains unknown.
South Africa has enforced one of the strictest lockdowns anywhere on the continent and has achieved a relatively high level of testing.
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The number of tests being carried out - around 16,000 a day - is considerably higher than any other African country, but still a long way short of European levels. Health Minister Zweli Mkhize has raised concerns over the country’s ability to scale up testing.
“In relation to the issue of tests, I’ve called both public and private labos - they are all suffering from the constraints of availability of test kits.”
Ghana has put emphasis on testing and tracing Covid-19, choosing not to implement harsh lockdown measures to protect the economy.
President Nana Akufo-Addo has eased Ghana’s lockdown measures and emphasised the need to test, track and trace virus cases, instead of keeping people at home. Ghana, much smaller than its neighbour Nigeria, has 11 testing centres, compared with 24 in Nigeria.
The government is using a “pool testing” approach which involves combining a group of samples and testing them together. Only if that produces a positive result will individual samples be tested.
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Using this method, Ghana has one of the highest testing rates on the continent, with just over five per thousand of the population - a total of around 160,000 tests.
However, a recent incident at a fish factory, where one worker infected 533 others, has raised concerns.
Kenya has been criticised for its lack of testing. The government says a shortage of testing supplies has affected the country’s ability to conduct tests.
Tanzania hasn’t released testing data since the end of April. President John Magufuli has said imported tests have been faulty.
There are concerns Tanzania, which has chosen not to enforce a strict lockdown, could be facing a very serious outbreak. The US government has warned the threat in Dar es Salaam is “extremely high”.
Uganda has carried out just over 60,000 tests. The Uganda Virus Research Institute said they are facing shortages of testing supplies. The government says it’s because of the need for increased testing on truck drivers, limited supplies and delays in delivery.
Two of the Africa’s smaller nations, Mauritius and Djibouti, have achieved the highest testing rates on the continent.
Getting kits and chemical reagents needed to process tests has proved hard as African countries don’t produce their own and need to compete for limited global supplies.