Trends of COVID-19 in the Central Africa Sub-region: Effective Health Care, Effect of Endogenous Parameters or a Matter of Time?

Background: After the worldwide spread of the coronavirus pandemic, several experts predicted a health catastrophe in Africa. However, the expected earthquake ultimately did not occur and the statistics of the number COVID-19 cases and deaths for other continents (Europe, America, Asia) were far higher than those of Africa. This study focused on Central Africa tried to explain this low incidence of COVID-19.

Methodology: A cross-sectional time series method was adopted and the data of COVID-19 cases and deaths for Angola, Cameroon, Chad, Central African Republic, Congo Brazzaville, Democratic Republic of Congo, Gabon, Equatorial Guinea and Sao Tome and Principe between March and November 2020 were extracted from the World Health Organization COVID-19 database. The evolution of COVID-19 cases and deaths for each country were plotted and the accuracy measures such as Mean Absolute Percentage Error, Median Absolute Deviation and Mean Squared Displacement were calculated. Association between the countries and the prevalence of cases, deaths and recovered was visualized through principal component analysis.

Results: The results showed that the highest number of cases was observed in Cameroon (21,793) while Sao Tome and Principe scored the smallest one (962). However, based on the total population, the prevalence of COVID-19 cases was high in Sao Tome and Principe (0.436%) and Gabon (0.400%). The highest death percentages (≥2%) were observed in Chad (6.742%), RDC (2.708%) and Angola (2.592%) while the highest recovered percentages were in Gabon (99.10%), Equatorial Guinea (97.62%) and Cameroon (97.02%). Development of traditional medicines and modification of food behavior including consumption of plant extracts appear as the reasons for the highest recovered rates. The accuracy measurements showed that the trend curves were not correlated with the actual evolution of the pandemic, but the Spearman correlation test revealed that except Equatorial Guinea (r=0.042, p=0.817), the evolution of COVID-19 cases and deaths were strongly correlated.

Conclusion: The overall prevalence and incidence of COVID-19 is low in the countries of the Central Africa sub-region despite the problems facing the health systems of these countries.