Théophile Abbah and Daniel Adaji
Testing for COVID-19 has dropped dramatically, according to weekly reports from the [i]Nigerian Center for Disease Control (NCDC) which show continued declines in fewer and fewer test records in most of the 36 states and the Federal Capital Territory (FCT). For example, for the week that ended April 17, 2022, 18 states recorded single-digit testing for seven days, indicating that many laboratories licensed to test Nigerians for COVID-19 were inactive in those states. States. From March 6 to April 17, 2022, the number of Nigerians tested for the virus across the country decreased, as shown in the graphs below:
Since February 2020, when COVID-19 broke out in Nigeria, a total of nearly 256,000 cases and 3,143 deaths have been recorded, according to NCDC data. The highest cases of 22,562 and 220 deaths were recorded in Lagos State, followed by 10,291 cases and 202 deaths in neighboring Oyo State. Other high incidence states are Edo (7,694 cases and 321 deaths), FCT (6,385 cases and 82 deaths) and Delta (5,369 cases and 111 deaths). However, these figures are believed to be just the tip of the iceberg due to the low rate of testing for COVID-19 across the country.
In terms of testing trends, it has gone from 1.4 million people tested in January 2021 to as few as 241,174 in the month of April 2022. The drop in testing rate affects the credibility of the number of COVID-19 cases reported in Nigeria. Our World in Data, which produces countries’ 7-day rolling average data on COVID-19, says of Nigeria that “due to limited testing, the number of confirmed cases is lower than the actual number of infections” . Its interactive chart on COVID-19 in Nigeria is expected to inexplicably rise and fall in COVID-19 cases, which can be attributed to random testing for the virus. This downward trend demonstrates the complacency of the government and the institutions vested with the responsibility of carrying out the tests. With a population of approximately [ii]211 million, the test rate of 5,152,011 million is just over 2% of people who should be targeted for preventive testing.
Compared to Nigeria, South Africa has tested as many as 24,885,511, about 40% of its population of 60,756,135. Another African country, Egypt, with a population of 106 million , actually tested 1,318 per million. Both countries have left Nigeria behind in the global citizen test for COVID-19.
However, in Nigeria’s strategy document to combat COVID-19, the government identifies testing as an important element, and the NCDC[iii] recognizes it thus: “Diagnostic tests are an essential response strategy to interrupt the transmission of the COVID-19 pandemic by informing patient care and identifying positive cases, which can then be isolated. The Federal Ministry of Health has prioritized testing as one of the key interventions in Nigeria’s COVID-19 response. In order to quickly contain the outbreak, the Government of Nigeria plans to rapidly expand diagnostic testing to cover all 36 states plus the FCT. The low testing rate contradicts the content of the government’s strategy document.
Testing has been scientifically proven to be critical in containing and mitigating the COVID-19 pandemic, as diagnostic testing helps prevent further person-to-person transmission. With a low rate of testing, NCDC data on the number of infected Nigerians cannot be relied upon as thousands of people may be living with COVID-19 but unaware of it. The World Health Organization estimates that only one in seven COVID-19 infections are detected in Africa. The number of undetected cases not only increases the chances of infection between individuals, but means the virus is likely to spread unnoticed and under-reported.
Why testing is weak in Nigeria
Laboratory scientist Dr Ifeanyi Casmir attributes Nigeria’s low COVID-19 testing rate to the framework put in place, which prioritizes testing in private sector-owned labs over government-owned labs . He argued that owners of labs for COVID-19 testing have raked in billions of naira from inbound and outbound international travelers who are forced by Nigerian authorities to present negative test results for the virus.
He said: “I have proposed that COVID-19 testing should be an integral part of our medical screening and be routine, so that if anyone reports possible cases of colds or malaria in Nigeria, they should be tested for COVID-19. free. As things stand, testing for the virus is not affordable. It costs between N40,000 and N50,000 to perform the molecular tests, which is suspicious. To cover more grounds, testing should be free. This is what is done in [iv]Cameroon. The reality is that COVID-19 has come to stay with us, so testing should be routine. This is all happening because Nigeria’s Medical Laboratory Science Council is asleep. The council is vested with the responsibility to assess and evaluate the laboratory testing centers in Nigeria.
The National Secretary of the Society for Scientists in Infectious Diseases in Nigeria, [v]Dr Solomon Chollom told reporters in March that Nigeria’s testing capacity was compromised by the deployment of low-throughput platforms compared to the use of high-throughput platforms.
He said, “Other possible reasons are the weakness of the surveillance and contact tracing system, the lack of motivation of health professionals and the preponderance of negative publicity that characterized each stage of the response.
A health economist, Dr Abigail Banji, also argued in March that for Nigeria to continue to fight COVID-19 effectively, all relevant agencies must “intensify vaccination, advance rapid self-testing of COVID-19 antigen, access COVID-19 treatment and promote public health and social measures.
She warned that although new COVID-19 cases and deaths were down globally, the pandemic was far from over. “Many countries still have high rates of hospitalizations, deaths, low vaccination coverage rates and high transmission. Nigeria is included. The threat of a new, more dangerous variant remains very real.
The low testing rate appears to have led to the perception that there is a low risk of COVID-19 in Nigeria. Indeed, those who fall ill have no opportunity to get tested for COVID-19 because laboratories are not readily available or the cost is prohibitive. The main method available is molecular testing which, although producing accurate and more reliable results, is expensive, with a relatively long turnaround time of 3-4 days.
“How to speed up testing”
In order to increase COVID-19 testing in Nigeria, virologist Professor Oyewole Tomori advocated for a switch from PCR to rapid tests, which are cheaper and affordable because, with rapid testing instruments, people individuals could even test themselves for the virus. “We need to adopt rapid tests urgently as we need to know the status of Nigerians at a time when several countries are recording cases of new variants of COVID-19. In southern Africa, for example, about five variants of Omicron have already been discovered. If Nigerians are not tested, we cannot detect if we have any of these variants here. With the lull in testing, we feel like Nigeria is out of COVID-19; it is totally false.
Apart from purchasing facilities for rapid testing for COVID-19, Prof Tomori said the National Primary Health Care Development Agency (NPHCDA), responsible for immunization, must devise strategies to ensure that more Nigerians have access to the vaccine, as soon as possible. “We are getting a deluge of vaccines, but Nigerians are not taking them. In the end, many vaccines will expire and be wasted. It’s a tragedy, as far as I’m concerned. »
Data obtained from ONE.org, an Africa data aggregation company, indicates that in April 2022, [vi]Nigeria had received 68.1 million doses of COVID-19 vaccines, but only about half of that amount, 34 million, was used. For vaccination, only about 16.5% of the population was covered, while only about 6.3% of Nigerians received the two doses of COVID-19 vaccines.
However, PHCDA chief executive Dr Fasail Shuab says his organization is not giving up on vaccinations. “We continue to vaccinate Nigerians. Right now, we’re at a point where we’ve surpassed a daily vaccination rate of over 230,000. Last time we got the report, the daily vaccination rate was around 210,000. So, more Nigerians are coming out to get vaccinated. The majority of those wishing to be vaccinated are potential travellers, who are required to present COVID-19 vaccination certificates at exit and entry points.
Dr Ifedayo Adetifa, executive director of the NCDC, did not respond to the inquiry into what his agency is doing to speed up testing, but his office responded to a WhatsApp message, saying: “It has already been established that the Nigerians’ perception of the risk of COVID -19 is generally low, so, in turn, testing will be low. We have made efforts to ensure that states have adequate laboratory supplies and that the use of rapid test kits is scaled up. »
There are around 140 testing centers across Nigeria. However, the [vii]The NCDC’s update for the week ending April 17 shows that 60 of them had no tests or undeclared test results, while many of the test centers that conducted tests COVID-19 have reported between one and two digits of tests for this week.
This piece was produced in partnership with the ONE campaign, a global campaign and advocacy organization. For more on the impacts of conflict, climate change and the impacts of COVID in Africa, subscribe to ONE’s Aftershocks Newsletter Where explore data.
[i] Nigeria Center for Disease Control (ncdc.gov.ng)
[ii] Nigeria population growth rate 1950-2022 | MacroTrends
[iii] COVID19TestingStrategy_2ZWBQwh.pdf (ncdc.gov.ng)
[iv] N50,400 for COVID-19 test in Nigeria, free in Cameroon — Sport — The Guardian Nigeria News – Nigeria and World News
[vi] ONE Africa COVID-19 Tracker – Nigeria
[vii] Nigeria Center for Disease Control (ncdc.gov.ng)