The coronavirus disease 2019 (COVID-19) outbreak in the WHO African Region continues to evolve rapidly, with several new countries reporting confirmed cases and an associated upsurge in incidence cases reported across the region. WHO and partners continue to monitor and provide technical and operational support to Member States to scale up the response in affected countries and enhance readiness in the rest of the region.

Since our last situation report on 11 March 2020 (External Situation Report 2), 18 new countries in the WHO African Region have reported confirmed COVID-19 cases; namely Benin, Central African Republic, Eswatini, Ethiopia, Equatorial Guinea, Gabon, Gambia, Ghana, Guinea, Kenya, Liberia, Mauritania, Namibia, Republic of Congo, Rwanda, Seychelles, Tanzania, and Zambia. As of 18 March 2020, a total of 345 confirmed COVID-19 cases have been reported across 27 countries in the region: South Africa (116), Algeria (72), Senegal (31), Burkina Faso (26), Democratic Republic of the Congo (14), Rwanda (11), Cameroon (10), Nigeria (8), Ghana (7), Kenya (7), Cote d’Ivoire (6), Ethiopia (6), Seychelles (6), Congo (Republic of) (3), Equatorial Guinea (3), Gabon (3), Tanzania (3), Liberia (2), Namibia (2), Zambia (2), Benin (1), Central African Republic (1), Eswatini (1), Gambia (1), Guinea (1), Mauritania (1), and Togo (1). A total of seven deaths have been reported from Algeria (6) and Burkina Faso (1). All deaths involved case-patients 50 years of age and above with comorbidities. Figures 1 and 2 show the temporal and geographical distribution of cases, respectively. In the rest of the African continent an additional 278 confirmed COVID-19 cases have been reported from six other countries: Egypt (196 cases with 4 deaths), Morocco (49 cases with 2 deaths), Tunisia (29 cases with 0 deaths), Sudan (2 cases with 1 death), Djibouti (1 case with 0 deaths), and Somalia (1 case with 0 death).

All index cases reported in the WHO African Region had a travel history either to Europe (mostly France, United Kingdom, Italy, Switzerland, Spain, and Germany), United States of America, United Arab Emirates, India, Iran, Japan, or New Zealand. Of 266 case-patients with a history of the likely country of exposure, 71% (n=188) were cases who became infected while travelling to another country prior to returning to the country in which they were detected and 29% (n=78) were locally infected, all of whom were contacts of imported cases. The 12 countries with locally infected cases include Algeria (34), Senegal (18), South Africa (14), Burkina Faso (1), Cameroon (1), Cote d’Ivoire (2), Democratic Republic of the Congo (1), Ethiopia (3), Gabon (1), Liberia (1), Nigeria (1), and Rwanda (1). Local infection in Senegal and Algeria occurred in the context of clusters of cases. All 18 locally infected cases in Senegal belong to a cluster in the Diourbel Region while in Algeria they are spread across 13 provinces. Of the 34 locally infected cases in Algeria, 17 belong to the same cluster of cases which has been linked to two confirmed cases of French nationality who travelled from France to Algeria from 14 to 21 February 2020.

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