So far, countries across the African continent and further afield have implemented varying testing strategies in their countries, with a no one-size-fits-all approach used universally.
While comparisons across countries are being made, most countries have been challenged in their testing capacity and the approach adopted for the coronavirus (COVID-19) testing was done according to resource.
Since the first case of coronavirus was reported in Nigeria on February 28, the number of confirmed cases in the country has risen to over 238.
There are currently eight laboratories in Nigeria carrying out the tests for COVID-19.
The Federal Teaching Hospital in Abakaliki, Ebonyi State and the Biosecurity Centre in Lagos that used to be supported by the Lagos University Teaching Hospital (LUTH) were activated, increasing the number of molecular laboratories carrying out testing in the country to eight.
With the rising demand for testing in the country, a further six new laboratories will be opened in the coming weeks in Kano, Kaduna, Sokoto, Maiduguri, Jos and Port Harcourt with the capacity to diagnose COVID-19. This will help to increase the number of daily tests that can be done in the country.
Different mitigation strategies have been put in place in Nigeria to reduce and contain the spread of COVID-19; from the closure of international airports, schools and businesses to directives to stop public gatherings, social distancing measures to the present lockdowns in Lagos, Federal Capital Territory and Ogun State.
The testing criteria in Nigeria has so far been targeted and prioritised certain groups, so it is important for people to understand the testing criteria adopted by the Federal Ministry of Health.
The Nigeria Centre for Disease Control (NCDC) has just published the fifth version of the case definition guide that outlines who is being tested. The case definition offers a standard criteria used to classify the clinical features used to determine who to test for COVID-19.
Commenting on the new case definition, Dr Chikwe Ihekweazu, Director General, NCDC, said that based on the new knowledge of COVID-19 and context in the country, the centre has expanded it case definition to enhance response of the disease.
Ihekweazu said that following are the category of people being tested at present for COVID-19 in the country.
• Anyone with a travel history outside Nigeria, who presents with a fever, cough or breathing difficulties within 14 days of arrival.
• Anyone who has symptoms and is a contact with a confirmed case.
• Anyone with fever and either cough, difficulty breathing or shortness of breath in an area of high COVID-19 prevalence in Nigeria with no other explanation.
He noted that people who fall in this category were advised to remain in self-isolation and immediately call the NCDC hotline on 080097000010 or their state hotline, which could be found on the state hotline directory published by the NCDC.
“They would then be tested and asked to self-isolate until they receive their test results. It is very important that people comply with the directives they are given by the health authorities.
“The high rate of transmission of the disease makes it more important that self-isolation is taken seriously and close contacts also need to self-isolate and reduce contact with others,” he explained.
Dr Osagie Ehanire, Minister of Health, however maintained that testing must be strategic and guided by the national case definition, especially given that global shortages of test kits and medical commodities had been a challenge.
Ehanire said that there was a lot of work happening in the background to increase testing capacity but the government need Nigerians to be patient.
The Minister said that the updated case definition takes into account the epidemiology of the virus and the transmission pattern seen in the country.
He said that the NCDC will continue to review guidelines such as the case definition, as more precise information emerges on the COVID-19 outbreak including characteristics of transmission and geographical spread.
There is an increasing push for Rapid Diagnostic Tests (RDTs) to scale up testing capacity, but it has not been validated, raising concerns about the reliability of their results.
However, according to Dr Chinwe Ochu, Deputy Director Prevention, Programmes and Knowledge Management at the NCDC, “they need to be validated through evaluation studies, using point estimates for sensitivity and specificity”. (NANFeatures)