True Dimensions of Monkeypox Outbreak in Africa Obscured by Testing Gap
Dr Ahmed Ogwell Ouma, Africa CDC’s acting director, asserts the continent should be top priority for vaccine doses for monkeypox.

WHO and Africa CDC are trying to close a huge testing gap for monkeypox that has left some health workers reliant on symptomatic diagnosis.

The World Health Organization (WHO) and African Centres for Disease Control and Prevention (Africa CDC) acknowledge they will not be able to gain a clear understanding of the monkeypox outbreak in Africa until the continent improves its ability to test better and close the gap between confirmed and suspected cases.

Just 104 new cases of monkeypox have been confirmed compared with 1,678 suspected cases in Africa since the beginning of 2022, Africa CDC’s acting director, Ahmed Ogwell Ouma, announced during a press briefing on Thursday.

He told Health Policy Watch the gap is due to limited capacity at labs and lack of enough test kits.

“This usually means appropriate training is not yet widespread and the test kits are also not available,” he said, adding that health workers in Africa are resorting to “clinical acumen and high levels of high index of suspicion” to identify monkeypox cases “because of capacity issues.”

This will hopefully change soon, he said, as Africa CDC acquires and provides more training and test kits. In Europe, the Americas and elsewhere some 3414 cases had been confirmed as of 22 June, WHO reported on Tuesday.  

Monkeypox rash

WHO is also procuring test kits for Africa

Along with Africa CDC, the UN health agency is working on building up testing capacity on the continent.

All African countries have the polymerase chain reaction (PCR) equipment needed to test for monkeypox.  But many lack essential reagents and training in specimen collection, handling and test administration, Dr Matshidiso Moeti, WHO AFRO’s regional director, told a press briefing on Thursday.

WHO is working to procure 60,000 tests, she announced, including 2,000 that will be dispatched to the countries at highest risk.

“Over the past month, five African cities have received donations of reagents from partners, bringing to 12 the number with enhanced monkeypox diagnostic capacity, and another group of countries in West Africa receiving agents just after participating in the necessary training,” Moeti said.

Monkeypox virus genome sequencing in Africa

Seven African countries are sequencing the monkeypox virus genome and using an improved genomic sequencing capacity acquired during the COVID-19 pandemic, according to Moeti. That should improve understanding of how the monkeypox virus is spreading across countries and continents.

Some 300 samples have been sequenced since the beginning of the year, with most of the published sequences showing the West African clade of the virus.

WHO says it is working to accelerate capacity through training in monkeypox genome sequencing that it is offering to lab experts from 20 countries in coming weeks.

Image Credits: US Centers for Disease Control.

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