Zambia's first known COVID-19 cases were a married couple who had traveled to France. Caught by screening at their point of entry and then monitored at home for 14 days, they developed respiratory symptoms, were identified as suspected cases on March 18, 2020, and tested positive. Six weeks later, Zambia had found its first 100 cases.
How cases were found
Zambia, a landlocked, lower-middle-income country of 17 million in southern Africa, cast a wide net. The Zambia National Public Health Institute's definition of a suspected case, adapted from World Health Organization guidance of March 20, 2020, covered people with acute respiratory illness after international travel or contact with a confirmed case, anyone hospitalized with severe acute respiratory illness — and, going beyond WHO's guidance, household and close contacts of confirmed cases even without symptoms. Cases were found through:
- screening at ports of entry, including temperature checks and symptom reports;
- contact tracing;
- testing of health care workers;
- screening of hospital inpatients;
- community screening;
- a national hotline run by the Disaster Management and Mitigation Unit and the public health institute.
The first 100
| Tests, March 18–April 28 | 6,165 (1.6% positive) |
| Found in Lusaka, the capital | 77% |
| Men | 61% |
| Largest age group | 30–44 years (32%) |
| Found by point-of-entry screening / contact tracing | 35% / 30% |
| Traveled abroad in the 14 days before testing | 35 |
| Without symptoms when tested | 79% |
| With underlying conditions | 20% — most often HIV (35%) and high blood pressure (35%) |
| Deaths | 3, all with at least one underlying condition |
The most common symptoms were fever, cough, sore throat, headache and fatigue. The median recovery time was 12 days. Of the 65 locally acquired cases, 30 were contacts of known cases who were not health care workers.
Zambia's first 100 COVID-19 cases, by how they were found. Credit: CDC, Morbidity and Mortality Weekly Report.
When cases stopped being linked
In the first 28 days, 65 percent of cases were found by entry screening and contact tracing. Then, in early April, cases with no apparent link to earlier ones appeared. Community screening in the neighborhoods and nearby markets where they lived picked up more. Widening testing to people without symptoms who might have been exposed, and to people who had not traveled, found and isolated cases that would otherwise have been missed — an approach the authors suggest may help other countries in the region or with similar populations.
Sources
Based on "First 100 Persons with COVID-19 — Zambia, March 18–April 28, 2020," by Peter J. Chipimo, Danielle T. Barradas and colleagues (Zambia National Public Health Institute; Zambia Ministry of Health; University Teaching Hospital, Lusaka; CDC), Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention; a work of the United States government in the public domain.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
1
0
0
0
Comments
