Congo boosts COVID-19 fight with community testing

In the capital Brazzaville, rapid response teams from the Health Department get an early start. Four teams each comprising six members cover communities in and around the city.
“We search for contacts to better detect cases and provide treatment, which in turn helps us protect our communities,” says Niclem Koundou, who heads one of the teams in Brazzaville.
COVID-19 testing has so far focused on symptomatic cases, although an estimated 65% to 85% of cases in Africa present few or no symptoms. Asymptomatic patients are a major cause of infection transmission.

First stop for Niclem’s team is Mfilou, an area on the outskirts of Brazzaville, where the team learned of a positive case. Dr Ramses Kalumbi, a WHO epidemiologist, joins the team to coordinate the testing of those living within a 100-metre radius of each confirmed case.
“When we find a positive case, we evaluate their condition to decide whether they should isolate at home or be referred to a health facility,” he says.
Eric*, 36, receives the team after previously testing positive for COVID-19. He explains that he had been unwell for several days and when the symptoms worsened, he decided to take a COVID-19 test. The mobile team initially sought his consent for a home visit to also test those who were in contact with him. Eric’s 18-year-old nephew François*, who lives with him, will be tested.

Once on-site, the team prepares meticulously. “We must wear the personal protective equipment correctly,” says team leader Koundou.

WHO’s Dr Kalumbi points out that “this campaign will help break the chain of COVID-19 transmission by enabling early detection in communities and in health facilities. This will help bring down new infections and raise the country’s testing capacity.”

François, Eric’s nephew was concerned about his uncle’s illness and agrees to be tested.

“The team explained that because we live together, I’m a contact and it would be wise to get tested,” he says. Community screenings are done on a voluntary basis using WHO-approved rapid antigen tests, which give results in just 15 minutes.

The campaign is helping to quickly isolate cases, contain the spread and save lives. The teams in Brazzaville had visited more than 3000 homes by 17 November, provided key preventive messages to nearly 10 000 people, identified 2460 contacts and tested 2329 people. That’s an acceptance rate of 95%, with 1.5% – or 34 individuals – testing positive. The community testing began on 25 October in Brazzaville and runs until 31 December 2021.

Each household with a positive case receives kits containing masks, liquid soaps and alcohol-based gels. Teams also educates on COVID-19 risks and prevention measures including vaccination.

For François, who used to think COVID-19 was just a myth, the message is now clear: “Wear a mask, avoid crowds, wash hands regularly with soap or alcohol-based gel and above all, get vaccinated. I don’t have doubts anymore. I’m going to get vaccinated. COVID is real,” he says.

For Dr Jean Claude Mobousse (right), Departmental Director of Health for Brazzaville, the campaign is timely. “The indicators were worsening and the situation becoming serious with many deaths and hospitalizations. With this project of listing, monitoring, screening and treatment we are observing a clear improvement. By going to the communities we will be able to reverse the trend.”

“I want people to stay hopeful,” adds Dr Mobousse. “Yes, COVID is here, but rest assured that we will resolve the situation, with the support of our partners. Life will go on.”

Team member Patience Mahendemoyi uses a mobile phone to upload screening data directly to the health directorate’s central database. “These phones make the difference because the data is centralized and this allows us to quickly target the right people and to coordinate field activities,” she says.

Brazzaville and the coastal city of Pointe-Noire are the epicentres of the COVID-19 epidemic in Congo, with more than 95% of the country’s cases. Based on results obtained in Brazzaville, teams will soon be deployed in Pointe-Noire.

Dr Ramses Kalumbi of WHO stresses that “if we’re to overcome this disease, communities must be at the heart of our interventions. Through this campaign, we’re tracking the virus in every nook and cranny to get rid of it for good.”