COVID-19 pandemic in Djibouti: Epidemiology and the response strategy followed to contain the virus during the first two months, 17 March to 16 May 2020

Abstract

First cases of COVID-19 were reported from Wuhan, China, in December 2019, and it progressed rapidly. On 30 January, WHO declared the new disease as a PHEIC, then as a Pandemic on 11 March. By mid-March, the virus spread widely; Djibouti was not spared and was hit by the pandemic with the first case detected on 17 March. Djibouti worked with WHO and other partners to develop a preparedness and response plan, and implemented a series of intervention measures. MoH together with its civilian and military partners, closely followed WHO recommended strategy based on four pillars: testing, isolating, early case management, and contact tracing. From 17 March to 16 May, Djibouti performed the highest per capita tests in Africa and isolated, treated and traced the contacts of each positive case, which allowed for a rapid control of the epidemic. COVID-19 data included in this study was collected through MoH Djibouti during the period from 17 March to 16 May 2020. A total of 1,401 confirmed cases of COVID-19 were included in the study with 4 related deaths (CFR: 0.3%) and an attack rate of 0.15%. Males represented (68.4%) of the cases, with the age group 31–45 years old (34.2%) as the most affected. Djibouti conducted 17,532 tests, and was considered as a champion for COVID-19 testing in Africa with 18.2 tests per 1000 habitant. All positive cases were isolated, treated and had their contacts traced, which led to early and proactive diagnosis of cases and in turn yielded up to 95–98% asymptomatic cases. Recoveries reached 69% of the infected cases with R0 (0.91). The virus was detected in 4 regions in the country, with the highest percentage in the capital (83%). Djibouti responded to COVID-19 pandemic following an efficient and effective strategy, using a strong collaboration between civilian and military health assets that increased the response capacities of the country. Partnership, coordination, solidarity, proactivity and commitment were the pillars to confront COVID-19 pandemic.

SARS-CoV-2 Transmission in the Military during the Early Phase of the Pandemic—A Systematic Analysis

“…After accounting for potential overlap in cases, this study utilized 36 articles from 17 countries—the U.S. ( n = 17), Israel ( n = 2), Switzerland ( n = 2), and the United Kingdom ( n = 2) and one each from Belgium, Bolivia, Brazil, Canada, Djibouti, France, India, Italy, Norway, Philippines, South Korea, Sri Lanka, and Tunisia [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ]. The Israel-based study by Talmy et al was solely used for the meta-analysis of specific symptoms since it was the only Israeli study reporting symptoms breakdown [ 58 ].…”

“…The following supporting information can be downloaded at: . References [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ] are cited in the Supplementary Materials.…”

Whole Genome Sequencing of SARS-CoV-2 Strains in COVID-19 Patients From Djibouti Shows Novel Mutations and Clades Replacing Over Time

“…The first case of COVID-19 was detected in Djibouti on 17 March 2020, leading the health authorities to apply the strategy aimed at testing any person suspected of being infected with the virus or of being a contact case. Djibouti became the African country that has performed the most SARS-CoV-2 screening in Africa (the country increased its laboratory testing capacity from 100 samples tested by PCR per day up to 2,000 samples per day in April 2020) ( 14 ). Between 17 March 2020 and 16 May 2020, Djibouti reported 1,401 confirmed COVID-19 cases including four deaths (a case fatality rate of 0.3%) ( 13 ).…”

“…To date no SARS-CoV-2 sequence has been characterized in the Djiboutian population although cases of COVID-19 have been declared by health authorities in March 2020 ( 13 ). In response to the WHO alert on the COVID-19 pandemic, the Republic of Djibouti has rapidly established a prevention strategy based on testing, isolation, treatment and tracing of contacts of each positive case ( 14 ). Being prepared for the prevention of the epidemic risk was perhaps more essential here than elsewhere due to regional specificities.…”

The COVID-19 Pandemic in the IGAD Region: Consequence and Responses

“…The measures included closing their borders by sea, air and land; closing schools, businesses, barring public gathering, etc. Sudan, Djibouti and Eritrea, in particular, were quick to take these drastic measures (Assal 2020, Bereketeab 2020, Elhakim, Tourab and Zouiten 2020. Lockdown, social distancing, curfews and state of emergency are the main practical mechanisms enforced to contain and mitigate the impact of the pandemic.…”