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Africa is seeing coronavirus cases rapidly increasing and deaths rising, according to the World Health Organisation (WHO).

We have looked at the situation across the continent, and examined which countries are of most concern. How fast is coronavirus spreading?

In terms of overall numbers, Africa currently accounts for only a small proportion of total global cases, but the acceleration in rates of infection in some countries is of increasing concern to health authorities in the region.

“With more than a third of countries in Africa doubling their cases over the past month, the threat of Covid-19 overwhelming fragile health systems is escalating,” says Dr Matshidiso Moeti, WHO director for Africa.

By 22 May, Africa had recorded a total of 100,000 cases. By 8 July, this number had passed 500,000.

The upward trend in Africa is starting to resemble other parts of the world that have been badly hit by the coronavirus.

Most African countries are now experiencing community transmission, according to the WHO.

This is when a person gets Covid-19 without having been in contact with a known case from abroad or a confirmed domestic case, which makes it hard for the authorities to track down the source of a local outbreak.

Where are Africa’s hotspots?

The two countries with the highest numbers of cases are South Africa and Egypt. They accounted for 75 per cent of all the new cases reported by mid-July.

South Africa has the highest recorded number of total cases and reported deaths.

It imposed one of the world’s strictest lockdowns in late March, but has seen cases rise steadily after this was relaxed in early May.

Steady increase 

Gauteng Province, which includes Johannesburg, is experiencing a steady increase in cases and accounts for more than a third of the total cases.

But Western Cape Province (where Cape Town is located) accounts for more than half of the deaths.

Egypt has seen case numbers rising rapidly since mid-May, but there are indications that this may now have reached a peak with recorded new infections levelling off slightly in early July.

There is also concern about what is happening in Nigeria, which is third in terms of total cases recorded so far on the continent.

Lesotho and Namibia have also seen steep increases in cases in recent days. It is worth stressing that some parts of the continent have seen relatively few cases, such as some areas of Central and East Africa.

In fact, WHO says five countries account for more than 70 per cent of all the reported cases on the continent.

How many people are dying in Africa?

The reported death rate per capita has been low compared to other parts of the world, despite the poor health infrastructure in many African countries. 

The WHO says this could be partly because of the relatively young population in Africa – more than 60 per  cent under the age of 25.

Covid-19 is known to have a higher mortality rate for older age groups. Another way to look at death rates is to see what proportion of people who get Covid-19 go on to die.

On this basis, there are ten countries with death rates that are comparable to or higher than the most recent global average rate of under 4.4 per cent.

But Githinji Gitahi, the head of Amref Health Africa, an NGO which specialises in health matters, says the higher rates could be an indication of much higher infection levels than those being recorded, and that it could be down to low levels of testing.

Higher death rate

The fewer tests you carry out, the fewer cases you find, and so the number of deaths appears relatively high.

Different methods of reporting deaths may also affect the number.  For example, where Community Health Workers and other frontline staff record Covid-19 deaths, such as in Chad and Liberia, you could get a higher death rate.

How much testing is done in Africa?

Ten countries account for about 80 per cent of the total tests conducted – South Africa, Morocco, Ghana, Egypt, Ethiopia, Uganda, Mauritius, Kenya, Nigeria and Rwanda.

There are wide variations in testing rates, with South Africa doing the most and Nigeria doing relatively few, according to Our World in Data, a UK-based project which collates Covid-19 information.

By 12 July, South Africa had done about 36 tests per 1,000 people, compared to 106 in the UK and 122 in the US.

Nigeria has achieved 0.9 tests per 1,000 people, Ghana 11 and Kenya 4.

It is worth pointing out that for some African countries, it is impossible to know what exactly is happening due to a lack of any data or data being incomplete.

“We have to take the numbers with a pinch of salt,” says Chiedo Nwankwor, a lecturer in African affairs at Johns Hopkins University in the US.

In Tanzania, President John Magufuli has voiced doubts about the validity of virus testing results at the national laboratory, and has allowed only limited data on infection rates and testing to be made public.

Equatorial Guinea had a row with the WHO after accusing its country representative of inflating the number of Covid-19 cases. For a while it held back its data, but has now started sharing it again.

And in Kano State in Northern Nigeria, an unusual spike of close to 1,000 deaths was reported in late April, but the government has not still confirmed how many were due to Covid-19.

Note: The graphics in this page use a different source for figures for France from that used by Johns Hopkins University, which results in a slightly lower overall total. US figures do not include Puerto Rico, Guam or the US Virgin Islands. —BBC