Challenges in strengthening sentinel surveillance network during COVID-19 pandemic in Africa.

The emergence of variants in the wake of the COVID-19 pandemic has put a strain on healthcare systems in Africa. The Afroscreen project is strengthening national sentinel surveillance systems, combined with sequencing capabilities to identify potentially highly virulent variants of interest at an early stage. The aim of this article is to present the results of this project and discuss the related challenges. Surveillance was based on national surveillance sentinel systems, either hospital-based or peripheral, and RT-PCR diagnostic capabilities, coupled with sequencing in the event of positivity, from July 2022 to June 2024. In 11 African countries (Senegal, Guinea, Côte d'Ivoire, Togo, Benin, Niger, Cameroon, the Central African Republic (CAR), Burkina Faso, Madagascar and the Democratic Republic of the Congo), it was possible to demonstrate a decline in the circulation of SARS-CoV-2 over the surveillance period, with only the Omicron variant circulating. Setting up and coordinating a multicountry sentinel surveillance system during a pandemic period is a real challenge. This highlights the need to strengthen surveillance systems during interepidemic and pandemic periods and the question of their sustainability in line with emerging disease preparedness and response programs.