Libreville – With over 60 sample collection sites, a network of laboratories, including a high-capacity one, Gabon has tested nearly a tenth of its 2 million people for COVID-19. Diagnosis has been expanded through mass testing and decentralization beyond the capital city.

Many African countries registered their initial COVID-19 cases in their capitals, as such response strategies, including testing, were concentrated in the major urban areas.

In Gabon, testing centres were initially set up in Libreville, including at the airport and the capital city’s hospitals, including military, as well as health centres. Mobile sample collection teams were also formed to complement the testing centres. At the onset of the pandemic, the health authorities focused on testing symptomatic patients and their contacts and patients with comorbidities.

President Ali Bongo Ondimba made mass testing a priority in COVID-19 response. Testing was increased through additional laboratories and sample collection centres established across the country, while a high-capacity laboratory was set up in the capital Libreville capable of carrying out up to 10 000 tests a day.

“The benefits of these improvements are undeniable since the entire response strategy is based on the performance of this [high-capacity] laboratory,” says Professor Romain Tchoua, the technical coordinator of Gabon’s COVID-19 response committee. “The laboratory handles more than three quarters of tests with samples from different regions.”

Since July, Gabon has been conducting more than 2000 tests daily compared with around 200 tests a week earlier in the year following the first confirmed cases. There are now 15 laboratories across the country, and with the support of World Health Organization (WHO) and Africa Centres for Disease Control and Prevention, 50 experts from various laboratories were trained in COVID-19 testing and biosafety. They then later trained more than 80 technicians working in COVID-19 testing centres.

With the increased diagnostic capacity, the time it takes to receive COVID-19 test results has also been drastically reduced. “Since the establishment of the laboratories in Libreville as well as in the provincial capitals, test results are delivered between 24 and 48 hours at the latest. We even now have three different types of PCR [polymerase chain reaction] technologies, some of which can give results within six hours,” says Dr Armel Mintsa Ndong, deputy director of the National Public Health Laboratory.

While COVID-19 diagnosis has improved significantly, isolating and treating patients needs to be improved to conform with the response strategy comprising testing, tracing and isolating patients, says Dr Magaran Monzon Bagayoko, WHO representative in Gabon. Gabon is among the 12 countries in Africa carrying out more than 10 tests per 100 000 people per week – a critical threshold for testing in the region.

As COVID-19 restrictions are being eased, the health authorities are stressing the importance of maintaining vigilance.  

“With the downward trend in cases, screening should be ramped up more than ever,” says Dr Magaran. “We are seeing a resurgence of a second wave of the virus in many countries that have links with Gabon. Currently 1% of arriving passengers test positive [for COVID-19]. Therefore, checks at arrivals must be stepped up to limit imported cases and reduce positive cases.”

Gabon’s Minister of Health, Guy Patrick Obiang, while voicing satisfaction with the progress the country has made in curbing the spread of the virus, warned that “we cannot relax. We are aware that to bring the situation under control, we must maintain and indeed strengthen the measures against COVID-19.”