ReviewThe Lancet. Infectious diseases2025
Rethinking the evidence on COVID-19 in Africa.
Review in The Lancet. Infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed.
- Life Course Malaria Exposure and SARS-CoV-2 Seroepidemiology in Ugandan Adolescents: A Longitudinal Study Nested in a Birth Cohort.Tropical medicine & international health : TM & IH · 2026Article
- Longitudinal Epidemiology and Variant Dynamics of SARS-CoV-2 in Coastal Kenya (2020-2025): Clinical Features and Wave Patterns.Open forum infectious diseases · 2026Article
- Determinants of long-term SARS-CoV-2 immune responses in asymptomatic-to-moderate COVID-19 patients in sub-Saharan Africa.BMC medicine · 2026Article
- Integrated surveillance in Kilifi reveals continued SARS-CoV-2 circulation and immune escape of emerging JN.1 sublineages post-pandemic.Frontiers in cellular and infection microbiology · 2026Article
- A narrative review of heterogeneity in SARS-CoV-2 infection outcomes and vaccine efficacy: strategizing pandemic preparedness in Africa.Frontiers in public health · 2026Review
- COVID19 Sero-epidemiology and vaccine uptake in two Southern Nigerian clinics.PLOS global public health · 2026Article
- Article
- Kinetics of naturally induced binding and neutralising anti-SARS-CoV-2 antibody levels and potencies among SARS-CoV-2 infected Kenyans with diverse grades of COVID-19 severity: an observational study.Wellcome open research · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
The COVID-19 pandemic was predicted to cause substantial mortality in Africa. However, some countries in Africa had a striking absence of overwhelmed hospitals and low reported mortality. The marked contrast with the overwhelmed hospitals and high mortality seen in Europe and other high-income settings was regarded as puzzling and a paradox. In this Review, we reflect on possible explanations for the paradox with particular reference to observations made on the ground in Kenya. The evidence is inconsistent with reduced viral transmission or poor surveillance as primary explanations for the discrepancy. Population age structure is an important but incomplete explanation of the epidemiology. Due to the high prevalence of asymptomatic infection, low mortality, and evidence of reduced inflammatory responses, we hypothesise that some populations in Africa might have reduced susceptibility to symptomatic COVID-19. The reduced inflammatory responses might result from immunoregulation or cross-reactive, pre-pandemic cellular immunity, although the evidence is not definitive. Local data are essential to develop public health policies that align with the reality on the ground rather than external perceptions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.