{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T15:43:25Z","timestamp":1790437405201,"version":"4.1.0"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","license":[{"start":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T00:00:00Z","timestamp":1617753600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Most African countries have recorded relatively lower COVID-19 burdens than Western countries. This has been attributed to early and strong political commitment and robust implementation of public health measures, such as nationwide lockdowns, travel restrictions, face mask wearing, testing, contact tracing, and isolation, along with community education and engagement. Other factors include the younger population age strata and hypothesized but yet-to-be confirmed partially protective cross-immunity from parasitic diseases and\/or other circulating coronaviruses. However, the true burden may also be underestimated due to operational and resource issues for COVID-19 case identification and reporting. In this perspective article, we discuss selected best practices and challenges with COVID-19 contact tracing in Nigeria, Rwanda, South Africa, and Uganda. Best practices from these country case studies include sustained, multi-platform public communications; leveraging of technology innovations; applied public health expertise; deployment of community health workers; and robust community engagement. Challenges include an overwhelming workload of contact tracing and case detection for healthcare workers, misinformation and stigma, and poorly sustained adherence to isolation and quarantine. Important lessons learned include the need for decentralization of contact tracing to the lowest geographic levels of surveillance, rigorous use of data and technology to improve decision-making, and sustainment of both community sensitization and political commitment. Further research is needed to understand the role and importance of contact tracing in controlling community transmission dynamics in African countries, including among children. Also, implementation science will be critically needed to evaluate innovative, accessible, and cost-effective digital solutions to accommodate the contact tracing workload.<\/jats:p>","DOI":"10.4269\/ajtmh.21-0033","type":"journal-article","created":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T13:51:55Z","timestamp":1613051515000},"page":"1179-1187","source":"Crossref","is-referenced-by-count":79,"title":["Contact Tracing and the COVID-19 Response in Africa: Best Practices, Key Challenges, and Lessons Learned from Nigeria, Rwanda, South Africa, and Uganda"],"prefix":"10.4269","volume":"104","author":[{"given":"Jean B.","family":"Nachega","sequence":"first","affiliation":[{"name":"1Department of Medicine and Center for Infectious Diseases, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa;"},{"name":"2Department of Epidemiology, Infectious Diseases and Microbiology, Center for Global Health, University of Pittsburgh, Pittsburgh, Pennsylvania;"},{"name":"3Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"},{"name":"4Department of International Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhoda","family":"Atteh","sequence":"additional","affiliation":[{"name":"5Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikwe","family":"Ihekweazu","sequence":"additional","affiliation":[{"name":"6Office of the Director-General, Nigeria Centre for Disease Control, Abuja, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia A.","family":"Sam-Agudu","sequence":"additional","affiliation":[{"name":"7International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria;"},{"name":"8Department of Pediatrics, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland;"},{"name":"9Department of Pediatrics and Child Health, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prisca","family":"Adejumo","sequence":"additional","affiliation":[{"name":"10Department of Nursing, University of Ibadan, Ibadan, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabin","family":"Nsanzimana","sequence":"additional","affiliation":[{"name":"11Rwanda Biomedical Centre, Ministry of Health, Kigali, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edson","family":"Rwagasore","sequence":"additional","affiliation":[{"name":"11Rwanda Biomedical Centre, Ministry of Health, Kigali, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanine","family":"Condo","sequence":"additional","affiliation":[{"name":"12University of Rwanda, School of Public Health, Kigali, Rwanda;"},{"name":"13School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masudah","family":"Paleker","sequence":"additional","affiliation":[{"name":"14South African Department of Health, Western Cape Province, Cape Town, South Africa;"},{"name":"15Division of Health Systems and Public Health, Department of Global Health, Stellenbosch Faculty of Medicine and Health Sciences and Western Cape Department of Health, Cape Town, South Africa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Mahomed","sequence":"additional","affiliation":[{"name":"14South African Department of Health, Western Cape Province, Cape Town, South Africa;"},{"name":"15Division of Health Systems and Public Health, Department of Global Health, Stellenbosch Faculty of Medicine and Health Sciences and Western Cape Department of Health, Cape Town, South Africa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Suleman","sequence":"additional","affiliation":[{"name":"16Discipline of Pharmaceutical Sciences, University of KwaZulu Natal, Durban, South Africa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex Riolexus","family":"Ario","sequence":"additional","affiliation":[{"name":"17Uganda National Institute of Public Health, Ministry of Health, Kampala, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsie","family":"Kiguli-Malwadde","sequence":"additional","affiliation":[{"name":"18African Centre for Global Health and Social Transformation, Kampala, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis G.","family":"Omaswa","sequence":"additional","affiliation":[{"name":"18African Centre for Global Health and Social Transformation, Kampala, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson K.","family":"Sewankambo","sequence":"additional","affiliation":[{"name":"19Department of Internal Medicine, College of Health Sciences, Makerere University, Kampala, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecile","family":"Viboud","sequence":"additional","affiliation":[{"name":"20Fogarty International Center, National Institutes of Health, Bethesda, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J. A.","family":"Reid","sequence":"additional","affiliation":[{"name":"21University of California San Francisco, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alimuddin","family":"Zumla","sequence":"additional","affiliation":[{"name":"22Division of Infection and Immunity, University College London, London, United Kingdom;"},{"name":"23NIHR Biomedical Research Centre, University College London Hospitals, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter H.","family":"Kilmarx","sequence":"additional","affiliation":[{"name":"20Fogarty International Center, National Institutes of Health, Bethesda, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/104\/4\/article-p1179.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/104\/4\/article-p1179.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T12:30:44Z","timestamp":1617798644000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/104\/4\/article-p1179.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,7]]},"references-count":0,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.21-0033","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,7]]}}}