One month after its onset in Senegal, the evolution of the pandemic seems slow, as for most African countries, unlike Europe and the Americas (14, 15). Several contextual factors have been mentioned to explain this situation as vaccination against certain diseases such as tuberculosis (16). However, the low diagnostic capacity encountered in these countries may also explain this situation. The appearance of community-based cases in Senegal since March 21st, 2020, suggests that not all the existing cases are reported (17). Active surveillance should be carried out to better assess the extent of these community-based cases. It is also important to readjust the definition of suspect cases. The results of our study show a slight predominance of women which is consistent with the distribution of women in the general population (8). The gender distribution varies from one country to another (18, 19). However, it seems that severe forms are more frequent in men (20 Yang X). Senegal situation can be explained by the fact that the most imported cases are men who had gone abroad to look for work. It happens that some men could transmit the disease to several co-spouses. Adults are the most affected. Similar results have been observed in China (21, 22) and Europe. Disparities in age and sex distribution in the populations of Asia, Europe, America, and Africa make it difficult to compare countries (23).
Except the region of Diourbel, all other regions are in a border position; as such, they are maritime, airport or road gateway. The Diourbel region was chosen because several nationals of this region emigrate to Italy, Spain or the United States to work there.
The Health Districts affected were among the 45 out of 78 under special surveillance by the alert committee because their high-risk status (24). This illustrates Senegal preparedness in fighting Covid-19.
Containment requires a gradual implementation of measures according to the phase of the epidemic (6). The commitment of the GOS is an important success factor. A mix of suppression and mitigation measures have been set, some targeting the general population and other populations at risk (25). The particularity of the measures is that they were intelligent and adapted to the Senegalese context (26, 27). Indeed, the adaptation of measures to the local context is a success factor for Covid-19.
By prohibiting movement between regions, by imposing a night curfew, and establishing the COB time at 3 p.m. instead of 5 p.m., Senegal has chosen less restrictive measures while maintaining proper economic activity. The hospitalization of cases, the use of hotels to isolate contact subjects for 14 days (28) combined with targeted quarantine measures for families or villages in rural areas are effective (25) and appropriate mitigation measures. All of this was facilitated at regional level by Governors involvement from the beginning of the process through the decentralized management committees. The borders closure and the suspension of air and sea lines seem to be working as no imported case has been reported since April 4th, 2020.
Social distance seems difficult to organize in Senegal (29). Full containment requires housing and economic resources for a decent daily life. For many African households living in urban areas, cramped housing conditions and precarious economic conditions make it difficult to adopt these measures consequently implementing such measures would be a failure because they are not adapted to the context.
However, if most of the measurements to date do not suffer from dispute, certain measures such as the prohibition of prayer in mosques in a country where more than 95% of the population is Muslim can arise problems of acceptability particularly during the upcoming month of Ramadan (starting the last week of April) in Senegal and where the people are called to make collective prayers in the evening.