Implementation of Antibody Rapid Diagnostic Testing versus Real-Time Reverse Transcription-PCR Sample Pooling in the Screening of COVID-19: a Case of Different Testing Strategies in Africa

COVID-19 has wreaked havoc across the globe, although cases in Africa remain lower than 50 other regions but they are gradually on an upward trajectory. To date, COVID-19 cases have 51 been reported in 54 countries. However, due to limited SARS-COV-2 rRT-PCR testing 52 capacity and scarcity of testing reagents, it is probable that the total number of cases could 53 far exceed published statistics. In this viewpoint, using Ghana, Malawi, South Africa and 54 Zimbabwe as examples of countries that have implemented different testing strategies, we 55 argue that the implementation of sample pooling for rRT-PCR over antibody rapid diagnostic 56 testing could have a greater impact in assessing disease burden. Sample pooling offers huge 57 advantages compared to single test rRT-PCR, as it lowers experimental costs, personnel 58 time, reduces burnout and analytical run-times. Africa is already strained in terms of testing 59 resources for COVID-19, hence cheaper alternative ways need to be implemented to 60 conserve resources, maximise on mass testing and reduce transmission in the wider 61 population