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Estimates of the COVID-19 Infection Fatality Rate for 48 African Countries: A Model-based Analysis

(1) Background: Examine global data from 48 African countries to estimate the SARS-CoV-2 infection fatality rate; (2) Methods: We analyzed time series data on the 135,126 confirmed cases and 3922 deaths from COVID-19 disease outbreak in Africa through 30 May 2020. In a Bayesian prediction model based on the Monte Carlo approach, we adjusted for demographic, economic, biological, and societal variables to account for the untested people; (3) Results: We calculated a total of 1,686,879 COVID-19 infections after correcting for possible risk variables in the Bayesian model, equal to 13 infections per confirmed case. In Africa, the IFR is projected to be 0.23% (95% CI: 0.14–0.33%). The percentages varied by country, ranging from 0.004% in Botswana and the Central African Republic to 1.53% in Nigeria. The projected IFR is twelvefold greater than the WHO’s 2009 H1N1 influenza pandemic estimate (0.02%). In four countries: Morocco, Nigeria, Cameroon, and South Africa, the inverse distance weighted interpolation map shows high IFR variability; (4) Conclusions: COVID-19 infection mortality rates can vary significantly between regions, and this might be due to changes in demography, underlying health conditions in the community, healthcare system capacity, positive health seeking behavior, and other variables.