OPEN LETTER The wearing of face masks in African countries under the COVID-19 crisis: luxury or necessity? [version 1; peer review: 1 approved, 1 approved with reservations] Zohra Aloui-Zarrouk 1,2 , Lahcen El Youssfi 3 , Kingsley Badu 4* , Adeniyi Francis Fagbamigbe 5* , Damaris Matoke-Muhia 6,7 , Caroline Ngugi 8 , Natisha Dukhi 9 , Grace Mwaura 10 1 LR16IPT04 Laboratoire d’Epidémiologie Moléculaire et de Pathologie Expérimentale appliquées aux Maladies infectieuses, Institut Pasteur de Tunis, Tunis, 1002, Tunisia 2 Université de Tunis El Manar, Tunis, Tunisia 3 Environment and Natural Resources Management Research Team & Biotechnology and Sustainable Management of Natural Resources Laboratory, Department of Environmental Engineering and Agrobiotech, Higher School of Technology, Sultan Moulay Slimane University, Khenifra, Morocco 4 Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana 5 Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria 6 Centre for Biotechnology Research and development,, Kenya Medical Research Institution, Nairobi, Kenya 7 Pan African Mosquito Control Association, Nairobi, P.O. Box 44455 -00100, Kenya 8 College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, P. O Box 62000-00200, Kenya 9 Human Sciences Research Council, Division of Human and Social Capabilities. Private Bag X9182, Cape Town, 8000, South Africa 10 African Academy of Sciences, Nairobi, Kenya * Equal contributors First published: 05 Aug 2020, 3:36 https://doi.org/10.12688/aasopenres.13079.1 Latest published: 05 Aug 2020, 3:36 https://doi.org/10.12688/aasopenres.13079.1 v1 Abstract The unforeseeable global crisis of the spread of coronavirus disease 2019 (COVID-19) has caused almost all affected countries to adopt a range of protective measures as recommended by the World Health Organization. However, the speed, type and level of adoption of these protective measures have been remarkably different. Social distancing and quarantine were the main measures adopted in addition to observing basic hygiene. Based on the available evidences, WHO continues to recommend wearing of face masks for healthcare workers and for those people caring for COVID-19 patients. However, some countries and organisations have recommended, and some have even made it mandatory, for their citizens to wear face masks. Particularly in low- and middle-income countries, protecting by wearing face masks is viewed as an affordable yet proactive preventive measure to avoid and slow down viral spread based on the experience of other affected countries. However, the wearing of face Open Peer Review Reviewer Status Invited Reviewers 1 2 version 1 05 Aug 2020 report report Ahmed Rebaï , University of Sfax, Sfax, Tunisia 1. Ludoviko Zirimenya , Medical Research Council/Uganda Virus Research Institute & London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, 2. AAS Open Research Page 1 of 14 AAS Open Research 2020, 3:36 Last updated: 17 FEB 2021