This review followed the Preferred Reporting Items for Systematic Reviews and Meta Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist and reporting guideline (Tricco et al. 2018). The research made use of the Sample, Phenomenon of Interest, Design, Evaluation, Research type (SPIDER) methodology for selecting relevant articles in order to achieve relevant qualitative outcomes. The Phenomenon of Interest was infodemics on social media during public health crises (including pandemics, epidemics and endemics) while the sample included studies conducted or focusing on Africa. The design, evaluation and research type parameters were broad, including empirical studies, literature reviews and theoretical articles as the research field is still in its infancy and enough studies needed to be included to produce a worthwhile and meaningful contribution to the knowledge area. A scoping review protocol was developed; however, it was not registered or published in any journal prior to the start of this review. On request, the protocol will be made available.

The literature search that informed this study was carried out systematically using Google Scholar, Science Direct, PubMed, Scopus and ProQuest. The search blocks used included: (1) COVID-19 infodemic + Africa, Zika virus infodemic + Africa, (2) Ebola infodemic + Africa, HIV/AIDS infodemic + Africa, and (3) Monkeypox infodemic + Africa. Articles published in English between January 2010 and July 2022 were included in the study.

The relevance of articles was determined based on the inclusion criteria of addressing misinformation, addressing the African context in a meaningful way and infodemics on social media during public health crises. The exclusion criteria were based on the following: (1) articles that were not focusing on Africa during a public health emergency; (2) articles written by organisations, for example, WHO, UNICEF, etc. – only academic research articles with research methodologies were included; (3) articles that did not focus on infodemics or any identified relevant topic such as misinformation; (4) articles without full access; (5) articles that were not in English and (6) duplicate articles.

Following the search process, the article title and abstract were examined for relevance to the study by the principal investigator (CH), who exported the results into an Endnote library. Duplicate articles were removed after which the principal investigator (CH) and co-screener (LC) analysed the articles. In cases where the abstract indicated continued relevance, the full text of the article was retrieved and included in the review. The inclusion criteria resulted in the selection of 41 articles that were ultimately included in the review.

Thematic analysis was conducted on the articles to identify key themes characterising the literature by the two researchers independently of each other (CH and LC). Where discrepancies were found, the researchers came to a consensus before a decision was made about the article. The location, methodologies, pandemic, categories measured and findings of the studies were all described. Figure 1 provides the oversight of how the articles were excluded while Table 1-A1 provides a summary of the articles included in the study.

This study is part of a postdoctoral research project and the researchers sought research ethical clearance. The clearance was granted under number HOV001-22 from the University of Fort Hare’s Inter-Faculty Research Ethics Committee (IFREC).

There is a common misperception that social media is the main channel responsible for the infodemic during COVID-19 (Adekoya & Fasae 2021; Demuyakor, Nyatuame & Obiri 2021; Ennab et al. 2022:20; Lucas et al. 2022; Madziva et al. 2022; Okereke et al. 2021;Osuagwu et al. 2021; Shobowale 2021; Stewart et al. 2022). This misperception occurred because of the original infodemiology study that was conducted by Eysenbach in 2009, which portrayed social media as a way of creating and enabling infodemics to flourish. While many are quick to associate social media with infodemics, social media is not the only channel that can be used to spread an infodemic. Traditional media channels are equally responsible for the spread of infodemics because of the large amount of information distributed during public health crises (Lucas et al. 2022). However, the difference between content created on social media as opposed to traditional media is that journalists need to adhere to a specific code of ethics when producing content that includes verification of the facts, whereas citizens can create and share information on social media without any verification of the data. Social media usage in Africa has increased exponentially since COVID-19 while many African countries imposed a lockdown to curb the spread of the disease. These measures contributed to more content being created, exchanged and consumed, which supported the infodemic during the COVID-19 infodemic (Adekoya & Fasae 2021; Santos-D’Amorim & De Oliveira Miranda 2021).

While the majority of the articles included in the study focused on COVID-19, five articles combine a discussion of COVID-19 and other epidemics that occurred in Africa (Shobowale 2021). This finding may signify the view that infodemics have started with COVID-19. However, this is not true as the term was used during the SARS pandemic in 2003 (Ijab, Shahril & Hamid 2021).

Fake news is hard to fight not only because it can spread quickly on social media, but there is often a political and financial motive to share such information (Adebisi et al. 2021b; Ademola et al. 2021). Since the start of the COVID-19 pandemic, there has been an increase in scams related to treatment, medication, testing and vaccines on social media. The importance of this public health threat becomes clear when one considers the correlation between an infodemic and COVID-19-related stress, suggesting that the infodemic is dangerous to one’s health and could affect healthy living in the long run (Shobowale 2021). Fake news often increases public anxiety, anger and frustration around these topics, that may lead to poor compliance by the public to protect themselves from COVID-19 (Ademole et al. 2021).

Social media platforms have responded to the threat of an infodemic and fake news by putting in place safeguards to make it easier to recognise fake news (Shobowale 2021). However, there are concerns if social media sites can be trusted to make these changes if it will affect their profitability (Zenone et al. 2023). Governments and public health agencies need to confront misinformation on social media and put in place policies and mechanisms to deal with the issue and bring those who are responsible for creating and spreading misinformation to justice (Ademole et al. 2021). Actions such as maintaining an official social media presence, making use of public opinion leaders in the fight against misinformation, and creating tools to facilitate the easy spread of accurate information will have a far-reaching effect to mitigate misinformation on social media (Shobowale 2021).

While governments need to guard against misinformation, they also have a responsibility to share information with each other. The COVID-19 pandemic has highlighted the need to reorganise data and streamline data sharing at all levels of government. They are further needed to share health information systems data, including observational studies and disease monitoring and surveillance programmes to ensure that all countries have the necessary information to implement rapid protocols and strategic plans for potential pandemics such as COVID-19 (Lal et al. 2022).

Madziva et al. (2022) stated that the notion that information shared on social media is a ‘magic bullet’ that will solve the intended problem when the audience receives the message. The authors suggest that not all members of the audience will interpret the message in the same way. Information shared on social media must consider the demography, culture, religion, health literacy and socio-economic conditions of the intended audience (Adebisi et al. 2021b; Okereke et al. 2021).

Rural communities have little or no access to accurate health information because of the unavailability of the Internet or even traditional media. The lack of health information often leads to a low level of health literacy in the rural areas of low- and middle-income countries. Health literacy allows an individual to understand abstract concepts such as germ theory, infectivity and prophylaxis such as vaccines. When health information is available but ambiguous or not accurate, the result is doubt and hostility from the citizens and mistrust in health authorities (Okereke et al. 2021).

Social media is the biggest source of the COVID-19 infodemic and related conspiracy theories (Demuyakor et al. 2021; Ufearoh 2020). The biggest culprit in this regard was Facebook, which accounted for 52.3% of vaccine infodemic when compared with WhatsApp, Twitter and YouTube (Demuyakor et al. 2021). Stewart et al. (2022) identified five potential domains of impact where misinformation can cause potential harm (Table 1).

Gagliardone et al. (2021) warns that conspiracies on social media are often interpreted as either falsehood versus fact; centre versus periphery dichotomy or an over-reliance on datasets that can be associated with moral panic. This debate on conspiracy theories is open to misuse where opportunistic individuals make use of the chance to include government corruption and political opposition in the conversation (Ogola 2020). These types of accusations normally take place around the periphery of the discussion and are used to influence those that do not have a strong opinion on the matter. This is true of the anti-vaccination movement that used the COVID-19 agenda to broadcast their message that one should not only be suspicious of new vaccines but any vaccine (Ajekwe 2022). The 5G conspiracy in Nigeria and Zimbabwe was linked to the government’s corruption and ill-will towards the citizens of the country, while in South Africa this particular conspiracy marginally intersected with local political debates. There is also the existential response to conspiracy theories, such as the Bill Gates conspiracy, where broader suspicion of foreign or Western interference in African affairs is incorporated into the narrative (Mare & Munoriyarwa 2022).

Africa Check reports that the main categories of misinformation focus on the cause of the virus, how to prevent infection, treatment and alleged sinister objectives of superpowers and wealthy businessmen (Mare & Munoriyarwa 2022). Table 2 provides an overview of the most popular conspiracy theories found in the literature.

There are strategies that have been developed to mitigate the potential and spread of misinformation on social media. These include (Wasserman et al. 2021):

The findings indicate that scholars identified different sources of information during a health infodemic. These are discussed in the following subheadings:

Misinformation is spread on social media without any intention to deceive others, the user is simply sharing information that they believe to be true or helpful to others (Adekoya & Fasae 2021). Unfortunately, fake news tends to spread faster on social media than accurate news, but there seems to be less engagement with fake news tweets when compared with science-based tweets on Twitter (Gbashi et al. 2021). This means that the information available on social media must be verified for accuracy. Fact-checking is important as misinformation is spread from news sources based abroad for example, Africa Check debunked a New York Times story that claimed South Africa had the fifth highest number of COVID-19 infections in the world (Ataguba & Ataguba 2020).

To improve the verification of COVID-19 information, Facebook has implemented a fact-checking pilot project while mass media agencies engage in pre- and post-fact-checking of news items (Adekoya & Fasae 2021; Etim, Iyamu & Chinwuba 2020; Olatunji et al. 2020). In 2020, Twitter updated its policy to include content sharing from authoritative sources of health information while Google put mechanisms in place that trigger an ‘SOS Alert’ when a search on COVID-19 is requested that gives preference to results from the WHO and the United States Centre for Disease Control and Prevention (Etim et al. 2020; Gbashi et al. 2021). Cooperation between various health agencies and social media platforms will further improve efforts to verify the information and thus prevent the spread of misinformation.

In order to curb misinformation, various stakeholders need to collaborate and share their expertise in the problem area. Stakeholders in this process include social media platforms, health organisations, civil society, public authorities and figures, tech companies, traditional media and medical associations. The rest of the section will discuss the various role players that were identified during the COVID-19 pandemic and their role to fight the infodemic.

The WHO has offices in various countries that provide technical cooperation and leadership in the health sector. These country offices provide policy advice and technical support, public relations and advocacy and health management to countries (Chisita & Ngulube 2022).

Global Pulse is a United Nations collaboration that provides tools that monitor talks on radio, find influencers and identifies those who spread rumours (Ennab et al. 2022). The International Federation of Red Cross and Red Crescent societies (IFRC) provides feedback and complaints systems that could be used to systematically listen to communities and respond to citizens (Erlach et al. 2021). The IFRC published a 5-step process for community engagement with the objective to improve decision-making during public health emergencies (Lal et al. 2022).

The Africa Infodemic Response Alliance (AIRA) is a WHO partner organisation that started in 2020. The AIRA uses listening tools to identify and track fake news on social media and then produces scientifically accurate information to counter these claims. Viral Fact Africa is a social content hub that develops and circulates content that corrects COVID-related misinformation. Both these organisations work with public health organisations and fact checkers (Ennab et al. 2022). Media Monitoring Africa is a media organisation that promotes the development of a critical and ethical media culture in Africa. Media Monitoring Africa provides a website called Real411 where the public can report disinformation about COVID-19 (Gbashi et al. 2021). AfricaCheck.org is a verification site that fact-checks a variety of information, including COVID-19-related misinformation (Offer-Westort, Rosenzweig & Athey 2021). AfricaCheck.org operates in South Africa, Kenya and Nigeria while there is a similar organisation operating in Zimbabwe and Namibia. The mission of AfricaCheck.org is to help the media to deliver accurate, fair and balanced news and information (Mare & Munoriyarwa 2022).

Locally, libraries have been identified as a source of quality and credible COVID-19 resources and information on their websites and Library Guides. The Universities of Stellenbosch, Pretoria, and Cape Town were the first to provide current information about COVID-19 on their library websites while most other universities provided links to free COVID-19 resources on their homepages as per government regulations (Bangani 2021; Chisita 2020).

Urban observatories collect, analyse and present urban data to enable factual decision-making for policymakers. An example is the Gauteng City-Region Observatory (GCRO), which was established in 2008 and operates in Johannesburg, South Africa. The GCRO works in partnership with the University of Johannesburg and the University of the Witwatersrand. During the COVID-19 pandemic, GCRO provided a crisis advisory role through data visualisation and analytics capacity that allowed the local government to interpret the evolving situation in Gauteng in terms of COVID-19 vulnerabilities (Acuto et al. 2021; Bangani 2021). Figure 2 provides a summary of the factors that were discussed in the preceding sections.