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Volume 26, Number 11—November 2020
Synopsis

Measuring Timeliness of Outbreak Response in the World Health Organization African Region, 2017–2019

Benido ImpoumaComments to Author , Maroussia Roelens, George Sie Williams, Antoine Flahault, Claudia Torres Codeço, Fleury Moussana, Bridget Farham, Esther L. Hamblion, Franck Mboussou, and Olivia Keiser
Author affiliations: World Health Organization Regional Office for Africa, Brazzaville, Congo (B. Impouma, G. Williams, F. Moussana, B. Farham, E.L. Hamblion, F. Mboussou); Institute of Global Health, University of Geneva, Switzerland (M. Roelens, A. Flahault, O. Keiser); Fundacao Oswaldo Cruz Ringgold Standard Institution, Rio de Janeiro, Brazil (C.T. Codeço)

Main Article

Table 1

Median time to progression for 3 outbreak milestones (detection, notification, and end) by predictor variables, WHO African Region, 2017–2019*

Categories Total no.† Time to detection (15)
Time to notification (15)
Time to end (15)
No. (%)‡ Median (IQR) No. (%)‡ Median (IQR) No. (%)‡ Median (IQR)
Income (16)
Low 156 107 (68.6) 9 (2–27) 127 (81.4) 3 (0–8) 109 (53.2) 86 (37–169)
Middle and high
140
77 (55.0)
8 (2–29)

105 (75.0)
2 (0–8)

92 (44.9)
54 (24–155)
WHO subregion (10)
Eastern/Southern 133 78 (58.6) 6 (1–23) 96 (72.2) 3 (0–9) 96 (46.8) 70 (30–148)
Western 102 74 (72.5) 10 (5–28) 88 (86.3) 2 (0–6) 37 (18.0) 68 (29–158)
Central
61
32 (52.5)
16 (3–33)

48 (78.7)
2 (0–9)

68 (33.2)
136 (50–221)
Outbreak start date§ (15)
2017 103 75 (72.8) 14 (6–37) 87 (84.5) 1 (0–5) 62 (30.2) 131 (67–237)
2018 101 62 (61.4) 7 (1–27) 83 (82.2) 3 (0–14) 72 (35.1) 67 (25–144)
2019
87
47 (54.0)
4 (1–11)

62 (71.3)
4 (1–9)

67 (32.7)
45 (22–90)
No. refugees from elsewhere (13)
Low¶ 199 129 (64.8) 8 (3–28) 160 (80.4) 2 (0–8) 133 (64.9) 69 (25–166)
High¶
97
55 (56.7)
8 (1–28)

72 (74.2)
3 (0–9)

68 (33.2)
84 (43–147)
IDP, % population (13)
Low¶ 212 139 (65.6) 7 (2–23) 170 (80.2) 3 (0–8) 145 (70.7) 60 (25–126)
High¶
84
45 (53.6)
17 (2–37)

62 (73.8)
2 (0–9)

56 (27.3)
153 (65–227)
Disease category
Food/waterborne 74 47 (63.5) 2 (0–7) 54 (73.0) 3 (0–6) 60 (29.3) 82 (24–154)
Vectorborne 48 24 (50.0) 7 (1–24) 34 (70.8) 3 (0–24) 31 (15.1) 138 (48–232)
Viral hemorrhagic fever 56 41 (73.2) 9 (6–17) 49 (87.5) 1 (0–4) 37 (18.0) 47 (28–82)
Vaccine-preventable 85 49 (57.6) 28 (8–50) 67 (78.8) 2 (0–15) 52 (25.4) 90 (52–175)
Other
33
23 (69.7)
11 (4–18)

28 (84.8)
5 (1–10)

21 (10.2)
42 (17–146)
Current health expenditure, % GDP (13)
Low¶ 162 99 (61.1) 11 (3–21) 126 (77.8) 2 (0–9) 112 (54.6) 79 (35–167)
High¶
134
85 (63.4)
7 (2–21)

106 (79.1)
3 (0–8)

89 (43.4)
77 (27–155)
Population density (13)
Low¶ 201 121 (60.2) 11 (3–31) 157 (78.1) 2 (0–9) 131 (63.9) 76 (36–191)
High¶ 95 63 (66.3) 6 (2–18) 75 (78.9) 2 (0–5) 70 (34.1) 77 (21–130)

*GDP, gross domestic product; IDP, internally displaced persons; IQR, interquartile range.
†Total number based on records of total outbreaks meeting selection criteria (total for each modality = 296). 
‡Numbers based on records of total outbreaks minus those with key missing dates (n [detection] = 184, n [notification] = 132, n [end] = 201 for each modality). Percentages are figured as no. in category/total number × 0.01.
§Five dates missing in initial dataset. 
¶Low indicates < median, high indicates > median of in-country value for variable compared with that value for all countries in the African region.

Main Article

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