Volume 26, Number 11—November 2020
Synopsis
Measuring Timeliness of Outbreak Response in the World Health Organization African Region, 2017–2019
Benido Impouma
, Maroussia Roelens, George Sie Williams, Antoine Flahault, Claudia Torres Codeço, Fleury Moussana, Bridget Farham, Esther L. Hamblion, Franck Mboussou, and Olivia Keiser
, Maroussia Roelens, George Sie Williams, Antoine Flahault, Claudia Torres Codeço, Fleury Moussana, Bridget Farham, Esther L. Hamblion, Franck Mboussou, and Olivia Keiser
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.
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