Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
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 3

Results of multivariable Cox proportional hazard regression analysis of substantiated outbreaks by predictor variables, WHO African Region, 2017–2019*

Categories Total no.† Time to detection (15) Time to notification (15) Time to end (15)
Income (16)
Low 156 Referent Referent Referent
Middle and high 140 1.01 (0.68–1.52) 1.11 (0.71–1.73) 1.07 (0.78–1.73)
Significance

p = 0.5147
p = 0.6289
p = 0.1513
WHO subregion (10)
Eastern and Southern 133 Referent Referent Referent
Western 102 1.02 (0.52–1.46) 0.84 (0.47–1.50) 0.94 (0.56–1.54)
Central 61 0.81 (0.49–1.38) 1.13 (0.65–1.97) 0.55 (0.33–0.90)
Significance

p = 0.0427
p = 0.6784
p = 0.0608
Outbreak start date‡ (15)
2017 103 Referent Referent Referent
2018 101 1.68 (1.16–2.34) 0.46 (0.31–0.70) 1.57 (1.08–2.27)
2019 87 2.59 (1.71–3.94) 0.40 (0.25–0.64) 0.94 (0.63–1.43)
Significance

p = 0.0000
p = 0.0000
p = 0.0182
No. refugees from elsewhere (13)
Low‡ 199 Referent Referent Referent
High‡ 97 1.61 (0.96–2.70) 0.82 (0.45–1.48) 0.80 (0.48–1.33)
Significance

p = 0.2017
p = 0.8066
p = 0.0236
IDP, % population (13)
Low‡ 212 Referent Referent Referent
High‡ 84 1.01 (0.64–2.70) 1.38 (0.85–2.23) 0.70 (0.47–1.04)
Significance

p = 0.8446
p = 0.2843
p = 0.0163
Disease category (13)
Food/waterborne 74 Referent Referent Referent
Vectorborne 48 0.59 (0.34–1.03) 1.18 (0.63–2.22) 0.89 (0.54–1.45)
Viral hemorrhagic fever 56 0.40 (0.25–0.66) 1.57 (0.89–2.77) 1.20 (0.75–1.91)
Vaccine-preventable 85 0.46 (0.29–0.73) 1.19 (0.69–2.05) 0.53 (0.34–0.83)
Other 33 0.44 (0.34–1.05) 0.91 (0.47–1.78) 1.45 (0.85–2.46)
Significance

p = 0.0023
p = 0.4704
p = 0.0014
Current health expenditure, % GDP (13)
Low§ 162 Referent Referent Referent
High§ 134 1.11 (0.75–1.65) 0.93 (0.58–1.49) 1.02 (0.69–1.51)
Significance

p = 0.5415
p = 0.7700
p = 0.9354
Population density (13)
Low§ 201 Referent Referent Referent
High§ 95 1.10 (0.74–1.61) 0.98 (0.64–1.49) 0.96 (0.67–1.38)
Significance p = 0.6555 p = 0.9258 p = 0.8251

*GDP, gross domestic product; IDP, internally displaced persons; IQR, interquartile range.
†Numbers, based on records of total outbreaks meeting selection criteria (total for each modality = 296). 
‡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

References
  1. World Health Organization Regional Office for Africa. WHO African Region country offices [in French] [cited 2019 Feb 17]. https://www.afro.who.int/countries
  2. World Health Organization. The African regional health report: the health of the people. 2017 [cited 2019 Feb 13]. https://www.who.int/bulletin/africanhealth/en/
  3. Impouma  B, Archer  BN, Lukoya  OC, Hamblion  EL, Fall  IS. World Health Organization Regional Office for Africa weekly bulletin on outbreaks and other emergencies. Emerg Infect Dis. 2018;24:1394–5.
  4. Lopez  AD, Mathers  CD, Ezzati  M, Jamison  DT, Murray  CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006;367:174757. DOIPubMedGoogle Scholar
  5. World Health Organization Regional Office for Africa. WHO Health Emergencies Programme [cited 2019 Apr 16]. https://www.afro.who.int/about-us/programmes-clusters/who-health-emergencies-programme
  6. World Health Organization. International Health Regulations (2005): areas of work for implementation. Geneva: World Health Organization; 2007 [cited on 15 November 2019]. http://apps.who.int/iris/bitstream/10665/69770/1/WHO_CDS_EPR_IHR_2007.1_eng.pdf
  7. World Health Assembly, 69. Reform of WHO’s work in health emergency management: WHO Health Emergencies Programme report by the Director-General. World Health Organization [cited 2019 Feb 17]. https://apps.who.int/iris/handle/10665/252688
  8. World Health Organization Regional Office for Africa. The compendium of short reports on selected outbreaks in the WHO African Region 2016–2018. 2018 [cited 2019 Dec 11]. https://www.afro.who.int/publications/compendium-short-reports-selected-outbreaks-who-african-region-2016-2018
  9. Smolinski  MS, Crawley  AW, Olsen  JM. Finding outbreaks faster. Heal Secur. 2017;15:21520.
  10. World Health Organization Regional Office for Africa. Organizational structure [cited 2019 Oct 21]. https://www.afro.who.int/about-us/organizational-structure
  11. World Health Organization. WHO event management for international public health security: operational procedures. Working document. Geneva: World Health Organization; 2008 [cited 2019 Mar 4]. https://www.who.int/csr/HSE_EPR_ARO_2008_1.pdf?ua=1
  12. World Bank world development indicators [cited 2019 Oct 21]. http://datatopics.worldbank.org/world-development-indicators/
  13. World Bank world development indicators databank [cited 2019 Oct 21]. https://databank.worldbank.org/source/world-development-indicators
  14. Roth  PL. Missing data: a conceptual review for applied psychologists. Person Psychol. 1994;47:53760. DOIGoogle Scholar
  15. Chan  EH, Brewer  TF, Madoff  LC, Pollack  MP, Sonricker  AL, Keller  M, et al. Global capacity for emerging infectious disease detection. Proc Natl Acad Sci U S A. 2010;107:217016. DOIPubMedGoogle Scholar
  16. World Health Organization. Communicable disease surveillance and response systems. Epidemic and pandemic alert and response. Geneva: World Health Organization; 2006 [cited on 15 November 2019]. http://www.who.int/csr/resources/publications/surveillance/WHO_CDS_EPR_LYO_2006_2/en/
  17. Calba  C, Goutard  FL, Hoinville  L, Hendrikx  P, Lindberg  A, Saegerman  C, et al. Surveillance systems evaluation: a systematic review of the existing approaches. BMC Public Health. 2015;15:448. DOIPubMedGoogle Scholar
  18. Kluberg  SA, Mekaru  SR, McIver  DJ, Madoff  LC, Crawley  AW, Smolinski  MS, et al. Global capacity for emerging infectious disease detection, 1996–2014. Emerg Infect Dis. 2016;22:E16. DOIPubMedGoogle Scholar
  19. Kuna  A, Gajewski  M. Cholera - the new strike of an old foe. Int Marit Health. 2017;68:1637. DOIPubMedGoogle Scholar
  20. World Health Organization. Technical guidelines for integrated disease surveillance and response in the African region. Geneva: World Health Organization; 3rd edition. 2019 [cited DATE]. https://www.afro.who.int/publications/technical-guidelines-integrated-disease-surveillance-and-response-african-region-third
  21. Fall  IS, Rajatonirina  S, Yahaya  AA, Zabulon  Y, Nsubuga  P, Nanyunja  M, et al. Integrated Disease Surveillance and Response (IDSR) strategy: current status, challenges and perspectives for the future in Africa. BMJ Glob Health. 2019;4:e001427. DOIPubMedGoogle Scholar
  22. Munier  A, Njanpop-Lafourcade  BM, Sauvageot  D, Mhlanga  RB, Heyerdahl  L, Nadri  J, et al. The African cholera surveillance network (Africhol) consortium meeting, 10-11 June 2015, Lomé, Togo. BMC Proc. 2017;11(Suppl 1):2. DOIPubMedGoogle Scholar
  23. Ganesan  D, Gupta  S Sen , Legros  D. Cholera surveillance and estimation of burden of cholera. Vaccine. 2020;38:A13–7.
  24. Nagbe  T, Williams  GS, Rude  JM, Flomo  S, Yeabah  T, Fallah  M, et al. Lessons learned from detecting and responding to recurrent measles outbreak in Liberia post Ebola-Epidemic 2016-2017. Pan Afr Med J. 2019;33(Suppl 2):7. DOIPubMedGoogle Scholar
  25. Sun  D, Ahn  H, Lievens  T, Zeng  W. Evaluation of the performance of national health systems in 2004-2011: An analysis of 173 countries. PLoS One. 2017;12:e0173346. DOIPubMedGoogle Scholar
  26. ReliefWeb. Central African Republic: humanitarian response plan, January–December 2019. 2019. https://reliefweb.int/report/central-african-republic/central-african-republic-humanitarian-response-plan-january-december
  27. World Health Organization Regional Office for Africa. Weekly bulletin on outbreaks and other emergencies, week 34. 2018 [cited on 24 August 2019]. https://apps.who.int/iris/handle/10665/274276
  28. Simons  H, Patel  D. International Health Regulations in practice: Focus on yellow fever and poliomyelitis. Hum Vaccin Immunother. 2016;12:26903. DOIPubMedGoogle Scholar
  29. Global Health Security, Solidarity and sustainability through the International Health Regulations [cited 2019 Dec 10]. https://www.coursera.org/learn/international-health-regulations
  30. Enderlein U, Regmi J. Strengthening public health: making the case for mass gatherings. Public Health Panorama. 2018;4:67–71.
  31. World Health Organization Regional Office for Europe. World Youth Day 2016 [cited 2019 Feb 17]. https://www.euro.who.int/en/countries/poland/news/news/2016/08/world-youth-day-2016
  32. Barboza  P. Epidemic Intelligence from Open Sources (EIOS) [cited 2019 Feb 17]. http://www.oie.int/eng/BIOTHREAT2017/Presentations/6.2_BARBOZA-presentation.pdf
  33. Mboussou  F, Ndumbi  P, Ngom  R, Kamassali  Z, Ogundiran  O, Van Beek  J, et al. Infectious disease outbreaks in the African region: overview of events reported to the World Health Organization in 2018. Epidemiol Infect. 2019;147:e299. DOIPubMedGoogle Scholar
  34. Ravi  SJ, Snyder  MR, Rivers  C. Review of international efforts to strengthen the global outbreak response system since the 2014-16 West Africa Ebola Epidemic. Health Policy Plan. 2019;34:4754. DOIPubMedGoogle Scholar
  35. World Health Organization. WHO guidance for the use of annex 2 of the International Health Regulations (2005). Geneva: World Health Organization; 2008 http://www.who.int/ihr/revised_annex2_guidance.pdf

Main Article

Page created: July 31, 2020
Page updated: October 17, 2020
Page reviewed: October 17, 2020
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external