Volume 26, Number 11—November 2020
Synopsis
Measuring Timeliness of Outbreak Response in the World Health Organization African Region, 2017–2019
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.
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