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Ikejezie J, Miglietta A, Hammermeister Nezu I, Adele S, Higdon MM, Feikin D, Lata H, Mesfin S, Idoko F, Shimizu K, Acma A, Moro S, Attar Cohen H, Sinnathamby MA, Otieno JR, Temre Y, Ajong BN, Mirembe BB, Guinko TN, Sodagar V, Schultz C, Muianga J, De Barros S, Escobar Corado Waeber AR, Jin Y, Rico Chinchilla A, Izawa Y, Khare S, Poole M, Alexander N, Ciobanu S, Dorji T, Hassan M, Kato M, Matsui T, Ogundiran O, Pebody RG, Phengxay M, Riviere-Cinnamond A, Greene-Cramer BJ, Peron E, Archer BN, Subissi L, Kassamali ZA, Awofisayo-Okuyelu A, le Polain de Waroux O, Hamblion E, Pavlin BI, Morgan O, Fall IS, Van Kerkhove MD, Mahamud A. Informing the pandemic response: the role of the WHO's COVID-19 Weekly Epidemiological Update. BMJ Glob Health 2024; 9:e014466. [PMID: 38580376 PMCID: PMC11002403 DOI: 10.1136/bmjgh-2023-014466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/19/2024] [Indexed: 04/07/2024] Open
Abstract
On 31 December 2019, the Municipal Health Commission of Wuhan, China, reported a cluster of atypical pneumonia cases. On 5 January 2020, the WHO publicly released a Disease Outbreak News (DON) report, providing information about the pneumonia cases, implemented response interventions, and WHO's risk assessment and advice on public health and social measures. Following 9 additional DON reports and 209 daily situation reports, on 17 August 2020, WHO published the first edition of the COVID-19 Weekly Epidemiological Update (WEU). On 1 September 2023, the 158th edition of the WEU was published on WHO's website, marking its final issue. Since then, the WEU has been replaced by comprehensive global epidemiological updates on COVID-19 released every 4 weeks. During the span of its publication, the webpage that hosts the WEU and the COVID-19 Operational Updates was accessed annually over 1.4 million times on average, with visits originating from more than 100 countries. This article provides an in-depth analysis of the WEU process, from data collection to publication, focusing on the scope, technical details, main features, underlying methods, impact and limitations. We also discuss WHO's experience in disseminating epidemiological information on the COVID-19 pandemic at the global level and provide recommendations for enhancing collaboration and information sharing to support future health emergency responses.
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Affiliation(s)
| | | | | | - Sandra Adele
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Melissa M Higdon
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Daniel Feikin
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Harsh Lata
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Samuel Mesfin
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Friday Idoko
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Kazuki Shimizu
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Ayse Acma
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Samuel Moro
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Homa Attar Cohen
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | | | | | - Yosef Temre
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | | | | | - Tondri Noe Guinko
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Vaishali Sodagar
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Craig Schultz
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Joao Muianga
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Stéphane De Barros
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | | | - Yeowon Jin
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | | | - Yurie Izawa
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Shagun Khare
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Marcia Poole
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Nyka Alexander
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Silviu Ciobanu
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Tshewang Dorji
- World Health Organization Regional Office for South-East Asia, New Delhi, India
| | - Mahmoud Hassan
- World Health Organisation Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Masaya Kato
- World Health Organization Regional Office for South-East Asia, New Delhi, India
| | - Tamano Matsui
- World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Opeayo Ogundiran
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Richard G Pebody
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Manilay Phengxay
- World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | | | | | - Emilie Peron
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | | | - Lorenzo Subissi
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | | | | | | | - Esther Hamblion
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Boris Igor Pavlin
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Oliver Morgan
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Ibrahima Socé Fall
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | | | - Abdi Mahamud
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
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2
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Kabego L, Balde T, Barasa D, Ndoye B, Hilde OB, Makamure T, Mulumeoderwa GO, Kanyowa T, Kamara RF, Hamadou B, Ogundiran O, Okeibunor J, Williams G, Tusiime JB, Atuhebwe PL, Oyugi B, Mawanda ET, Razakamanantsoa A, Braka F, Chamla D, Gueye AS. Analysing the implementation of infection prevention and control measures in health care facilities during the COVID-19 pandemic in the African Region. BMC Infect Dis 2023; 23:824. [PMID: 37996811 PMCID: PMC10668477 DOI: 10.1186/s12879-023-08830-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/17/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND The declaration of SARS-CoV-2 as a public health emergency of international concern in January 2020 prompted the need to strengthen infection prevention and control (IPC) capacities within health care facilities (HCF). IPC guidelines, with standard and transmission-based precautions to be put in place to prevent the spread of SARS-CoV-2 at these HCFs were developed. Based on these IPC guidelines, a rapid assessment scorecard tool, with 14 components, to enhance assessment and improvement of IPC measures at HCFs was developed. This study assessed the level of implementation of the IPC measures in HCFs across the African Region during the COVID-19 pandemic. METHOD An observational study was conducted from April 2020 to November 2022 in 17 countries in the African Region to monitor the progress made in implementing IPC standard and transmission-based precautions in primary-, secondary- and tertiary-level HCFs. A total of 5168 primary, secondary and tertiary HCFs were assessed. The HCFs were assessed and scored each component of the tool. Statistical analyses were done using R (version 4.2.0). RESULTS A total of 11 564 assessments were conducted in 5153 HCFs, giving an average of 2.2 assessments per HCF. The baseline median score for the facility assessments was 60.2%. Tertiary HCFs and those dedicated to COVID-19 patients had the highest IPC scores. Tertiary-level HCFs had a median score of 70%, secondary-level HCFs 62.3% and primary-level HCFs 56.8%. HCFs dedicated to COVID-19 patients had the highest scores, with a median of 68.2%, followed by the mixed facilities that attended to both COVID-19 and non-COVID-19 patients, with 64.84%. On the components, there was a strong correlation between high IPC assessment scores and the presence of IPC focal points in HCFs, the availability of IPC guidelines in HCFs and HCFs that had all their health workers trained in basic IPC. CONCLUSION In conclusion, a functional IPC programme with a dedicated focal person is a prerequisite for implementing improved IPC measures at the HCF level. In the absence of an epidemic, the general IPC standards in HCFs are low, as evidenced by the low scores in the non-COVID-19 treatment centres.
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Affiliation(s)
- Landry Kabego
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo.
| | - Thierno Balde
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Deborah Barasa
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Babacar Ndoye
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Okou-Bisso Hilde
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Tendai Makamure
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | | | - Trevor Kanyowa
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Rashidatu Fouad Kamara
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Boiro Hamadou
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Opeayo Ogundiran
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Joseph Okeibunor
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | - George Williams
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Jayne Byakika Tusiime
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Phionah Lynn Atuhebwe
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Boniface Oyugi
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Elande-Taty Mawanda
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Andry Razakamanantsoa
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Fiona Braka
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Dick Chamla
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Abdou Salam Gueye
- World Health Organization/Regional Office for Africa, Brazzaville, Republic of the Congo
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Laurenson-Schafer H, Sklenovská N, Hoxha A, Kerr SM, Ndumbi P, Fitzner J, Almiron M, de Sousa LA, Briand S, Cenciarelli O, Colombe S, Doherty M, Fall IS, García-Calavaro C, Haussig JM, Kato M, Mahamud AR, Morgan OW, Nabeth P, Naiene JD, Navegantes WA, Ogundiran O, Okot C, Pebody R, Matsui T, Ramírez HLG, Smallwood C, Tasigchana RFP, Vaughan AM, Williams GS, Mala PO, Lewis RF, Pavlin BI, le Polain de Waroux O. Description of the first global outbreak of mpox: an analysis of global surveillance data. Lancet Glob Health 2023; 11:e1012-e1023. [PMID: 37349031 PMCID: PMC10281644 DOI: 10.1016/s2214-109x(23)00198-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 04/04/2023] [Accepted: 04/13/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND In May 2022, several countries with no history of sustained community transmission of mpox (formerly known as monkeypox) notified WHO of new mpox cases. These cases were soon followed by a large-scale outbreak, which unfolded across the world, driven by local, in-country transmission within previously unaffected countries. On July 23, 2022, WHO declared the outbreak a Public Health Emergency of International Concern. Here, we aim to describe the main epidemiological features of this outbreak, the largest reported to date. METHODS In this analysis of global surveillance data we analysed data for all confirmed mpox cases reported by WHO Member States through the global surveillance system from Jan 1, 2022, to Jan 29, 2023. Data included daily aggregated numbers of mpox cases by country and a case reporting form (CRF) containing information on demographics, clinical presentation, epidemiological exposure factors, and laboratory testing. We used the data to (1) describe the key epidemiological and clinical features of cases; (2) analyse risk factors for hospitalisation (by multivariable mixed-effects binary logistic regression); and (3) retrospectively analyse transmission trends. Sequencing data from GISAID and GenBank were used to analyse monkeypox virus (MPXV) genetic diversity. FINDINGS Data from 82 807 cases with submitted CRFs were included in the analysis. Cases were primarily due to clade IIb MPXV (mainly lineage B.1, followed by lineage A.2). The outbreak was driven by transmission among males (73 560 [96·4%] of 76 293 cases) who self-identify as men who have sex with men (25 938 [86·9%] of 29 854 cases). The most common reported route of transmission was sexual contact (14 941 [68·7%] of 21 749). 3927 (7·3%) of 54 117 cases were hospitalised, with increased odds for those aged younger than 5 years (adjusted odds ratio 2·12 [95% CI 1·32-3·40], p=0·0020), aged 65 years and older (1·54 [1·05-2·25], p=0·026), female cases (1·61 [1·35-1·91], p<0·0001), and for cases who are immunosuppressed either due to being HIV positive and immunosuppressed (2·00 [1·68-2·37], p<0·0001), or other immunocompromising conditions (3·47 [1·84-6·54], p=0·0001). INTERPRETATION Continued global surveillance allowed WHO to monitor the epidemic, identify risk factors, and inform the public health response. The outbreak can be attributed to clade IIb MPXV spread by newly described modes of transmission. FUNDING WHO Contingency Fund for Emergencies. TRANSLATIONS For the French and Spanish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
| | | | - Ana Hoxha
- Health Emergencies Programme, WHO, Geneva, Switzerland
| | | | | | - Julia Fitzner
- Health Emergencies Programme, WHO, Geneva, Switzerland
| | - Maria Almiron
- WHO Regional Office for the Americas, Washington, DC, USA
| | | | - Sylvie Briand
- Health Emergencies Programme, WHO, Geneva, Switzerland
| | | | | | - Meg Doherty
- Health Emergencies Programme, WHO, Geneva, Switzerland
| | | | | | - Joana M Haussig
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Masaya Kato
- WHO Regional Office for South-East Asia, Delhi, India
| | | | | | - Pierre Nabeth
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | | | | | - Opeayo Ogundiran
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Charles Okot
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | | | - Tamano Matsui
- WHO Regional Office for the Western Pacific, Manila, Philippines
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4
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McMenamin M, Kolmer J, Djordjevic I, Campbell F, Laurenson-Schafer H, Abbate JL, Abdelgawad BM, Babu A, Balde T, Batra N, Bélorgeot VD, Brindle H, Dorji T, Esmail M, Hammermeister Nezu I, Hernández-García L, Hassan M, Idoko F, Karmin S, Kassamali ZA, Kato M, Matsui T, Duan M, Motaze V, Ogundiran O, Pavlin BI, Riviere-Cinnamond A, Ryan K, Schmidt T, Sedai T, Van Kerkhove MD, Zakaria T, Höhle M, Mahamud AR, le Polain de Waroux O. WHO Global Situational Alert System: a mixed methods multistage approach to identify country-level COVID-19 alerts. BMJ Glob Health 2023; 8:e012241. [PMID: 37495371 PMCID: PMC10373705 DOI: 10.1136/bmjgh-2023-012241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/14/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Globally, since 1 January 2020 and as of 24 January 2023, there have been over 664 million cases of COVID-19 and over 6.7 million deaths reported to WHO. WHO developed an evidence-based alert system, assessing public health risk on a weekly basis in 237 countries, territories and areas from May 2021 to June 2022. This aimed to facilitate the early identification of situations where healthcare capacity may become overstretched. METHODS The process involved a three-stage mixed methods approach. In the first stage, future deaths were predicted from the time series of reported cases and deaths to produce an initial alert level. In the second stage, this alert level was adjusted by incorporating a range of contextual indicators and accounting for the quality of information available using a Bayes classifier. In the third stage, countries with an alert level of 'High' or above were added to an operational watchlist and assistance was deployed as needed. RESULTS Since June 2021, the system has supported the release of more than US$27 million from WHO emergency funding, over 450 000 rapid antigen diagnostic testing kits and over 6000 oxygen concentrators. Retrospective evaluation indicated that the first two stages were needed to maximise sensitivity, where 44% (IQR 29%-67%) of weekly watchlist alerts would not have been identified using only reported cases and deaths. The alerts were timely and valid in most cases; however, this could only be assessed on a non-representative sample of countries with hospitalisation data available. CONCLUSIONS The system provided a standardised approach to monitor the pandemic at the country level by incorporating all available data on epidemiological analytics and contextual assessments. While this system was developed for COVID-19, a similar system could be used for future outbreaks and emergencies, with necessary adjustments to parameters and indicators.
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Affiliation(s)
- Martina McMenamin
- WHO Health Emergencies Programme, WHO Headquarters, Geneva, Switzerland
| | - Jessica Kolmer
- WHO Health Emergencies Programme, WHO Headquarters, Geneva, Switzerland
| | - Irena Djordjevic
- WHO Health Emergencies Programme, WHO Headquarters, Geneva, Switzerland
| | - Finlay Campbell
- WHO Health Emergencies Programme, WHO Headquarters, Geneva, Switzerland
| | | | - Jessica Lee Abbate
- WHO Health Emergencies Programme, WHO Regional Office for Africa, Brazzaville, Republic of Congo
| | - Basma Mostafa Abdelgawad
- WHO Health Emergencies Programme, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Amarnath Babu
- WHO Health Emergencies Programme, WHO Regional Office for South-East Asia, New Delhi, Delhi, India
| | - Thierno Balde
- WHO Health Emergencies Programme, WHO Regional Office for Africa, Brazzaville, Republic of Congo
| | - Neale Batra
- WHO Health Emergencies Programme, WHO Headquarters, Geneva, Switzerland
| | - Victoria D Bélorgeot
- WHO Health Emergencies Programme, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Hannah Brindle
- WHO Health Emergencies Programme, WHO Headquarters, Geneva, Switzerland
| | - Tshewang Dorji
- WHO Health Emergencies Programme, WHO Regional Office for the Americas, Washington, DC, USA
| | | | | | | | - Mahmoud Hassan
- WHO Health Emergencies Programme, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Friday Idoko
- WHO Health Emergencies Programme, WHO Headquarters, Geneva, Switzerland
| | | | | | - Masaya Kato
- WHO Health Emergencies Programme, WHO Regional Office for South-East Asia, New Delhi, Delhi, India
| | - Tamano Matsui
- WHO Health Emergencies Programme, WHO Regional Office for the Western Pacific, Manila, Philippines
| | - Mengjuan Duan
- WHO Health Emergencies Programme, WHO Regional Office for the Western Pacific, Manila, Philippines
| | - Villyen Motaze
- WHO Health Emergencies Programme, WHO Headquarters, Geneva, Switzerland
| | - Opeayo Ogundiran
- WHO Health Emergencies Programme, WHO Regional Office for Africa, Brazzaville, Republic of Congo
| | - Boris I Pavlin
- WHO Health Emergencies Programme, WHO Headquarters, Geneva, Switzerland
| | - Ana Riviere-Cinnamond
- WHO Health Emergencies Programme, WHO Regional Office for the Americas, Washington, DC, USA
| | - Kathleen Ryan
- WHO Health Emergencies Programme, WHO Regional Office for the Western Pacific, Manila, Philippines
| | - Tanja Schmidt
- WHO Health Emergencies Programme, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Tika Sedai
- WHO Health Emergencies Programme, WHO Regional Office for South-East Asia, New Delhi, Delhi, India
| | | | - Teresa Zakaria
- WHO Health Emergencies Programme, WHO Headquarters, Geneva, Switzerland
| | - Michael Höhle
- WHO Health Emergencies Programme, WHO Headquarters, Geneva, Switzerland
- Stockholm University, Stockholm, Sweden
| | - Abdi R Mahamud
- WHO Health Emergencies Programme, WHO Headquarters, Geneva, Switzerland
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5
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Balde T, Oyugi B, Byakika-Tusiime J, Ogundiran O, Kayita J, Banza FM, Landry K, Ejiofor EN, Kanyowa TM, Mbasha JJ, Rashidatu K, Atuhebwe P, Gumede N, Herring BL, Anoko JN, Zongo M, Okeibunor J, O'Malley H, Chamla D, Braka F, Gueye AS. Transitioning the COVID-19 response in the WHO African region: a proposed framework for rethinking and rebuilding health systems. BMJ Glob Health 2022; 7:bmjgh-2022-010242. [PMID: 36581336 PMCID: PMC9805822 DOI: 10.1136/bmjgh-2022-010242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/27/2022] [Indexed: 12/31/2022] Open
Abstract
The onset of the pandemic revealed the health system inequities and inadequate preparedness, especially in the African continent. Over the past months, African countries have ensured optimum pandemic response. However, there is still a need to build further resilient health systems that enhance response and transition from the acute phase of the pandemic to the recovery interpandemic/preparedness phase. Guided by the lessons learnt in the response and plausible pandemic scenarios, the WHO Regional Office for Africa has envisioned a transition framework that will optimise the response and enhance preparedness for future public health emergencies. The framework encompasses maintaining and consolidating the current response capacity but with a view to learning and reshaping them by harnessing the power of science, data and digital technologies, and research innovations. In addition, the framework reorients the health system towards primary healthcare and integrates response into routine care based on best practices/health system interventions. These elements are significant in building a resilient health system capable of addressing more effectively and more effectively future public health crises, all while maintaining an optimal level of essential public health functions. The key elements of the framework are possible with countries following three principles: equity (the protection of all vulnerable populations with no one left behind), inclusiveness (full engagement, equal participation, leadership, decision-making and ownership of all stakeholders using a multisectoral and transdisciplinary, One Health approach), and coherence (to reduce the fragmentation, competition and duplication and promote logical, consistent programmes aligned with international instruments).
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Affiliation(s)
- Thierno Balde
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
| | - Boniface Oyugi
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Jayne Byakika-Tusiime
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
| | - Opeayo Ogundiran
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
| | - Janet Kayita
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
| | - Freddy Mutoka Banza
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
| | - Kabego Landry
- Emergency Preparedness and Response, WHO Regional Office for Africa, Brazzaville, Congo
| | - Ephraim Nonso Ejiofor
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
| | - Trevor M Kanyowa
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
| | - Jerry-Jonas Mbasha
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
| | - Kamara Rashidatu
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
| | - Phionah Atuhebwe
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
| | - Nicksy Gumede
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
| | - Belinda Louise Herring
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
| | - Julienne Ngoundoung Anoko
- Emergency Preparedness and Response, WHO Regional Office for Africa, Brazzaville, Congo
- Dakar Hub, World Health Organization Regional Office for Africa, Dakar, Senegal
| | - Mamadou Zongo
- Operation Support and Logistics, Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
| | - Joseph Okeibunor
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
| | - Helena O'Malley
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
| | - Dick Chamla
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
| | - Fiona Braka
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
| | - Abdou Salam Gueye
- Emergency Preparedness and Response Programme, World Health Organization, Brazzaville, Congo
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6
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James A, Dalal J, Kousi T, Vivacqua D, Câmara DCP, Dos Reis IC, Botero Mesa S, Ng'ambi W, Ansobi P, Bianchi LM, Lee TM, Ogundiran O, Stoll B, Chimbetete C, Mboussou F, Impouma B, Hofer CB, Coelho FC, Keiser O, Abbate JL. An in-depth statistical analysis of the COVID-19 pandemic's initial spread in the WHO African region. BMJ Glob Health 2022; 7:bmjgh-2021-007295. [PMID: 35418411 PMCID: PMC9013786 DOI: 10.1136/bmjgh-2021-007295] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/25/2022] [Indexed: 11/08/2022] Open
Abstract
During the first wave of the COVID-19 pandemic, sub-Saharan African countries experienced comparatively lower rates of SARS-CoV-2 infections and related deaths than in other parts of the world, the reasons for which remain unclear. Yet, there was also considerable variation between countries. Here, we explored potential drivers of this variation among 46 of the 47 WHO African region Member States in a cross-sectional study. We described five indicators of early COVID-19 spread and severity for each country as of 29 November 2020: delay in detection of the first case, length of the early epidemic growth period, cumulative and peak attack rates and crude case fatality ratio (CFR). We tested the influence of 13 pre-pandemic and pandemic response predictor variables on the country-level variation in the spread and severity indicators using multivariate statistics and regression analysis. We found that wealthier African countries, with larger tourism industries and older populations, had higher peak (p<0.001) and cumulative (p<0.001) attack rates, and lower CFRs (p=0.021). More urbanised countries also had higher attack rates (p<0.001 for both indicators). Countries applying more stringent early control policies experienced greater delay in detection of the first case (p<0.001), but the initial propagation of the virus was slower in relatively wealthy, touristic African countries (p=0.023). Careful and early implementation of strict government policies were likely pivotal to delaying the initial phase of the pandemic, but did not have much impact on other indicators of spread and severity. An over-reliance on disruptive containment measures in more resource-limited contexts is neither effective nor sustainable. We thus urge decision-makers to prioritise the reduction of resource-based health disparities, and surveillance and response capacities in particular, to ensure global resilience against future threats to public health and economic stability.
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Affiliation(s)
- Ananthu James
- Department of Chemical Engineering, Indian Institute of Science, Bangalore, Karnataka, India .,The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland
| | - Jyoti Dalal
- The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland
| | - Timokleia Kousi
- The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland.,Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Daniela Vivacqua
- The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland.,Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Daniel Cardoso Portela Câmara
- The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland.,Laboratório de Mosquitos Transmissores de Hematozoários (LATHEMA), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Núcleo Operacional Sentinela de Mosquitos Vetores (NOSMOVE), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Izabel Cristina Dos Reis
- The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland.,Laboratório de Mosquitos Transmissores de Hematozoários (LATHEMA), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Núcleo Operacional Sentinela de Mosquitos Vetores (NOSMOVE), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Sara Botero Mesa
- The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland.,Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Wignston Ng'ambi
- The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland.,Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Health Economics Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - Papy Ansobi
- The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland.,Research and Training Unit in Ecology and Control of Infectious Diseases (URF-ECMI), Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Lucas M Bianchi
- The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland.,World Health Organization Regional Office for Africa, Brazzaville, Congo.,National School of Public Health Sérgio Arouca, ENSP/Fiocruz, Rio de Janeiro, Brazil
| | - Theresa M Lee
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Opeayo Ogundiran
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Beat Stoll
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Cleophas Chimbetete
- The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland.,Newlands Clinic, Harare, Zimbabwe
| | - Franck Mboussou
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Benido Impouma
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Cristina Barroso Hofer
- The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland.,Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávio Codeço Coelho
- The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland.,School of Applied Mathematics, Getulio Vargas Foundation, Rio de Janeiro, Brazil
| | - Olivia Keiser
- The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland.,Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Jessica Lee Abbate
- The Global Research and Analysis for Public Health (GRAPH) Network, Association Actions en Santé, Geneva, Switzerland.,World Health Organization Regional Office for Africa, Brazzaville, Congo.,UMI TransVIHMI (Institut de Recherche pour le Développement Institut National de la Santé et de la Recherche Médicale Université de Montpellier), Montpellier, France.,Geomatys, Montpellier, France
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7
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Impouma B, Carr ALJ, Spina A, Mboussou F, Ogundiran O, Moussana F, Williams GS, Wolfe CM, Farham B, Flahault A, Codeco Tores C, Abbate JL, Coelho FC, Keiser O. Time to death and risk factors associated with mortality among COVID-19 cases in countries within the WHO African region in the early stages of the COVID-19 pandemic. Epidemiol Infect 2022; 150:1-29. [PMID: 35177157 PMCID: PMC9002149 DOI: 10.1017/s095026882100251x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 10/03/2021] [Accepted: 11/15/2021] [Indexed: 11/12/2022] Open
Abstract
This study describes risk factors associated with mortality among COVID-19 cases reported in the WHO African region between 21 March and 31 October 2020. Average hazard ratios of death were calculated using weighted Cox regression as well as median time to death for key risk factors. We included 46 870 confirmed cases reported by eight Member States in the region. The overall incidence was 20.06 per 100 000, with a total of 803 deaths and a total observation time of 3 959 874 person-days. Male sex (aHR 1.54 (95% CI 1.31–1.81); P < 0.001), older age (aHR 1.08 (95% CI 1.07–1.08); P < 0.001), persons who lived in a capital city (aHR 1.42 (95% CI 1.22–1.65); P < 0.001) and those with one or more comorbidity (aHR 36.37 (95% CI 20.26–65.27); P < 0.001) had a higher hazard of death. Being a healthcare worker reduced the average hazard of death by 40% (aHR 0.59 (95% CI 0.37–0.93); P = 0.024). Time to death was significantly less for persons ≥60 years (P = 0.038) and persons residing in capital cities (P < 0.001). The African region has COVID-19-related mortality similar to that of other regions, and is likely underestimated. Similar risk factors contribute to COVID-19-associated mortality as identified in other regions.
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Affiliation(s)
- Benido Impouma
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Alice L. J. Carr
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Alexander Spina
- University of Exeter Medical School, Heavitree Road, Exeter, UK
| | - Franck Mboussou
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Opeayo Ogundiran
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Fleury Moussana
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | | | - Caitlin M. Wolfe
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Bridget Farham
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Antoine Flahault
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | | | - Jessica L. Abbate
- UMI TransVIHMI (Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale, Université de Montpellier), Montpellier, France
- The GRAPH Network, Geneva, Switzerland
| | | | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- The GRAPH Network, Geneva, Switzerland
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8
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Ibrahim LM, Okudo I, Stephen M, Ogundiran O, Pantuvo JS, Oyaole DR, Tegegne SG, Khalid A, Ilori E, Ojo O, Ihekweazu C, Baraka F, Mulombo WK, Lasuba CLP, Nsubuga P, Alemu W. Electronic reporting of integrated disease surveillance and response: lessons learned from northeast, Nigeria, 2019. BMC Public Health 2021; 21:916. [PMID: 33985451 PMCID: PMC8117577 DOI: 10.1186/s12889-021-10957-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 05/04/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Electronic reporting of integrated disease surveillance and response (eIDSR) was implemented in Adamawa and Yobe states, Northeastern Nigeria, as an innovative strategy to improve disease reporting. Its objectives were to improve the timeliness and completeness of IDSR reporting by health facilities, prompt identification of public health events, timely information sharing, and public health action. We evaluated the project to determine whether it met its set objectives. METHOD We conducted a cross-sectional study to assess and document the lessons learned from the project. We reviewed the performance of the local government areas (LGAs) on timeliness and completeness of reporting, rumors identification, and reporting on the eIDSR and the traditional paper-based system using a checklist. Respondents were interviewed online on the relevance, efficiency, sustainability, project progress and effectiveness, the effectiveness of management, and potential impact and scalability of the strategy using structured questionnaires. Data were cleaned, analyzed, and presented as proportions using an MS Excel spreadsheet. Responses were also presented as direct quotes. RESULTS The number of health facilities reporting IDSR increased from 103 to 228 (117%) before and after implementation of the eIDSR respectively. The timeliness of reporting was 43% in the LGA compared to 73% in health facilities implementing eIDSR. The completeness of IDSR reports in the last 6 months before the evaluation was ≥85%. Of the 201 rumors identified and verified, 161 (80%) were from the eIDSR pilot sites. The majority of the stakeholders interviewed believed that eIDSR met its predetermined objectives for public health surveillance. The benefits of eIDSR included timely reporting and response to alerts and disease outbreaks, improved timeliness, and completeness of reporting, and supportive supervision to the operational levels. The strategy helped stakeholders to appreciate their roles in public health surveillance. CONCLUSION The eIDSR has increased the number of health facilities reporting IDSR, enabled early identification, reporting, and verification of alerts, improved timeliness and completeness of reports, and supportive supervision of staff at the operational levels. It was well accepted by the stakeholder as a system that made reporting easy with the potential to improve the public health surveillance system in Nigeria.
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Affiliation(s)
- Luka Mangveep Ibrahim
- World Health Organization, Rivers House, #83 Ralph Shodeinde Street, Abuja, Nigeria.
| | - Ifeanyi Okudo
- World Health Organization, Rivers House, #83 Ralph Shodeinde Street, Abuja, Nigeria
| | | | | | - Jerry Shitta Pantuvo
- World Health Organization, Rivers House, #83 Ralph Shodeinde Street, Abuja, Nigeria
| | | | - Sisay Gashu Tegegne
- World Health Organization, Rivers House, #83 Ralph Shodeinde Street, Abuja, Nigeria
| | - Abdelrahim Khalid
- World Health Organization, Rivers House, #83 Ralph Shodeinde Street, Abuja, Nigeria
| | - Elsie Ilori
- Nigerian Center for Disease Control, Jabi, Abuja, Nigeria
| | - Olubunmi Ojo
- Nigerian Center for Disease Control, Jabi, Abuja, Nigeria
| | | | - Fiona Baraka
- World Health Organization, Rivers House, #83 Ralph Shodeinde Street, Abuja, Nigeria
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9
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Akpan GU, Bello IM, Touray K, Ngofa R, Oyaole D, Maleghemi S, Babona Nshuti MA, Chikwanda CS, Poy A, Roland Mboussou FF, Ogundiran O, Impouma B, Mihigo R, Yao NKM, Ticha JM, Tuma J, Mohammed HFAH, Kanmodi K, Ejiofor NE, Manengu C, Kasolo F, Seaman V, Mkanda P. Leveraging Polio GIS platforms in the African Region for mitigating Covid-19 contact tracing and Surveillance challenges. JMIR Mhealth Uhealth 2021; 10:e22544. [PMID: 34854813 PMCID: PMC8972111 DOI: 10.2196/22544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 02/01/2021] [Accepted: 05/08/2021] [Indexed: 11/18/2022] Open
Abstract
Background The ongoing COVID-19 pandemic in Africa is an urgent public health crisis. Estimated models projected over 150,000 deaths and 4,600,000 hospitalizations in the first year of the disease in the absence of adequate interventions. Therefore, electronic contact tracing and surveillance have critical roles in decreasing COVID-19 transmission; yet, if not conducted properly, these methods can rapidly become a bottleneck for synchronized data collection, case detection, and case management. While the continent is currently reporting relatively low COVID-19 cases, digitized contact tracing mechanisms and surveillance reporting are necessary for standardizing real-time reporting of new chains of infection in order to quickly reverse growing trends and halt the pandemic. Objective This paper aims to describe a COVID-19 contact tracing smartphone app that includes health facility surveillance with a real-time visualization platform. The app was developed by the AFRO (African Regional Office) GIS (geographic information system) Center, in collaboration with the World Health Organization (WHO) emergency preparedness and response team. The app was developed through the expertise and experience gained from numerous digital apps that had been developed for polio surveillance and immunization via the WHO’s polio program in the African region. Methods We repurposed the GIS infrastructures of the polio program and the database structure that relies on mobile data collection that is built on the Open Data Kit. We harnessed the technology for visualization of real-time COVID-19 data using dynamic dashboards built on Power BI, ArcGIS Online, and Tableau. The contact tracing app was developed with the pragmatic considerations of COVID-19 peculiarities. The app underwent testing by field surveillance colleagues to meet the requirements of linking contacts to cases and monitoring chains of transmission. The health facility surveillance app was developed from the knowledge and assessment of models of surveillance at the health facility level for other diseases of public health importance. The Integrated Supportive Supervision app was added as an appendage to the pre-existing paper-based surveillance form. These two mobile apps collected information on cases and contact tracing, alongside alert information on COVID-19 reports at the health facility level; the information was linked to visualization platforms in order to enable actionable insights. Results The contact tracing app and platform were piloted between April and June 2020; they were then put to use in Zimbabwe, Benin, Cameroon, Uganda, Nigeria, and South Sudan, and their use has generated some palpable successes with respect to COVID-19 surveillance. However, the COVID-19 health facility–based surveillance app has been used more extensively, as it has been used in 27 countries in the region. Conclusions In light of the above information, this paper was written to give an overview of the app and visualization platform development, app and platform deployment, ease of replicability, and preliminary outcome evaluation of their use in the field. From a regional perspective, integration of contact tracing and surveillance data into one platform provides the AFRO with a more accurate method of monitoring countries’ efforts in their response to COVID-19, while guiding public health decisions and the assessment of risk of COVID-19.
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Affiliation(s)
- Godwin Ubong Akpan
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | | | - Kebba Touray
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Reuben Ngofa
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | | | | | - Marie Aimee Babona Nshuti
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Chanda Sangawambi Chikwanda
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Alain Poy
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Franck Fortune Roland Mboussou
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Opeayo Ogundiran
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Benido Impouma
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Richard Mihigo
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - N'da Konan Michel Yao
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Johnson Muluh Ticha
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Jude Tuma
- World Health Organization, Geneva, CH
| | - Hani Farouk Abdel Hai Mohammed
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | | | - Nonso Ephraim Ejiofor
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Casimir Manengu
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Francis Kasolo
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | | | - Pascal Mkanda
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
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10
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Mboussou F, Ndumbi P, Ngom R, Kamassali Z, Ogundiran O, Van Beek J, Williams G, Okot C, Hamblion EL, Impouma B. Infectious disease outbreaks in the African region: overview of events reported to the World Health Organization in 2018. Epidemiol Infect 2019; 147:e299. [PMID: 31709961 PMCID: PMC6873157 DOI: 10.1017/s0950268819001912] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/14/2019] [Accepted: 10/15/2019] [Indexed: 12/03/2022] Open
Abstract
The WHO African region is characterised by the largest infectious disease burden in the world. We conducted a retrospective descriptive analysis using records of all infectious disease outbreaks formally reported to the WHO in 2018 by Member States of the African region. We analysed the spatio-temporal distribution, the notification delay as well as the morbidity and mortality associated with these outbreaks. In 2018, 96 new disease outbreaks were reported across 36 of the 47 Member States. The most commonly reported disease outbreak was cholera which accounted for 20.8% (n = 20) of all events, followed by measles (n = 11, 11.5%) and Yellow fever (n = 7, 7.3%). About a quarter of the outbreaks (n = 23) were reported following signals detected through media monitoring conducted at the WHO regional office for Africa. The median delay between the disease onset and WHO notification was 16 days (range: 0-184). A total of 107 167 people were directly affected including 1221 deaths (mean case fatality ratio (CFR): 1.14% (95% confidence interval (CI) 1.07%-1.20%)). The highest CFR was observed for diseases targeted for eradication or elimination: 3.45% (95% CI 0.89%-10.45%). The African region remains prone to outbreaks of infectious diseases. It is therefore critical that Member States improve their capacities to rapidly detect, report and respond to public health events.
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Affiliation(s)
- F. Mboussou
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - P. Ndumbi
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - R. Ngom
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Z. Kamassali
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - O. Ogundiran
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - J. Van Beek
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - G. Williams
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - C. Okot
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - E. L. Hamblion
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - B. Impouma
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
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11
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Wang B, Akanbi OA, Harms D, Adesina O, Osundare FA, Naidoo D, Deveaux I, Ogundiran O, Ugochukwu U, Mba N, Ihekweazu C, Bock CT. A new hepatitis E virus genotype 2 strain identified from an outbreak in Nigeria, 2017. Virol J 2018; 15:163. [PMID: 30352598 PMCID: PMC6199738 DOI: 10.1186/s12985-018-1082-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 10/16/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND In 2017 the Nigerian Ministry of Health notified the World Health Organization (WHO) of an outbreak of hepatitis E located in the north-east region of the country with 146 cases with 2 deaths. The analysis of the hepatitis E virus (HEV) genotypes responsible for the outbreak revealed the predominance of HEV genotypes 1 (HEV-1) and 2 (HEV-2). Molecular data of HEV-2 genomes are limited; therefore we characterized a HEV-2 strain of the outbreak in more detail. FINDING The full-length genome sequence of an HEV-2 strain (NG/17-0500) from the outbreak was amplified using newly designed consensus primers. Comparison with other HEV complete genome sequences, including the only HEV-2 strain (Mex-14) with available complete genome sequences and the availability of data of partial HEV-2 sequences from Sub-Saharan Africa, suggests that NG/17-0500 belongs to HEV subtype 2b (HEV-2b). CONCLUSIONS We identified a novel HEV-2b strain from Sub-Saharan Africa, which is the second complete HEV-2 sequence to date, whose natural history and epidemiology merit further investigation.
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Affiliation(s)
- Bo Wang
- Division of Viral Gastroenteritis and Hepatitis Pathogens and Enteroviruses, Department of Infectious Diseases, Robert Koch Institute, 13353 Berlin, Germany
| | - Olusola Anuoluwapo Akanbi
- Division of Viral Gastroenteritis and Hepatitis Pathogens and Enteroviruses, Department of Infectious Diseases, Robert Koch Institute, 13353 Berlin, Germany
| | - Dominik Harms
- Division of Viral Gastroenteritis and Hepatitis Pathogens and Enteroviruses, Department of Infectious Diseases, Robert Koch Institute, 13353 Berlin, Germany
| | - Olufisayo Adesina
- Division of Viral Gastroenteritis and Hepatitis Pathogens and Enteroviruses, Department of Infectious Diseases, Robert Koch Institute, 13353 Berlin, Germany
| | - Folakemi Abiodun Osundare
- Division of Viral Gastroenteritis and Hepatitis Pathogens and Enteroviruses, Department of Infectious Diseases, Robert Koch Institute, 13353 Berlin, Germany
- Ladoke Akintola University of Technology, Ogbomoso, Oyo State P.M.B 4000 Nigeria
| | - Dhamari Naidoo
- Infectious Hazard Management Department, World Health Organization, Geneva, Switzerland
| | - Isabel Deveaux
- Nigeria Centre for Disease Control, Plot 801, Ebitu Ukiwe Street, Jabi, Abuja, Nigeria
| | - Opeayo Ogundiran
- Nigeria Centre for Disease Control, Plot 801, Ebitu Ukiwe Street, Jabi, Abuja, Nigeria
| | - Uzoma Ugochukwu
- Nigeria Centre for Disease Control, Plot 801, Ebitu Ukiwe Street, Jabi, Abuja, Nigeria
| | - Nwando Mba
- Nigeria Centre for Disease Control, Plot 801, Ebitu Ukiwe Street, Jabi, Abuja, Nigeria
| | - Chikwe Ihekweazu
- Nigeria Centre for Disease Control, Plot 801, Ebitu Ukiwe Street, Jabi, Abuja, Nigeria
| | - C.-Thomas Bock
- Division of Viral Gastroenteritis and Hepatitis Pathogens and Enteroviruses, Department of Infectious Diseases, Robert Koch Institute, 13353 Berlin, Germany
- Institute of Tropical Medicine, University of Tübingen, 72074 Tübingen, Germany
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