Spatial and temporal distribution of infectious disease epidemics, disasters and other potential public health emergencies in the World Health Organisation Africa region, 2016\u20132018

Ambrose Otau Talisuna,Joseph Okeibunor,Ali Ahmed Yahaya,Haruna Mamoudou Djingarey,Emelda Aluoch Okiro,Benido Impouma,Boukare Bonkoungou,Mary Stephen,Etienne Magloire Minkoulou,Sakuya Oka,Emmanuel Onuche Musa,N’Da Konan Michel Yao,Zabulon Yoti,Ibrahima Socé Fall

doi:10.1186/s12992-019-0540-4

Abstract

BackgroundEmerging and re-emerging diseases with pandemic potential continue to challenge fragile health systems in Africa, creating enormous human and economic toll. To provide evidence for the investment case for public health emergency preparedness, we analysed the spatial and temporal distribution of epidemics, disasters and other potential public health emergencies in the WHO African region between 2016 and 2018.MethodsWe abstracted data from several sources, including: the WHO African Region’s weekly bulletins on epidemics and emergencies, the WHO-Disease Outbreak News (DON) and the Emergency Events Database (EM-DAT) of the Centre for Research on the Epidemiology of Disasters (CRED). Other sources were: the Program for Monitoring Emerging Diseases (ProMED) and the Global Infectious Disease and Epidemiology Network (GIDEON). We included information on the time and location of the event, the number of cases and deaths and counter-checked the different data sources.Data analysisWe used bubble plots for temporal analysis and generated graphs and maps showing the frequency and distribution of each event. Based on the frequency of events, we categorised countries into three: Tier 1, 10 or more events, Tier 2, 5–9 events, and Tier 3, less than 5 or no event. Finally, we compared the event frequencies to a summary International Health Regulations (IHR) index generated from the IHR technical area scores of the 2018 annual reports.ResultsOver 260 events were identified between 2016 and 2018. Forty-one countries (87%) had at least one epidemic between 2016 and 2018, and 21 of them (45%) had at least one epidemic annually. Twenty-two countries (47%) had disasters/humanitarian crises. Seven countries (the epicentres) experienced over 10 events and all of them had limited or developing IHR capacities. The top five causes of epidemics were: Cholera, Measles, Viral Haemorrhagic Diseases, Malaria and Meningitis.ConclusionsThe frequent and widespread occurrence of epidemics and disasters in Africa is a clarion call for investing in preparedness. While strengthening preparedness should be guided by global frameworks, it is the responsibility of each government to finance country specific needs. We call upon all African countries to establish governance and predictable financing mechanisms for IHR implementation and to build resilient health systems everywhere.

Highlights

Emerging and re-emerging diseases with pandemic potential continue to challenge fragile health systems in Africa, creating enormous human and economic toll
A public health event was reported in almost all countries in the World Health Organization (WHO) Africa Region, Cholera being the most geographically widespread
Cholera and Measles caused outbreaks in many parts of the WHO African Region, while outbreaks of Meningitis and Crimean-Congo Haemorrhagic Fever primarily occurred in a few areas

Summary

Introduction

Emerging and re-emerging diseases with pandemic potential continue to challenge fragile health systems in Africa, creating enormous human and economic toll. Emerging and re-emerging infectious diseases with a potential to spread internationally continue to challenge the fragile health systems in developing countries and in the developed countries, creating enormous human and economic toll. A disaster is a serious disruption of the functioning of a community or a society causing widespread human, material, economic or environmental losses which exceed the ability of the affected community or society to cope using its own resources [5] It could be defined as a situation or event, which overwhelms local capacity, necessitating national or international level external assistance [6]. The most extreme is a public health emergency of international concern (PHEIC), which is an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response [3]

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