Spatial and temporal distribution of infectious disease epidemics, disasters and other potential public health emergencies in the World Health Organisation Africa region, 2016-2018
Spatial and temporal distribution of infectious disease epidemics, disasters and other potential public health emergencies in the World Health Organisation Africa region, 2016-2018
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DOI：
10.1186/s12992-019-0540-4
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发表时间：
2020-01-15
影响因子：
10.8
通讯作者：
Fall, Ibrahima Soce
中科院分区：
文献类型：
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作者：
Talisuna, Ambrose Otau;Okiro, Emelda Aluoch;Fall, Ibrahima Soce
具有大流行潜力的新出现和重新出现的疾病继续挑战非洲脆弱的卫生系统，造成巨大的人员和经济损失。为了为公共卫生应急准备的投资案例提供证据，我们分析了2016年至2018年期间世卫组织非洲区域流行病、灾害和其他潜在公共卫生突发事件的时空分布。方法：我们从几个来源，包括：世界卫生组织非洲区域的流行病和紧急情况的每周公报，世界卫生组织疾病暴发新闻（DON）和紧急事件数据库（EM-DAT）的研究中心的灾害流行病学（CRED）。其他来源包括：新出现疾病监测方案和全球传染病和流行病学网络。我们纳入了有关事件发生时间和地点、病例和死亡人数的信息，并对不同的数据源进行了复核。数据分析我们使用气泡图进行时间分析，并生成显示每个事件的频率和分布的图表和地图。根据事件发生频率，我们将国家分为三类：第1级，10起或更多事件;第2级，5-9起事件;第3级，少于5起或无事件。最后，我们将事件频率与2018年年度报告的《国际卫生条例》（IHR）技术领域评分生成的汇总指数进行了比较。结果2016年至2018年期间确定了260多起事件。41个国家（87%）在2016年至2018年期间至少发生过一次疫情，其中21个国家（45%）每年至少发生一次疫情。22个国家（47%）发生了灾害/人道主义危机。7个国家（震中）经历了10多起事件，所有这些国家的《国际卫生条例》能力有限或正在发展中。流行病的前五大原因是：霍乱、麻疹、病毒性出血性疾病、疟疾和脑膜炎。流行病和灾害在非洲的频繁和广泛发生，是投资于备灾的号角。虽然加强备灾工作应遵循全球框架，但各国政府有责任为本国的具体需求提供资金。我们呼吁所有非洲国家为实施《国际卫生条例》建立治理和可预测的筹资机制，并在各地建立有复原力的卫生系统。
Background Emerging 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. Methods We 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 analysis We 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. Results Over 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. Conclusions The 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.