Africa lags on epidemic detection

African lags in warning of outbreaks of diseases such as cholera, primarily spread through contaminated food and water Copyright: Flickr/Julien Harneis

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[NAIROBI] Africa lags behind in detecting infectious diseases and warning of emerging epidemics, yet bears half the world’s outbreaks, says a report.

The study, of nearly 400 WHO-verified disease outbreaks from 1996–2009, found more than half (53 per cent) were in Africa. Yet the continent took the longest to detect the outbreaks and to communicate about them — on average 30 and 43 days respectively after the estimated start of an outbreak.

Globally, the shortest times to discovery and public communication were in the Western Pacific, with an average of four days until discovery and 18 days until communication. In South–East Asia discovery and communication both averaged around 15 days.

Worldwide, time to detection of disease outbreaks has improved overall by just over seven per cent a year, and time to communication by just over six per cent a year, since 1996 — but with considerable regional variation. One reason for this improvement was the rapid expansion of the Internet.

The most common diseases causing epidemic outbreaks were cholera, yellow fever, meningitis, avian influenza and dengue.

Emily Chan, from the Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology, in the United States, and lead author of the study, said: "Openness in communication … is crucial for a speedy response once disease has broken out".

Abdisalan Noor, a research scientist at the Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, said the reasons for Africa’s poor performance were many and they reflected the general weakness in information systems in the wider public sector.

"Given the serious weaknesses in routine health information systems in Sub-Saharan Africa, it is not surprising the surveillance systems for detecting emerging infections, which require dynamic real-time data collection, are deficient," he told SciDev.Net. But he said that Africa is gradually improving its mechanisms for timely detection of emerging infections.

Noor said that Africa was dealing with major infectious diseases like HIV/AIDS, malaria and tuberculosis, all of which require routine data and prompt detection of epidemics for efficient control.

He called for investment in infrastructure and capacity for early disease detection and response, saying: "The lack of a timely mechanism for case detection and response can lead to rapid spread of disease, making the management of the case even more difficult, and this could have severe health consequences — in many cases, a large number of fatalities".

The study was published in the Proceedings of the National Academy of Sciences (PNAS) (29 November).

Link to full paper in PNAS


PNAS doi:10.1073/pnas.1006219107 (2010)