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. 2012 Dec;41(6):1829-46.
doi: 10.1093/ije/dys189.

Current status and future prospects of epidemiology and public health training and research in the WHO African region

Jean B Nachega  1 , Olalekan A Uthman, Yuh-Shan Ho, Melanie Lo, Chuka Anude, Patrick Kayembe, Fred Wabwire-Mangen, Exnevia Gomo, Papa Salif Sow, Ude Obike, Theophile Kusiaku, Edward J Mills, Bongani M Mayosi, Carel Ijsselmuiden
Affiliations

Current status and future prospects of epidemiology and public health training and research in the WHO African region

Jean B Nachega et al. Int J Epidemiol. 2012 Dec.

Abstract

Background: To date little has been published about epidemiology and public health capacity (training, research, funding, human resources) in WHO/AFRO to help guide future planning by various stakeholders.

Methods: A bibliometric analysis was performed to identify published epidemiological research. Information about epidemiology and public health training, current research and challenges was collected from key informants using a standardized questionnaire.

Results: From 1991 to 2010, epidemiology and public health research output in the WHO/AFRO region increased from 172 to 1086 peer-reviewed articles per annum [annual percentage change (APC) = 10.1%, P for trend < 0.001]. The most common topics were HIV/AIDS (11.3%), malaria (8.6%) and tuberculosis (7.1%). Similarly, numbers of first authors (APC = 7.3%, P for trend < 0.001), corresponding authors (APC = 8.4%, P for trend < 0.001) and last authors (APC = 8.5%, P for trend < 0.001) from Africa increased during the same period. However, an overwhelming majority of respondents (>90%) reported that this increase is only rarely linked to regional post-graduate training programmes in epidemiology. South Africa leads in publications (1978/8835, 22.4%), followed by Kenya (851/8835, 9.6%), Nigeria (758/8835, 8.6%), Tanzania (549/8835, 6.2%) and Uganda (428/8835, 4.8%) (P < 0.001, each vs South Africa). Independent predictors of relevant research productivity were 'in-country numbers of epidemiology or public health programmes' [incidence rate ratio (IRR) = 3.41; 95% confidence interval (CI) 1.90-6.11; P = 0.03] and 'number of HIV/AIDS patients' (IRR = 1.30; 95% CI 1.02-1.66; P < 0.001).

Conclusions: Since 1991, there has been increasing epidemiological research productivity in WHO/AFRO that is associated with the number of epidemiology programmes and burden of HIV/AIDS cases. More capacity building and training initiatives in epidemiology are required to promote research and address the public health challenges facing the continent.

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Figures

Figure 1
Figure 1
Map representing WHO/AFRO public health and epidemiology publications indexed by SCI (1991–2010)
Figure 2
Figure 2
Trends in public health and epidemiology articles output by WHO/AFRO researchers as first, last or corresponding authors indexed by SCI (1991–2010)
Figure 3
Figure 3
Top seven countries (highest quintile) and trends in epidemiology and public health articles output indexed by SCI (1991–2010). TP, total published articles
Figure 4
Figure 4
Trends in WHO/AFRO sub-regional epidemiology and public health articles output indexed by SCI (1991–2010). Note: The apparent contrast in North African showing little rise in published output for 2 decades need to take account of the fact that our bibliometric analysis covers only WHO/AFRO region, which include Algeria as the only North Africa country. Four other North African countries (Morocco, Libya, Egypt, Tunisia) are included the WHO’s Eastern Mediterranean Regional Office (WHO/EMRO). TP, total published articles
Figure 5
Figure 5
Scatter plot showing association between total publications and country’s GDP. Note: Gross domestic product, 2009 United Nations Development Programme estimates
Figure 6
Figure 6
Scatter plot showing association between total publications and country’s expenditure on health. Note: Expenditure on health (as % of GDP), 2009 United Nations Development Programme estimates
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