Performance of a safe and dignified burial intervention during an Ebola epidemic in the eastern Democratic Republic of the Congo, 2018–2019
Abstract Background A protracted Ebola Virus Disease (EVD) epidemic in the eastern Ituri, North and South Kivu provinces of the Democratic Republic of Congo (DRC) caused 3470 confirmed and probable cases between July 2018 and April 2020. During the epidemic, the International Federation of Red Cross...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12916-023-03194-x |
| _version_ | 1827590464084115456 |
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| author | Abdihamid Warsame Gwendolen Eamer Alaria Kai Lucia Robles Dios Hana Rohan Patrick Keating Jacques Katshishi Francesco Checchi |
| author_facet | Abdihamid Warsame Gwendolen Eamer Alaria Kai Lucia Robles Dios Hana Rohan Patrick Keating Jacques Katshishi Francesco Checchi |
| author_sort | Abdihamid Warsame |
| collection | DOAJ |
| description | Abstract Background A protracted Ebola Virus Disease (EVD) epidemic in the eastern Ituri, North and South Kivu provinces of the Democratic Republic of Congo (DRC) caused 3470 confirmed and probable cases between July 2018 and April 2020. During the epidemic, the International Federation of Red Cross and Red Crescent Societies (IFRC) supported the DRC Red Cross and other local actors to offer safe and dignified burials (SDB) for suspected and confirmed EVD cases, so as to reduce transmission associated with infectious dead bodies. We conducted a retrospective cohort study of the SDB service’s performance in order to inform future applications of this intervention. Methods We analysed data on individual SDB responses to quantify performance based on key indicators and against pre-specified service standards. Specifically, we defined SDB timeliness as response within 24 h and success as all components of the service being implemented. Combining the database with other information sources, we also fit generalised linear mixed binomial models to explore factors associated with unsuccessful SDB. Results Out of 14,624 requests for SDB, 99% were responded to, 89% within 24 h. Overall, 61% of SDBs were successful, somewhat below target (80%), with failures clustered during a high-insecurity period. Factors associated with increased odds of unsuccessful SDB included reported community and/or family nonacceptance, insecurity and suspensions of the EVD response, low health facility coverage and high coverage of radio and telephony. Burials supported by mobile Civil Protection (local authorities) and/or static, community-based ‘harm reduction’ teams were associated with lower odds of failure. Conclusions A large-scale, timely and moderately performant SDB service proved feasible during the challenging eastern DRC EVD response. Burial teams that are managed by community actors and operate locally, and supported rather than owned by the Red Cross or other humanitarian organisations, are a promising modality of delivering this pillar of EVD control. |
| first_indexed | 2024-03-09T01:17:13Z |
| format | Article |
| id | doaj.art-06c678082df84eebb86501b391f9f005 |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-03-09T01:17:13Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-06c678082df84eebb86501b391f9f0052023-12-10T12:21:31ZengBMCBMC Medicine1741-70152023-12-0121111410.1186/s12916-023-03194-xPerformance of a safe and dignified burial intervention during an Ebola epidemic in the eastern Democratic Republic of the Congo, 2018–2019Abdihamid Warsame0Gwendolen Eamer1Alaria Kai2Lucia Robles Dios3Hana Rohan4Patrick Keating5Jacques Katshishi6Francesco Checchi7Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical MedicineInternational Federation of Red Cross and Red Crescent SocietiesFaculty of Epidemiology and Population Health, London School of Hygiene & Tropical MedicineInternational Federation of Red Cross and Red Crescent SocietiesFaculty of Public Health and Policy, London School of Hygiene & Tropical MedicineFaculty of Epidemiology and Population Health, London School of Hygiene & Tropical MedicineRed Cross Society of the Democratic Republic of CongoFaculty of Epidemiology and Population Health, London School of Hygiene & Tropical MedicineAbstract Background A protracted Ebola Virus Disease (EVD) epidemic in the eastern Ituri, North and South Kivu provinces of the Democratic Republic of Congo (DRC) caused 3470 confirmed and probable cases between July 2018 and April 2020. During the epidemic, the International Federation of Red Cross and Red Crescent Societies (IFRC) supported the DRC Red Cross and other local actors to offer safe and dignified burials (SDB) for suspected and confirmed EVD cases, so as to reduce transmission associated with infectious dead bodies. We conducted a retrospective cohort study of the SDB service’s performance in order to inform future applications of this intervention. Methods We analysed data on individual SDB responses to quantify performance based on key indicators and against pre-specified service standards. Specifically, we defined SDB timeliness as response within 24 h and success as all components of the service being implemented. Combining the database with other information sources, we also fit generalised linear mixed binomial models to explore factors associated with unsuccessful SDB. Results Out of 14,624 requests for SDB, 99% were responded to, 89% within 24 h. Overall, 61% of SDBs were successful, somewhat below target (80%), with failures clustered during a high-insecurity period. Factors associated with increased odds of unsuccessful SDB included reported community and/or family nonacceptance, insecurity and suspensions of the EVD response, low health facility coverage and high coverage of radio and telephony. Burials supported by mobile Civil Protection (local authorities) and/or static, community-based ‘harm reduction’ teams were associated with lower odds of failure. Conclusions A large-scale, timely and moderately performant SDB service proved feasible during the challenging eastern DRC EVD response. Burial teams that are managed by community actors and operate locally, and supported rather than owned by the Red Cross or other humanitarian organisations, are a promising modality of delivering this pillar of EVD control.https://doi.org/10.1186/s12916-023-03194-xEbolaEpidemicBurialDead bodyPerformanceIntervention |
| spellingShingle | Abdihamid Warsame Gwendolen Eamer Alaria Kai Lucia Robles Dios Hana Rohan Patrick Keating Jacques Katshishi Francesco Checchi Performance of a safe and dignified burial intervention during an Ebola epidemic in the eastern Democratic Republic of the Congo, 2018–2019 BMC Medicine Ebola Epidemic Burial Dead body Performance Intervention |
| title | Performance of a safe and dignified burial intervention during an Ebola epidemic in the eastern Democratic Republic of the Congo, 2018–2019 |
| title_full | Performance of a safe and dignified burial intervention during an Ebola epidemic in the eastern Democratic Republic of the Congo, 2018–2019 |
| title_fullStr | Performance of a safe and dignified burial intervention during an Ebola epidemic in the eastern Democratic Republic of the Congo, 2018–2019 |
| title_full_unstemmed | Performance of a safe and dignified burial intervention during an Ebola epidemic in the eastern Democratic Republic of the Congo, 2018–2019 |
| title_short | Performance of a safe and dignified burial intervention during an Ebola epidemic in the eastern Democratic Republic of the Congo, 2018–2019 |
| title_sort | performance of a safe and dignified burial intervention during an ebola epidemic in the eastern democratic republic of the congo 2018 2019 |
| topic | Ebola Epidemic Burial Dead body Performance Intervention |
| url | https://doi.org/10.1186/s12916-023-03194-x |
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