Assessment of a health facility based active case finding system for Ebola virus disease in Mbandaka, Democratic Republic of the Congo, June–July 2018
Abstract Background The ninth outbreak of Ebola Virus Disease (EVD) in the Democratic Republic of the Congo occurred in Équateur Province from 8 May-24 July 2018. A system of health facility (HF)-based active case finding (ACF) was implemented in Mbandaka, a regional capital with four confirmed EVD...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-11-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12879-019-4600-4 |
| _version_ | 1818256041234661376 |
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| author | Amber Kunkel Mory Keita Boubacar Diallo Olivier le Polain de Waroux Lorenzo Subissi Bocar Wague Roger Molala Pierre Lonfandjo Sébastien Bokoo Bokete William Perea Mamoudou Harouna Djingarey |
| author_facet | Amber Kunkel Mory Keita Boubacar Diallo Olivier le Polain de Waroux Lorenzo Subissi Bocar Wague Roger Molala Pierre Lonfandjo Sébastien Bokoo Bokete William Perea Mamoudou Harouna Djingarey |
| author_sort | Amber Kunkel |
| collection | DOAJ |
| description | Abstract Background The ninth outbreak of Ebola Virus Disease (EVD) in the Democratic Republic of the Congo occurred in Équateur Province from 8 May-24 July 2018. A system of health facility (HF)-based active case finding (ACF) was implemented in Mbandaka, a regional capital with four confirmed EVD cases, following completion of contact tracing. The goal of this HF-based ACF system was to look for undetected EVD cases among patients that visited HFs beginning one week prior to the system’s implementation. Methods From 23 June – 24 July 2018, ACF teams visited HFs in Mbandaka and reviewed all medical records as far back as 17 June for any consultations meeting the suspected EVD case definition. The teams then assessed whether to validate these as suspected EVD cases based on factors such as recovery, epidemiological links, and their clinical judgement. ACF teams also assessed HFs’ awareness of EVD symptoms and the process for alerting suspected cases. We calculated descriptive statistics regarding the characteristics of reviewed consultations, alert cases, and visited HFs. We also used univariate and multivariate random effects logistic regression models to evaluate the impact of repeated ACF visits to the same HF on the staff’s awareness of EVD. Results ACF teams reviewed 37,746 consultations, of which 690 met the definition of a suspected case of EVD. Two were validated as suspected EVD cases and transferred to the Ebola Treatment Unit for testing; both tested negative. Repeated ACF visits to the same HF were significantly associated with improved EVD awareness (p < 0.001) in univariate and multivariate analyses. Conclusion HF-based ACF during EVD outbreaks may improve EVD awareness and reveal many individuals meeting the suspected case definition. However, many who meet this definition may not have EVD, depending on the population size covered by ACF and amount of ongoing EVD transmission. Given the burdensome procedure of testing suspected EVD cases, future HF-based ACF systems would benefit from improved clarity on which patients require further testing. |
| first_indexed | 2024-12-12T17:21:27Z |
| format | Article |
| id | doaj.art-b978f9246c594dae9a6f8cf80f3eb070 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-12T17:21:27Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-b978f9246c594dae9a6f8cf80f3eb0702022-12-22T00:17:39ZengBMCBMC Infectious Diseases1471-23342019-11-011911910.1186/s12879-019-4600-4Assessment of a health facility based active case finding system for Ebola virus disease in Mbandaka, Democratic Republic of the Congo, June–July 2018Amber Kunkel0Mory Keita1Boubacar Diallo2Olivier le Polain de Waroux3Lorenzo Subissi4Bocar Wague5Roger Molala6Pierre Lonfandjo7Sébastien Bokoo Bokete8William Perea9Mamoudou Harouna Djingarey10Emerging Diseases Epidemiology Unit, Institut PasteurWHO Regional Office for AfricaWHO Regional Office for AfricaGlobal Outbreak Alert and Response Network (GOARN)SciensanoGlobal Outbreak Alert and Response Network (GOARN)Provincial Health Division of the Équateur RegionProvincial Health Division of the Équateur RegionProvincial Health Division of the Équateur RegionWHO HeadquartersWHO Regional Office for AfricaAbstract Background The ninth outbreak of Ebola Virus Disease (EVD) in the Democratic Republic of the Congo occurred in Équateur Province from 8 May-24 July 2018. A system of health facility (HF)-based active case finding (ACF) was implemented in Mbandaka, a regional capital with four confirmed EVD cases, following completion of contact tracing. The goal of this HF-based ACF system was to look for undetected EVD cases among patients that visited HFs beginning one week prior to the system’s implementation. Methods From 23 June – 24 July 2018, ACF teams visited HFs in Mbandaka and reviewed all medical records as far back as 17 June for any consultations meeting the suspected EVD case definition. The teams then assessed whether to validate these as suspected EVD cases based on factors such as recovery, epidemiological links, and their clinical judgement. ACF teams also assessed HFs’ awareness of EVD symptoms and the process for alerting suspected cases. We calculated descriptive statistics regarding the characteristics of reviewed consultations, alert cases, and visited HFs. We also used univariate and multivariate random effects logistic regression models to evaluate the impact of repeated ACF visits to the same HF on the staff’s awareness of EVD. Results ACF teams reviewed 37,746 consultations, of which 690 met the definition of a suspected case of EVD. Two were validated as suspected EVD cases and transferred to the Ebola Treatment Unit for testing; both tested negative. Repeated ACF visits to the same HF were significantly associated with improved EVD awareness (p < 0.001) in univariate and multivariate analyses. Conclusion HF-based ACF during EVD outbreaks may improve EVD awareness and reveal many individuals meeting the suspected case definition. However, many who meet this definition may not have EVD, depending on the population size covered by ACF and amount of ongoing EVD transmission. Given the burdensome procedure of testing suspected EVD cases, future HF-based ACF systems would benefit from improved clarity on which patients require further testing.http://link.springer.com/article/10.1186/s12879-019-4600-4Active case findingEbolaEbola virus diseaseHealth facilitySurveillanceDemocratic Republic of the Congo |
| spellingShingle | Amber Kunkel Mory Keita Boubacar Diallo Olivier le Polain de Waroux Lorenzo Subissi Bocar Wague Roger Molala Pierre Lonfandjo Sébastien Bokoo Bokete William Perea Mamoudou Harouna Djingarey Assessment of a health facility based active case finding system for Ebola virus disease in Mbandaka, Democratic Republic of the Congo, June–July 2018 BMC Infectious Diseases Active case finding Ebola Ebola virus disease Health facility Surveillance Democratic Republic of the Congo |
| title | Assessment of a health facility based active case finding system for Ebola virus disease in Mbandaka, Democratic Republic of the Congo, June–July 2018 |
| title_full | Assessment of a health facility based active case finding system for Ebola virus disease in Mbandaka, Democratic Republic of the Congo, June–July 2018 |
| title_fullStr | Assessment of a health facility based active case finding system for Ebola virus disease in Mbandaka, Democratic Republic of the Congo, June–July 2018 |
| title_full_unstemmed | Assessment of a health facility based active case finding system for Ebola virus disease in Mbandaka, Democratic Republic of the Congo, June–July 2018 |
| title_short | Assessment of a health facility based active case finding system for Ebola virus disease in Mbandaka, Democratic Republic of the Congo, June–July 2018 |
| title_sort | assessment of a health facility based active case finding system for ebola virus disease in mbandaka democratic republic of the congo june july 2018 |
| topic | Active case finding Ebola Ebola virus disease Health facility Surveillance Democratic Republic of the Congo |
| url | http://link.springer.com/article/10.1186/s12879-019-4600-4 |
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