Level of Community Preparedness for Ebola Virus Epidemics in the Democratic Republic of the Congo: A Multiple Case Study
Central African Journal of Public Health
Volume 5, Issue 6, December 2019, Pages: 292-301
Received: Oct. 23, 2019; Accepted: Nov. 13, 2019; Published: Nov. 21, 2019
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Authors
Eric Mafuta Musalu, Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, DRC
Dieudonne Mwamba Kazadi, Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, DRC; Directorate of Diseases Control, Ministry of Health, Kinshasa, DRC
Marie Onyamboko Akatshi, Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, DRC
Didine Kaba Kinkodi, Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, DRC
Pelagie Babakazo Diambalula, Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, DRC
Justus Nsio, Directorate of Diseases Control, Ministry of Health, Kinshasa, DRC
Noriaki Ikeda, Japan International Cooperation Agency, DRC Office, Kinshasa, DRC
Raymond Mufwaya, Japan International Cooperation Agency, DRC Office, Kinshasa, DRC
Jack Kokolomami Hyyombo Tambwe, Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, DRC
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Abstract
The Ebola virus disease (EVD) epidemics analysis from the Democratic Republic of the Congo (DRC) and West Africa showed an increased frequency in the intervals between outbreaks and the unpreparedness of the local health system including the community in the response thereto. This study describes the level of DRC community preparedness for EVD and other epidemics in order to judge its potential involvement in epidemiological surveillance at the Health Zone (HZ) level. A secondary analysis was conducted on the data collected during the evaluation of the DRC epidemiological surveillance system, carried out from December 2015 to May 2016 in 32 HZs of the 16 provinces at risk of EVD. Data were collected using semi-structured interview with leaders of the Health Area Development Committees (HADC), village chiefs as well as by focus group with the women of the community. Those respondents were sampled through a purposive sampling strategy. Community preparedness was explored in terms of community organization, knowledge of epidemiological surveillance, and knowledge of EVD. Data were transcribed verbatim in French and analysed using thematic analysis. Some results were tabulated and summarized as proportion. A total of 72 communities were studied. The study showed that the community participates in epidemiological surveillance through the HADCs. The HADC members and community health workers (CHWs) conduct case searches in the community and case referrals to the health centres. The majority of CHWs and community members were unknowledgeable of epidemiological surveillance and very few had received training for epidemic prone diseases. Few knew how to actually describe the steps of a case search. The study also noted that the level of knowledge of the population on EVD in the communities visited was not optimal with a lot of erroneous data and a perception that could be harmful for epidemiological surveillance and outbreak response. The study showed that the population as a whole claimed to participate in epidemiological surveillance only through sensitization and the passing on of information. These study results show that the community at the local level in the DRC is not optimally prepared for EVD and other epidemics. These results suggest a strengthening of community preparedness in the DRC more extensively for diseases with epidemic potential through sensitization and social mobilization, in particular by strengthening the capacity of the teams of health centres, health committees and CHWs in terms of training, technical guides and simple prevention materials.
Keywords
Ebola, Congo, Community Health Workers, Health Committee, Preparedness
To cite this article
Eric Mafuta Musalu, Dieudonne Mwamba Kazadi, Marie Onyamboko Akatshi, Didine Kaba Kinkodi, Pelagie Babakazo Diambalula, Justus Nsio, Noriaki Ikeda, Raymond Mufwaya, Jack Kokolomami Hyyombo Tambwe, Level of Community Preparedness for Ebola Virus Epidemics in the Democratic Republic of the Congo: A Multiple Case Study, Central African Journal of Public Health. Vol. 5, No. 6, 2019, pp. 292-301. doi: 10.11648/j.cajph.20190506.21
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Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Rosello A, Mossoko M, Flasche S, Van Hoek AJ, Mbala P, Camacho A, et al. Ebola virus disease in the Democratic Republic of the Congo, 1976-2014. Elife. 2015; 4 (NOVEMBER2015): 1–19.
[2]
Maganga GD, Kapetshi J, Berthet N, Ilunga BK, Kabange F, Kingebeni PM, et al. Ebola virus disease in the Democratic Republic of Congo. N Engl J Med. 2014; 371 (22): 2083–91.
[3]
Claude KM, Underschultz J, Hawkes MT. Ebola virus epidemic in war-torn eastern DR Congo. Lancet. 2018; 392 (10156): 1399–401.
[4]
Barry A, Ahuka-Mundeke S, Ali Ahmed Y, Allarangar Y, Anoko J, Archer BN, et al. Outbreak of Ebola virus disease in the Democratic Republic of the Congo, April–May, 2018: an epidemiological study. Lancet. 2018; 392 (10143): 213–21.
[5]
Kasolo F, Roungou JB (OMS-AFRO), Perry H (CDC-ATLANTA). Guide Technique pour la Surveillance Intégrée de la Maladie et la Riposte dans la Région Africaine. 2ième. Kasolo F, Roungou JB, Perry H, editor. Vol. 1, Organisation mondiale de la Santé et Centers for Disease Control and Prevention (2010). Brazzaville & Atlanta, Organisation mondiale de la Santé & Centers for Disease Control and Prevention; 2010. 1–439 p.
[6]
Coltart CEM, Lindsey B, Ghinai I, Johnson AM, Heymann DL. The Ebola outbreak, 2013–2016: Old lessons for new epidemics. Philos Trans R Soc B Biol Sci. 2017; 372 (1721): 2013–6.
[7]
Perry HB, Dhillon RS, Liu A, Chitnis K, Panjabi R, Palazuelos D, et al. Community health worker programmes after the 2013–2016 Ebola outbreak. Bull World Health Organ. 2016; 94 (7): 551–3.
[8]
Moran B. Fighting Ebola in conflict in the DR Congo. Lancet (London, England) [Internet]. 2018; 392 (10155): 1295–6. Available from: http://dx.doi.org/10.1016/S0140-6736(18)32512-1.
[9]
Marais F, Minkler M, Gibson N, Mwau B, Mehtar S, Ogunsola F, et al. A community-engaged infection prevention and control approach to Ebola. Health Promot Int. 2016; 31 (2): 440–9.
[10]
Over B, States M, Ces C, Membres E. Implementing integrated disease surveillance and response Surveillance et action intégrées : mise en œuvre. Wkly Epidemological Rec. 2003; (27).
[11]
Peterson AT. Biogeography of diseases: A framework for analysis. Naturwissenschaften. 2008; 95 (6): 483–91.
[12]
McMahon SA, Ho LS, Scott K, Brown H, Miller L, Ratnayake R, et al. “we and the nurses are now working with one voice”: How community leaders and health committee members describe their role in Sierra Leone’s Ebola response. BMC Health Serv Res. 2017; 17 (1): 1–10.
[13]
Perry H, Zulliger R. How effective are commnity health workers? Summary report. Baltimore; 2012.
[14]
Gillespie A, Obregon R, Asawi R El, Richey C, Manoncourt E, Joshi K, et al. Social mobilization and community engagement central to the Ebola response in West Africa: Lessons for future public health emergencies. Glob Heal Sci Pract. 2016; 4 (4): 626–46.
[15]
Kok MC, Ormel H, Broerse JEW, Kane S, Namakhoma I, Otiso L, et al. Optimising the benefits of community health workers ’ unique position between communities and the health sector : A comparative analysis of factors shaping relationships in four countries. Glob Public Health. 2016; 1692 (June).
[16]
Li ZJ, Tu WX, Wang XC, Shi GQ, Yin ZD, Su HJ, et al. A practical community-based response strategy to interrupt Ebola transmission in sierra Leone, 2014-2015. Infect Dis Poverty [Internet]. 2016; 5 (1): 1–10. Available from: http://dx.doi.org/10.1186/s40249-016-0167-0.
[17]
Kobayashi M, Beer KD, Bjork A, Chatham-Stephens K, Cherry CC, Arzoaquoi S, et al. Community knowledge, attitudes, and practices regarding Ebola virus disease — Five counties, Liberia, September–October, 2014. Morb Mortal Wkly Rep. 2015; 64 (26): 714–8.
[18]
Cohn S, Kutalek R. Historical parallels, ebola virus disease and cholera: Understanding community distrust and social violence with epidemics. Vol. 8, PLoS Currents. 2016.
[19]
Fletcher TE, Bower H. Unrecognised Ebola virus infection in contact persons: what can we learn from it? Lancet Infect Dis [Internet]. 2019; 19 (3): 225–6. Available from: http://dx.doi.org/10.1016/S1473-3099(18)30689-3.
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