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Analyses of the performance of the Ebola virus disease alert management system in South Sudan: August 2018 to November 2019.

ABSTRACT: South Sudan implemented Ebola virus disease preparedness interventions aiming at preventing and rapidly containing any importation of the virus from the Democratic Republic of Congo starting from August 2018. One of these interventions was a surveillance system which included an Ebola alert management system. This study analyzed the performance of this system. A descriptive cross-sectional study of the Ebola virus disease alerts which were reported in South Sudan from August 2018 to November 2019 was conducted using both quantitative and qualitative methods. As of 30 November 2019, a total of 107 alerts had been detected in the country out of which 51 (47.7%) met the case definition and were investigated with blood samples collected for laboratory confirmation. Most (81%) of the investigated alerts were South Sudanese nationals. The alerts were identified by health workers (53.1%) at health facilities, at the community (20.4%) and by screeners at the points of entry (12.2%). Most of the investigated alerts were detected from the high-risk states of Gbudwe (46.9%), Jubek (16.3%) and Torit (10.2%). The investigated alerts commonly presented with fever, bleeding, headache and vomiting. The median timeliness for deployment of Rapid Response Team was less than one day and significantly different between the 6-month time periods (K-W = 7.7567; df = 2; p = 0.0024) from 2018 to 2019. Strengths of the alert management system included existence of a dedicated national alert hotline, case definition for alerts and rapid response teams while the weaknesses were occasional inability to access the alert toll-free hotline and lack of transport for deployment of the rapid response teams which often constrain quick response. This study demonstrates that the Ebola virus disease alert management system in South Sudan was fully functional despite the associated challenges and provides evidence to further improve Ebola preparedness in the country.

SUBMITTER: Olu OO

PROVIDER: S-EPMC7728195 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Analyses of the performance of the Ebola virus disease alert management system in South Sudan: August 2018 to November 2019.

Olu Olushayo Oluseun OO Lako Richard R Bunga Sudhir S Berta Kibebu K Kol Matthew M Ramadan Patrick Otim PO Ryan Caroline C Udenweze Ifeanyi I Guyo Argata Guracha AG Conteh Ishata I Huda Qudsia Q Gai Malick M Saulo Dina D Papowitz Heather H Gray Henry John HJ Chimbaru Alex A Wangdi Kencho K Grube Steven M SM Barr Beth Tippett BT Wamala Joseph Francis JF

PLoS neglected tropical diseases 20201130 11

South Sudan implemented Ebola virus disease preparedness interventions aiming at preventing and rapidly containing any importation of the virus from the Democratic Republic of Congo starting from August 2018. One of these interventions was a surveillance system which included an Ebola alert management system. This study analyzed the performance of this system. A descriptive cross-sectional study of the Ebola virus disease alerts which were reported in South Sudan from August 2018 to November 201 ...[more]

PMID: 33253169

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Project description:BackgroundA 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.MethodsWe 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.ResultsOut 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.ConclusionsA 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.

Project description:Between 16 November 2019 and 15 February 2020, 36 highly pathogenic avian influenza (HPAI) A(H5N8) virus outbreakswere reported in Europe in poultry (n=34), captive birds (n=1) and wild birds (n=2), in Poland, Hungary, Slovakia, Romania, Germany, Czechiaand Ukraine,one HPAI outbreakcaused by a simultaneous infection with A(H5N2) and A(H5N8) was reported in poultry in Bulgaria, andtwo low pathogenic avian influenza (LPAI) A(H5) virus outbreaks were reported in poultryin the United Kingdom and in Denmark. Genomic characterisation of the HPAI A(H5N8) viruses suggests that they are reassortants of HPAI A(H5N8) viruses from Africa and LPAI viruses from Eurasia. It is likely that this reassortment occurred in wild migratory birds in Asia during the summer and then spread to eastern Europe with the autumnmigration. This is the first time that wild bird migration from Africa to Eurasia has been implicated in the long-distance spread of HPAI viruses to the EU. Given the late incursion of HPAI A(H5N8) virus into the EU in this winter season (first outbreak reported on 30 December 2019), its overall restriction to eastern Europe, and the approaching spring migration, the risk of the virus spreadingfurther in the west via wild birds is decreasing for the coming months. Genetic analysis of the HPAI A(H5N2) and A(H5N8) viruses detected in the Bulgarian outbreak reveals that these virusesare both related to the 2018-19 Bulgarian HPAI A(H5N8) viruses and not to the HPAI A(H5N8) viruses currently circulating in Europe.An increasing number of HPAI A(H5N1), A(H5N2), A(H5N5) and A(H5N6) virus outbreaks in poultry in Asia were reported during the time period for this report compared with the previous reporting period. Single outbreaks of HPAI A(H5N8) virus were notified by Saudi Arabia and South Africa. Furthermore, in contrast to the last report, HPAI virus-positive wild birds were reported from Israel and one of the key migration areas in northern China.Two human cases due to A(H9N2) virus infection were reported during the reporting period.

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Analyses of the performance of the Ebola virus disease alert management system in South Sudan: August 2018 to November 2019.

Publications

Analyses of the performance of the Ebola virus disease alert management system in South Sudan: August 2018 to November 2019.

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