1
|
Stephens MT, Juniastuti, Sulistiawati, Dossen PC. The potential risk components and prevention measures of the Ebola virus disease outbreak in Liberia: An in-depth interview with the health workers and stakeholders. BELITUNG NURSING JOURNAL 2024; 10:67-77. [PMID: 38425680 PMCID: PMC10900057 DOI: 10.33546/bnj.3069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/01/2023] [Accepted: 01/13/2024] [Indexed: 03/02/2024] Open
Abstract
Background The Ebola virus, a highly infectious and deadly pathogen, has posed a significant public health threat in West Africa for several decades. Liberia is one of the most severely affected countries. Healthcare personnel, including nurses, are on the front lines of patient care, and their perspectives are invaluable in understanding the challenges that arise during outbreaks, especially in implementing prevention measures. Objective This study aimed to explore the potential risk components and prevention measures of the Ebola virus disease (EVD). Methods This study used an exploratory descriptive qualitative design. Five stakeholders, ten doctors and five nurses who had suffered from EVD during the outbreak in Liberia participated in semi-structured interviews to provide their experience and comprehensive perspectives on EVD. Data were collected from February 2022-August 2023. NVivo 12 plus was used for inductive thematic analysis. Results Six themes and several subthemes emerged: 1) transmission modes (body contact, body fluid, sexual intercourse, traditional burial), 2) funeral attendance (traditional practices and crowded gatherings), 3) community-led prevention (promoting good hygiene practices, increasing awareness, contact tracing, and surveillance), 4) Ebola virus vaccine (false sense of security, potential side effects, and limited data), 5) challenges in implementing prevention measures (inadequate health infrastructures, difficulty of tracing infected people, lack of resources, and cultural-social barriers), 6) Liberia's health systems (a weak, underfunded, fragile health infrastructure, lack of health facilities and shortage of health workers). Conclusion Several potential risk components contributing to the EVD outbreak should be a public concern. Strengthening the current healthcare system supported by local community and international aid providers (multidisciplinary teams) is needed to anticipate behavioral problems and to improve the efficacy of the prevention measures appropriate to the conditions in Liberia. Accordingly, the nurses' compliance with the recommended prevention practices is necessary.
Collapse
Affiliation(s)
- Moses Tende Stephens
- Master Program of Basic Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Health Science, United Methodist University, Monrovia, Liberia
| | - Juniastuti
- Department of Medical Microbiology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Sulistiawati
- Department of Public Health and Prevention Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Peter Chilaque Dossen
- Department of Health Science Education, William V.S Tubman University, Maryland, Liberia
| |
Collapse
|
2
|
Mai TN, Sekiguchi S, Huynh TML, Cao TBP, Le VP, Dong VH, Vu VA, Wiratsudakul A. Dynamic Models of Within-Herd Transmission and Recommendation for Vaccination Coverage Requirement in the Case of African Swine Fever in Vietnam. Vet Sci 2022; 9:vetsci9060292. [PMID: 35737344 PMCID: PMC9228824 DOI: 10.3390/vetsci9060292] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/05/2022] [Accepted: 06/12/2022] [Indexed: 01/09/2023] Open
Abstract
African swine fever (ASF) is a highly contagious disease that is caused by the ASF virus (ASFV) with a high fatality rate in domestic pigs resulting in a high socio-economic impact. The pig business in Vietnam was recently affected by ASF for the first time. This study thus aimed to develop a disease dynamic model to explain how ASFV spreads in Vietnamese pig populations and suggest a protective vaccine coverage level required to prevent future outbreaks. The outbreak data were collected from ten private small-scale farms within the first wave of ASF outbreaks in Vietnam. Three methods were used to estimate the basic reproduction number (R0), including the exponential growth method, maximum likelihood method, and attack rate method. The average R0 values were estimated at 1.49 (95%CI: 1.05–2.21), 1.58 (95%CI: 0.92–2.56), and 1.46 (95%CI: 1.38–1.57), respectively. Based on the worst-case scenario, all pigs in a herd would be infected and removed within 50 days. We suggest vaccinating at least 80% of pigs on each farm once a commercially approved ASF vaccine is available. However, an improvement in biosecurity levels in small-scale farms is still greatly encouraged to prevent the introduction of the virus.
Collapse
Affiliation(s)
- Thi Ngan Mai
- Faculty of Veterinary Medicine, Vietnam National University of Agriculture, Hanoi 100000, Vietnam; (T.N.M.); (T.M.L.H.); (T.B.P.C.); (V.P.L.); (V.H.D.)
| | - Satoshi Sekiguchi
- Department of Veterinary Science, Faculty of Agriculture, University of Miyazaki, Miyazaki 889-2192, Japan;
- Center for Animal Disease Control, University of Miyazaki, Miyazaki 889-2192, Japan
| | - Thi My Le Huynh
- Faculty of Veterinary Medicine, Vietnam National University of Agriculture, Hanoi 100000, Vietnam; (T.N.M.); (T.M.L.H.); (T.B.P.C.); (V.P.L.); (V.H.D.)
| | - Thi Bich Phuong Cao
- Faculty of Veterinary Medicine, Vietnam National University of Agriculture, Hanoi 100000, Vietnam; (T.N.M.); (T.M.L.H.); (T.B.P.C.); (V.P.L.); (V.H.D.)
| | - Van Phan Le
- Faculty of Veterinary Medicine, Vietnam National University of Agriculture, Hanoi 100000, Vietnam; (T.N.M.); (T.M.L.H.); (T.B.P.C.); (V.P.L.); (V.H.D.)
| | - Van Hieu Dong
- Faculty of Veterinary Medicine, Vietnam National University of Agriculture, Hanoi 100000, Vietnam; (T.N.M.); (T.M.L.H.); (T.B.P.C.); (V.P.L.); (V.H.D.)
| | - Viet Anh Vu
- Faculty of Animal Science, Vietnam National University of Agriculture, Hanoi 100000, Vietnam;
| | - Anuwat Wiratsudakul
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom 73170, Thailand
- The Monitoring and Surveillance Center for Zoonotic Diseases in Wildlife and Exotic Animals, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom 73170, Thailand
- Correspondence: ; Tel.: +662-441-5242
| |
Collapse
|
3
|
The Impact of Human Mobility on Regional and Global Efforts to Control HIV Transmission. Viruses 2020; 12:v12010067. [PMID: 31935811 PMCID: PMC7019949 DOI: 10.3390/v12010067] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/30/2019] [Accepted: 01/02/2020] [Indexed: 12/30/2022] Open
Abstract
HIV prevention and control methods are implemented on different scales to reduce the spread of the virus amongst populations. However, despite such efforts, HIV continues to persist in populations with a global incidence rate of 1.8 million in 2017 alone. The introduction of new infections into susceptible regional populations promotes the spread of HIV, indicating a crucial need to study the impact of migration and mobility on regional and global efforts to prevent HIV transmission. Here we reviewed studies that assess the impact of human mobility on HIV transmission and spread. We found an important role for both travel and migration in driving the spread of HIV across regional and national borders. Combined, our results indicate that even in the presence of control and preventive efforts, if migration and travel are occurring, public health efforts will need to remain persistent to ensure that new infections do not grow into outbreaks.
Collapse
|
4
|
Thompson RN, Stockwin JE, van Gaalen RD, Polonsky JA, Kamvar ZN, Demarsh PA, Dahlqwist E, Li S, Miguel E, Jombart T, Lessler J, Cauchemez S, Cori A. Improved inference of time-varying reproduction numbers during infectious disease outbreaks. Epidemics 2019; 29:100356. [PMID: 31624039 PMCID: PMC7105007 DOI: 10.1016/j.epidem.2019.100356] [Citation(s) in RCA: 244] [Impact Index Per Article: 48.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 07/15/2019] [Accepted: 07/16/2019] [Indexed: 02/07/2023] Open
Abstract
Accurate estimation of the parameters characterising infectious disease transmission is vital for optimising control interventions during epidemics. A valuable metric for assessing the current threat posed by an outbreak is the time-dependent reproduction number, i.e. the expected number of secondary cases caused by each infected individual. This quantity can be estimated using data on the numbers of observed new cases at successive times during an epidemic and the distribution of the serial interval (the time between symptomatic cases in a transmission chain). Some methods for estimating the reproduction number rely on pre-existing estimates of the serial interval distribution and assume that the entire outbreak is driven by local transmission. Here we show that accurate inference of current transmissibility, and the uncertainty associated with this estimate, requires: (i) up-to-date observations of the serial interval to be included, and; (ii) cases arising from local transmission to be distinguished from those imported from elsewhere. We demonstrate how pathogen transmissibility can be inferred appropriately using datasets from outbreaks of H1N1 influenza, Ebola virus disease and Middle-East Respiratory Syndrome. We present a tool for estimating the reproduction number in real-time during infectious disease outbreaks accurately, which is available as an R software package (EpiEstim 2.2). It is also accessible as an interactive, user-friendly online interface (EpiEstim App), permitting its use by non-specialists. Our tool is easy to apply for assessing the transmission potential, and hence informing control, during future outbreaks of a wide range of invading pathogens.
Collapse
Affiliation(s)
- R N Thompson
- Department of Zoology, University of Oxford, South Parks Road, Oxford OX1 3PS, UK; Mathematical Institute, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK; Christ Church, University of Oxford, St Aldates, Oxford OX1 1DP, UK.
| | - J E Stockwin
- Lady Margaret Hall, University of Oxford, Norham Gardens, Oxford OX2 6QA, UK
| | - R D van Gaalen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), 3720 BA Bilthoven, the Netherlands
| | - J A Polonsky
- World Health Organization, Avenue Appia, Geneva 1202, Switzerland; Faculty of Medicine, University of Geneva, 1 Rue Michel-Servet, Geneva 1211, Switzerland
| | - Z N Kamvar
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, Faculty of Medicine, London W2 1PG, UK
| | - P A Demarsh
- The Surveillance Lab, McGill University, 1140 Pine Avenue West, Montreal H3A 1A3, Canada; Centre for Foodborne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, 130 Colonnade Road, Ottawa, Ontario, K1A 0K9, Canada
| | - E Dahlqwist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - S Li
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - E Miguel
- MIVEGEC, IRD, University of Montpellier, CNRS, Montpellier, France
| | - T Jombart
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, Faculty of Medicine, London W2 1PG, UK; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - J Lessler
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - S Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris 75015, France
| | - A Cori
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, Faculty of Medicine, London W2 1PG, UK
| |
Collapse
|
5
|
Grobusch MP, Schaumburg F, Weitzel T, Rothe C, Hanscheid T, Goorhuis A. Ebola 2018 – Implications for travel health advice and relevance for travel medicine. Travel Med Infect Dis 2018; 24:1-3. [DOI: 10.1016/j.tmaid.2018.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 06/08/2018] [Indexed: 10/14/2022]
|
6
|
Wiratsudakul A, Suparit P, Modchang C. Dynamics of Zika virus outbreaks: an overview of mathematical modeling approaches. PeerJ 2018; 6:e4526. [PMID: 29593941 PMCID: PMC5866925 DOI: 10.7717/peerj.4526] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 03/02/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The Zika virus was first discovered in 1947. It was neglected until a major outbreak occurred on Yap Island, Micronesia, in 2007. Teratogenic effects resulting in microcephaly in newborn infants is the greatest public health threat. In 2016, the Zika virus epidemic was declared as a Public Health Emergency of International Concern (PHEIC). Consequently, mathematical models were constructed to explicitly elucidate related transmission dynamics. SURVEY METHODOLOGY In this review article, two steps of journal article searching were performed. First, we attempted to identify mathematical models previously applied to the study of vector-borne diseases using the search terms "dynamics," "mathematical model," "modeling," and "vector-borne" together with the names of vector-borne diseases including chikungunya, dengue, malaria, West Nile, and Zika. Then the identified types of model were further investigated. Second, we narrowed down our survey to focus on only Zika virus research. The terms we searched for were "compartmental," "spatial," "metapopulation," "network," "individual-based," "agent-based" AND "Zika." All relevant studies were included regardless of the year of publication. We have collected research articles that were published before August 2017 based on our search criteria. In this publication survey, we explored the Google Scholar and PubMed databases. RESULTS We found five basic model architectures previously applied to vector-borne virus studies, particularly in Zika virus simulations. These include compartmental, spatial, metapopulation, network, and individual-based models. We found that Zika models carried out for early epidemics were mostly fit into compartmental structures and were less complicated compared to the more recent ones. Simple models are still commonly used for the timely assessment of epidemics. Nevertheless, due to the availability of large-scale real-world data and computational power, recently there has been growing interest in more complex modeling frameworks. DISCUSSION Mathematical models are employed to explore and predict how an infectious disease spreads in the real world, evaluate the disease importation risk, and assess the effectiveness of intervention strategies. As the trends in modeling of infectious diseases have been shifting towards data-driven approaches, simple and complex models should be exploited differently. Simple models can be produced in a timely fashion to provide an estimation of the possible impacts. In contrast, complex models integrating real-world data require more time to develop but are far more realistic. The preparation of complicated modeling frameworks prior to the outbreaks is recommended, including the case of future Zika epidemic preparation.
Collapse
Affiliation(s)
- Anuwat Wiratsudakul
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Phutthamonthon, Nakhon Pathom, Thailand
- The Monitoring and Surveillance Center for Zoonotic Diseases in Wildlife and Exotic Animals, Faculty of Veterinary Science, Mahidol University, Phutthamonthon, Nakhon Pathom, Thailand
| | - Parinya Suparit
- Biophysics Group, Department of Physics, Faculty of Science, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Charin Modchang
- Biophysics Group, Department of Physics, Faculty of Science, Mahidol University, Ratchathewi, Bangkok, Thailand
- Centre of Excellence in Mathematics, CHE, Ratchathewi, Bangkok, Thailand
| |
Collapse
|
7
|
Undurraga EA, Carias C, Meltzer MI, Kahn EB. Potential for broad-scale transmission of Ebola virus disease during the West Africa crisis: lessons for the Global Health security agenda. Infect Dis Poverty 2017; 6:159. [PMID: 29191243 PMCID: PMC5710062 DOI: 10.1186/s40249-017-0373-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 10/27/2017] [Indexed: 01/19/2023] Open
Abstract
Background The 2014–2016 Ebola crisis in West Africa had approximately eight times as many reported deaths as the sum of all previous Ebola outbreaks. The outbreak magnitude and occurrence of multiple Ebola cases in at least seven countries beyond Liberia, Sierra Leone, and Guinea, hinted at the possibility of broad-scale transmission of Ebola. Main text Using a modeling tool developed by the US Centers for Disease Control and Prevention during the Ebola outbreak, we estimated the number of Ebola cases that might have occurred had the disease spread beyond the three countries in West Africa to cities in other countries at high risk for disease transmission (based on late 2014 air travel patterns). We estimated Ebola cases in three scenarios: a delayed response, a Liberia-like response, and a fast response scenario. Based on our estimates of the number of Ebola cases that could have occurred had Ebola spread to other countries beyond the West African foci, we emphasize the need for improved levels of preparedness and response to public health threats, which is the goal of the Global Health Security Agenda. Our estimates suggest that Ebola could have potentially spread widely beyond the West Africa foci, had local and international health workers and organizations not committed to a major response effort. Our results underscore the importance of rapid detection and initiation of an effective, organized response, and the challenges faced by countries with limited public health systems. Actionable lessons for strengthening local public health systems in countries at high risk of disease transmission include increasing health personnel, bolstering primary and critical healthcare facilities, developing public health infrastructure (e.g. laboratory capacity), and improving disease surveillance. With stronger local public health systems infectious disease outbreaks would still occur, but their rapid escalation would be considerably less likely, minimizing the impact of public health threats such as Ebola. Conclusions The Ebola outbreak could have potentially spread to other countries, where limited public health surveillance and response capabilities may have resulted in additional foci. Health security requires robust local health systems that can rapidly detect and effectively respond to an infectious disease outbreak. Electronic supplementary material The online version of this article (10.1186/s40249-017-0373-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Eduardo A Undurraga
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. .,Present address: School of Government, Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile.
| | - Cristina Carias
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Martin I Meltzer
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Emily B Kahn
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|